Muscle-driven forward dynamic simulations for the study of normal and pathological gait

There has been much recent interest in the use of muscle-actuated forward dynamic simulations to describe human locomotion. These models simulate movement through the integration of dynamic equations of motion and usually are driven by excitation inputs to muscles. Because motion is effected by individual muscle actuators, these simulations offer potential insights into the roles played by muscles in producing walking motions. Better knowledge of the actions of muscles should lead to clarification of the etiology of movement disorders and more effective treatments. This article reviews the use of such simulations to characterize musculoskeletal function and describe the actions of muscles during normal and pathological locomotion. The review concludes by identifying ways in which models must be improved if their potential for clinical utility is to be realized.