Computational musculoskeletal modeling and simulation platforms are efficient tools to gain insight into the muscular coordination of patients with motor disabilities such as cerebral palsy (CP). Muscle force predictions from simulation programs are influenced by the architectural and contractile properties of muscle-tendon units. In this study, we aimed to evaluate the sensitivity of major lower limb muscle forces in patients with CP to changes in muscle-tendon parameters. Open-access datasets of children with CP ([Formula: see text]) and healthy children ([Formula: see text]) were considered. Monte Carlo analysis was executed to specify how sensitive the muscle forces to perturbations between [Formula: see text]% and [Formula: see text]% of the nominal value of the maximum isometric muscle force, optimal muscle fiber length, muscle pennation angle, tendon slack length, and maximum contraction velocity of muscle. The sensitivity analysis revealed that muscle forces of CP patients and healthy individuals were most sensitive to perturbations in the tendon slack length ([Formula: see text]), while forces of CP patients were more sensitive to tendon slack length when compared to the healthy group ([Formula: see text]). Muscle forces of patients and healthy individuals were insensitive to the other four parameters ([Formula: see text]), except for the gracilis and sartorius muscles in which the proportion of optimal muscle fiber length to tendon slack length is higher than 1; forces of these two muscles were also sensitive to the optimal muscle fiber length. The results of this study are expected to contribute to our understanding of which parameters should be personalized when conducting musculoskeletal modeling and simulation of patients with CP.

中文翻译：

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脑瘫患者模型预测的肌肉力量对肌腱参数变化的敏感性

计算肌肉骨骼建模和模拟平台是深入了解脑瘫 (CP) 等运动障碍患者肌肉协调的有效工具。来自模拟程序的肌肉力量预测受肌肉肌腱单元的结构和收缩特性的影响。在这项研究中，我们旨在评估 CP 患者主要下肢肌肉力量对肌腱参数变化的敏感性。考虑了 CP 儿童（[公式：见文本]）和健康儿童（[公式：见文本]）的开放获取数据集。执行蒙特卡罗分析以指定肌肉力对最大等长肌肉力的标称值、最佳肌纤维长度的 [公式：见文本]% 和 [公式：见文本]% 之间的扰动有多敏感，肌肉羽状角、肌腱松弛长度和肌肉的最大收缩速度。敏感性分析显示，CP患者和健康人的肌肉力量对肌腱松弛长度的扰动最为敏感（[公式：见正文]），而与健康组相比，CP患者的肌力对肌腱松弛长度更敏感（[公式：见正文]）。患者和健康人的肌肉力量对其他四个参数不敏感（[公式：见正文]），除了股薄肌和缝匠肌，其中最佳肌纤维长度与肌腱松弛长度的比例高于1；这两个肌肉的力量对最佳肌纤维长度也很敏感。