The energetic basis for smooth human arm movements
Abstract
The central nervous system plans human reaching movements with stereotypically smooth kinematic trajectories and fairly consistent durations. Smoothness seems to be explained by accuracy as a primary movement objective, whereas duration seems to economize energy expenditure. But the current understanding of energy expenditure does not explain smoothness, so that two aspects of the same movement are governed by seemingly incompatible objectives. Here, we show that smoothness is actually economical, because humans expend more metabolic energy for jerkier motions. The proposed mechanism is an underappreciated cost proportional to the rate of muscle force production, for calcium transport to activate muscle. We experimentally tested that energy cost in humans (N = 10) performing bimanual reaches cyclically. The empirical cost was then demonstrated to predict smooth, discrete reaches, previously attributed to accuracy alone. A mechanistic, physiologically measurable, energy cost may therefore explain both smoothness and duration in terms of economy, and help resolve motor redundancy in reaching movements.
Editor's evaluation
This paper will be of interest to researchers in the fields of biomechanics, movement control, and decision making. A novel, mechanistic model of metabolic cost is presented to account for a phenomenon not explained by current models of metabolic energy. This is followed by a demonstration of how this metabolic model can improve our understanding of movement control by revealing an energetic basis for smooth movements.
https://doi.org/10.7554/eLife.68013.sa0Introduction
Upper extremity reaching movements are characterized by a stereotypical, bellshaped speed profile for the hand’s motion to its target (Figure 1A). The profile’s smoothness seems to preserve kinematic accuracy (Harris and Wolpert, 1998) and have little to do with the effort needed to produce the motion. But effort or energy expenditure appear to affect other aspects of reaching (Huang et al., 2012; Shadmehr et al., 2019), and influence a vast array of other animal behaviors and actions (Alexander, 1996). It seems possible that effort or energy do influence the bellshaped profile, but have gone unrecognized because of incomplete quantification of such costs. If so, then dynamic goals including effort could play a key role in movement planning.
The kinematic goal for accuracy may be expressed quantitatively as minimization of the final endpoint position variance (Harris and Wolpert, 1998). Nonsmooth motions introduce inaccuracy because motor noise increases with motor command amplitude, a phenomenon termed signaldependent noise (Matthews, 1996; Sutton and Sykes, 1967). It predicts well the speed profiles for not only the hand but also the eye. It explains why more curved or more accurate motions need to be slower, and also subsumes an older theory for minimizing kinematic jerk (Flash and Hogan, 1985). The single objective of movement variance explains multiple aspects of smooth movements, and makes better predictions than competing theories (Diedrichsen et al., 2010; Haith et al., 2012; Todorov, 2004).
There are nonetheless reasons to consider effort. Many optimal control tasks must include an explicit objective for effort, without which movements would be expected to occur at maximal effort (‘bangbang control’, Harris and Wolpert, 1998; Bryson and Ho, 1975). In addition, metabolic energy expenditure is substantial during novel reaching tasks and decreases as adaptation progresses (Huang et al., 2012). Such a cost also helps to determine movement duration and vigor (Shadmehr et al., 2016), not addressed by the minimumvariance hypothesis. Indeed, optimal control studies have long examined effort costs such as for muscle force (Kolossiatis et al., 2016), mechanical work (Alexander, 1997), squared force or activation (Nelson, 1983; Ma et al., 1994), or ‘torquechange’ (integral of squared joint torque derivatives; Uno et al., 1989). But many such costs produce nonsmooth velocity profiles (Figure 1B), or lack physiological justification, or both. Some studies have included explicit models of muscle energy expenditure, but without testing such costs physiologically (Kistemaker et al., 2010). There is good evidence that energy expenditure is relevant to reaching (Shadmehr et al., 2016), but no physiologically tested cost function predicts the velocity profiles of reaching as well as the minimum variance hypothesis.
The issue could be that metabolic energy expenditure for muscle is not quantitatively wellunderstood. Energy is expended in proportion to force and time (‘tensiontime integral’) in isometric conditions (Crow and Kushmerick, 1982), and in proportion to mechanical work in steady work conditions (Barclay, 2015; Margaria, 1976), neither of which apply well to reaching. There is, however, a lessappreciated cost for muscles that increases with brief bursts of intermittent or cyclic action. It is due to active calcium transport to activate/deactivate muscle, observed in both isolated muscle preparations (Hogan et al., 1998) and whole organisms (Bergström and Hultman, 1988). It has also been hypothesized quantitatively (Doke and Kuo, 2007), as a cost per contraction roughly proportional to the rate of change of muscle force. Such a cost has indeed been observed in a variety of lower extremity tasks (Dean and Kuo, 2011; Doke et al., 2005; van der Zee and Kuo, 2020). It has a mechanistic and physiological basis, is supported by experimental evidence, and would appear to penalize jerky motions due to their energetic cost. What is not known is whether this energetic cost can explain reaching.
We therefore tested whether there is an energetic basis for reaching movements (Figure 2). We did so by measuring oxygen consumption during steadystate cyclic reaching motions. The expectation was that the proposed forcerate cost would cost metabolic energy in excess of what could be explained by mechanical work. We next applied the empirically derived cost for both forcerate and work to an optimal control model of discrete, pointtopoint reaching, and tested whether it could predict the smooth, bellshaped velocities normally attributed to minimumvariance. If the proposed cost is observed as expected and predicts bellshaped profiles, it could potentially provide a reinterpretation of existing theories based on kinematics alone, and integrate energy expenditure into a general framework for planning reaching movements.
Results
Model optimization resulted in a prediction of the metabolic cost of cyclic reaching movements. With movement amplitude decreasing with movement frequency, metabolic cost was predicted to increase with movement frequency $f$ to the 5/2 power (Figure 3A). This is in proportion to the forcerate cost, also expected to increase with $f}^{5/2$ . We also expected a fixed metabolic cost for mechanical work, because these conditions result in fixed mechanical power across frequencies. The specific movement conditions needed to separate the costs of work and forcerate were as follows: movement amplitude decreasing according to ${f}^{3/2}$ (Figure 3B), joint torque increasing with $f}^{1/2$ (Figure 3C), and hand speed decreasing with ${f}^{1/2}$ (Figure 3D). Thus, even though mechanical power is expected to contribute substantially to metabolic cost, the forcerate cost can be tested for an increasing contribution to overall metabolic cost.
