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Published on: January 15, 2016
Predictive simulations identify potential neuromuscular contributors to idiopathic toe walking
Kirsten Veerkamp1, Marjolein M van der Krogt2, Niels F J Waterval3
1Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical & Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University Gold Coast, Australia.
Idiopathic toe walking in children may stem from ankle muscle contractures and altered neural control. Predictive simulations revealed these factors contribute to the condition, offering insights for future research.
Area of Science:
- Biomechanics
- Neuromuscular Physiology
- Computational Modeling
Background:
- Idiopathic toe walking (ITW) is common in children, often lacking a clear cause.
- Understanding the underlying neuromusculoskeletal mechanisms is crucial for effective intervention.
Purpose of the Study:
- To identify potential neural and muscular mechanisms contributing to ITW using predictive simulations.
- To model ITW by incorporating pathology-specific characteristics into a musculoskeletal model.
Main Methods:
- A musculoskeletal model was adapted with ankle plantarflexor musculotendon contracture to simulate ITW.
- Forward dynamic simulations incorporated reflexes and supraspinal drive with a multi-objective cost function.
- Predicted gait patterns were validated against experimental data from children with ITW.
Main Results:
- The simulation with contracture closely matched experimental ITW data (RMSE = 1.37 SD).
- Simulated ITW exhibited doubled gastrocnemius activation without the typical early stance peak and increased plantarflexor reflex gains.
- The simulated ITW was energetically more costly than typical gait.
Conclusions:
- Musculotendon contracture combined with altered neural control offers a plausible explanation for ITW.
- These findings can guide future computational and experimental research into the causes of ITW.
