This position paper proposes a modeling pipeline to develop clinically relevant neuromusculoskeletal models to understand and treat complex neurological disorders. Although applicable to a variety of neurological conditions, we provide direct pipeline applicative examples in the context of cerebral palsy (CP). This paper highlights technologies in: (1) patient-specific segmental rigid body models developed from magnetic resonance imaging for use in inverse kinematics and inverse dynamics pipelines; (2) efficient population-based approaches to derive skeletal models and muscle origins/insertions that are useful for population statistics and consistent creation of continuum models; (3) continuum muscle descriptions to account for complex muscle architecture including spatially varying material properties with muscle wrapping; (4) muscle and tendon properties specific to CP; and (5) neural-based electromyography-informed methods for muscle force prediction. This represents a novel modeling pipeline that couples for the first time electromyography extracted features of disrupted neuromuscular behavior with advanced numerical methods for modeling CP-specific musculoskeletal morphology and function. The translation of such pipeline to the clinical level will provide a new class of biomarkers that objectively describe the neuromusculoskeletal determinants of pathological locomotion and complement current clinical assessment techniques, which often rely on subjective judgment.
|Journal||Wiley Interdisciplinary Reviews: Systems Biology and Medicine|
|Publication status||Published - 2017|
Sartori, M., Fernandez, JW., Modenese, L., Carty, CP., Barber, LA., Oberhofer, K., ... Lloyd, D. G. (2017). Toward modeling locomotion using electromyography-informed 3D models: application to cerebral palsy. Wiley Interdisciplinary Reviews: Systems Biology and Medicine, 9(2), [e1368]. https://doi.org/10.1002/wsbm.1368