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R. Hainisch, M. Gföhler, Z. Karim, A. Kranzl, MG Pandy:
"Computational Modeling of Crouch Gait in Children with Cerebral Palsy";
Vortrag: Dreiländertagung 2011 der ÖGMP, DGMP und SGSMP, Wien; 28.09.2011 - 01.10.2011.

Cerebral Palsy (CP) results from a static injury to the developing brain.
This type of injury to the central nervous system commonly results in
abnormal motor control with associated delay in onset of walking and an
abnormal gait pattern. Crouch gait is a common gait abnormality
associated with CP. An overall goal of our long-term research is to
develop and use subject specified 3-dimensional computational models
of the musculoskeletal system to better understand muscle function
during gait. The aim of the present study is to compare kinematics,
kinetics and EMG data of CP children with crouch gait with those of
aged-matched healthy control subjects. Gait experiments were
performed on 5 healthy children (7-11 yrs) and two CP children (10-12
yrs). We created musculoskeletal biomechanical models with 46
muscles and 23 degrees of freedom for the simulation platform
OpenSim. The model parameters were customized according to
individual anatomical data which was aquired via magnetic resonace
imaging (MRI) of all subjects. The coordinates of the muscles
attachment points, where extracted from a manual segmented MR-dataset.
The parameters for the Hill-type muscle-model in particular
maximum isometric force, optimal muscle-fiber-length and tendon-slacklength
where set according specially developed calculation algorithms.
Current results indicate that for crouched gait, the net extensor moment
exerted about the hip increases during early stance, which may be due
to an increase in the passive force exerted by the hamstrings. Increased
knee flexion during stance was accompanied by an increase in the net
extensor moment exerted about the knee in late stance. An increase in
ankle dorsiflexion was accompanied by an increase in the net
plantarflexion moment exerted about the ankle in the early stance and a
decrease in late stance. Data obtained from this study will be further
used as input to subject specified musculoskeletal models of the lower
limbs to evaluate individual leg-muscle forces during crouch gait in
children with CP.

Biomechanics, Muscle Modelling, Cerebral Palsy, Gait Analysis