High accuracy prediction of the knee extensor moment required to support the body during crouch gait

Authors

• ZF Lerner
• TC Bulea
• DL Damiano

Abstract

Individuals with Cerebral Palsy frequently exhibit crouch gait, a pathological walking pattern characterized by excessive bilateral knee flexion. This pattern increases the energy cost of walking and may precipitate ambulatory decline in adulthood. In order to treat and monitor this condition, clinicians must understand the biomechanical loads required by the knee to walk in a crouched posture. In particular, knowledge of the knee extensor moment (KEM, the joint torque/moment required by the knee to support the body) is necessary for the appropriate customization of assistive devices (e.g. powered exoskeletons) and/or training strategies (e.g. muscle strengthening). Currently, calculating the KEM requires expensive and sophisticated equipment, lengthy experimental procedures and computational modeling. Therefore, the purpose of this study was to determine if readily attainable clinical measures could accurately predict the peak KEM during crouch gait. We conducted an inverse dynamics analysis in OpenSim musculoskeletal modeling software to compute the KEM during walking in 9 children with CP. Participants exhibited a wide-range of crouch severity (15.5-86°). The experimental kinematic and kinetic walking data were from a publically-available dataset. We used multiple regression analysis to develop a prediction equation for peak KEM based on body-weight, degree of crouch, and walking speed. We found that these regression parameters were jointly statistically significant (p

Scientific Focus Area: Biomedical Engineering and Biophysics

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