A model for spasticity and contracture in Opensim: refinement and validation

Thalia Kindt
Cerebral Palsy (CP) is een vaak voorkomende aandoening tijdens de kinderjaren (Himmelmann et al. 2010) en gaat in 85% gepaard met spasticiteit [1]. De patiënt wordt gekenmerkt door een onwillekeurig verhoogde spierspanning of plotse spiersamentrekking, en verminderde willekeurige kracht. Spasticiteit wordt gekenmerkt door twee effecten, namelijk lengte-afhankelijkheid [2] en snelheidsafhankelijkheid [3]. Het eerstgenoemde betekent dat als men een spier verder uitrekt er meer spasticiteit optreedt.

A model for spasticity and contracture in Opensim: refinement and validation

Cerebral Palsy (CP) is een vaak voorkomende aandoening tijdens de kinderjaren (Himmelmann et al. 2010) en gaat in 85% gepaard met spasticiteit [1]. De patiënt wordt gekenmerkt door een onwillekeurig verhoogde spierspanning of plotse spiersamentrekking, en verminderde willekeurige kracht. Spasticiteit wordt gekenmerkt door twee effecten, namelijk lengte-afhankelijkheid [2] en snelheidsafhankelijkheid [3]. Het eerstgenoemde betekent dat als men een spier verder uitrekt er meer spasticiteit optreedt. De snelheidsafhankelijkheid houdt in dat wanneer een spier sneller gerekt wordt, er meer spasticiteit zal optreden.Het doel van onze studie was deze fenomenen te integreren in een neuromusculoskeletaal model. De stijfheidsparameters van de spieren in dit model werden bepaald door passieve spierrekkingen aan verschillende snelheden te onderzoeken bij patiënten met CP. Aanpassingen aan de parameters droeg bij tot het begrip van spasticiteit. Eens dit model op punt stond, werden diezelfde spierrekkingen gesimuleerd met het model. Op deze manier werd spasticiteit in zijn zuiverste vorm onderzocht. Een gesimuleerde spieractivatie opleggen aan deze beweging leidde tot rekkingen met zuivere snelheids-afhankelijke spasticiteit. Dit project ontwikkelde dus een adequaat model voor verder spasticiteitsonderzoek. Uitbreiding van de toepassing zal gebeuren naar actieve bewegingen. Deze kennis kan een belangrijke bijdrage leveren tot het klinisch onderzoek en de behandeling van CP.Referenties[1] Himmelmann, K. Hagberg, G. Uvebrant, P. 2010. The changing panorama of cerebral palsy in Sweden. X. Prevalence and origin in the birth year period 1999-2002. Acta Paediatr 99, 1337-43.[2] Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW. (2003) Classification and definition of disorders causing hypertonia in childhood. Pediatrics 111: 89-97.[3] Lance JW. What is spasticity? The Lancet March 10, 1990: 606.

Bibliografie

Reference list[1] Arnold, AS. Delp, SL.2005. Computer modeling of gait abnormalities in cerebral palsy: application to treatment planning. Theoretical Issues in Ergonomics Science 6(3-4), 305-312.[2] Barber, L. Barett, R., Lichtwark, G. 2012. Medial gastrocnemicus muscle fascicle active moment-length and Achilles tendon properties in young adults with spastic cerebral palsy. Journal of Biomechanics 45(15), 2526-2530.[3] Barber, L. Barett, R., Lichtwark, G. 2011. Passive muscle mechanical properties of the medial gastrocnemius in young adults with spastic cerebral palsy. Journal of Biomechanics 44(13), 2496-2500.[4] Barett, R. Lichtwark, G. 2010. Gross muscle morphology and structure in spastic cerebral palsy: a systematic review. Developmental Medicine & Child Neurology 52(9), 794-804.[5] Bar-On, L. Aertbeliën, E. Wambacq, H. Severijns, D. Lambrecht, K. Dan, B. Huenaerts, C. Bruyninckx, H. Janssens, L. Van Gestel, L. Jaspers, E. Molenaers, G. Desloovere, K. 2012. A clinical measurement to quantify spasticity in children with cerebral palsy by integration of multidimensional signals. Gait & Posture 38 (1), 141-147.