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Comparison between a subject-specific and a scaled generic musculoskeletal model of the lower extremities in a subject with unilateral cerebral palsy
KTH, School of Engineering Sciences (SCI), Mechanics, Structural Mechanics.
Department of Orthopaedics, Skaraborg Hospital, Skövde, Sweden.
Karolinska Intitutet, Dept. of Women's and Children's Health, Stockholm, Sweden.
KTH, School of Engineering Sciences (SCI), Mechanics, Biomechanics.ORCID iD: 0000-0001-5417-5939
2011 (English)In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271Article in journal (Other academic) Submitted
Abstract [en]

The purpose of this paper was to develop methods to build a subject-specific musculoskeletal model of the lower extremities based on MRIs of a subject with unilateral CP, and to determine whether a scaled generic musculoskeletal model is accurate enough to characterize MTLs and MALs of 70 muscles in both lower limbs during gait in a subject with unilateral cerebral palsy. We found, that the generic models produced accurate values for changes in MTL during gait for almost all muscles, except adductor longus, adductor magnus, adductor brevis, quadratus femoris, pectineus, extensor digitorum longus, soleus, lateral gastrocnemius, and medial gastrocnemius. MALs computed from the scaled generic model, however, differed considerably from those computed from the subject-specific model. Upon comparison of hip, knee and ankle MALs in affected and non-affected sides of the lower extremities, the scaled generic model generally failed to identify level arm dysfunction in the subject with unilateral CP

Place, publisher, year, edition, pages
2011.
Keyword [en]
MRI, musculoskeletal modeling, muscle-tendon length, muscle volume, muscle moment arm, cerebral palsy, lower extremities, subject-specific
National Category
Mechanical Engineering
Identifiers
URN: urn:nbn:se:kth:diva-38835OAI: oai:DiVA.org:kth-38835DiVA: diva2:438175
Note
QS 20120316Available from: 2011-09-01 Created: 2011-09-01 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Subject-specific musculoskeletal modeling of the lower extremities in persons with unilateral cerebral palsy
Open this publication in new window or tab >>Subject-specific musculoskeletal modeling of the lower extremities in persons with unilateral cerebral palsy
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The computational musculoskeletal models that are used to study muscle moment-generating capacities of persons with movement disorders and planning treatment options must be accurate, and take into account the inter-individual variability of musculoskeletal geometry.

In Paper I the methods of creating the subject-specific musculoskeletal model of the lower extremities from magnetic resonance images (MRIs) were developed. The subject-specific model was used to analyze hip, knee and ankle muscle moment arms (MALs) and muscle-tendon lengths (MTLs) during gait in a subject with unilateral cerebral palsy (CP), and to evaluate the accuracy of widespread and commonly-used scaled generic model.

It was found that the scaled generic model delivered accurate values for changes in MTLs in most muscles. However, the scaled generic and the subject-specific lower extremity musculoskeletal models showed substantial differences in MALs calculated during gait.

In Paper II subject-specific musculoskeletal models of nine subjects with unilateral CP were created to study muscles volumes, MTLs and MALs; and to examine the accuracy of MALs calculated by the scaled generic models.

It was shown that the scaled generic model significantly underestimated hip MALs discrepancies between the affected and the non-affected sides of the lower extremities. However, it significantly overestimated hip adduction/abduction of gluteus maximus, gluteus medius, gluteus minimus, tensor fascia latae and biceps femoris long head; and hip flexion of adductor longus and rectus femoris in the affected and the non-affected sides.

It was also found that muscle volumes and hip abduction MALs in gluteus medius and gluteus minimus, hip flexion MALs in iliacus and hip rotation in gluteus maximus were smaller in the affected side of lower extremities. MTLs in the affected and the non-affected sides throughout the range of hip motion were similar.

This thesis suggests the need for the subject-specific musculoskeletal models that can account for variability of muscle attachments and musculoskeletal geometry of persons with movement disorders. Based on inaccuracies of the scaled generic model reported here, the generic models that are used to guide treatment decisions must be tested, and interpreted with care.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2011. x, 42 p.
Series
Trita-MEK, ISSN 0348-467X ; 11:08
Keyword
cerebral palsy, moment arm, muscle length, hemiplegic, MRI, subject-specific, musculoskeletal modeling, lower extremities, muscle volume
Identifiers
urn:nbn:se:kth:diva-37002 (URN)978-91-7501-036-6 (ISBN)
Presentation
2011-06-13, Sal E3, KTH, Osquars backe 14, 10044, Stockholm, 01:13 (English)
Opponent
Supervisors
Note
QC 20110901Available from: 2011-09-01 Created: 2011-07-22 Last updated: 2011-09-01Bibliographically approved

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