P 020 - Is gait asymmetry correlated to anatomic leg length discrepancy when abnormal clinical findings are also present?

Abstract

Background: Plantarflexor structure is an important predictor of function in healthy, athletic, and some patient populations. Computational simulations are powerful tools capable of testing the isolated effects of muscle-tendon structure on gait function.Research Question: The purpose of this study was to characterize the sensitivity of plantarflexor muscle function based on muscle-tendon unit (MTU) parameters. We hypothesized that plantarflexor metabolics and shortening dynamics would be sensitive to MTU parameters.Methods: Stance phase of gait was simulated using a musculoskeletal model and computed muscle control algorithm. Optimal muscle fiber length, resting ankle angle, and tendon stiffness parameters were systematically changed to test these effects on plantarflexor metabolics, activation, and power. Dorsiflexor metabolics were also measured to determine the impact of the action of the antagonist muscle group.Results and Significance: Plantarflexor metabolic demands were 1.5 and 2.7 times more sensitive to optimal fiber length and resting ankle angle, respectively, compared to the effect of tendon stiffness. Increased resting ankle plantarflexion induced a large passive plantarflexion moment during early stance, which required non-physiologic dorsiflexor contractions. Conversely, longer optimal fiber and more neutral resting ankle angles increased the shortening demands of the plantarflexors. These findings highlight the importance of carefully selecting MTU parameters when modeling gait with musculoskeletal models, especially in pathologic or high-performance athlete populations.