[6] Bar-On, L. Aertbeliën, E. Molenaers, G. Bruyninckx, H. Monari, D. Jaspers, E. Cazaerck, A. Desloover, K. 2013. Comprehensive quantification of the spastic catch in children with cerebral palsy. Research in Developmental Disabilities 34, 386-39.[7] Bar- Bar-On, L. Aertbeliën, E. Molenaers, G. Desloovere, K. 2014. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy. PloS One 9, 917-59.[8] Bax, M. Goldstein, M. Rosenbaum, P. Leviton, A. Paneth, N. 2005. Proposed definition and classification of cerebral palsy. Developmental Medicine & Child Neurology 47, 571-576.[9] Bohannon, R. Smith M. 1987. Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity. Physical Therapy 67 (2), 206-207.[10] Brændvik, S. Elvrum, A. Vereijken, B. Roeleveld, K. 2013. Involuntary and voluntary muscle activation in children with unilateral cerebral palsy – Relationship to upper limb activity. European journal of paediatric neurology 17 (3), 274-279.[11] Brooke, MH. Kaiser, K. 1970. Muscle Fiber Types: How many and what kind? Arch Neurol 23(4), 369-379.30[12] Chung, SG. Van Rey, E. Bai, Z. Rymer, Z. Roth, EJ. Zhang, L. 2008 Separate Quantification of Reflex and Nonreflex Components of Spastic Hypertonia in Chronic Hemiparesis. Arch Phys Med Rehabil 89, 700-710.[13] Crenna, P. Spasticity and ‘Spastic’ Gait in Children with Cerebral Palsy. 1998. Neuroscience and Biobehavioral Reviews 22(4), 571–578.[14] Daniels, L. Worthingham, C. 1986. Muscle testing techniques of manual examination. 4th ed. Philadelphia: WB Saunders, 4–26.[15] Delp, S. Anderson, F. Arnold, A. Loan, P. Habib, A. John, C. Guendelman, E. Thelen, D. 2007. Opensim: Open-source Software to Create and Analyze Dynamic Simulations of Movement. IEEE Trans Biomed Eng 54(11), 1940-50.[16] De Vlugt, E. de Groot, JH. Schenkeveld, KE. Arendzen, JH. Van der Helm F. Meskers, C. 2010. The relation between neuromechanical parameters and Ashworth score in stroke patients. Journal of Neuroengineering and Rehabilitation 7 (35), 1-16.[17] Dietz, V. Sinkjaer, T. 2007. Spastic movement disorder: impaired reflex function and altered muscle mechanics. Lancet neurology 6, 725-33.[18] Fee, JW. Richard, A. 2004. Neuromuscular Modeling of Spasticity in Cerebral Palsy. IEEE Transactions on Neural Systems and Rehabilitation Engineering 12(1), 55-64.[19] Fleuren, JF. Snoek, GJ. Voerman, GE. Hermens, HJ. 2009. Muscle activation patterns of knee flexors and extensors during passive and active movement of the spastic lower limb in chronic stroke patients. J Electromyogr Kinesiol. 19(5), 301-10.[20] Fleuren, JFM. Voerman, GE. Erren-Wolters, CV. Snoek, GJ. Rietman, JS. Hermens, HJ. Nene, AV. 2010. Stop using the Ashworth Scale for the assessment of spasticity. J Neurol Neurosurg Psychiatry 81, 46-52.[21] Fregly, BJ. 2009. Design of Optimal Treatments for Neuromusculoskeletal Disorders using Patient-specific Multibody Dynamic Models. Int J Comput Vis Biomech 2(2), 145-155. [22] Fridén, J. Lieber, R. 2003. Spastic muscle cells are shorter and stiffer than normal cells. Muscle & Nerve 27 (2), 157-164. [23] Gajdosik, R. 2001. Passive extensibility of skeletal muscle: review of the literature with clinical implications. Clinical Biomechanics 16 (2), 87-101.[24] Gage, JR. Schwartz, MH. Koop, SE. Novacheck, TF. 2009. The Identification and Treatment of Gait Problems in Cerebral Palsy. John Wiley & Sons, 660p.31[25] Gao, F. Grant, TH. Elliot, JR. Zhang L. 2009. Changes in Passive Mechanical Properties of the Gastrocnemius Muscle at the Muscle Fascicle and Joint Levels in Stroke Survivors. Archives of Physical Medicine and Rehabilitation 90 (5), 819-826.