Trunk and hip muscle activity in early walkers with and without cerebral palsy – A frequency analysis

Poor control of postural muscles is a primary impairment in cerebral palsy (CP), yet core trunk and hip muscle activity has not been thoroughly investigated. Frequency analysis of electromyographic (EMG) signals provides insight about the intensity and pattern of muscle activation, correlates with functional measures in CP, and is sensitive to change after intervention. The objective of this study was to investigate differences in trunk and hip muscle activation frequency in children with CP compared to children with similar amounts of walking experience and typical development (TD). EMG data from 31 children (15 with CP, 16 with TD) were recorded from 16 trunk and hip muscles bilaterally. A time–frequency pattern was generated using the continuous wavelet transform and instantaneous mean frequency (IMNF) was calculated at each interval of the gait cycle. Functional principal component analysis (PCA) revealed that IMNF was significantly higher in the CP group throughout the gait cycle for all muscles. Additionally, stride-to-stride variability was higher in the CP group. This evidence demonstrated altered patterns of trunk and hip muscle activation in CP, including increased rates of motor unit firing, increased number of recruited motor units, and/or decreased synchrony of motor units. These altered muscle activation patterns likely contribute to muscle fatigue and decreased biomechanical efficiency in children with CP.     

Evaluation of a method to scale muscle strength for gait simulations of children with cerebral palsy

Cerebral palsy (CP) is a neurological disorder that results in life-long mobility impairments. Musculoskeletal models used to investigate mobility deficits for children with CP often lack subject-specific characteristics such as altered muscle strength, despite a high prevalence of muscle weakness in this population. We hypothesized that incorporating subject-specific strength scaling within musculoskeletal models of children with CP would improve accuracy of muscle excitation predictions in walking simulations. Ten children (13.5 ± 3.3 years; GMFCS level II) with spastic CP participated in a gait analysis session where lower-limb kinematics, ground reaction forces, and bilateral electromyography (EMG) of five lower-limb muscles were collected. Isometric strength was measured for each child using handheld dynamometry. Three musculoskeletal models were generated for each child including a ‘Default’ model with the generic musculoskeletal model’s muscle strength, a ‘Uniform’ model with muscle strength scaled allometrically, and a ‘Custom’ model with muscle strength scaled based on handheld dynamometry strength measures. Muscle-driven gait simulations were generated using each model for each child. Simulation accuracy was evaluated by comparing predicted muscle excitations and measured EMG signals, both in the duration of muscle activity and the root-mean-square difference (RMSD) between signals. Improved agreement with EMG were found in both the ‘Custom’ and ‘Uniform’ models compared to the ‘Default’ model indicated by improvement in RMSD summed across all muscles, as well as RMSD and duration of activity for individual muscles. Incorporating strength scaling into musculoskeletal models can improve the accuracy of walking simulations for children with CP.     

Assessment of wavelet analysis of gait in children with typical development and cerebral palsy

The objective of this study was to examine the use of the continuous wavelet transform (CWT) on surface electromyographic (sEMG) signals acquired from the lower extremity muscles during gait in children with typical development (TD) and cerebral palsy (CP). This was done to explore the possibility of developing a quantitative assessment scale of motor function based on time-frequency information. An initial study was conducted on retrospective gait data from three children, matched in gender and in anthropometric variables but with differing levels of walking ability. EMG data were extracted from five lower extremity muscles to assess the degrees of differentiation. The data were processed using the CWT to derive an average scalogram, from which the instantaneous mean frequency (IMNF) was calculated. Principal component analysis was used to assess the differences between the curves. Preliminary results indicated that for select lower extremity muscles, there was a significant deviation in the IMNF curves in the child with CP as compared to the child with TD. Furthermore, as motor impairment increased, total percent explained variance to the TD curves decreased. This suggests that it might be possible to derive a physiologically based quantitative index for assessing motor function and for assessing clinical treatments in CP using the wavelet analysis.     

A mathematical model for predicting relative muscle force with a perturbation analysis of selected muscle parameters

A mathematical model is presented that predicts relative muscle forces using a minimum of experimentally derived input data. Tests of this model against literature values for maximum muscle force of four cat hindlimb muscles show a maximum error of only 5%. A perturbation analysis using this model demonstrates its sensitivity and applicability, as well as the congruence between this model and previous theoretical discussions of muscle function.     

