Muscle coordination retraining inspired by musculoskeletal simulations reduces knee contact force.
Muscle coordination retraining inspired by musculoskeletal simulations reduces knee contact force.
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DOI：
10.1038/s41598-022-13386-9
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发表时间：
2022-07-07
影响因子：
4.6
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中科院分区：
文献类型：
--
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人类通常协调他们的肌肉以满足运动目标，如最大限度地减少能量消耗。在病理学的存在下，新的目标变得重要，比如减少骨关节炎关节的负荷，但人们通常不会改变他们的肌肉协调模式来满足这些新的目标。在这里，我们使用肌肉骨骼模拟来识别简单的协调变化，可以使用肌电生物反馈进行教学，实现减少关节负荷的治疗目标。我们的模拟预测，改变两个多余的踝跖屈肌腓肠肌和比目鱼肌的相对激活可以减少行走过程中膝盖的接触力，但目前还不清楚人类是否可以在行走等复杂任务中重新协调多余的肌肉。我们的实验表明，在进行单次步行并对跖屈肌激活的汇总测量进行生物反馈后，健康个体的腓肠肌与比目鱼肌激活比率降低了25 ± 15%（p = 0.004，配对t检验，n = 10）。以这种“腓肠肌回避”步态模式行走的参与者将站立后期膝关节接触力降低了12 ± 12%（p = 0.029，配对t检验，n = 8）。模拟通知协调再训练可能是一种有前途的治疗膝关节骨关节炎和一个强大的工具，优化协调的各种康复和性能应用。
Humans typically coordinate their muscles to meet movement objectives like minimizing energy expenditure. In the presence of pathology, new objectives gain importance, like reducing loading in an osteoarthritic joint, but people often do not change their muscle coordination patterns to meet these new objectives. Here we use musculoskeletal simulations to identify simple changes in coordination that can be taught using electromyographic biofeedback, achieving the therapeutic goal of reducing joint loading. Our simulations predicted that changing the relative activation of two redundant ankle plantarflexor muscles—the gastrocnemius and soleus—could reduce knee contact force during walking, but it was unclear whether humans could re-coordinate redundant muscles during a complex task like walking. Our experiments showed that after a single session of walking with biofeedback of summary measures of plantarflexor muscle activation, healthy individuals reduced the ratio of gastrocnemius-to-soleus muscle activation by 25 ± 15% (p = 0.004, paired t test, n = 10). Participants who walked with this “gastrocnemius avoidance” gait pattern reduced late-stance knee contact force by 12 ± 12% (p = 0.029, paired t test, n = 8). Simulation-informed coordination retraining could be a promising treatment for knee osteoarthritis and a powerful tool for optimizing coordination for a variety of rehabilitation and performance applications.
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