Assessment of in vivo tendon tissue behavior in a pediatric population

项目总结/摘要 儿童的生长和发育涉及身体许多组织的重大变化，包括 肌肉骨骼系统中的结缔软组织，如肌腱和韧带。而这些软组织 需要改变以适应从早期过渡到晚期的解剖学和生物力学的重大变化。 儿童期至青春期后期，它们可能使病理情况下的临床干预复杂化， 神经肌肉疾病或矫形损伤。在脑瘫（CP）的情况下，常见的神经肌肉 通常导致姿势和步态改变的疾病，临床治疗，如截骨术，肌肉肌腱 延长程序和肌腱转移必须设计为适应持续的增长相关的 组织几何形状和硬度的变化。虽然目前有一些方法可以评估 组织在生长过程中，我们缺乏直接测量个体肌腱硬度的非侵入性方法， 例如这些儿科人群。因此，该项目的目标有两个方面： 验证一种新颖的非侵入性工具和计算模型，用于在实验室中测量肌腱刚度， 使用这种非侵入性工具来表征儿科队列中与年龄相关的肌腱硬度变化。 具体而言，该提案的目标1描述了先前开发的两种独特方法的组合使用， 该实验室用于非侵入性地评估局部肌腱刚度。该工具将联合收割机与电影超声波 区域组织应变的测量和通过肌腱的剪切波传播的测量， 其可用于确定拉伸组织应力。该测试的参数将用于驱动和 验证个体化肌腱生物力学的有限元模型。然后，在目标2中， 例如目标1中描述的那些将被应用于测量跟腱的刚度的变化， 儿童和青少年受试者。成功地完成这些目标将导致一个新的验证， 非侵入性方法测量体内肌腱刚度在年轻的科目，并将有助于增强 了解儿童和青少年时期肌腱僵硬的年龄和性别特异性变化的时间 增长这些结果有可能改善儿科临床程序的预测， 患有肌肉骨骼疾病（如CP）和骨科手术重建的人群 韧带和肌腱断裂等损伤。此外，所述技术和专业发展 在这个培训计划将准备PI为成功的职业生涯在教育干学生，同时执行 生物力学领域的研究与儿科临床人群的应用。

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.