We found that the rate of metabolic energy expenditure increased substantially with movement frequency, even as the rate of mechanical work was nearly constant. We first confirmed that cyclic reaching was performed largely by sinusoidal motions at the shoulder, across all conditions (Figure 4). These were accompanied by approximately sinusoidal torque and power, and fairly consistent EMG profiles. Under such conditions, subjects expended more than triple (a factor of 3.56) the net metabolic power for about twice the frequency (a factor of 2.33), with 5.32 ± 2.73 W at the lowest frequency of 0.58 Hz, compared to 18.95 ± 6.02 W at the highest frequency of 1.36 Hz (Figure 5A). As predicted, metabolic rate increased approximately with ${f}^{5/2}$ (Equation 9; adjusted R^{2} = 0.50; p = 1e8; Figure 4a; Table 1).
Other aspects of the cyclic reaching task were as prescribed and intended (Figure 5B–E; Table 1). Reach amplitudes decreased according to the targets, approximately with ${f}^{3/2}$ (Figure 5B). Shoulder torque amplitude and endpoint speed also changed with respectively ${f}^{1/2}$ (Figure 5C; adjusted R^{2} = 0.52; p = 4e9) ${f}^{1/2}$ (Figure 5D; R^{2} = 0.93; p = 7e29). Consistent with the fixedpower condition, average positive mechanical power did not change significantly with frequency $f$ (Figure 5E; slope = 0.081 ± 0.13 W.s^{–1}; mixedeffects linear model with a fixed effect proportional to ${f}^{1}$ , and individual subject offsets as random effects; p = 0.16). Amplitude of torque rate per time increased more sharply, approximately with ${f}^{5/2}$ (Figure 5E), with coefficient $b$ of 78.93 ± 6.55 CI, 95% confidence interval.
The net metabolic cost was also consistent with the hypothesized sum of separate terms for positive mechanical work and forcerate (Figure 6). This is demonstrated with metabolic power as a function of movement frequency $f$, and as a function of forcerate per time. With positive mechanical work at a fixed rate of about 1.2 W, the metabolic cost of work was expected to be constant at approximately 5 W. The difference between net metabolic rate and the constant work cost yielded the remaining forcerate metabolic power, increasing approximately with ${f}^{5/2}$ (Figure 6A). This same forcerate cost could also be expressed as a linear function of the empirical torque rate per time, with an estimated coefficient of ${c}_{t}$ = 8.5e2 (Figure 6B; see Equation 11); joint torque is treated as proportional to muscle force, assuming constant shoulder moment arm. In terms of proportions, mechanical power accounted for about 94% of the net metabolic cost at 0.58 Hz, and 26% at 1.36 Hz. Correspondingly, forcerate accounted for about 6% and 74% of net metabolic rate at the two respective frequencies.
Muscle EMG amplitudes increased with movement frequency (Figure 7). Deltoid and pectoralis both increased approximately with ${f}^{3/2}$ (pectoralis: R^{2} = 0.65; p = 1.1e6; deltoid: R^{2} = 0.56; p = 1.5e5), as did the cocontraction index (R^{2} = 0.58; p = 0.0009). This was consistent with expectations of muscle activation increasing faster than torque for increasing movement frequencies.
Crossvalidation of metabolic cost during cyclic reaching
Separate crossvalidation trials agreed well with forcerate coefficients. The second group of subjects moved with slightly increasing mechanical power, and slightly higher metabolic cost (Figure 8). But applying the cost coefficient ${c}_{t}$ derived from the primary experiment, the model (Equations 1; 10) was nevertheless able to predict crossvalidation costs reasonably well (R^{2} = 0.42; p = 2.7e6).
Passive elastic energy storage during cyclic reaching
The estimated natural frequency of cyclic arm motions was 2.83 ± 0.56 Hz. This suggests a rotational stiffness about the shoulder joint of about 250 N·m·rad^{–1}, if series elasticity were assumed for shoulder muscles. With passive elastic energy storage, the average positive mechanical power of muscle fascicles would decrease slightly, from about 0.5 W per arm to 0.33 W. Thus, series elasticity would cause active mechanical power to decrease with movement frequency, as energy expenditure increased.
Hilltype model does not predict experimentally observed energy cost
The Hilltype model’s predicted net energy cost increased approximately linearly with movement frequency, from 33 W to 47 W. The model dramatically overpredicted the net metabolic cost for all movements (by up to a factor of 6.2), and metabolic cost rose across frequency by less than half as found experimentally (a factor of 1.42 vs. empirical 3.56). Current musculoskeletal models do not accurately predict the cost of cyclic reaching.
Forceratedependent cost predicts pointtopoint reaching motions and durations
We applied the energy cost from cyclic reaching to predict discrete, pointtopoint reaching (Figure 9) of fixed and free durations. The prediction from trajectory optimization (Equation 11) was for a standard movement of fixed duration and distance (0.65 s and 30 cm, respectively; Harris and Wolpert, 1998), using the energy cost coefficients ${c}_{W}$ and ${c}_{t}$ derived from the primary experiment. This yielded bellshaped velocities (Figure 9) similar to the minimum variance model and to empirical data (Harris and Wolpert, 1998). Also compared were minimum torquerate (Uno et al., 1989), and minimum activation squared using a Hilltype muscle model (Kistemaker et al., 2014). Each objective approximately reproduces the empirical bellshaped profile, with metabolic cost (Equation 1), torqueratesquared, and activationsquared all having correlation coefficients above 0.8 (0.99, 0.98, and 0.82, respectively). The metabolic energy cost including empirically tested work and forcerate terms therefore predicts trajectories similar to other, nonenergetic costs proposed previously, and to human data.
Similar predictions were made for different distances, leaving duration unconstrained (Figure 10). The predicted, optimal durations increased with movement distance, roughly similar to human preferred durations (Reppert et al., 2018). The associated trajectories also retained the bellshaped velocities across all distances. The proposed metabolic energy cost, plus a penalty for long durations, therefore predicts both trajectories and durations roughly similar to human data.
Discussion
We tested whether the metabolic cost of reaching movements is predicted by the hypothesized energetic cost including forcerate. Our experimental data showed a cost increasing with movement frequency as predicted with forcerate, more so than did the mechanical work performed. The same cost model was also crossvalidated with a separate set of reaching movements, and predicts smooth reaching movements, similar to the minimum variance model. We interpret these findings as suggesting the forcerate hypothesis as an energetic basis for reaching movements.
