A child with cerebral palsy can have a surgery in which a muscle is disconnected from the front of the knee and reattached to the back of the leg.

The surgery could improve the child’s mobility by correcting the way the muscles move. Or it could make the child even more likely to lose balance and fall while tripping.

Right now, there’s no way to know for sure which children with cerebral palsy could be helped by the surgery, which is done fairly frequently. But, thanks to research by a University of Tennessee doctoral student, in a couple of years doctors may be able to predict which children would do well with the surgery and which ones would be better off without it.

Misagh Mansouri, a doctoral student in UT’s College of Engineering’s Department of Mechanical, Aerospace and Biomedical Engineering, has been working on that project since he came to UT from Iran in 2009. Mansouri has an undergraduate degree in mechanical engineering and intended to get a doctorate in that field, but he switched to biomechanical engineering because he liked the idea of his research being “more useful to society.”

His adviser, Jeffrey Reinbolt, an assistant professor in the same department, had worked on similar projects at Stanford University. Under Reinbolt’s guidance, Mansouri combined two software programs to create a computer model that showed how the brain controlled the way these children’s bodies moved when they walked.

He used already-available data collected by Gillette Children’s Specialty Healthcare, a nonprofit hospital in Minnesota that had analyzed the children’s gait and level of crouch, to build a computer simulation that showed how specific children would move before and after the surgery.

“In real life, we couldn’t put these children on a platform and push them to see if they would fall or not,” but the detailed program, which uses 92 muscle simulators across 21 lower-body joints, can show that, he said.

What Mansouri and his team — which included researchers from UT, Stanford and the University of Australia — found with the simulation was that “children who had the surgery were more likely to lose balance and fall during tripping than ones who did not, regardless of degree of crouched posture and whether they had the surgery on one side or both sides of their knees,” he said, adding that more studies are needed, but the work could translate into doctors someday being able to enter measurements into a computer to see if a child is a good candidate for the surgery.

The research was funded by the National Institutes of Health and the National Science Foundation. Mansouri graduates in May but hopes to continue working on the project, adding details to see if gender and age of the children affect the outcome, and how other types of motion are affected.

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