Neuromuscular control arises from a closed-loop process in which descending neural commands shape muscle activity, while peripheral sensory feedback continuously updates central motor control. Corticomuscular coupling (CMC) has provided a valuable window into brain-muscle synchronization, but conventional pairwise and time-averaged analyses capture only a limited subset of this distributed and time-varying system, thereby oversimplifying complex neuromuscular control and limiting the characterization of dynamic movements. In this Perspective, we introduce neuromuscular conjugation as a broader conceptual and analytical framework that integrates three complementary dimensions: temporal dynamics, spatially distributed neuromuscular interactions, and frequency-domain interactions. We further identify two priorities for advancing this framework: extending neuromuscular conjugation research toward deeper neural structures, and AI-enabled integration of temporal, spatial, and frequency information. By revealing when, where, and in which frequency bands neuromuscular control is disrupted, this framework may support mechanism-guided assessment, targeted neuromodulation, and more reliable motor-intention decoding for exoskeletons and other assistive technologies. We also outline current methodological challenges and research priorities for interdisciplinary development. Neuromuscular conjugation may offer a systems-level extension of CMC for next-generation neurorehabilitation technologies.
Spinal cord injury (SCI) patients face a high risk of deep tissue injury (DTI), and while epidemiological data indicate sex differences in DTI incidence, the biomechanical role of pelvic sexual dimorphism remains unclear. This study investigates how sex-specific pelvic geometry affects deep tissue mechanics using parametric finite element (FE) modeling. Sex-specific parametric FE models were developed in which two geometric parameters were modulated: ischial tuberosity (IT) width (inter-IT horizontal distance) and IT height (vertical distance to the acetabulum). Thirty-two model variants (16 per sex) were generated using 2-mm increments while maintaining a constant soft-tissue configuration, and mechanical sensitivity was evaluated using von Mises, maximum principal compressive, and shear stresses. The results indicated that von Mises stress generally increased with IT height, with increases of 44.0–49.1% in male models and 35.0–50.2% in female models between the lowest and highest tested heights. At a fixed male IT width of 112.14 mm, increasing height from 48.65 to 54.65 mm increased von Mises and compressive stresses by 45.3% and 8.6%, respectively; the compressive response was not monotonic. Increasing male width from 110.14 to 114.14 mm increased von Mises stress by 3.0–8.4%, with a decrease at 116.14 mm. Female width responses varied with height and the response metric. This study quantifies the sex-specific biomechanical effects of pelvic geometry, indicating that the mechanical response depends on the geometric parameter and the metric considered. These findings may inform further investigation of anatomical factors relevant to DTI risk.