The forcerate hypothesis explains the observed metabolic energy cost increases better than more conventionally recognized costs. For example, the cost of mechanical work alone cannot explain the higher cost at higher movement frequencies, because the rate of work remained fixed (Figure 5). A possible explanation is that the energetic cost per unit of work (${c}_{W}$ in Equation 1) could increase with faster movements, due to the muscle forcevelocity relationship (Barclay, 2015). But the conditions here actually yielded slower hand speeds with higher frequencies (Figure 5D), and thus cannot explain the higher cost. Nor were our results explained by a current musculoskeletal model (Umberger, 2010), which drastically overestimated the overall cost and underestimated the increases with movement frequency. The proposed forcerate hypothesis thus explains these data better than previous quantitative models or relationships.
The forcerate hypothesis was also consistent with three other observations: (1) electromyography, (2) crossvalidation, and (3) pointtopoint reaching. First, muscle EMGs increased more rapidly (approximately with ${f}^{3/2}$ ; Figure 7) with movement frequency than did joint torques (approximately with ${f}^{1/2}$ ; Figure 5C). The proposed mechanism is that brief bursts of activation require greater active calcium transport (and thus greater energy cost), because muscle force production has slower dynamics than muscle activation (van der Zee and Kuo, 2020). Second, we crossvalidated the primary experiment, by applying its cost coefficients (${c}_{t}$ and ${c}_{W}$ , Figure 6) to predict an independent set of conditions. We found good agreement between crossvalidation data and the forcerate prediction (Figure 8). The overall energy cost ($\dot{E}$ from Equation 1) depends on a particular combination of work, force, and movement frequency, yet only has one degree of freedom (${c}_{t}$). Third, the forcerate hypothesis also explains discrete, pointtopoint reaching. The characteristic bellshaped velocity profile is predicted by optimal control, using the cost coefficients derived from cyclic movements (Figure 9). Moreover, movement duration is predicted to increase with distance, approximately similar to human reaches (Reppert et al., 2018). These observations serve as tests of the forcerate hypothesis, independently predicted by a single model.
The forcerate cost is surely not the sole explanation for reaching. The optimal control approach has been used to propose a variety of abstract mathematical objective functions that can predict movement. But there may be multiple objectives that predict similar behavior. As such, careful experimentation (Harris and Wolpert, 1998; Kawato, 1999) was required to disambiguate minimumvariance from competing hypotheses such as minimumjerk and torquechange (Kawato, 1999). Similarly, the present study does not disambiguate forcerate from minimumvariance, since both predict similar pointtopoint movements. In fact, minimumvariance also has some dependency on effort, albeit implicitly, due to the mechanism of signaldependent noise (Harris and Wolpert, 1998). It also explains well the tradeoff between movement speed and endpoint accuracy, where energy expenditure is unlikely to be important. However, the ambiguity also means that both variance and forcerate could potentially contribute to movement. It is quite possible that minimum variance dominates for fast and accurate movements, and energy cost for the trajectory and duration of slower ones, with both contributing to a unified objective for reaching.
Effort objectives have long been considered potential counterparts to the kinematic performance objective. For example, the integrated squared muscle force or activation or torquechange all emphasize effort and arm dynamics as explicit features for reaching (Uno et al., 1989). Effort is also important for selection of feedback control gains (Kuo, 1995; Todorov and Jordan, 2002), adaptation of coordination (Emken et al., 2007), identification of control objectives from data (Vu et al., 2016), and determination of movement duration (Shadmehr et al., 2016). The problem is that these manifestations of effort are abstract constructs with limited physiological basis, justified mainly by their ability to reproduce bellshaped velocities through inverse optimization. However, multiple objectives can reproduce such velocities nonuniquely (Figure 9), making additional and independent tests important for disambiguating them. Accordingly, metabolic energy expenditure is a physiological, independently testable measure of effort.The change in metabolic cost during adaptation (Huang et al., 2012) and the effect of metabolic state on reaching patterns (Taylor and Faisal, 2018) strongly suggest a role for energy in reaching. The present study offers a means to incorporate a truly physiological effort cost into optimal control predictions for smooth and economical movements.
There is a measurable and nontrivial energetic cost for cyclic reaching. Even though the arms were supported by a planar manipulandum, at a movement frequency of 1.5 Hz, we observed a net metabolic rate of about 19 W. For comparison, the difference in cost between continuous standing and sitting is about 24 W (Mansoubi et al., 2015), making the reaching task nearly as costly as standing up. For each halfcycle reaching action, analogous to a pointtopoint movement, the metabolic cost was about 3.5 J per arm. The cost may not be particularly high, but the nervous system may nonetheless prefer economical ways to accomplish a reaching task.
There are several limitations to this study. One is that energetic cost was experimentally measured for the whole body, and not distinguished at the level of the muscle. Forcerate was also estimated from joint torque and not from actual muscle forces. We therefore cannot eliminate other physiological processes as possible contributions to the observed energy cost. In addition, the hypothesized cost ($\dot{E}}_{FR$) is thus far a highly simplified, conceptual model for a muscle activation cost. More precise mechanistic predictions of this cost would be facilitated with specific models for muscle activation, myoplasmic calcium transport, and force delivery are needed (e.g. Baylor and Hollingworth, 1998; Ma and Zahalak, 1991). We also tested the forcerate cost in continuous reaches of fixed work, predominantly by the shoulder, and with the arms supported against gravity. Further studies are needed to test more ecological movements such as discrete reaching in arbitrary directions, and while interacting with objects.
The forcerate hypothesis suggests a substantial role for effort or energy expenditure in upper extremity reaching movements. Some form of effort cost is often employed to examine selection of feedback gains or muscle forces, and even generally expected for optimal control problems where maximaleffort actions are to be avoided (Bryson and Ho, 1975). And in the experimental realm, energy expenditure is regarded as a major factor in animal life and behavior (Alexander, 1996), even to the small scale of a single neural action potential (Sterling and Laughlin, 2017). Under the minimumvariance hypothesis alone, reaching seems unusually dominated by kinematics. But our results suggest that metabolic energy expenditure may have been overshadowed by the minimumvariance hypothesis, because it makes similar predictions for pointtopoint movements. There is need to both quantify and test the forcerate hypothesis more specifically, perhaps in combination with minimumvariance. Nonetheless, there is a meaningful energetic cost to reaching that can also explain the smoothness of reaching motions.
Materials and methods
There were three main components to this study: (1) a simple cost model, (2) a set of human subjects experiments with cyclic reaching, and (3) an application of the model to predict discrete reaching trajectories. The model predicts that metabolic cost should increase with the hypothesized forcerate measure, particularly for faster frequencies of movement. Key to the experiment (Figure 2) was to isolate the hypothesized forcerate cost, by applying combinations of movement amplitude and frequency that control for the cost of mechanical work. This primary test was accompanied by a secondary, crossvalidation test, with different combinations of movement amplitude and frequency. Finally, we applied this same forcerate cost to the prediction of discrete reaching movement trajectories. This was to test whether the energetic cost, derived from continuous, cyclic reaching movements, could also predict the smooth, discrete motions often found in the literature.
