A Systematic Review of Continuum Modeling of Skeletal Muscles: Current Trends, Limitations, and Recommendations.

Finite elasticity theory has been commonly used to model skeletal muscle. A very large range of heterogeneous constitutive laws has been proposed. In this review, the most widely used continuum models of skeletal muscles were synthetized and discussed. Trends and limitations of these laws were highlighted to propose new recommendations for future researches. A systematic review process was performed using two reliable search engines as PubMed and ScienceDirect. 40 representative studies (13 passive muscle materials and 27 active muscle materials) were included into this review. Note that exclusion criteria include tendon models, analytical models, 1D geometrical models, supplement papers, and indexed conference papers. Trends of current skeletal muscle modeling relate to 3D accurate muscle representation, parameter identification in passive muscle modeling, and the integration of coupled biophysical phenomena. Parameter identification for active materials, assumed fiber distribution, data assumption, and model validation are current drawbacks. New recommendations deal with the incorporation of multimodal data derived from medical imaging, the integration of more biophysical phenomena, and model reproducibility. Accounting for data uncertainty in skeletal muscle modeling will be also a challenging issue. This review provides, for the first time, a holistic view of current continuum models of skeletal muscles to identify potential gaps of current models according to the physiology of skeletal muscle. This opens new avenues for improving skeletal muscle modeling in the framework of in silico medicine.