[26] Granata, KP. Ikeda, AJ. Abel, MF. 2000. Electromechanical Delay and Reflex Response in Spastic Cerebral Palsy. Arch Med Rehabil 81, 888-894.[27] He, J. Norling, WR. Wang, Y. 1997. A Dynamic Neuromuscular Model for Describing the Pendulum Test of Spasticity. IEEE Transactions on Biomedical Engineering 44(3): 175-184.[28] Hermens, HJ. Freriks, B. Disselhorst-Klug C, Rau G. 2000. Development of recommendations for sEMG sensors and sensor placement procedures. Journal of Electromyography and Kinesiology 179, 323–30.[29] Hill, AV. 1938. The Heat of Shortening and the Dynamic Constants of Muscle. Proc R Soc Lond 126, 138-195.[30] Himpens, E. Van den Broeck, C. Oostra, A. Calders, P. Van Haesebrouck, P. 2008. Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review. Dev Med Child Neurol 50, 334–40.[31] Hirtz, D. Thurman, DJ. Gwinn-Hardy, K. Mohamed, M. Chaudhuri, AR. Zalutsky, R. 2007. How common are the ‘common’ neurologic disorders? Neurology 68, 326–37.[32] Hislop, HJ. Montgomery, J. Connely, B. Daniels, L. 2007. Daniel’s and Worthingham's Muscle Testing: Techniques of Manual Examination. Elsevier Science Health Science Division, 473p.[33] Hoy, MG. Zajac, FE. Gordon, ME. 1990. Musculoskeletal model of the Human Lower Extremity: The effect of muscle, tendon, and moment arm on moment-angle relationship of musculotendon actuators at the hip, knee and ankle. J Biomechanics 23 (4), 157-169.[34] Ikemoto, Y. Yu, W. Inoue, J. 2008. A Study on Balance Maintenance Strategies during Walking - A Simulation Study. 30th Annual International IEEE EMBS Conference Vancouver, British Columbia, Canada, 5073-5076.[35] Ishikawa, M. Pakaslahti, J. Komi, PV. 2007. Medial gastrocnemius muscle behavior during human running and walking. Gait & Posture 25, 380-384.[36] Lance JW. 1990. What is spasticity? The Lancet March 10, 606.[37] Lebiedowska, MK. Fisk, JR. 2009. Knee resistance during passive stretch in patients with hypertonia. J Neurosci Methods 179 (2), 323-30.32[38] Lichtwark, GA. Bougoulias, K. Wilson, AM. 2007. Muscle fascicle and series elastic element length changes along the length of the human gastrocnemius during walking and running. Journal of Biomechanics 40, 157–164.[39] Lieber, RL. Fridèn, J. 2000. Functional and Clinical Significance of Skeletal muscle architecture. Muscle Nerve 23, 1647-1666.[40] Lieber RL. Skeletal muscle adaptation to spasticity. 2010. Skelet muscle Struct Funct Plast 3rd ed., 271–89.[41] Lindberg, PG. Gäverth, J. Islam, M. Fagergren, A. Borg, J. Forssberg, H. 2011. Validation of a New Biomechanical Model to Measure Muscle Tone in Spastic Muscles. Neurorehabil Neural Repair 25: 617-625.[42] Meinders, M. Price, R. Lehmann, JF. Questad, KA. 1996. The stretch reflex response in the normal and spastic ankle: effect of ankle position. Archives of physical medicine and rehabilitation 77, 487-92[43] Meyns, P. Van Gestel, L. Bruijn, SM. Desloovere, K. Swinnen, SP. Duysens, J. 2012. Is interlimb coordination during walking preserved in children with cerebral palsy. Research in Developmental Disabilities 33, 1418-1428.[44] Millard, M. Uchida, T. Seth, A. Delp, SL. 2013. Flexing Computational Muscle: Modeling and Simulation of Musclotendon Dynamics. Journal of Biomechanical Engineering 35, 1-11.[45] Mileusnic, MP. Brown, IE. Lan, N. Loeb, GE: 2006. Mathematical models of proprioceptors. I. Control and transduction in the muscle spindle. Journal of Neurophysiol 96, 1772–1788.