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首页> 外文期刊>Journal of Biomechanics >A simulation analysis of the combined effects of muscle strength and surgical tensioning on lateral pinch force following brachioradialis to flexor pollicis longus transfer.
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A simulation analysis of the combined effects of muscle strength and surgical tensioning on lateral pinch force following brachioradialis to flexor pollicis longus transfer.

机译：臂radi骨屈肌腱长转移后肌肉力量和手术张力对侧向挤压力的综合影响的模拟分析。

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摘要

Biomechanical simulations of tendon transfers performed following tetraplegia suggest that surgical tensioning influences clinical outcomes. However, previous studies have focused on the biomechanical properties of only the transferred muscle. We developed simulations of the tetraplegic upper limb following transfer of the brachioradialis (BR) to the flexor pollicis longus (FPL) to examine the influence of residual upper limb strength on predictions of post-operative transferred muscle function. Our simulations included the transfer, ECRB, ECRL, the three heads of the triceps, brachialis, and both heads of the biceps. Simulations were integrated with experimental data, including EMG and joint posture data collected from five individuals with tetraplegia and BR-FPL tendon transfers during maximal lateral pinch force exertions. Given a measured co-activation pattern for the non-paralyzed muscles in the tetraplegic upper limb, we computed the highest activation for the transferred BR for which neither the elbow nor the wrist flexor moment was larger than the respective joint extensor moment. In this context, the effects of surgical tensioning were evaluated by comparing the resulting pinch force produced at different muscle strength levels, including patient-specific scaling. Our simulations suggest that extensor muscle weakness in the tetraplegic limb limits the potential to augment total pinch force through surgical tensioning. Incorporating patient-specific muscle volume, EMG activity, joint posture, and strength measurements generated simulation results that were comparable to experimental results. Our study suggests that scaling models to the population of interest facilitates accurate simulation of post-operative outcomes, and carries utility for guiding and developing rehabilitation training protocols.
机译：四肢瘫痪后进行的肌腱转移的生物力学模拟表明，手术张力会影响临床结果。然而，先前的研究集中在仅转移的肌肉的生物力学特性上。我们开发了臂ple肌（BR）转移到长屈肌屈肌（FPL）后四肢瘫痪上肢的模拟，以检查残余上肢力量对术后转移的肌肉功能预测的影响。我们的模拟包括转移，ECRB，ECRL，三头肌的三个头，肱肌和二头肌的两个头。模拟与实验数据集成在一起，包括从五个最大的四肢瘫痪和BR-FPL肌腱转移过程中从最大的横向捏力施加过程中收集的肌电图和关节姿势数据。给定四肢瘫痪上肢非瘫痪肌肉的共激活模式，我们计算出了转移的BR的最高激活，对于BR，肘或腕屈肌力矩均不大于各自的关节伸肌力矩。在这种情况下，通过比较在不同肌肉强度水平（包括患者特定的结垢）下产生的合拢力来评估手术张力的效果。我们的模拟表明，四肢瘫痪肢体的伸肌无力限制了通过手术拉紧来增加总捏力的可能性。结合患者特定的肌肉体积，EMG活动，关节姿势和力量测量，得出的模拟结果与实验结果相当。我们的研究表明，将模型缩放到感兴趣的人群有助于准确模拟术后结果，并有助于指导和制定康复训练方案。

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