Development of a Geometric Forefoot Model: A tool for Clinical Decision Making

几何前足模型的开发：临床决策的工具

• 批准号: 7284896
• 负责人: Howard J. Hillstrom
• 金额: $ 9.33万
• 依托单位: HOSPITAL FOR SPECIAL SURGERY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-05 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7284896
• 关键词: Address; Amputation; Biomechanics; Bunion; Chronic; Clinical; Data; Databases; Decision Making; Deformity; Degenerative polyarthritis; Development; Diabetes Mellitus; Diabetic Neuropathies; Diagnosis; Diagnostic radiologic examination; Ensure; Esthesia; Flatfoot; Forefoot model; Functional disorder; Gait; Gangrene; Goals; Hallux Limitus; Hallux Valgus; Hallux structure; Head; Health; Heel; Individual; Infection; Investigation; Ionizing radiation; Limb structure; Measures; Metatarsal bone structure; Metatarsalgia; Methods; Mission; Modeling; National Institute of Child Health and Human Development; Neuroma; Operative Surgical Procedures; Orthopedics; Pathology; Patients; Peripheral Nervous System Diseases; Personal Satisfaction; Physicians; Plantar Fasciitis; Pliability; Productivity; Rehabilitation therapy; Research; Research Personnel; Research Proposals; Shapes; Structural Models; Structure; Surgeon; Talipes cavus; Techniques; Tendinitis; Testing; Ulcer; Weight-Bearing state; base; design; digital; foot; improved; indexing; mathematical model; pressure; tool

DESCRIPTION (provided by applicant): It is the ultimate objective of this research team to develop a mathematical model of the foot structure that is sensitive to aberrant function and can be used to plan more effective conservative and surgical treatments. The mission of the NICHD is to ensure the health, productivity, independence, and well-being of all people through optimal rehabilitation. The proposed forefoot model would be useful as a guide to Podiatric physicians, Orthopedic surgeons, Physiatrists, and Physical Therapists to optimize treatment strategies in order to better rehabilitate patients. This project will focus upon three specific aims: (A) to develop a structural model of the forefoot from radiographic and 3D digital pointer based input data and demonstrate concurrent validity, (B) to develop a normative database of model parameters and associated foot function during gait for asymptomatic healthy individuals and stratify across foot type (i.e. pes planus, rectus, and pes cavus), and (C) to distinguish the model parameters and foot function for a group of patients with diabetes and hallux abducto valgus (HAV) from that of healthy. Improved understanding of the pathomechanics that afflict pes planus (e.g. HAV, Hallux limitus, osteoarthritis, tendonitis, plantar fasciitis, neuroma, posterior tibial dysfunction, chronic keratomata, collapsing pes valgus.etc) and pes cavus (e.g. hammertoes, tailor bunion, metatarsalgia, diabetic neuropathy, etc.) feet is needed. The proposed model of forefoot geometry is expected to be sensitive to different foot structures (and associated pathologies) and hence be predictive of commensurate foot function. Based upon positive findings from this investigation subsequent studies will be conducted to use the model as a tool for clinical decision making. Individuals with diabetes and lack of sensation may develop limb threatening wounds beneath their feet. If an ulcer forms and does not heel quickly an infection may ensue. If not successfully treated this infection could result in gangrene and the necessity for amputation. One goal of the proposed model is to predict the abnormally high pressures beneath these patients' feet so as to alert clinicians and suggest a course of action.

描述（由申请人提供）：本研究团队的最终目标是开发对异常功能敏感的足部结构数学模型，并可用于计划更有效的保守和手术治疗。NICHD的使命是通过最佳康复确保所有人的健康、生产力、独立性和福祉。所提出的前足模型将是有用的足科医生，整形外科医生，理疗师和物理治疗师的指导，以优化治疗策略，以更好地康复患者。该项目将侧重于三个具体目标：（A）根据基于放射照相和3D数字指针的输入数据开发前脚的结构模型，并证明并发有效性，（B）开发无症状健康个体步态期间模型参数和相关足部功能的规范数据库，并在足部类型中分层（即，扁平足、直肌和高弓足），以及（C）将患有糖尿病和拇外展外翻（HAV）的一组患者的模型参数和足部功能与健康的足部功能区分开。加深对扁平足（如HAV、拇趾局限、骨关节炎、肌腱炎、足底筋膜炎、神经瘤、胫骨后功能障碍、慢性角膜肿、塌陷性外翻足等）和高弓足（如锤状趾、裁缝性拇囊炎、跖骨痛、糖尿病性神经病变等）的病理机制的理解脚是需要的。所提出的前足几何形状的模型预期对不同的足部结构（和相关的病理）敏感，并且因此预测相称的足部功能。基于这项调查的积极结果，将进行后续研究，以使用该模型作为临床决策的工具。患有糖尿病和缺乏感觉的人可能会在他们的脚下发展出威胁肢体的伤口。如果溃疡形成而不能迅速愈合，感染可能随之而来。如果不成功治疗，这种感染可能导致坏疽和截肢的必要性。所提出的模型的一个目标是预测这些患者脚下的异常高压，以便提醒临床医生并建议采取行动。

项目成果

The effect of foot structure on 1st metatarsophalangeal joint flexibility and hallucal loading.

• DOI: 10.1016/j.gaitpost.2011.02.028
• 发表时间: 2011-05
• 期刊: GAIT & POSTURE
• 影响因子: 2.4
• 作者: Rao, Smita;Song, Jinsup;Kraszewski, Andrew;Backus, Sherry;Ellis, Scott J.;Deland, Jonathan T.;Hillstrom, Howard J.
• 通讯作者: Hillstrom, Howard J.