Generic scaled versus subject-specific models for the calculation of musculoskeletal loading in cerebral palsy gait: Effect of personalized musculoskeletal geometry outweighs the effect of personalized neural control

BackgroundMusculoskeletal modelling is used to assess musculoskeletal loading during gait. Linear scaling methods are personalize generic models each participant's anthropometry. This approach introduces simplifications, especially when in paediatric and/or pathological populations. study aimed compare results from simulations using various ranging linear scaled highly subject-specific models, i.e., including the geometry and electromyography data.MethodsMagnetic resonance images (MRI) gait data of one typically developing child three children with cerebral palsy were analysed. Musculoskeletal performed calculate joint kinematics, kinetics, muscle forces contact four frameworks: 1) Generic-scaled model static optimization, 2) an electromyography-informed approach, 3) MRI-based 4) approach.FindingsRoot-mean-square-differences kinematics kinetics between generic-scaled below 5° 0.15 Nm/kg, respectively. Root-mean-square-differences over all muscles was 0.2 body weight for every participant. different frameworks up 2.2 weight. Comparing simulation showed similar root-mean-square-differences frameworks.InterpretationIn our participants, impact on higher than electromyography. Clinical reasoning based overall healthy participants unlikely be affected by choice.