{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:08:45Z","timestamp":1788890925014,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/S013687\/1"],"award-info":[{"award-number":["EP\/S013687\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["101083647"],"award-info":[{"award-number":["101083647"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Early limb motor development progresses from spontaneous to increasingly complex movements. Restricted movement variety in infancy can indicate neuromotor impairment associated with cerebral palsy (CP) risk. The General Movement Optimality Score (GMOS) used in clinic detects abnormal movement patterns, but requires highly trained physiotherapists, limiting accessibility. Objective biomechanical measures may provide quantitative predictors of CP risk, reducing clinical burden while offering novel physiotherapeutic targets. This study investigated whether variation in lower limb kinematics and muscle forces during spontaneous kicking is reduced in infants with lower GMOS scores, indicating higher CP risk. We also examined whether variation correlates with gestational and corrected age, reflecting the transition to more complex movements. Twenty-six Infants aged 0\u20133 months underwent wired electromagnetic motion capture (Polhemus Liberty System) with musculoskeletal modelling to estimate kinematics and muscle force waveforms, alongside GMOS scoring. Waveform variation was quantified using functional principal component analysis and correlated with GMOS scores and age, while partial least squares discriminant analysis (PLS-DA) identified biomechanical predictors of GMOS indications of \u2018normal\u2019 versus \u2018poor repertoire\u2019 (PR) movements. Variation in knee flexion, hip flexion and abduction kinematics, and rectus femoris, pectineus, biceps femoris and gemelli forces significantly correlated with GMOS scores. Gestational age correlated with hip abduction, ankle dorsiflexion, and gemelli and medial gastrocnemius forces. PLS-DA achieved 85% accuracy distinguishing normal from poor repertoire movements, with knee and hip kinematics and biceps femoris force as key discriminators. These findings demonstrate that lower limb kinematic and neuromuscular variation aligns with clinical motor assessments, supporting their potential as objective biomechanical markers of CP risk.<\/jats:p>","DOI":"10.1371\/journal.pone.0357214","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:37:35Z","timestamp":1788889055000},"page":"e0357214","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Infant limb kinematics and muscle force variation during kicking is associated with clinical cerebral palsy risk measures"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7768-762X","authenticated-orcid":true,"given":"Nidal S.","family":"Khatib","sequence":"first","affiliation":[{"name":"School of Engineering and Materials Science, Queen Mary University of London","place":["London, United Kingdom"]},{"name":"School of Mechanical and Materials Engineering, University College Dublin","place":["Dublin, Ireland"]},{"name":"Imperial College London","place":["London, United Kingdom"],"department":["Department of Computing"]},{"name":"Imperial College London","place":["London, United Kingdom"],"department":["Department of Bioengineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca J.","family":"Schmidtke","sequence":"additional","affiliation":[{"name":"Imperial College London","place":["London, United Kingdom"],"department":["Department of Computing"]},{"name":"Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg","place":["Erlangen, Germany"],"department":["Dept. AIBE"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lukens","sequence":"additional","affiliation":[{"name":"Evelina London Children\u2019s Hospital, Guy\u2019s and St Thomas\u2019 NHS Trust","place":["London, United Kingdom"],"department":["Neonatal Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3550-1644","authenticated-orcid":true,"given":"Tomoki","family":"Arichi","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King's College London","place":["London, United Kingdom"],"department":["Early Life Imaging Research Department"]},{"name":"MRC Centre for Neurodevelopmental Disorders, King\u2019s College London","place":["London, United Kingdom"]},{"name":"Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Muceli","sequence":"additional","affiliation":[{"name":"Chalmers University of Technology","place":["Goteborg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2123-0185","authenticated-orcid":true,"given":"Etienne","family":"Burdet","sequence":"additional","affiliation":[{"name":"Imperial College London","place":["London, United Kingdom"],"department":["Department of Bioengineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-5023","authenticated-orcid":true,"given":"Bernhard","family":"Kainz","sequence":"additional","affiliation":[{"name":"Imperial College London","place":["London, United Kingdom"],"department":["Department of Computing"]},{"name":"Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg","place":["Erlangen, Germany"],"department":["Dept. 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