Measuring morphological parameters of the pelvic floor for finite element modelling purposes

The goal of this study was to obtain a complete data set needed for studying the complex biomechanical behaviour of the pelvic floor muscles using a computer model based on the finite element (FE) theory. The model should be able to predict the effect of surgical interventions and give insight into the function of pelvic floor muscles. Because there was a lack of any information concerning morphological parameters of the pelvic floor muscle structures, we performed an experimental measurement to uncover those morphological parameters. Geometric parameters as well as muscle parameters of the pelvic floor muscles were measured on an embalmed female cadaver. A three-dimensional (3D) geometric data set of the pelvic floor including muscle fibre directions was obtained using a palpator device. A 3D surface model based on the experimental data, needed for mathematical modelling of the pelvic floor, was created. For all parts of the diaphragma pelvis, the optimal muscle fibre length was determined by laser diffraction measurements of the sarcomere length. In addition, other muscle parameters such as physiological cross-sectional area and total muscle fibre length were determined. Apart from these measurements we obtained a data set of the pelvic floor structures based on nuclear magnetic resonance imaging (MRI) on the same cadaver specimen. The purpose of this experiment was to discover the relationship between the MRI morphology and geometrical parameters obtained from the previous measurements. The produced data set is not only important for biomechanical modelling of the pelvic floor muscles, but it also describes the geometry of muscle fibres and is useful for functional analysis of the pelvic floor in general. By the use of many reference landmarks all these morphologic data concerning fibre directions and optimal fibre length can be morphed to the geometrical data based on segmentation from MRI scans.These data can be directly used as an input for building a mathematical model based on FE theory.     

A commentary on muscle unit properties in cat hindlimb muscles

A broad survey of muscle unit properties in 14 muscles of the cat hind limb is presented which emphasizes some general features of unit properties in mammalian muscles. A more detailed analysis of muscle unit properties in three muscles of the posterior compartment of the lower leg is then presented using Burke's tetrapartite (FF, FI or F (Int.), FR, and S) unit classification scheme. Our data on the properties of motor units in cat tibialis posterior (TP) have been compared to those generated by Burke and colleagues on units in flexor digitorum longus (FDL) and medial gastrocnemius (MG). In all three muscles, twitch contraction time was distinctly slower for type S units and specific tension outputs were substantially greater for type FF units than for type S units. The innervation ratios of type FR units were slightly lower than for type S units but the specific tension of the FR units was closer to FF units than to type S units. The FF units controlled 70–74% of the cumulative force output of each muscles, indicating a substantial capacity for powerful rapid contractions of all three of these muscles despite their differences in “size,” action, and force generation. Distinctive features of the three muscles included differences in the unit types' force producing capabilities and in the relative representation of “nonfatigable” type FR and S units in each muscle. In particular, TP is endowed with some unusually powerful type FF units and a high percentage (42%) of type S units. In contrast, FDL has units that develop relatively little force and an unusually high representation (56%) of type FR units. The possible relationships between these muscle features and their presumed role in posture and locomotion is discussed.     

The effects of electromyography-assisted modelling in estimating musculotendon forces during gait in children with cerebral palsy

Neuro-musculoskeletal modelling can provide insight into the aberrant muscle function during walking in those suffering cerebral palsy (CP). However, such modelling employs optimization to estimate muscle activation that may not account for disturbed motor control and muscle weakness in CP. This study evaluated different forms of neuro-musculoskeletal model personalization and optimization to estimate musculotendon forces during gait of nine children with CP (GMFCS I-II) and nine typically developing (TD) children. Data collection included 3D-kinematics, ground reaction forces, and electromyography (EMG) of eight lower limb muscles. Four different optimization methods estimated muscle activation and musculotendon forces of a scaled-generic musculoskeletal model for each child walking, i.e. (i) static optimization that minimized summed-excitation squared; (ii) static optimization with maximum isometric muscle forces scaled to body mass; (iii) an EMG-assisted approach using optimization to minimize summed-excitation squared while reducing tracking errors of experimental EMG-linear envelopes and joint moments; and (iv) EMG-assisted with musculotendon model parameters first personalized by calibration. Both static optimization approaches showed a relatively low model performance compared to EMG envelopes. EMG-assisted approaches performed much better, especially in CP, with only a minor mismatch in joint moments. Calibration did not affect model performance significantly, however it did affect musculotendon forces, especially in CP. A model more consistent with experimental measures is more likely to yield more physiologically representative results. Therefore, this study highlights the importance of calibrated EMG-assisted modelling when estimating musculotendon forces in TD children and even more so in children with CP.     

