A Biomechanical Study of Work-Related Shoulder Disorder

描述（由申请人提供）：虽然国家职业安全与健康研究所（NIOSH）已经确定了工作场所重复性手臂运动和肩部疾病之间的明确流行病学联系，但关于这种联系的生物力学的科学数据很少。肩关节过度使用损伤最初可能表现为弥漫性肩痛，然而，绝大多数反映了肩峰下空间的肩袖肌腱病变。我们研究议程的长期目标是确定与工作相关的肩袖损伤相关的重要生物力学机制，并随后制定针对这些机制的干预和预防策略。本申请的目的是确定肩袖机制的完整性与其载荷环境之间的联系。为了实现这一目标，我们制定了三个具体目标。我们的第一个具体目标是建立在体内的运动反应，减少肩袖功能的神经阻滞模型。我们的第二个具体目标是建立在体内的运动反应，高风险的职业工作。我们的第三个具体目标是建立改变体内运动学的生物力学后果。我们期望拟议的研究计划将确定在工作场所观察到的袖带功能减弱的直接后果。这些结果将是重要的，因为它们代表了理解从疲劳和虚弱到异常负荷的进展的下一步。由于有强有力的证据支持异常负荷可能导致从急性肌腱炎进展为慢性肩袖撕裂的概念，因此该提案的结果也将作为更有效的治疗和预防策略的基础。

DESCRIPTION (provided by applicant): Although the National Institute of Occupational Safety and Health (NIOSH) has identified a clear epidemiological link between repetitive arm motion and shoulder disorders in the workplace, there are few scientific data available regarding the biomechanics of this connection. Shoulder overuse injuries may initially manifest as diffuse shoulder pain, however, the vast majority reflect pathology of the rotator cuff tendons in the subacromial space. The long-term goal of our research agenda is to identify the important biomechanical mechanisms associated with work related rotator cuff injuries and subsequently develop intervention and prevention strategies that address these mechanisms. The objective of this application is to identify the link between the integrity of the rotator cuff mechanism and its loading environment. To accomplish this objective, we have developed three specific aims. Our first specific aim is to establish the in-vivo kinematic response to diminished rotator cuff function in a nerve block model. Our second specific aim is to establish the in-vivo kinematic response to high risk occupational work. Our third specific aim is to establish the biomechanical consequences of altered in-vivo kinematics. It is our expectation that the proposed research plan will identify the direct consequences of diminished cuff function observed in the workplace. These results will be significant because they represent the next step towards understanding the progression from fatigue and weakness to abnormal loading. Since there is strong evidence to support the concept that abnormal loading may lead to a progression from acute tendinitis to chronic rotator cuff tears, the results from this proposal will also serve as the basis for more effective treatment and prevention strategies.