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Estimating Muscle Forces in Patients With Cerebral Palsy During Walking Using Static Optimization and Computed Muscle

Alina Nawab Kidwai1,2, Kerim Atmaca3, Ergin Tönük1,2

  • 1Department of Mechanical Engineering, Faculty of Engineering, Middle East Technical University, Cankaya, Ankara 06800, Turkey.

Journal of Biomechanical Engineering
|October 4, 2025
PubMed
Summary

Static optimization (SO) and computed muscle control (CMC) models show variable accuracy for predicting muscle forces in cerebral palsy (CP) crouch gait. Further refinement is needed for clinical use in CP rehabilitation.

Keywords:
cerebral palsycomputed muscle controlcrouch gaitmuscle force predictionstatic optimization

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Area of Science:

  • Biomechanics
  • Neuromuscular Disorders
  • Computational Modeling

Background:

  • Cerebral palsy (CP) poses significant rehabilitation challenges.
  • Accurate muscle force estimation is crucial for clinical decision-making but direct measurement is infeasible.
  • Model-based methods like static optimization (SO) and computed muscle control (CMC) are alternatives.

Purpose of the Study:

  • To compare the accuracy of SO and CMC in predicting muscle forces and activations in individuals with CP exhibiting varying crouch gait severity.
  • To assess the influence of crouch severity on the performance of SO and CMC models.

Main Methods:

  • Utilized the OpenSim software to analyze an openly available dataset of CP gait.
  • Estimated muscle forces and activations using both SO and CMC approaches.
  • Validated predictions against experimental electromyography (EMG) data using Spearman's rank correlation (ρ) and root-mean-squared error (RMSE).

Main Results:

  • Both SO and CMC demonstrated variable prediction accuracy (ρ: -0.7 to 0.9, RMSE: 0.14 to 0.7) across different muscles and crouch severities.
  • CMC generally predicted higher muscle forces than SO.
  • Crouch severity significantly impacted the correlation difference between methods for specific muscles (lateral hamstrings, rectus femoris).
  • CMC showed higher sensitivity to variations in tendon slack length.

Conclusions:

  • Neither SO nor CMC currently provides sufficiently validated muscle force estimates for direct clinical application in CP rehabilitation.
  • Further methodological advancements are required to improve the accuracy and reliability of these computational models for CP.