A transformation method to estimate muscle attachments based on three bony landmarks

In order to create musculoskeletal models that can be scalable to different subject specificities the calculation of the exact locations of muscle attachment is required. For this purpose, a scaling method is presented that estimates muscle attachment locations in homologous segments using three bony landmarks per segment.A data-set of 17 muscles’ attachment lines from the shoulders of seven cadavers was used to assess the estimation quality of the scaling method. By knowing from the cadaver data the measured location of the muscles’ attachment lines it is possible to assess the quality of the estimated ones. The scaling results showed an overall mean RMSE for the scapula and humerus muscles of 7.6 and 11.1 mm, respectively. These results were then analyzed with an upper extremity model, in order to compute the influence of the RMSE in glenohumeral elevation muscle moment arms in the scapular plane.The results presented were considered to be satisfactory. Among other error contributors, the inter- and intra-subject variability should be further investigated, along with the sensitivity of a biomechanical model to these error variations.     

Predicted pattern of human muscle activity during clenching derived from a computer assisted model: symmetric vertical bite forces

A computer assisted three-dimensional model of the jaw, based on linear programming, is presented. The upper and lower attachments of the muscles of mastication have been measured on a single human skull and divided into thirteen independent units on each side--a total of 26 muscle elements. The direction (in three dimensions) and maximum forces that could be developed by each muscle element, the bite reaction and two joint reactions are included in the model. It is shown for symmetrical biting that a model which minimizes the sum of the muscle forces used to produce a given bite force activates muscles in a way which corresponds well with previous observations on human subjects. A model which minimizes the joint reactions behaves differently and is rejected. An analysis of the way the chosen model operates suggests that there are two types of jaw muscles, power muscles and control muscles. Power muscles (superficial masseter, medial pterygoid and some of temporalis) produce the bite force but tend to displace the condyle up or down the articular eminence. This displacement is prevented by control muscles (oblique temporalis and lateral pterygoid) which have very poor moment arms for generating usual bite forces, but are efficient for preventing condylar slide. The model incorporates the concept that muscles consist of elements which can contract independently. It predicts that those muscle elements with longer moment arms relative to the joint are the first to be activated and, as the bite force increases, a ripple of activity spreads into elements with shorter moment arms. In general, the model can be used to study the three-dimensional activity in any system of joints and muscles.     

Musculoskeletal Model of the Upper Limb Based on the Visible Human Male Dataset

A mathematical model of Ihe human upper limb was developed based on high-resolution medical images of the muscles and bones obtained from the Visible Human Male ( HM) project. Three-dimensional surfaces of the muscles and bones were reconstructed from Computed Tomography (CT) images and Color Cryosection images obtained from the VHM cadaver. Thirteen degrees of freedom were used to describe the orientations of seven bones in the model: clavicle, scapula, humerus, radius, ulna, carpal bones, and hand. All of the major articulations from the shoulder girdle down to the wrist were included in the model. The model was actuated by 42 muscle bundles, which represented the actions of 26 muscle groups in the upper limb. The paths of the muscles were modeled using a new approach called the Obstacle-set Method (33) The calculated paths of the muscles were verified by comparing the muscle moment arms computed in the model with the results of anatomical studies reported in the literature, In-vivo measurements of maximum isometric muscle torques developed at the shoulder, elbow, and wrist were also used to estimate the architectural properties of each musculotendon actuator in the model. The entire musculoskeletal model can be reconstructed using the data given in this paper, along with information presented in a companion paper which defines the kinematic structure of the model (26)     

Modeling of the muscle/tendon excursions and moment arms in the thumb using the commercial software anybody

A biomechanical model of a thumb would be useful for exploring the mechanical loadings in the musculoskeletal system, which cannot be measured in vivo. The purpose of the current study is to develop a practical kinematic thumb model using the commercial software Anybody (Anybody Technology, Aalborg, Denmark), which includes real CT-scans of the bony sections and realistic tendon/muscle attachments on the bones. The thumb model consists of a trapezium, a metacarpal bone, a proximal and a distal phalanx. These four bony sections are linked via three joints, i.e., IP (interphalangeal), MP (metacarpophalangeal) and CMC (carpometacarpal) joints. Nine muscles were included in the proposed model. The theoretically calculated moment arms of the tendons are compared with the corresponding experimental data by Smutz et al. [1998. Mechanical advantage of the thumb muscles. J. Biomech. 31(6), 565–570]. The predicted muscle moment arms of the majority of the muscle/tendon units agree well with the experimental data in the entire range of motion. Close to the end of the motion range, the predicted moment arms of several muscles (i.e., ADPt and ADPo (transverse and oblique heads of the adductor pollicis, respectively) muscles for CMC abduction/adduction and ADPt and FPB (flexor pollicis brevis) muscle for MP extension/flexion) deviate from the experimental data. The predicted moment potentials for all muscles are consistent with the experimental data. The findings thus suggest that, in a biomechanical model of the thumb, the mechanical functions of muscle–tendon units with small physiological cross-sectional areas (PCSAs) can be well represented using single strings, while those with large PCSAs (flat-wide attachments, e.g., ADPt and ADPo) can be represented by the averaged excursions of two strings. Our results show that the tendons with large PCSAs can be well represented biomechanically using the proposed approach in the major range of motion.     