Model predictions for forcerate hypothesis
Request a detailed protocolWe hypothesized that the energetic cost for reaching includes a cost for performing mechanical work, and another for the rate of force production. These costs are implemented on a simple, twosegment model of arm dynamics, actuated with joint torques. These torques perform work on the arm, at an approximately proportional energetic cost (Margaria, 1976) attributed to actinmyosin crossbridge action (Barclay, 2015). The forcerate cost is hypothesized to result from rapid activation and deactivation of muscle, increasing with the amount of force and inversely with the time duration. It is attributable to active transport of myoplasmic calcium (Bergström and Hultman, 1988; Hogan et al., 1998), where more calcium is required for higher forces and/or shorter time durations, hence forcerate (Doke and Kuo, 2007).
For the simple motion employed here, the prediction of the total metabolic energy $E$ consumed per movement is the sum of costs for work and forcerate,
where W is the positive mechanical work per movement, ${c}_{W}$ the metabolic cost per unit of work, and ${E}_{FR}$ is the hypothesized forcerate cost
where $\dot{F}$ denotes the amplitude of forcerate (timederivative of muscle force) per movement, and ${c}_{f}$ is the energetic cost for forcerate. This cost is to be distinguished from the earlier torquechange hypothesis (Uno et al., 1989), which integrates a sumsquared forcerate over time, and which had no hypothesized relationship to metabolic energetic cost. During cyclic reaching, the peak forcerate $\dot{F}$ increases with both force amplitude and the frequency of cyclic movement. Here, positive and negative work are performed in equal magnitudes, and so their respective costs are lumped together into a single proportionality ${c}_{W}$ . We assigned ${c}_{W}$ a value of 4.2, from empirical mechanical work efficiencies of 25% for positive work and –120% for negative work (Margaria et al., 1963).
The work and force of the cyclic reaching movements about the shoulder are predicted by a simple model of arm dynamics. In the horizontal plane of a manipulandum supporting the arm,
with shoulder angle $\theta \left(t\right)$ , shoulder torque ${\rm T}\left(t\right)$ (treated as proportional to muscle force), and rotational inertia $I$. Applying sinusoidal motion at amplitude $A$ and movement frequency $f$ (in cycle/s),
The torque is therefore
and amplitude of mechanical power $\dot{W}$
We apply a particular movement condition, termed the fixed power constraint (Figure 2A), where the average positive mechanical power is kept fixed across movement frequencies, so that the hypothesized forcerate cost will dominate energetic cost (Figure 3A). This is achieved by constraining amplitude to decrease with movement frequency (Figure 3B),
This fixed power condition also means that hand (endpoint) speed, proportional to $\dot{\theta}$ , should have amplitude varying with ${f}^{1/2}$ , and torque amplitude with ${f}^{1/2}$ (Figure 3C and D).
Applying fixed power to the forcerate cost yields the energetic cost prediction. Torquerate amplitude $\dot{T}$ with Equation 2 and Equation 7 yields
where $b$ is a constant coefficient. The proportional cost per movement is therefore (Equation 2)
where ${c}_{f}$ is a constant coefficient across conditions. Experimentally, it is most practical to measure metabolic power $\dot{E}$ (Figure 3a) in steady state. Multiplying $E$ (cost per movement, Equation 2) by $f$ (movement cycles per time) yields the predicted proportionality for average metabolic power,
The net metabolic rate $\dot{E}$ is expected to increase similarly, but with an additional offset for the constant work cost $\dot{E}}_{W$ under the fixedpower constraint (Figure 3A). Finally, the metabolic energy per time associated with forcerate would be expected to increase directly with torquerate per time $f\cdot \dot{T}$ ,
where movement frequency $f$ represents cycles per time, and coefficient ${c}_{t}$ is equal to ${c}_{f}$ divided by $b$.
This forcerate coefficient is not specific to cyclic movements alone. The general metabolic cost model (Equations 1; 2) is potentially applicable to pointtopoint and other motions, with different amounts of work and forcerate. The forcerate cost $\dot{E}}_{FR$ is independent of mechanical work, and may be predicted using the cost coefficient derived from cyclic experiments. The model may therefore make testable predictions of energetic cost even for movements that are acyclic and not constrained to fixed power.
Experiments
Request a detailed protocolWe measured the metabolic power expended by healthy adults ($N$ = 10) performing cyclic movements at a range of speeds but fixed power (Equation 7). We tested whether metabolic power would increase with the hypothesized forcerate cost $\dot{E}}_{FR$, in amount not explained by mechanical work. We also characterized the mechanics of the task in terms of kinematics, shoulder torque amplitude, and forcerate for shoulder muscles. These were used to test whether the mechanics were consistent with the model of arm dynamics, and whether forcerate increased as predicted (Equations 7–10). We first describe a primary experiment with fixed power conditions, followed by an additional crossvalidation experiment. All subjects provided written informed consent, as approved by University of Calgary Ethics board.
Subjects performed cyclic bimanual reaching movements in the horizontal plane, with the arms supported by a robotic exoskeleton (KINARM, BKIN Technologies, Inc). The movements were cyclic and bimanually symmetrical to induce steady energy expenditure sufficient to be distinguished easily by expired gas respirometry. The exoskeleton was used to counteract gravity in a lowfriction environment (with no actuator loads), and to measure kinematics, from which shoulder and elbow joint torques were estimated using inverse dynamics. Subjects were asked to move each arm between a pair of targets, reachable mostly by mediolateral shoulder motion, with relatively little elbow motion (less than 1 deg average excursion across all conditions). A single visual cursor (5 mm in diameter) was displayed for the right hand, along with one pair of visual targets (circles 2.5 cm in diameter), all optically projected onto the movement plane. To encourage equal bimanual motion, the cursor’s position was not for one hand alone, but rather computed as an average of right and left arm joint angles, making it insufficient to move one arm alone.
Timing was set with a metronome beat for reaching each of the two targets, and amplitude by adjusting the distance between the targets. Prior to data collection, subjects completed a 20min familiarization session (up to 48 hr before the experiment) where they received task instructions and briefly practiced each of the tasks.