[46] O'Dwyer, NJ. Ada, L. Neilson, PD: 1996. Spasticity and muscle contracture following stroke. Brain 119(5), 1737–1749.[47] Ogihara, N. Yamazaki, N. 2001. Generation of human bipedal locomotion by a bio-mimetic neuro-musculo-skeletal model. Biol Cybern 84, 1–11.[48] O’Shea, M. 2008. Cerebral Palsy. Semin Perinatol 32, 35-41.[49] Oskoui, M. Coutinho, F. Dykeman, J. Jetté, N. Pringsheim, T. 2013. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Developmental Medicine & Child Neurology 55 (6), 509-519.[50] Paul, C. Bellotti, M. Jezernik, S. Curt, A. 2005. Development of a human neuro-musculoskeletal model for investigation of spinal cord injury. Biol Cybern 93, 153–170.33[51] Pava˜o, SL. Neves dos Santos, A. Hines Woollacott, M. Cicuto Ferreira Rocha, NA. 2013. Assessment of postural control in children with cerebral palsy: A review. Research in Developmental Disabilities 34, 1367–1375.[52] Rauch, HE. Tung, F. Striebel, CT. 1965. Maximum likelihood estimates of linear dynamic systems. American Institute of Aeronautics Astronautics Journal 3,1445–50.[53] Rutka, JT. Apodace, G. Stern, R. Rosenblum, M. 1988. The extracellular matrix of the central and peripheral nervous systems: structure and function. J Neurosurg 69, 155-170.[54] Sanger, TD. Delgado, MR. Gaebler-Spira, D. Hallett, M. Mink, JW. 2003. Classification and definition of disorders causing hypertonia in childhood. Pediatrics 111, 89–97.[55] Sheean, G. 2008. Neurophysiology of spasticity. In: Barnes M, Johnson G (Eds.). Upper Motor Neurone Syndrome And Spasticity. Clinical Management And Neurophysiology. Cambridge University Press, 9–54.[56] Sheean, G. 2002. The pathophysiology of spasticity. Eur J Neurol 9(Suppl 1), 3-9; discussion 53-61.[57] Smith, LR. Lee, KS. Ward, SR. Chambers, HG. Lieber, R. 2011. Hamstring contractures in children with spastic cerebral palsy result from a stiffer extracellular matrix and increased in vivo sarcomere length. J Physiol. 589 (10), 2625-39.[58] Staude G, Wolf W. 1999. Objective motor response onset detection in surface myoelectric signals. Medical Engineering and Physics 21, 449–67.[59] Stefanovska, A. Vodovnik, L. Rebersek, S. Acimovic-Janevic, R. 1989. FES and Spasticity. IEEE Transactions on Biomedical Engineering 36 (7), 738-745.[60] Tardieu, G. Tardieu, C. Colbeau-Justin, P. Bret, MD. 1982. Effects of muscle length on an increased stretch reflex in children with cerebral palsy. J Neurol Neurosurg Psychiatry 45, 348-52.[61] Thelen, D.G. 2003. Adjustment of muscle mechanics model parameters to simulate dynamic contractions in older adults. ASME Journal of Biomechanical Engineering 125(1),70–77.[62] Van der Krogt, MM. Doorenbosch, CA. Becher, JG. Harlaar, J. 2010. Dynamic spasticity of plantar flexor muscles in cerebral palsy gait. J Rehabil Med. 42 (7), 656-63.[63] Van der Krogt, M. Doorenbosch, CAM. Becher, JG. Harlaar, J. 2009. Walking speed modifies spasticity effects in gastrocnemicus and soleus in cerebral palsy gait. Clinical Biomechanics 24, 422-428.34[64] Wickiewicz, TL. Roy, RR. Powell, PL. Edgerton, VR. 1983. Muscle Architecture of Human Lower Limb. Orthopaedic Practice 179, 2-308.[65] Wu, Y. Ren, Y. Goldsmith, A. Gaebler, D. Liu, SQ. Zhang, L. 2010. Characterization of spasticity in cerebral palsy: dependence of catch angle on velocity. Developmental Medicine & Child Neurology 52 (6), 563-569.

Universiteit of Hogeschool
Revalidatiewetenschappen en Kinesitherapie
Publicatiejaar
2014
Kernwoorden
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