2024 journal article
Use of computational modeling to examine fingertip force production in children with hemiplegic cerebral palsy
JOURNAL OF BIOMECHANICS, 172.
author keywords: Cerebral palsy; Upper limb; Opensim; Hand; Static optimization; And neuromuscular control
UN Sustainable Development Goal Categories
3. Good Health and Well-being
(Web of Science)
Source: Web Of Science
Added: July 22, 2024
Most children with hemiplegic cerebral palsy (HCP), one of the most prevalent subtypes of cerebral palsy, struggle with grasping and manipulating objects. This impairment may arise from a diminished capacity to properly direct forces created with the finger pad due to aberrant force application. Children with HCP were asked to create maximal force with the index finger pad in the palmar (normal) direction with both the paretic and non-paretic hands. The resulting forces and finger postures were then applied to a computational musculoskeletal model of the hand to estimate the corresponding muscle activation patterns. Subjects tended to create greater shear force relative to normal force with the paretic hand (p < 0.05). The resultant force was directed 33.6°±10.8° away from the instructed palmar direction in the paretic hand, but only 8.0°±7.3° in the non-paretic hand. Additionally, participants created greater palmar force with the non-paretic hand than with the paretic hand (p < 0.05). These differences in force production are likely due to differences in muscle activation pattern, as our computational models showed differences in which muscles are active and their relative activations when recreating the measured force vectors for the two hands (p < 0.01). The models predicted reduced activation in the extrinsic and, especially, the intrinsic finger muscles, potentially due to reduced voluntary activation or muscle atrophy. As the large shear forces could lead to objects slipping from grasp, creation and modulation of the appropriate muscle activation patterns may provide an important target for therapeutic treatment in children with HCP.