The primary experiment was to test for the predicted energetic cost for reaching, in five conditions of cyclic reaching at increasing frequency and decreasing amplitude. The frequencies were 0.58, 0.78, 0.97, 1.17, 1.36 Hz, and amplitudes were 12.5, 8, 5.8, 4.4, 3.5°, respectively. These cyclic movements were chosen to be of moderate hand speed, with peak speeds between 0.4 and 0.6 m/s.
We estimated metabolic rate using expired gas respirometry. Subjects performed each condition for 6 min, analyzing only the final 3 min of data for steadystate aerobic conditions, with standard equations used to convert O2 and CO2 rates into metabolic power (Brockway, 1987).We report net metabolic rate $\dot{\mathrm{E}}$ for bimanual movement, defined as gross rate minus the cost of quiet sitting (obtained in a separate trial, 98.6 ± 11.5 W, mean ± s.d.).
We also recorded arm segment positions and electromyographs simultaneously at 1000 Hz. These included kinematics from the robot, and electromyographs (EMGs) from four muscles (pectoralis lateral, posterior deltoid, biceps, triceps) in a subset of our subjects (five subjects in primary experiment, five in crossvalidation). The EMGs were used to characterize muscle activation and coactivation.
The metabolic cost hypothesis was tested using a linear mixedeffects model of net metabolic power. This included the hypothesized forcerate cost (Equation 10) as a fixed effect, yielding coefficient ${c}_{f}$ for the forcerate term proportional to ${f}^{5/2}$ . A constant offset was included for each subject as a random effect. In addition, the forcerate cost $\dot{E}}_{FR$ was estimated by subtracting the fixed mechanical work cost $\dot{E}}_{W$ from net metabolic power $\dot{E}$ , and then compared against torque rate amplitude per time (Equation 11). Sample size was appropriate to yield a statistical power of 0.99 based on statistical characteristics of previous reaching studies of metabolic cost (Wong et al., 2018). Both the main experiment and cross validation experiment were performed a single time.
We tested expectations for movement amplitude and other quantities from kinematic data. Hand velocity was filtered using a bidirectional lowpass Butterworth filter (first order, 12 Hz cutoff). Shoulder and elbow torques were computed using inverse dynamics, based on KINARM dynamics (BKIN Technologies, Kingston), and subjectspecific inertial parameters (Winter, 1990). The approximate rotational inertia of a single human arm and exoskeleton about the shoulder was estimated as 0.9 kg⋅m^{2}. The positive portion of bimanual mechanical power was integrated over total movement duration and divided by cycle time, yielding average positive mechanical power. Linear mixedeffects models were used to characterize the powerlaw relations for mechanical power, movement amplitude, movement speed, torque amplitude, and torque rate amplitude (Figure 3). The latter was estimated by integrating the torque rate amplitude per time (Equation 11) for each joint, and then summing the two. The forcerate hypothesis was also tested by comparing $\dot{E}}_{FR$ with torque rate per time (Figure 3A), assuming torque is proportional to muscle force.
Electromyographs were used to test for changes in muscle activation and coactivation. Data were meancentred, lowpass filtered (bidirectional, second order, 30 Hz cutoff), rectified, and lowpass filtered again (Roberts and Gabaldón, 2008), from which the EMG amplitude was measured at peak and then normalized to each subject’s maximum EMG across the five conditions. We expected EMG amplitude to increase with muscle activation, with simplified firstorder dynamics between activation (EMG) and muscle force production (van der Zee and Kuo, 2020). This treats the ratelimiting step of force production as a lowpass filter, so that greater activation or EMG amplitudes would be needed to produce a given force at higher waveform frequencies. The firstorder dynamics mean that EMG would be expected to increase with torque rate ${f}^{3/2}$ rather than torque, as tested with a linear mixedeffects model. We also computed a cocontraction index for EMG, in which the smallest value of antagonist muscle pairs was computed over time, and then integrated for comparison across conditions (Gribble et al., 2003). All statistical tests were performed with threshold for significance of p < 0.05.
As a crossvalidation test of the forcerate cost, we tested the generalizability of coefficient ${c}_{t}$ against a second set of conditions with a separate set of subjects (also $N$ = 10; two subjects participated in both sets). The conditions were slightly different: frequencies ranging 0.67–1.3 Hz and amplitudes 12.5–4.42°, which resulted in higher mechanical work and forcerate. We applied the model (Equation 1, Equation 11) and ${c}_{t}$ coefficient identified from the primary experiment to the crossvalidation conditions. As a further test of the central hypothesis, we expected the model to roughly predict trends regarding mechanical and metabolic rates for the crossvalidation conditions.
Estimation of elastic energy storage in shoulder muscles
Request a detailed protocolWe estimated the resonant frequency of cyclic reaching, to account for possible series elasticity in shoulder actuation. Series elasticity could potentially store and return energy and thus require less mechanical work from muscle fascicles. We estimated this contribution from resonant frequency, obtained by asking subjects to swing their arms back and forth rapidly at large amplitudes (at least 15°) for 20 s, and determining the frequency of peak power (PWelch in Matlab). We then used this to estimate torsional series elasticity, and the passive contribution to mechanical power.
Musculoskeletal model to simulate experimental conditions
Request a detailed protocolWe tested whether a Hilltype musculoskeletal model could explain the metabolic cost of cyclic reaching. The hypothesized forcerate is not explicitly included in current models of energy expenditure, and would not be expected to explain the experimental metabolic cost. We therefore tested an energetics model available in the OpenSim modeling system (Seth et al., 2018; Uchida et al., 2016; Umberger, 2010), applied to a model of arm dynamics with six muscles (Kistemaker et al., 2014). We used trajectory optimization to determine muscle states and stimulations, with torques from inverse dynamics as a tracking reference. Optimization was performed using TOMLAB/SNOPT (Tomlab Software AB, Sweden; Gill et al., 2002), to minimize meansquared torque error, squared stimulation level, and squared stimulation rate. The optimized muscle states were then fed into the metabolic cost model (Umberger, 2010).
Model of pointtopoint reaching movements
Request a detailed protocolThe forcerate cost hypothesis was also used to predict pointtopoint reaching movements and their durations. Here, we form an overall objective function $J$ that includes the energetic cost per movement $E$ (Equation 1) as a physiological effort term, and a simple penalty proportional to movement duration ${t}_{f}$ . This may be regarded as an adaptation of Shamehr et al.’s (2016) hypothesis that duration is a tradeoff between effort and (the inverse of) a temporally discounted reward. The overall objective is thus:
where the energy expenditure is expressed a function of joint angle $\theta \left(t\right)$ and torque $\tau \left(t\right)$ trajectories, and duration is penalized with proportionality $k$. Minimization of this objective can predict pointtopoint reaching trajectories both of fixed duration (by constraining ${t}_{f}$) and of free duration. We show that this objective predicts smooth, bellshaped velocity profiles similar to minimumvariance, as well as durations increasing with movement distance.
