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dc.contributor.authorFox, Aaronen_US
dc.contributor.authorCarty, Christopheren_US
dc.contributor.authorModenese, Lucaen_US
dc.contributor.authorBarber, Leeen_US
dc.contributor.authorLichtwark, Glenen_US
dc.date.accessioned2019-05-29T13:06:17Z
dc.date.available2019-05-29T13:06:17Z
dc.date.issued2018en_US
dc.identifier.issn0966-6362en_US
dc.identifier.doi10.1016/j.gaitpost.2018.01.010en_US
dc.identifier.urihttp://hdl.handle.net/10072/380303
dc.description.abstractAltered neural control of movement and musculoskeletal deficiencies are common in children with spastic cerebral palsy (SCP), with muscle weakness and contracture commonly experienced. Both neural and musculoskeletal deficiencies are likely to contribute to abnormal gait, such as equinus gait (toe-walking), in children with SCP. However, it is not known whether the musculoskeletal deficiencies prevent normal gait or if neural control could be altered to achieve normal gait. This study examined the effect of simulated muscle weakness and contracture of the major plantarflexor/dorsiflexor muscles on the neuromuscular requirements for achieving normal walking gait in children. Initial muscle-driven simulations of walking with normal musculoskeletal properties by typically developing children were undertaken. Additional simulations with altered musculoskeletal properties were then undertaken; with muscle weakness and contracture simulated by reducing the maximum isometric force and tendon slack length, respectively, of selected muscles. Muscle activations and forces required across all simulations were then compared via waveform analysis. Maintenance of normal gait appeared robust to muscle weakness in isolation, with increased activation of weakened muscles the major compensatory strategy. With muscle contracture, reduced activation of the plantarflexors was required across the mid-portion of stance suggesting a greater contribution from passive forces. Increased activation and force during swing was also required from the tibialis anterior to counteract the increased passive forces from the simulated dorsiflexor muscle contracture. Improvements in plantarflexor and dorsiflexor motor function and muscle strength, concomitant with reductions in plantarflexor muscle stiffness may target the deficits associated with SCP that limit normal gait.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherElsevieren_US
dc.publisher.placeNetherlandsen_US
dc.relation.ispartofpagefrom169en_US
dc.relation.ispartofpageto175en_US
dc.relation.ispartofjournalGait & Postureen_US
dc.relation.ispartofvolume61en_US
dc.subject.fieldofresearchClinical Sciences not elsewhere classifieden_US
dc.subject.fieldofresearchClinical Sciencesen_US
dc.subject.fieldofresearchHuman Movement and Sports Sciencesen_US
dc.subject.fieldofresearchcode110399en_US
dc.subject.fieldofresearchcode1103en_US
dc.subject.fieldofresearchcode1106en_US
dc.titleSimulating the effect of muscle weakness and contracture on neuromuscular control of normal gait in childrenen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dc.type.codeC - Journal Articlesen_US
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/en_US
dc.description.versionPost-printen_US
gro.rights.copyright© 2018 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.en_US
gro.hasfulltextFull Text
gro.griffith.authorCarty, Chris P.


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