Subacromial space reductions in rotator cuff disease: Effects on soft tissue

肩袖疾病的肩峰下间隙缩小：对软组织的影响

• 批准号: 7313830
• 负责人: PAULA Marie LUDEWIG
• 金额: $ 7万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-26 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7313830
• 关键词: Address; Affect; Anatomy; Blinded; Cadaver; Clinical; Complex; Condition; Data; Data Set; Dimensions; Disease; Dissection; Effectiveness; Elevation; Exposure to; Foundations; Functional disorder; Goals; Healed; Image; Link; Localized; Location; MRI Scans; Measurable; Measurement; Measures; Methods; Modeling; Motion; Movement Disorders; Numbers; Occupational Exposure; Operative Surgical Procedures; Orthopedic Surgery procedures; Pain; Pathology; Persons; Population; Prevalence; Public Health; Randomized Controlled Clinical Trials; Rate; Rehabilitation therapy; Relative (related person); Risk; Rotator Cuff; Scanning; Schedule; Shoulder; Shoulder Pain; Spinal cord injury; Stroke; Structure; Surgeon; Techniques; Tendon structure; Testing; Three-Dimensional Image; Three-Dimensional Imaging; Tissues; Upper Extremity; Upper arm; Validation; Work; X-Ray Computed Tomography; base; bone; bone imaging; clinical application; cost effective; design; disability; healing; image processing; improved; kinematics; novel; rehabilitation strategy; soft tissue

DESCRIPTION (provided by applicant): The PIs' long-term objective is to develop and test the effectiveness of biomechanically-based rehabilitation strategies for improving upper extremity function and reducing pain and disability in persons with shoulder pathologies. Rotator cuff pathologies have up to 50% prevalence rates across several populations including persons with spinal cord injury, stroke, occupational exposure to repetitive overhead work, and athletes with repetitive overhead motion exposure. There is increasing evidence linking altered shoulder kinematics with pain and dysfunction in these populations. The altered kinematics is hypothesized to reduce the subacromial space, resulting in impingement of the musculotendinous structures. With sustained or repeated impingement, tissue damage can result, and healing is compromised. The goal of this R03 application is to validate a method to measure the soft tissue geometry and volume of the subacromial space and to establish the relation between this space and tendon pathology. The general hypotheses are that soft tissue data derived from 3D imaging can be accurately registered, and that one can predict when reduction in the subacromial space will generate shoulder pathology. MR scans will be registered to CT scan and bone-fixed motion data from the same subjects. Determination of soft tissue origin/insertion and volume data from imaging data sets will be validated against direct measurement on cadaver shoulders. Additionally, measurement predictions of the location of rotator cuff tissue affected by subacromial reductions during motion will be tested against musculotendinous disease identified operatively. These data will enhance understanding of how rotator cuff tissue is impacted by subacromial space reductions. Addition of soft tissue data will allow for a comprehensive linked data set of precise 3D shoulder complex anatomy and motion across subjects with and without shoulder pathology, and serve as input to enhance existing mathematical shoulder models. This work is novel in its dynamic, comprehensive measurement of the subacromial space, and validation of soft tissue effects with operative data. Subsequent proposals will use these data and derived models to address clinical applications, including design and testing of rehabilitation and surgical interventions through randomized controlled clinical trials. Rotator cuff tendon pathology is the most common of all tendon disorders. The proposed work will improve the understanding of how shoulder movement disorders relate to rotator cuff pathology and provide a foundation for optimizing conservative rehabilitation approaches. Improving cost effective treatment is relevant to public health.

描述（由申请人提供）：pi的长期目标是开发和测试基于生物力学的康复策略的有效性，以改善上肢功能，减少肩部病变患者的疼痛和残疾。在一些人群中，肩袖病变的患病率高达50%，包括脊髓损伤、中风、重复性头顶工作的职业暴露者和重复性头顶运动暴露的运动员。越来越多的证据表明，这些人群的肩部运动改变与疼痛和功能障碍有关。运动学的改变被假设为减少肩峰下空间，导致肌腱肌肉结构的撞击。持续或反复的撞击可导致组织损伤，并影响愈合。本R03应用的目的是验证一种测量肩峰下空间软组织几何形状和体积的方法，并建立该空间与肌腱病理之间的关系。一般的假设是，来自3D成像的软组织数据可以准确地记录，并且可以预测肩峰下空间的缩小何时会产生肩部病理。磁共振扫描将与CT扫描和来自同一受试者的骨固定运动数据相匹配。从成像数据集中确定软组织起源/插入和体积数据将与尸体肩部的直接测量进行验证。此外，运动中肩峰下复位影响的肩袖组织位置的测量预测将针对手术确定的肌肉肌腱疾病进行测试。这些数据将增强对肩峰下间隙复位对肩袖组织影响的理解。软组织数据的添加将允许在有或没有肩部病理的受试者之间建立精确的3D肩部复杂解剖和运动的全面关联数据集，并作为输入来增强现有的肩部数学模型。这项工作是新颖的，它的动态，全面测量肩峰下空间，并验证软组织的影响与手术数据。后续的建议将使用这些数据和衍生模型来解决临床应用问题，包括通过随机对照临床试验设计和测试康复和手术干预措施。肩袖肌腱病理是所有肌腱疾病中最常见的。所提出的工作将提高对肩关节运动障碍与肩袖病理之间关系的理解，并为优化保守康复方法提供基础。改善具有成本效益的治疗关系到公共卫生。