Muscle behavior adaptations after supervised exercise training in peripheral artery disease: and OpenSim simulation

Cody Anderson (1), Hafizur Rahman (1), Iraklis Pipinos (2,3), Jason Johanning (2,3), & Sara Myers (1,2): (1) Department of Biomechanics: University of Nebraska at Omaha, 6001 Dodge St, Omaha, NE 68182 (2) Department of Surgery: Omaha VA Medical Center, 4101 Woolworth Ave, Omaha, NE 68105 (3) Department of Surgery: University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198

Central research question: To investigate how muscle adapts as a result of supervised exercise training in individuals with peripheral artery disease.

Research context: PAD is characterized by the development of atherosclerotic plaques in the conduit arteries. A common manifestation of PAD is intermittent claudication, a cramping-like pain that arises in the muscles as a result of exercise and is only attenuated with rest. Claudication pain limits an individual’s ability to participate in activities of daily living. Current treatment options for PAD include revascularization surgeries and supervised exercise training. While supervised exercise programs have been shown to produce favorable outcomes in PAD, little is known about how muscle activation changes as a result of supervised exercise training.

Research Methodology

Kinematic data, captured via a motion capture system, and kinetic data, captured via overground force plates, from patients with PAD (n=13), before and after a 6-month exercise intervention, was used as input for musculoskeletal modeling (OpenSim). Virtual models were scaled with the scaling tool to match the anthropometry of the subjects before muscle parameters were derived. Muscle activation was analyzed across the stance phase of gait with the computed muscle control tool (CMC). Output from the CMC tool was analyzed to determine if muscle activation changed as a result of supervised exercise training in PAD.


Our study indicates that supervised exercise training does not significantly impact muscle force extrema but does impact various muscle impulses across stance. This indicates that muscle activation patterns change as a result of supervised exercise training. Various significant correlates were also identified between muscle impulses and clinically relevant parameters, such as the six-minute walking distance, walking velocity, and absolute claudication distance. These correlates indicate that gait analysis coupled with musculoskeletal modeling may serve as a valuable predictive tool for PAD outcomes.

Additional Abstract Information

Presenter: Cody Anderson

Institution: University of Nebraska at Omaha

Type: Poster

Subject: Exercise Science & Nutrition

Status: Approved

Time and Location

Session: Poster 7
Date/Time: Tue 3:30pm-4:30pm
Session Number: 5022