Modelling the line of action for the oblique abdominal muscles using an elliptical torso model

When modelling the line of action of a muscle, anatomical considerations must be included if the model is to realistically mimic the muscle behaviour. The internal and external oblique muscles are examples of muscles that do not follow a straight line between origin and insertion, instead having to wrap around the torso. A model is presented which describes the shape of the torso using a right elliptical cylinder of varying dimensions. The muscle lines of action are then calculated based on this underlying torso shape. The model has been successfully fitted to the data reported by Stokes and Gardner-Morse (Journal of Biomechanics 32(3) (1999) 311). When compared to a linear model, the use of the torso model results in a 15% increase in the axial twist moment, and decreases in the lateral bend and extension moments (5% and 2%, respectively), able to be generated by the internal and external oblique muscles combined in upright stance. These differences become larger (up to 37%) when the torso is flexed, extended or twisted. The structure of the torso model allows it to be used to model any posture without significant increases in the overall model complexity.     

Musculoskeletal model of the upper limb based on the visible human male dataset

A mathematical model of the human upper limb was developed based on high-resolution medical images of the muscles and bones obtained from the Visible Human Male (VHM) project. Three-dimensional surfaces of the muscles and bones were reconstructed from Computed Tomography (CT) images and Color Cryosection images obtained from the VHM cadaver. Thirteen degrees of freedom were used to describe the orientations of seven bones in the model: clavicle, scapula, humerus, radius, ulna, carpal bones, and hand. All of the major articulations from the shoulder girdle down to the wrist were included in the model. The model was actuated by 42 muscle bundles, which represented the actions of 26 muscle groups in the upper limb. The paths of the muscles were modeled using a new approach called the Obstacle-set Method [33]. The calculated paths of the muscles were verified by comparing the muscle moment arms computed in the model with the results of anatomical studies reported in the literature. In-vivo measurements of maximum isometric muscle torques developed at the shoulder, elbow, and wrist were also used to estimate the architectural properties of each musculotendon actuator in the model. The entire musculoskeletal model can be reconstructed using the data given in this paper, along with information presented in a companion paper which defines the kinematic structure of the model [26].     

Motorneuron pools innervating muscles in vitamin A-induced proximal-distal duplicate limbs in the axolotl

Serially duplicated limbs containing two sets of proximal muscles were created in axolotls by vitamin A treatment. The innervation of three replicated proximal muscles was studied by using retrograde transport of horseradish peroxidase. These were the forelimb muscles biceps (seven cases) and anconeus (five cases) and the hindlimb muscle puboischiotibialis (five cases). In two cases (both of anconeus) innervation was from a correct motorneuron pool. In the other 15 cases the innervation was from an incorrect, distal limb muscle, motorneuron pool. These results are interpreted as evidence against long range signals between nerve and muscle controlling specific nerve regeneration. However, the data are compatible with models of axonal guidance that use local pathway cues.     

An equation to calculate individual muscle contributions to joint stability

The purpose of the current paper was to use the energy approach to develop a simplified equation for quantifying individual muscle contributions to mechanical stability about all three axes of a particular joint. Specific examples are provided for muscles acting about the lumbar spine's L4/L5 joint. The stability equation requires input of: (1) origin and insertion coordinates, relative to the joint of interest, (2) muscle force, and (3) muscle stiffness. The muscle force must be derived from a biomechanical analysis that first results in static equilibrium about all axes being studied. The equation can also accommodate muscles with nodes that change the line of action, with respect to a particular joint, as it passes from the origin to insertion. The results from this equation were compared to those from a Moment approach using more than two million simulated muscles with three-dimensional orientations. The differences between approaches were negligible in all cases. The primary advantage of the current method is that it is very easy to implement into any 2D or 3D biomechanical model of any joint, or system of joints. Furthermore, this approach will be useful in dissecting total joint stability into the individual contributions of each muscle for various systems, joints, postures and recruitment patterns.     

