Methods for integrating postural control into biomechanical human simulations: a systematic review.
Julian Shanbhag, Alexander Wolf, Iris Wechsler and 7 others
PMID 37605197WHAT IT FOUND
Existing computer simulations of human balance rely heavily on simplified mathematical controllers rather than realistic biological processes.
No current model accurately replicates how the nervous system integrates sensory feedback, so these tools cannot yet guide clinical therapy decisions.
Key findings
01The review included 102 studies that used computer models to simulate standing or walking, mostly relying on simplified non-musculoskeletal models for standing and musculoskeletal models for gait.
02Proportional-derivative (PD) controllers were the most common method used to simulate balance, appearing in 43 of the 108 control approaches identified across the studies.
03The underlying neural processes for how the human body integrates sensory information for balance remain unclear, meaning current simulations match movement patterns but do not necessarily reflect biological reality.
STILL TO COME
How it was doneWhat they found
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What it does not show
The nomenclature for postural control is inconsistent in the literature, which may have caused some relevant studies to be missed despite a backward search. Many included models have been linearized to simplify calculation, which ignores important nonlinear biological behaviors like specific muscle dynamics. Different studies used different methods to compare their simulations to experimental data, making it difficult to directly compare the accuracy of the various models. The review excluded studies involving patients with specific diseases (such as post-stroke patients) or robotic applications, limiting its scope to healthy human movement simulation.
Declared interests
The study was funded by the Deutsche Forschungsgemeinschaft and Friedrich-Alexander-Universität Erlangen-Nürnberg.
The easy way to misread this
Do not interpret the ability of these computer models to simulate human-like balance as evidence that we understand the biological mechanisms of postural control. The review states that the underlying neural processes are still unclear, and current models are engineering approximations that cannot yet be used to prescribe therapy.