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dc.contributor.authorDavico, G
dc.contributor.authorPizzolato, C
dc.contributor.authorLloyd, DG
dc.contributor.authorObst, SJ
dc.contributor.authorWalsh, HPJ
dc.contributor.authorCarty, CP
dc.description.abstractBACKGROUND: Cerebral palsy is a complex neuromuscular disorder that affects the sufferers in multiple different ways. Neuromusculoskeletal models are promising tools that can be used to plan patient-specific treatments for cerebral palsy. However, current neuromusculoskeletal models are typically scaled from generic adult templates that poorly represent paediatric populations. Furthermore, muscle activations are commonly computed via optimisation methods, which may not reproduce co-contraction observed in cerebral palsy. Alternatively, calibrated EMG-informed approaches within OpenSim can capture pathology-related muscle activation abnormalities, possibly enabling more feasible estimations of muscle and joint contact forces. METHODS: Two identical twin brothers, aged 13, one with unilateral cerebral palsy and the other typically developing, were enrolled in the study. Four neuromusculoskeletal models with increasing subject-specificity were built in OpenSim and CEINMS combining literature findings, experimental motion capture, EMG and MR data for both participants. The physiological and biomechanical validity of each model was assessed by quantifying its ability to track experimental joint moments and muscle excitations. FINDINGS: All developed models accurately tracked external joint moments; however EMG-informed models better tracked muscle excitations compared to neural solutions generated by static optimisation. Calibrating muscle-tendon unit parameters with EMG data allowed for more physiologically plausible joint contact forces estimates. Further scaling the maximal isometric force of muscles with MR-derived muscle volumes did not affect model predictions. INTERPRETATION: Given their ability to identify atypical joint contact forces profiles and accurately reproduce experimental data, calibrated EMG-informed models should be preferred over generic models using optimisation methods in informing the management of cerebral palsy.
dc.description.sponsorshipThe University of Melbourne ARC
dc.relation.ispartofjournalClinical Biomechanics
dc.subject.fieldofresearchBiomedical engineering
dc.subject.fieldofresearchMechanical engineering
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchSports science and exercise
dc.subject.keywordsCerebral palsy
dc.subject.keywordsJoint contact forces
dc.subject.keywordsNeuromusculoskeletal model
dc.titleIncreasing level of neuromusculoskeletal model personalisation to investigate joint contact forces in cerebral palsy: A twin case study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationDavico, G; Pizzolato, C; Lloyd, DG; Obst, SJ; Walsh, HPJ; Carty, CP, Increasing level of neuromusculoskeletal model personalisation to investigate joint contact forces in cerebral palsy: A twin case study., Clinical Biomechanics, 2019, 72, pp. 141-149
gro.hasfulltextNo Full Text
gro.griffith.authorObst, Steven J.
gro.griffith.authorLloyd, David
gro.griffith.authorPizzolato, Claudio
gro.griffith.authorCarty, Chris P.
gro.griffith.authorDavico, Giorgio
gro.griffith.authorWalsh, Henry Patrick John

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