Electromyography of superficial and deep neck muscles during isometric, voluntary, and reflex contractions

Increasingly complex models of the neck neuromusculature need detailed muscle and kinematic data for proper validation. The goal of this study was to measure the electromyographic activity of superficial and deep neck muscles during tasks involving isometric, voluntary, and reflexively evoked contractions of the neck muscles. Three male subjects (28-41 years) had electromyographic (EMG) fine wires inserted into the left sternocleidomastoid, levator scapulae, trapezius, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles. Surface electrodes were placed over the left sternohyoid muscle. Subjects then performed: (i) maximal voluntary contractions (MVCs) in the eight directions (45 deg intervals) from the neutral posture; (ii) 50 N isometric contractions with a slow sweep of the force direction through 720 deg; (iii) voluntary oscillatory head movements in flexion and extension; and (iv) initially relaxed reflex muscle activations to a forward acceleration while seated on a sled. Isometric contractions were performed against an overhead load cell and movement dynamics were measured using six-axis accelerometry on the head and torso. In all three subjects, the two anterior neck muscles had similar preferred activation directions and acted synergistically in both dynamic tasks. With the exception of splenius capitis, the posterior and posterolateral neck muscles also showed consistent activation directions and acted synergistically during the voluntary motions, but not during the sled perturbations. These findings suggest that the common numerical-modeling assumption that all anterior muscles act synergistically as flexors is reasonable, but that the related assumption that all posterior muscles act synergistically as extensors is not. Despite the small number of subjects, the data presented here can be used to inform and validate a neck model at three levels of increasing neuromuscular-kinematic complexity: muscles generating forces with no movement, muscles generating forces and causing movement, and muscles generating forces in response to induced movement. These increasingly complex data sets will allow researchers to incrementally tune their neck models' muscle geometry, physiology, and feedforward/feedback neuromechanics.     

Active force-length relationship of human lower-leg muscles estimated from morphological data: a comparison of geometric muscle models

Muscle fibre lengths, pennation angles, and sarcomere lengths were measured (the latter by a diffraction technique) for each of the muscles of three embalmed lower-leg specimens. From these data and filament lengths from Walker & Schrodt (1973), the optimum fibre lengths were determined. Relationships between length and active force (at full activation) of the lower-leg muscles were calculated by use of (i) a unipennate muscle model, (ii) a bipennate model, and (iii) bipennate models in which the cosine of the pennation angle is approximated as length independent. It is concluded that the first two models are equally useful and that the use of the last models is discouraged in case of strongly pennated muscles. Non-uniformity of fibre parameters within one muscle appears to have little effect on the force-length relationship.     

A biomechanical model for analysis of muscle force,power output and lower jaw motion in fishes

Fish skulls are complex kinetic systems with movable components that are powered by muscles. Cranial muscles for jaw closing pull the mandible around a point of rotation at the jaw joint using a third-order lever mechanism. The present study develops a lever model for the jaw of fishes that uses muscle design and the Hill equation for nonlinear length-tension properties of muscle to calculate dynamic power output. The model uses morphometric data on skeletal dimensions and muscle proportions in order to predict behavior and force transmission mediated by lever action. The computer model calculates a range of dynamic parameters of jaw function including muscle force, torque, effective mechanical advantage, jaw velocity, bite duration, bite force, work and power. A complete list of required morphometrics is presented and a software program (MandibLever 2.0) is available for implementing lever analysis. Results show that simulations yield kinematics and timing profiles similar to actual fish feeding events. Simulation of muscle properties shows that mandibles reach their peak velocity near the start of jaw closing, peak force at the end of jaw closing, and peak power output at about 25% of the closing cycle time. Adductor jaw muscles with different mechanical designs must have different contractile properties and/or different muscle activity patterns to coordinate jaw closing. The effective mechanical advantage calculated by the model is considerably lower than the mechanical advantage estimated from morphological lever ratios, suggesting that previous studies of morphological lever ratios have overestimated force and underestimated velocity transmission to the mandible. A biomechanical model of jaw closing can be used to interpret the mechanics of a wide range of jaw mechanisms and will enable studies of the functional results of developmental and evolutionary changes in skull morphology and physiology.     

The non-linear response of a muscle in transverse compression: assessment of geometry influence using a finite element model

Most recent finite element models that represent muscles are generic or subject-specific models that use complex, constitutive laws. Identification of the parameters of such complex, constitutive laws could be an important limit for subject-specific approaches. The aim of this study was to assess the possibility of modelling muscle behaviour in compression with a parametric model and a simple, constitutive law. A quasi-static compression test was performed on the muscles of dogs. A parametric finite element model was designed using a linear, elastic, constitutive law. A multi-variate analysis was performed to assess the effects of geometry on muscle response. An inverse method was used to define Young's modulus. The non-linear response of the muscles was obtained using a subject-specific geometry and a linear elastic law. Thus, a simple muscle model can be used to have a bio-faithful, biomechanical response.