Advancements in Understanding Spasticity: A Neuromusculoskeletal Modeling Perspective.

Spasticity, a complex consequence of upper motor neuron lesions, poses challenges for clinical assessment due to its neural and mechanical origins. Traditional scales like the Modified Ashworth and Tardieu Scales provide subjective, context-limited insights, often missing spasticity's dynamic nature. Neuromusculoskeletal (NMS) modeling offers objective, quantitative insights by integrating patient-specific muscle-tendon properties, reflex dynamics, and multi-joint biomechanics. This scoping review examines advancements in spasticity modeling, comparing mechanical, neurological, and integrated approaches, and their applications in conditions like cerebral palsy and stroke. We highlight barriers to clinical translation, including computational demands and regulatory challenges, and propose future directions, such as real-time simulation and machine learning integration, to enhance personalized assessment and treatment.