Neuro-musculoskeletal Upper Limb in-silico asvirtual patient

Virtual patients and physiologies allow experimentation, design, and early-stage clinical trials in-silico. Virtual patient technology for human movement systems that encompasses musculoskeleton and its neural control are few and far in between. In this work, we present one such neuro-musculoskeletal upper limb in-silico model. This upper limb is both modular in architecture and generates movement as an emergent phenomenon out of a multiscale co-simulation of spinal cord neural control and musculoskeletal dynamics. It is developed on the NEUROiD movement simulation platform that enables a co-simulation of popular neural simulator NEURON and the musculoskeletal simulator OpenSim. In this work, we describe the design and development of the upper limb in a modular fashion, while reusing existing models and modules. We further characterize and demonstrate the use of this model in generating a range of commonly observed movements by means of a spatio temporal stimulation pattern delivered to the cervical spinal cord. We believe this work enables a first and small step towards an in-silico paradigms for understanding upper limb movement, disease pathology, medication, and rehabilitation.