BR Shuman, M Goudriaan, K Desloovere, MH Schwartz, KM Steele (2019) “Muscle Synergy Constraints Do Not Improve Estimates of Muscle Activity From Static Optimization During Gait for Unimpaired Children or Children With Cerebral Palsy” Frontiers in Neurorobotics

Journal Article in Frontiers of Neurorobotics:

This study demonstrated that muscle activations estimated from static optimization using generic musculoskeletal modeling does not accurately predict EMG profiles for children with CP or TD peers. Constraining activation patterns to experimentally measured synergies increased estimated muscle stresses, but did not improve the estimation of muscle activations for either group.

figure depicting flow chart with modeling optimization and muscle activity
Constraining simulated activations in inverse dynamic simulations to subject-specific synergies alone does not improve estimation of muscle activations during gait for generic musculoskeletal models.

Background

Neuromusculoskeletal simulation provides a promising platform to inform the design of assistive devices or inform rehabilitation. For these applications, a simulation must be able to accurately represent the person of interest, such as an individual with a neurologic injury. If a simulation fails to predict how an individual recruits and coordinates their muscles during movement, it will have limited utility for informing design or rehabilitation. While inverse dynamic simulations have previously been used to evaluate anticipated responses from interventions, like orthopaedic surgery or orthoses, they frequently struggle to accurately estimate muscle activations, even for tasks like walking. The simulated muscle activity often fails to represent experimentally measured muscle activity from electromyographic (EMG) recordings. Research has theorized that the nervous system may simplify the range of possible activations used during dynamic tasks, by constraining activations to weighted groups of muscles, referred to as muscle synergies. Synergies are altered after neurological injury, such as stroke or cerebral palsy (CP), and may provide a method for improving subject-specific models of neuromuscular control.

Purpose

The aim of this study was to test whether constraining simulation to synergies could improve estimated muscle activations compared to EMG data.

Method

We evaluated modeled muscle activations during gait for six typically developing children (TD) and six children with CP. Muscle activations were estimated with: 1) static optimization (SO), minimizing muscle activations squared, and 2) synergy static optimization (SynSO), minimizing synergy activations squared using the weights identified from EMG data for 2-5 synergies.

Results

While SynSO caused changes in estimated activations compared to SO, the correlation to EMG data was not higher in SynSO than SO for either TD or CP groups . The correlations to EMG were higher in CP than TD for both SO (CP: 0.48, TD: 0.36) and SynSO (CP: 0.46, TD: 0.26 for 5 synergies). Constraining activations to SynSO caused the simulated muscle stress to increase compared to SO for all individuals, causing a 157% increase with two synergies.

Conclusions

These results suggest that constraining simulated activations in inverse dynamic simulations to subject-specific synergies alone does not improve estimation of muscle activations during gait for generic musculoskeletal models.

M Goudriaan, BR Shuman, KM Steele, M Van den Hauwe, N Goemans, G Molenaers, K Desloovere (2018) “Non-neural Muscle Weakness Has Limited Influence on Complexity of Motor Control during Gait.” Frontiers in Human Neuroscience

Journal Article in Frontiers in Human Neuroscience:

Despite significant differences in kinematics children with Duchenne muscular dystrophy have similar control complexity to typically developing children.

Abstract: Cerebral palsy (CP) and Duchenne muscular dystrophy (DMD) are neuromuscular disorders characterized by muscle weakness. Weakness in CP has neural and non-neural components, whereas in DMD, weakness can be considered as a predominantly non-neural problem. Despite the different underlying causes, weakness is a constraint for the central nervous system when controlling gait. CP demonstrates decreased complexity of motor control during gait from muscle synergy analysis, which is reflected by a higher total variance accounted for by one synergy (tVAF1). However, it remains unclear if weakness directly contributes to higher tVAF1 in CP, or whether altered tVAF1 reflects mainly neural impairments. If muscle weakness directly contributes to higher tVAF1, then tVAF1 should also be increased in DMD. To examine the etiology of increased tVAF1, muscle activity data of gluteus medius, rectus femoris, medial hamstrings, medial gastrocnemius, and tibialis anterior were measured at self-selected walking speed, and strength data from knee extensors, knee flexors, dorsiflexors and plantar flexors, were analyzed in 15 children with CP [median (IQR) age: 8.9 (2.2)], 15 boys with DMD [8.7 (3.1)], and 15 typical developing (TD) children [8.6 (2.7)]. We computed tVAF1 from 10 concatenated steps with non-negative matrix factorization, and compared tVAF1between the three groups with a Mann-Whiney U-test. Spearman’s rank correlation coefficients were used to determine if weakness in specific muscle groups contributed to altered tVAF1. No significant differences in tVAF1 were found between DMD [tVAF1: 0.60 (0.07)] and TD children [0.65 (0.07)], while tVAF1 was significantly higher in CP [(0.74 (0.09)] than in the other groups (both p < 0.005). In CP, weakness in the plantar flexors was related to higher tVAF1 (r = −0.72). In DMD, knee extensor weakness related to increased tVAF1 (r = −0.50). These results suggest that the non-neural weakness in DMD had limited influence on complexity of motor control during gait and that the higher tVAF1 in children with CP is mainly related to neural impairments caused by the brain lesion.