000151981 001__ 151981 000151981 005__ 20250321155444.0 000151981 0247_ $$2doi$$a10.1016/j.clinbiomech.2021.105405 000151981 0248_ $$2sideral$$a126570 000151981 037__ $$aART-2021-126570 000151981 041__ $$aeng 000151981 100__ $$aKainz H. 000151981 245__ $$aESB Clinical Biomechanics Award 2020: Pelvis and hip movement strategies discriminate typical and pathological femoral growth – Insights gained from a multi-scale mechanobiological modelling framework 000151981 260__ $$c2021 000151981 5060_ $$aAccess copy available to the general public$$fUnrestricted 000151981 5203_ $$aBackground: Many children with cerebral palsy (CP) develop skeletal deformities during childhood. So far, it is unknown why some children with CP develop bony deformities whereas others do not. The aims of this study were to (i) investigate what loading characteristics lead to typical and pathological femoral growth, and (ii) evaluate why some children with CP develop femoral deformities whereas other do not. Methods: A multi-scale mechanobiological modelling workflow was used to simulate femoral growth based on three-dimensional motion capture data of six typically developing children and 16 children with CP. Based on the growth results, the participants with CP were divided into two groups: typical growth group and pathological growth group. Gait kinematics and femoral loading were compared between simulations resulting in typical growth and those resulting in pathologic growth. Findings: Hip joint contact forces were less posteriorly-oriented in the pathological growth simulations compared to the typical ones. Compared to the typically developing participants, the CP group with pathological femoral growth presented increased knee flexion and no hip extension. The CP group with simulated typical growth presented similar sagittal plane joint kinematics but differed in the frontal plane pelvic and hip movement strategy, which normalized the hip joint contact force and therefore contributed to typical femoral growth trends. Interpretation: Our simulation results identified specific gait features, which may contribute to pathological femoral growth. Furthermore, the hip joint contact force orientation in the sagittal plane seems to be the dominant factor for determining femoral growth simulations. 000151981 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000151981 590__ $$a2.034$$b2021 000151981 591__ $$aORTHOPEDICS$$b55 / 86 = 0.64$$c2021$$dQ3$$eT2 000151981 591__ $$aSPORT SCIENCES$$b68 / 88 = 0.773$$c2021$$dQ4$$eT3 000151981 591__ $$aENGINEERING, BIOMEDICAL$$b76 / 98 = 0.776$$c2021$$dQ4$$eT3 000151981 592__ $$a0.559$$b2021 000151981 593__ $$aOrthopedics and Sports Medicine$$c2021$$dQ2 000151981 593__ $$aBiophysics$$c2021$$dQ2 000151981 594__ $$a3.3$$b2021 000151981 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000151981 700__ $$aKillen B.A. 000151981 700__ $$aVan Campenhout A. 000151981 700__ $$aDesloovere K. 000151981 700__ $$0(orcid)0000-0002-9864-7683$$aGarcía Aznar J.M.$$uUniversidad de Zaragoza 000151981 700__ $$aShefelbine S. 000151981 700__ $$aJonkers I. 000151981 7102_ $$15004$$2605$$aUniversidad de Zaragoza$$bDpto. Ingeniería Mecánica$$cÁrea Mec.Med.Cont. y Teor.Est. 000151981 773__ $$g87 (2021), 105405 [9 pp.]$$pClin. biomech.$$tClinical Biomechanics$$x0268-0033 000151981 8564_ $$s5158419$$uhttps://zaguan.unizar.es/record/151981/files/texto_completo.pdf$$yVersión publicada 000151981 8564_ $$s2457618$$uhttps://zaguan.unizar.es/record/151981/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000151981 909CO $$ooai:zaguan.unizar.es:151981$$particulos$$pdriver 000151981 951__ $$a2025-03-21-14:41:12 000151981 980__ $$aARTICLE