{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:05:28Z","timestamp":1780401928158,"version":"3.54.1"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Surface electromyography (EMG) is widely used to assess muscle activation. However, direct interpretation of its functional biomechanical consequences remains challenging. This study aimed to develop and evaluate an EMG-driven musculoskeletal simulation framework for investigating how controlled modifications of muscle activation patterns influence joint-level biomechanics in the upper limb. The objective was not to reproduce specific clinical pathologies but to enable systematic virtual scenario analysis of activation-dependent movement alterations. Materials and Methods: Surface EMG signals were recorded from five healthy adults (3 males, 2 females; age 22 \u00b1 1 years) during cyclic elbow flexion\/extension tasks using a wireless system (sampling frequency: 2000 Hz). Processed and normalized EMG envelopes were directly applied as prescribed neural inputs in forward dynamic simulations implemented in OpenSim, without optimization-based muscle recruitment. Controlled virtual scenarios were generated through parametric modification of activation signals to represent reduced activation capacity, increased antagonist co-activation, spasticity-like activation modulation, and tremor-like oscillatory modulation. Joint kinematics, joint moments, and movement stability were evaluated. A Movement Quality Index (MQI) was introduced as a comparative research metric integrating biomechanical performance indicators. Simulations were deterministic and analyzed descriptively. Results: Distinct activation modifications produced characteristic kinematic and kinetic responses. Reduced activation capacity decreased simulated joint moment output, increased co-activation altered joint moment timing and mechanical stability, and tremor-like oscillatory modulation generated periodic fluctuations in joint kinematics and kinetics. The MQI enabled quantitative differentiation between simulated scenarios and severity levels within the controlled modelling framework. Conclusions: The proposed EMG-driven forward dynamic simulation framework provides a methodological platform for controlled virtual scenario analysis of activation-dependent biomechanical changes. The findings highlight the sensitivity of joint-level mechanics to altered muscle activation patterns, within the deterministic modelling environment. The framework is intended for research-oriented biomechanical investigation and hypothesis testing rather than direct clinical diagnosis of neuromuscular disorders.<\/jats:p>","DOI":"10.3390\/medicina62030530","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T13:12:24Z","timestamp":1773321144000},"page":"530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["EMG-Driven Musculoskeletal Modelling Framework for Virtual Simulation of Upper Limb Activation-Modulated Impairment Scenarios"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0876-5776","authenticated-orcid":false,"given":"Dovydas","family":"Cic\u0117nas","sequence":"first","affiliation":[{"name":"Department of Biomechanical Engineering, Faculty of Mechanics, Vilnius Gediminas Technical University, Plytin\u0117s g. 25, LT-10105 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-4860","authenticated-orcid":false,"given":"Kristina","family":"Daunoravi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering, Faculty of Mechanics, Vilnius Gediminas Technical University, Plytin\u0117s g. 25, LT-10105 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nussbaumer, S., Leunig, M., Glatthorn, J.F., Stauffacher, S., Gerber, H., and Maffiuletti, N. 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