# From Simplified Markers to Muscle Function: A Deep Learning Approach for Personalized Cervical Biomechanics Assessment Powered by Massive Musculoskeletal Simulation

## TL;DR

This paper introduces a deep learning method to estimate cervical muscle forces using personalized simulations, enabling non-invasive and accurate biomechanical assessments for clinical use.

## Contribution

A novel data-driven framework combining large-scale musculoskeletal simulations and a neural network for personalized cervical muscle force estimation.

## Key findings

- The FNN model achieved an R2 score exceeding 0.95 for all 72 cervical muscle forces.
- The framework accurately identifies motion deficits by comparing real and simulated head trajectories.
- The method is validated on both healthy and restricted mobility subjects, showing clinical translatability.

## Abstract

Accurate, subject-specific estimation of cervical muscle forces is a critical prerequisite for advancing spinal biomechanics and clinical diagnostics. However, this task remains challenging due to substantial inter-individual anatomical variability and the invasiveness of direct measurement techniques. In this study, we propose a novel data-driven biomechanical framework that addresses these limitations by integrating massive-scale personalized musculoskeletal simulations with an efficient Feedforward Neural Network (FNN) model. We generated an unprecedented dataset comprising one million personalized OpenSim cervical models, systematically varying key anthropometric parameters (neck length, shoulder width, head mass) to robustly capture human morphological diversity. A random subset was selected for inverse dynamics simulations to establish a comprehensive, physics-based training dataset. Subsequently, an FNN was trained to learn a robust, nonlinear mapping from non-invasive kinematic and anthropometric inputs to the forces of 72 cervical muscles. The model’s accuracy was validated on a test set, achieving a coefficient of determination (R2) exceeding 0.95 for all 72 muscle forces. This approach effectively transforms a computationally intensive biomechanical problem into a rapid tool. Additionally, the framework incorporates a functional assessment module that evaluates motion deficits by comparing observed head trajectories against a simulated idealized motion envelope. Validation using data from a healthy subject and a patient with restricted mobility demonstrated the framework’s ability to accurately track muscle force trends and precisely identify regions of functional limitations. This methodology offers a scalable and clinically translatable solution for personalized cervical muscle evaluation, supporting targeted rehabilitation and injury risk assessment based on readily obtainable sensor data.