We used this objective in trajectory optimization of planar, twojoint reaching movements. For fixed duration ${t}_{f}$ , the objective $J$ depends only on energetic cost $E$, with the mechanical work and forcerate terms expressed as a time integral for both joints:
with joint torques ${\tau}_{i}$ ($i=\mathrm{1,2}$ for elbow and shoulder, respectively). To compare with the minimum variance model of Harris and Wolpert, 1998, we used a similar straight reaching movement of amplitude 30 cm and duration ${t}_{f}$ of 650 ms. We also used the empirically estimated ${c}_{t}$ from the cyclic reaching experiment (assuming the same coefficient for both shoulder and elbow), along with a pointtopoint constraint to have zero initial and final acceleration of the hand, again using TOMLAB. The predicted hand velocity trajectory was qualitatively compared with the empirical bellshaped velocity from minimum variance (Harris and Wolpert, 1998).
We also examined movements of unconstrained duration, which have been shown to take longer with greater movement distance (Reppert et al., 2018). We selected $k$ so that the average movement speed was approximately equal to the average preferred movement duration across the empirically measured reach speeds ($k$ = 25 J/s). We qualitatively compared the trajectories and durations from model against data for movements ranging 8–40 cm (Reppert et al., 2018).
Data availability
Data has been deposited to Dryad Digital Repository, accessible here: doi:http://doi.org/10.5061/dryad.qfttdz0gn.

Dryad Digital RepositoryThe energetic basis for smooth human arm movements.https://doi.org/10.5061/dryad.qfttdz0gn
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Decision letter

Alaa AhmedReviewing Editor; University of Colorado, United States

Richard B IvrySenior Editor; University of California, Berkeley, United States

Mazen Al BornoReviewer; Stanford University, United States
Our editorial process produces two outputs: (i) public reviews designed to be posted alongside the preprint for the benefit of readers; (ii) feedback on the manuscript for the authors, including requests for revisions, shown below. We also include an acceptance summary that explains what the editors found interesting or important about the work.
Decision letter after peer review:
Thank you for submitting your article "The energetic basis for smooth human arm movements" for consideration by eLife. Your article has been reviewed by 2 peer reviewers, one of whom is a member of our Board of Reviewing Editors, and the evaluation has been overseen by Richard Ivry as the Senior Editor. The following individual involved in review of your submission has agreed to reveal their identity: Mazen Al Borno (Reviewer #2).
The reviewers have discussed their reviews with one another, and the Reviewing Editor has drafted this to help you prepare a revised submission.
Essential revisions:
1) The authors claim to present a theory of movement control that unifies smoothness and duration. They currently only show that their metabolic cost model can explain smoothness. However, their metabolic cost model on its own cannot explain the speedaccuracy tradeoff and minimum variance on its own cannot explain duration. Thus to support a unifying theory, they need to show that their metabolic cost model and minimum variance combined can explain all three movement properties: smoothness, the speedaccuracy tradeoff and duration. They also need to show that this new unifying model performs better than models using a combination of minimum variance and other effort models (such as mech work, hill muscle models, and torquechange). Alternatively, instead of this additional analysis, the authors could temper their claims of a unifying theory and instead focus on their result that smoothness can also be explained by energy minimization. Although a weaker finding, this is also a an important contribution to the field.
2) A comparison of the predicted velocity profiles by their metabolic model and the predictions of models based on squared muscle activations, torque rate, and Hilltype muscle model is needed.
3) To support their claim that energy explains duration, the authors should demonstrate the ability of their metabolic model to explain movement duration, and compare its predictions to the predictions of other effort models (mechanical work, squared muscle activations, torque rate, Hilltype muscle models). This analysis should also include whether their metabolic model predicts a nonzero metabolically optimal movement duration and if so, how the metabolically optimal duration scales with movement distance.
Reviewer #1 (Recommendations for the authors):
1. For the predictions of the bellshaped velocity profile, it is not clear how the effort cost was represented in the cost function. Equation (1) represents the effort cost per movement, and even Equation (9) seems to represent the average energy per time associated with forcerate, since it is a function of the frequency of the contraction and the amplitude of the torque rate of the contraction. Thus, there is no expression for effort cost as a function of instantaneous time (i.e. similar to effort models based on torque rate squared or force squared or activation squared), rather it is calculated based on the total mechanical work and the frequency (or duration) of the movement. It would help to have the authors clarify how effort was represented in their optimization approach.
2. Additional figures should be provided plotting individual and average subject trajectory data and emg data across the different conditions. A figure of the experimental setup and visual feedback should also be provided. It is unclear how a single cursor was used to show the average joint angles.
3. As written, it seems that Equations 7 and 9 are dependent upon the fixed power assumption. This would mean that the fitted coefficient in Equation 9 as a whole could only apply when comparing conditions with identical power. Specifically, Equation (2) states the hypothesis that the forcerate per contraction increases proportionally with the amplitude of force rate (or amplitude of torque rate). For the model in Equation (3) and the sinusoidal motion shown, the amplitude of torque rate increases with Af3 (the product of the amplitude of the motion A, and the frequency, f, cubed). In the fixed power condition, the amplitude of the motion is a function of the frequency, so torque rate increases proportionally with bf3/2, where b is a fitted coefficient. Thus, Equation 7 (and Equation 9) which related amplitude of torque rate to cost per contraction, and cost per contraction per unit time, appear specific to the fixed power constraint. The authors should more clearly explain how this derivation, and the fitted coefficient, can generalize to nonfixed power conditions. I assume that any differences in mechanical power are absorbed in the first term in Equation (1), thus the coefficient would generalize, but this should be clarified.
4. Related to the point above, more effort should be made to explain these frequencybased experiments and findings to a single movement with varying distance and duration.
5. The authors should also plot metabolic cost vs movement duration for the different distances, as this is more of a standard form. This would allow for an easier understanding of the data in the context of a single reach.
6. Related to the point above, the authors do not address how their metabolic model predictions compare to published data on the metabolic cost of a single reach as a function of distance and duration. It would strengthen the impact of their findings to demonstrate whether the current dataset exhibits similar relationships between metabolic cost, movement duration and distance.
