基于OpenSim预测青少年跖屈肌无力的下肢生物力学行为  

OpenSim-based prediction of lower-limb biomechanical behavior in adolescents with plantarflexor weakness

作　　者：付恩洪 杨行 梁成 张小刚 张亚丽 靳忠民 Fu Enhong;Yang Hang;Liang Cheng;Zhang Xiaogang;Zhang Yali;Jin Zhongmin(School of Mechanical Engineering,Southwest Jiaotong University,Chengdu 610031,Sichuan Province,China)

机构地区：[1]西南交通大学,机械工程学院,四川省成都市610031

出　　处：《中国组织工程研究》2025年第9期1789-1795,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金委员会面上项目(52375207),项目负责人:张小刚;国家自然科学基金委员会重点项目(52035012),项目负责人:靳忠民;中央高校基本科研业务费(2682023ZTPY052),项目负责人:张亚丽。

摘　　要：背景:跖屈肌无力是痉挛型脑瘫和腓骨肌萎缩症患者的常见肌肉缺陷,临床上会表现出异常步态,而跖屈肌无力与异常步态间的关系尚不明晰。目的:探讨跖屈肌无力单因素作用时对下肢生物力学行为的影响,以揭示跖屈肌无力诱发异常步态的机制,为跖屈肌无力患者康复训练提供指导。方法:基于OpenSim Moco建立矢状面内骨肌多体动力学预测框架,预测正常受试者下肢关节角和肌肉激活变化,结合实验数据逆运动学和肌电图激活时间,验证框架有效性。减小等距肌肉力进行跖屈肌无力建模并将预测得到的下肢关节角、关节力矩和肌肉能量消耗,与正常受试者对比,以分析跖屈肌无力对下肢生物力学的影响。结果与结论:①基于Moco的预测框架较真实地预测了正常受试者步行过程中的下肢生物力学变化(关节角归一化相关系数≥0.73,均方根误差≤7.10°);②跖屈肌无力时模型采用小步幅且支撑相上升的“脚跟行走”步态,当跖屈肌无力达到80%时,肌肉能量消耗为5.6914 J/(kg·m),腓肠肌和比目鱼肌激活度最大分别为0.72,0.53,可能致使跖屈肌无力患者步行时更易疲劳;③当跖屈肌无力超过40%时,肌肉能量消耗显著升高;跖屈肌无力超过60%时,下肢关节角和关节力矩出现较明显恶化,说明跖屈肌无力对步态的影响可能存在“阈值”,这或许对应于医护人员进行临床干预的时间点。BACKGROUND:The plantarflexor weakness is a common muscle defect in patients with spastic cerebral palsy and Charcot-Marie-Tooth,which clinically manifests abnormal gaits,and the relationship between plantarflexor weakness and abnormal gaits is unclear.OBJECTIVE:To explore the biomechanical behavior of the lower limb under the action of a single factor of plantarflexor weakness to reveal the mechanism of abnormal gait induced by plantarflexor weakness and to provide guidance for the rehabilitation training of patients with plantarflexor weakness.METHODS:A predictive framework of musculoskeletal multibody dynamics in the sagittal plane was established based on OpenSim Moco to predict lower limb joint angles and muscle activation changes during walking in normal subjects.The validity of the framework was verified by combining the inverse kinematics and electromyogram activation time of the experimental data.Reduced isometric muscle forces were used to model plantarflexor weakness and to compare predicted lower extremity joint angles,joint moments,and muscle energy expenditure with normal subjects to analyze the effects of plantarflexor weakness on lower extremity biomechanics.RESULTS AND CONCLUSION:(1)The Moco-based prediction framework realistically predicted the biomechanical changes of the lower limbs during walking in normal subjects (joint angles: normalized correlation coefficient ≥0.73, root mean square error ≤7.10°). (2) The musculoskeletal model used a small stride support phase to increase the“heel-walking”gait during plantarflexor weakness.When the plantarflexor weakness reached 80%,the muscle energy expenditure was 5.6914 J/kg/m,and the maximum activation levels of the gastrocnemius and soleus muscles were 0.72 and 0.53,which might cause the plantarflexor weakness patients to be more prone to fatigue when walking.(3)Muscle energy expenditure was significantly higher when the weakness of plantarflexors exceeded 40%,and the joint angles and moments of the lower limbs deteriorated significantly whe

关 键 词：下肢 跖屈肌无力 生物力学 步态 预测 肌肉能量消耗 肌肉激活 OpenSimMoco 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R685