Macaque Model of Carpal Tunnel Syndrome: Effects of Force and Posture Exposures

腕管综合症的猕猴模型：力和姿势暴露的影响

• 批准号: 7524423
• 负责人: Carolyn M Sommerich
• 金额: $ 36.79万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7524423
• 关键词: Macaque; Model; Carpal; Tunnel; Syndrome

DESCRIPTION (provided by applicant): The long term objective of this research is to reduce occurrence of work-related Carpal Tunnel Syndrome (CTS). In pursuit of this goal we need to refine our understanding of the contribution of physical factors in the work environment (force, task duration, posture and repetition) to development of the disorder. Ultimately we aim to 1) characterize associations between various physical exposures (force, repetition, etc) and development of CTS due to chronic overuse; 2) understand injury and recovery cycles; and 3) learn the degree to which modification of physical exposures can prevent CTS development or recurrence. We have previously developed and used a new non-human primate model to demonstrate a direct link between chronic overuse and onset of median mononeuropathy at the wrist (Dx closely associated with CTS). In this application we propose to apply this novel approach to quantifying relationships between selected work exposures and disorder development. The specific aims of this application are to: 1) To quantify the combined effects of force and wrist posture in altering the expected development of CTS; 2) To quantify the recovery period associated with a natural recovery from CTS; and 3) To expand our database of maximum voluntary pinch exertion force of the macaque, which we use to predict and set experimental levels of force (as % of maximum) in our protocols. Research design and methods: Macaca fascicularis monkeys will be trained to perform a repetitive pinching task for daily food rations. Task performance data will be measured continuously: force exerted, quantity and duration of pinches, and intervals between pinches. Every two weeks Sensory Nerve Conduction Velocity (SNCV) will be assessed in the working and the non-working hand. Effects of pinch force and wrist posture will be studied using a longitudinal, between group design to characterize effect of each factor on resulting median nerve impairment, over a 18-week exposure period. Cumulative workload, degree of impairment, time to occurrence are some of the dependent measures that will be used to characterize the association between exposure factors and outcomes. MRI will be collected at baseline, at end of task exposure, and at point of recovery, to quantify change in nerve morphology. Low and higher exposure levels will allow us to explore where exposure thresholds might lay. We also propose to expand our database of macaque volitional strength, which will be a resource for future research (ours and other research teams). Relevance to public health: CTS occurs at high rates in some worker populations with a median of 28 lost work days per case, making this a disorder that is costly for employees and employers. Our previous work confirms that CTS can result from overuse of the hands. Now we need to differentiate amongst exposures, in terms of extent of nerve impairment, so that, in the long term, the risk for development or recurrence of work- related CTS can be reduced.

描述（由申请人提供）：本研究的长期目标是减少与工作相关的腕管综合症（CTS）的发生。为了实现这一目标，我们需要加深对工作环境中物理因素（力量、任务持续时间、姿势和重复）对疾病发展的影响的理解。最终我们的目标是 1) 描述各种身体暴露（用力、重复等）与慢性过度使用导致的 CTS 发展之间的关联； 2）了解受伤和恢复周期； 3) 了解改变物理暴露可以在多大程度上预防 CTS 的发展或复发。我们之前开发并使用了一种新的非人类灵长类动物模型来证明长期过度使用与腕部正中单神经病（Dx 与 CTS 密切相关）发病之间的直接联系。在此应用中，我们建议应用这种新颖的方法来量化选定的工作暴露与疾病发展之间的关系。该应用程序的具体目标是： 1) 量化力量和手腕姿势对改变 CTS 预期发展的综合影响； 2) 量化与 CTS 自然恢复相关的恢复期； 3）扩展我们的猕猴最大自愿捏捏力数据库，我们用它来预测和设置我们协议中的实验力水平（作为最大的百分比）。研究设计和方法：食蟹猴将被训练执行重复的捏捏任务以获得日常食物配给。任务表现数据将被连续测量：施加的力、捏的数量和持续时间以及捏的间隔。每两周评估工作手和非工作手的感觉神经传导速度 (SNCV)。将使用纵向组间设计来研究捏力和手腕姿势的影响，以表征在 18 周暴露期内每个因素对正中神经损伤的影响。累积工作量、损伤程度、发生时间是一些相关指标，将用于描述暴露因素与结果之间的关联。将在基线、任务结束时和恢复时收集 MRI，以量化神经形态的变化。较低和较高的暴露水平将使我们能够探索暴露阈值可能在哪里。我们还建议扩大我们的猕猴意志强度数据库，这将成为未来研究（我们和其他研究团队）的资源。与公共卫生的相关性：CTS 在某些工人群体中发病率很高，每个病例平均损失 28 个工作日，这使得这种疾病对雇员和雇主来说代价高昂。我们之前的工作证实，CTS 可能是由于双手过度使用造成的。现在，我们需要根据神经损伤的程度来区分不同的暴露情况，以便从长远来看，可以降低与工作相关的 CTS 发生或复发的风险。