7. The authors seem to be underselling the crossvalidation. If we understand correctly, the coefficient fitted in one experiment with one group of subjects, was able to explain data in a different experiment with different subjects with different frequencies and amplitudes, and the conditions had different power requirements. This is a lovely finding and should be highlighted more strongly. To help highlight the strengths of the crossvalidation, there should be a more detailed explanation of the purpose of the crossvalidation: to check whether the coefficient generalizes to different subjects as well as different frequencies/amplitudes/mech.power conditions.
8. A more quantitative comparison is needed (in addition to the figure presented in figure 8), when comparing the metabolic model velocity profile predictions to empirical data and the minimum variance predictions.
9. Why was the experiment a bilateral movement? Did the authors divide the measured power by 2? I couldn't find mention of this in the methods.
10. It seems that the elbow is externally fixed during the movement. Otherwise the subjects would need to stabilize the elbow and the model used of a single joint/rigid body would be inappropriate. However this is not clear from the text. Please confirm.
11. Sometimes the authors refer to 'energy cost per contraction' and sometimes 'energy cost per movement'. Please clarify the distinction, if any.
Reviewer #2 (Recommendations for the authors):
The paper states that minimizing squared muscle activations does not predict smooth movements. My understanding is that optimal feedback theory does predict smooth movements (Todorov 2002; Al Borno 2020). For instance, in your model, if you included only the squared muscle activations term (or just used the Hilltype model), would you obtain a nonsmooth bellshaped velocity profile?
As pointed out in the paper, in minimumvariance theory, an effort term is implicitly there. This could indicate that minimumvariance theory is sufficient to explain all the data (in addition to the speedaccuracy tradeoff, which this work does not address). If this is incorrect, it would be useful for the authors to point out where minimumvariance theory falls short. For instance, recent work by Nagamori et al., 2021 questions the main assumption behind the theory.
https://doi.org/10.7554/eLife.68013.sa1Author response
Essential revisions:
1) The authors claim to present a theory of movement control that unifies smoothness and duration. They currently only show that their metabolic cost model can explain smoothness. However, their metabolic cost model on its own cannot explain the speedaccuracy tradeoff and minimum variance on its own cannot explain duration. Thus to support a unifying theory, they need to show that their metabolic cost model and minimum variance combined can explain all three movement properties: smoothness, the speedaccuracy tradeoff and duration. They also need to show that this new unifying model performs better than models using a combination of minimum variance and other effort models (such as mech work, hill muscle models, and torquechange). Alternatively, instead of this additional analysis, the authors could temper their claims of a unifying theory and instead focus on their result that smoothness can also be explained by energy minimization. Although a weaker finding, this is also a an important contribution to the field.
We were unclear about the unified objective, and have amended the discussion to make it clearer that energy economy is not treated as the sole objective for reaching movements. For example:
“…both variance and forcerate could potentially contribute to movement. It is quite possible that minimum variance dominates for fast and accurate movements, and energy cost for the trajectory and duration of slower ones, with both contributing to a unified objective for reaching.”
We have also added more explanation for how economy can predict duration (Figure 10), and have added discussion about how “metabolic energy expenditure is a physiological, independently testable measure of effort” (in contrast to more abstract objectives such as minimum activation or torque change).
2) A comparison of the predicted velocity profiles by their metabolic model and the predictions of models based on squared muscle activations, torque rate, and Hilltype muscle model is needed.
As suggested, we have included these predictions in an updated figure (now Figure 9). We also expanded discussion regarding them: “…multiple objectives can reproduce such velocities nonuniquely, making additional tests important for disambiguating them. The advantage of metabolic energy expenditure is that it is a physiological, independently testable measure of effort.
3) To support their claim that energy explains duration, the authors should demonstrate the ability of their metabolic model to explain movement duration, and compare its predictions to the predictions of other effort models (mechanical work, squared muscle activations, torque rate, Hilltype muscle models). This analysis should also include whether their metabolic model predicts a nonzero metabolically optimal movement duration and if so, how the metabolically optimal duration scales with movement distance.
We have added simulations using forcerate cost to predict preferred movement duration as a function of distance (new Figure 10), along with comparison to recent experimental literature (Reppert et al., 2018). The figure shows how predicted duration is nonzero and increases with distance. We did not test the other objectives, because to our knowledge they have not been proposed to predict duration.
Reviewer #1 (Recommendations for the authors):
1. For the predictions of the bellshaped velocity profile, it is not clear how the effort cost was represented in the cost function. Equation (1) represents the effort cost per movement, and even Equation (9) seems to represent the average energy per time associated with forcerate, since it is a function of the frequency of the contraction and the amplitude of the torque rate of the contraction. Thus, there is no expression for effort cost as a function of instantaneous time (i.e. similar to effort models based on torque rate squared or force squared or activation squared), rather it is calculated based on the total mechanical work and the frequency (or duration) of the movement. It would help to have the authors clarify how effort was represented in their optimization approach.
We agree, and have added the explicit energy equation that is minimized during the fixedtime optimization, on page 16.
2. Additional figures should be provided plotting individual and average subject trajectory data and emg data across the different conditions. A figure of the experimental setup and visual feedback should also be provided. It is unclear how a single cursor was used to show the average joint angles.
We have added text to explain the motion of the cursor located in the methods section Page 13. We neglected to note clearly that the second panel includes individual subject data, and we have amended the caption appropriately. Finally, we have added an additional figure (new figure 4) of average reaches.
3. As written, it seems that Equations 7 and 9 are dependent upon the fixed power assumption. This would mean that the fitted coefficient in Equation 9 as a whole could only apply when comparing conditions with identical power. Specifically, Equation (2) states the hypothesis that the forcerate per contraction increases proportionally with the amplitude of force rate (or amplitude of torque rate). For the model in Equation (3) and the sinusoidal motion shown, the amplitude of torque rate increases with Af3 (the product of the amplitude of the motion A, and the frequency, f, cubed). In the fixed power condition, the amplitude of the motion is a function of the frequency, so torque rate increases proportionally with bf3/2, where b is a fitted coefficient. Thus, Equation 7 (and Equation 9) which related amplitude of torque rate to cost per contraction, and cost per contraction per unit time, appear specific to the fixed power constraint. The authors should more clearly explain how this derivation, and the fitted coefficient, can generalize to nonfixed power conditions. I assume that any differences in mechanical power are absorbed in the first term in Equation (1), thus the coefficient would generalize, but this should be clarified.
