Assessment of in vivo tendon tissue behavior in a pediatric population

项目摘要/摘要 儿童时期的生长发育涉及到体内许多组织的重大变化，包括 肌肉骨骼系统中的结缔组织，如肌腱和韧带。而这些软组织 需要改变，以适应从早期的解剖学和生物力学的重大变化 从儿童期到青春期后期，它们会使临床干预变得复杂，例如 神经肌肉疾病或骨科损伤。在脑瘫(CP)的情况下，一种常见的神经肌肉 疾病通常导致姿势和步态的改变，临床治疗如截骨术、肌腱 延长程序和肌腱转移术的设计必须适应持续的生长相关 组织几何形状和硬度的变化。虽然目前有评估几何变化的方法 组织在生长过程中，我们缺乏一种非侵入性的方法来直接测量个体肌腱的硬度， 比如在这些儿科人群中。因此，该项目的目标有两个：开发和 在实验室中验证一种新的非侵入性工具和计算模型来测量肌腱硬度，并 使用这种非侵入性工具来表征儿科队列中肌腱僵硬与年龄相关的变化。 具体地说，本提案的目标1描述了先前在 本实验室对局部肌腱僵硬进行无创性评估。这个工具将结合电影超声波 测量局部组织应变和测量横波在肌腱中的传播， 它可以用来确定拉伸组织应力。此测试中的参数将用于驱动和 验证个性化肌腱生物力学的有限元模型。然后，在目标2中，非侵入性技术 例如目标1中描述的那些将被应用于测量跟腱僵硬的变化 儿童和青少年受试者。这些目标的成功完成将导致一部小说的验证， 无创性测量年轻受试者体内肌腱硬度的方法，将有助于增强 儿童期和青春期肌腱僵硬的年龄和性别特异性变化时间的理解 成长。这些结果有可能改善儿科临床操作的预测。 患有CP等肌肉骨骼疾病和骨科外科重建的人群 韧带和肌腱断裂等损伤。此外，所描述的技术和专业发展 在这个培训计划中，PI将为成功的职业生涯做准备，在表演的同时教育STEM学生 生物力学领域的研究及其在儿科临床人群中的应用。

Project Summary/Abstract Childhood growth and development involves significant changes to many tissues in the body, including connective soft tissues in the musculoskeletal system, such as tendons and ligaments. While these soft tissue changes are needed to adapt to major changes in anatomy and biomechanics during the transition from early childhood to late adolescence, they can complicate clinical interventions in the case of pathologies such as neuromuscular disorders or orthopedic injuries. In the instance of cerebral palsy (CP), a common neuromuscular disorder often resulting in altered posture and gait, clinical treatments such as osteotomies, muscle-tendon lengthening procedures, and tendon-transfers must be designed to accommodate ongoing growth-related changes in tissue geometry and stiffness. While there are current methods for assessing geometric changes in tissues during growth, we lack a non-invasive means of directly measuring the stiffness of tendons in individuals, such as those in these pediatric populations. As such, the objective of this project is two-fold: to develop and validate a novel, non-invasive tool and a computational model for measuring tendon stiffness in the lab, and to use this non-invasive tool to characterize age-related changes in tendon stiffness in a pediatric cohort. Specifically, Aim 1 of this proposal describes the combined use of two unique methods previously developed in this laboratory to non-invasively assess regional tendon stiffness. This tool will combine a cine ultrasonic measurement of regional tissue strain and the measurement of shear wave propagation through the tendon, which can be used to determine tensile tissue stress. Parameters from this testing will be used to drive and validate a finite element model of individualized tendon biomechanics. Then, in Aim 2, non-invasive techniques such as those described in Aim 1 will be applied to measure changes in the stiffness of the Achilles tendon in pediatric and adolescent subjects. Successful completion of these aims will result in the validation of a novel, non-invasive method for measuring in vivo tendon stiffness in young subjects, and will contribute to an enhanced understanding of the timing of age- and sex-specific changes in tendon stiffness during childhood and adolescent growth. These outcomes have the potential to improve predictions from clinical procedures in pediatric populations suffering from musculoskeletal disorders such as CP and surgical reconstructions for orthopedic injuries such as ligament and tendon ruptures. In addition, the technical and professional development described in this training plan will prepare the PI for a successful career in educating STEM students while performing research in the field of biomechanics with applications in pediatric clinical populations.