We have added specific equations to show how Equation (2) applies to pointtopoint movements (new Equations 10 and 11), along with clarification how the coefficient to forcerate is independent of the fixed power constraint (new subsection Model of pointtopoint reaching). In Methods:
“This forcerate coefficient is not specific to cyclic movements alone… The model may therefore make testable predictions of energetic cost even for movements that are acyclic and not constrained to fixed power.”
4. Related to the point above, more effort should be made to explain these frequencybased experiments and findings to a single movement with varying distance and duration.
The new subsection Model of pointtopoint reaching (page 16) provides greater detail on single movements. Briefly, we applied the coefficient found from cyclic movements to predict discrete movements, which use a statedependent form of the objective, plus different boundary constraints at movement start and end.
5. The authors should also plot metabolic cost vs movement duration for the different distances, as this is more of a standard form. This would allow for an easier understanding of the data in the context of a single reach.
We have added a second axis to our (new Figure 5)A to include movement amplitude.
6. Related to the point above, the authors do not address how their metabolic model predictions compare to published data on the metabolic cost of a single reach as a function of distance and duration. It would strengthen the impact of their findings to demonstrate whether the current dataset exhibits similar relationships between metabolic cost, movement duration and distance.
The new pointtopoint subsection adds detail about duration. We have included predictions of increasing movement time with distance (new Figure 10), which reuses the forcerate coefficient found in experiment.
7. The authors seem to be underselling the crossvalidation. If we understand correctly, the coefficient fitted in one experiment with one group of subjects, was able to explain data in a different experiment with different subjects with different frequencies and amplitudes, and the conditions had different power requirements. This is a lovely finding and should be highlighted more strongly. To help highlight the strengths of the crossvalidation, there should be a more detailed explanation of the purpose of the crossvalidation: to check whether the coefficient generalizes to different subjects as well as different frequencies/amplitudes/mech.power conditions.
Yes, that understanding is correct. We have modified the Methods topic sentence:
“As a crossvalidation test of the forcerate cost, we tested the generalizability of coefficient ;;_{!} against a second set of conditions with a separate set of subjects”.
Later in same paragraph:
“we expected the model to roughly predict trends regarding mechanical and metabolic rates for the crossvalidation conditions.”
8. A more quantitative comparison is needed (in addition to the figure presented in figure 8), when comparing the metabolic model velocity profile predictions to empirical data and the minimum variance predictions.
We have added a quantitative comparison of the different models to capture bellshapes, page 14. We report correlation coefficients for the models. Even though our model yielded the highest correlation (0.99), we state in Discussion:
“However, multiple objectives can reproduce such [bellshaped] velocities nonuniquely (page 10)… metabolic energy expenditure is a physiological, independently testable measure of effort.”
9. Why was the experiment a bilateral movement? Did the authors divide the measured power by 2? I couldn't find mention of this in the methods.
In Methods, we have added:
“The movements were cyclic and bimanually symmetrical to induce steady energy expenditure sufficient to be distinguished easily by expired gas respirometry.”
Also in Methods:
“We report net metabolic rate ;;; for bimanual movement…” We did not divide by 2, except in Discussion, where we have added “And per reaching movement, the metabolic cost (at two movements per cycle) was about 3.5 J per arm.”
10. It seems that the elbow is externally fixed during the movement. Otherwise the subjects would need to stabilize the elbow and the model used of a single joint/rigid body would be inappropriate. However this is not clear from the text. Please confirm.
We have amended the text to clarify that both shoulder and elbow torques were computed from inverse dynamics, and the same forcerate coefficient identified for both. That same coefficient was then used to predict pointtopoint movements.
11. Sometimes the authors refer to 'energy cost per contraction' and sometimes 'energy cost per movement'. Please clarify the distinction, if any.
We have simplified to “cost per movement,” and in Discussion consider the cost for each halfcycle movement.
Reviewer #2 (Recommendations for the authors):
The paper states that minimizing squared muscle activations does not predict smooth movements. My understanding is that optimal feedback theory does predict smooth movements (Todorov 2002; Al Borno 2020). For instance, in your model, if you included only the squared muscle activations term (or just used the Hilltype model), would you obtain a nonsmooth bellshaped velocity profile?
We added now Figure 9 includes a comparison to hillmodel activationsquared and other objectives. We agree that some specific models can produce bellshaped velocities, and have amended the text accordingly. We also note:
“However, multiple objectives can reproduce such [bellshaped] velocities nonuniquely (page 10)…Accordingly metabolic energy expenditure is a physiological, independently testable measure of effort.”
As pointed out in the paper, in minimumvariance theory, an effort term is implicitly there. This could indicate that minimumvariance theory is sufficient to explain all the data (in addition to the speedaccuracy tradeoff, which this work does not address). If this is incorrect, it would be useful for the authors to point out where minimumvariance theory falls short. For instance, recent work by Nagamori et al., 2021 questions the main assumption behind the theory.
We did not intend to dismiss the minimumvariance theory, and have amended the text to be clearer. In Discussion:
“However, the ambiguity also means that both variance and forcerate could potentially contribute to movement. It is quite possible that minimum variance dominates for fast and accurate movements, and energy cost for the trajectory and duration of slower ones, with both contributing to a unified objective for reaching.”
We agree with the reviewer that minimumvariance remains a viable theory, but it does not explain the metabolic cost predicted and measured here.
https://doi.org/10.7554/eLife.68013.sa2Article and author information
Author details
Funding
University of Calgary (Benno Nigg Chair)
 Arthur D Kuo
Natural Sciences and Engineering Research Council of Canada
 Arthur D Kuo
Alberta Health Services
 Arthur D Kuo
Natural Sciences and Engineering Research Council of Canada
 Tyler Cluff
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Acknowledgements
This work was funded by NSERC (Discovery and CRC Tier 1), Dr. Benno Nigg Research Chair, and Alberta Health Trust. We acknowledge Dinant Kistemaker for sharing simulation code for Hilltype muscle model energetics.
Ethics
Human subjects: Informed consent was obtained from all subjects and the Health Research Ethics Board approved of all procedures (REB181521).
Senior Editor
 Richard B Ivry, University of California, Berkeley, United States
Reviewing Editor
 Alaa Ahmed, University of Colorado, United States
Reviewer
 Mazen Al Borno, Stanford University, United States
Publication history
 Preprint posted: December 29, 2020 (view preprint)
 Received: March 3, 2021
 Accepted: December 15, 2021
 Accepted Manuscript published: December 20, 2021 (version 1)
 Version of Record published: January 7, 2022 (version 2)
 Version of Record updated: January 27, 2022 (version 3)
 Version of Record updated: February 3, 2022 (version 4)
Copyright
© 2021, Wong et al.
This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.
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