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Kinematic and Kinetic effect of Orthotic Devices for subjects with stage II Poste

矫形装置对 II 期术后受试者的运动学和动力学效应

基本信息

批准号：
8367636
负责人：
Christopher Glenn Neville
金额：
$ 40.39万
依托单位：
UPSTATE MEDICAL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2017-06-30
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Orthotic devices serve as essential elements of conservative care programs for posterior tibial tendon dysfunction (PTTD). Data on currently used devices remain limited. Current device designs are restrictive and focus on correction of flatfoot kinematics in subjects with stage II PTTD. Restrictive designs that limit ankle motion may lead to weakness and altered gait dynamics. It remains unclear if less restrictive device designs would be more optimal for subjects with stage II PTTD. The aims of the current proposal are to examine the in- vivo biomechanics of different device designs and to use outcomes to identify the device and design optimal for subjects with stage II PTTD. Research Design: This study will use a laboratory based repeated measures design to explore the function of four different orthotic devices in a sample of 60 subjects with stage II PTTD at baseline. Then each subject will be followed prospectively for 12 weeks while wearing one of the orthotic devices. Clinical outcomes including strength, tendon morphology, and self-reported outcomes will be measured at 12 weeks. Baseline foot kinematics will be collected using a three segment foot model (first metatarsal, calcaneus, tibia) while data on ankle kinetics will be derived from the kinematic data and the ground reaction forces. Impact: There are currently no head-to-head comparisons available among the various devices used in the conservative management of stage II PTTD. The proposed study will provide the necessary controlled data to determine the kinematic and kinetic effects of selected devices and the specific components needed to optimize device design. Outcomes will be used to determine which designs are successful to use clinically. PUBLIC HEALTH RELEVANCE: The lack of high quality evidence to guide conservative care for patients with posterior tibial tendon dysfunction (PTTD) has led to controversy over clinical care. Numerous orthotic devices are available to avoid a costly and debilitating surgery but no consensus on which to use has been made. The current study aims to link biomechanical testing of selected devices to clinical outcomes in subjects with PTTD after wearing a device for 12 weeks.

描述（由申请人提供）：矫形器是胫骨后肌腱功能障碍（PTTD）保守治疗计划的基本要素。目前使用的设备的数据仍然有限。目前的装置设计是限制性的，并专注于矫正患有II期PTTD的受试者的扁平足运动学。限制踝关节运动的限制性设计可能导致虚弱和步态动力学改变。目前尚不清楚对于II期PTTD受试者，限制性较小的器械设计是否更佳。当前提案的目的是检查不同器械设计的体内生物力学，并使用结果来确定II期PTTD受试者的最佳器械和设计。研究设计：本研究将使用基于实验室的重复测量设计，以探索四种不同矫正装置在60例基线时患有II期PTTD的受试者样本中的功能。然后，每例受试者将在佩戴其中一种矫正装置时接受12周的前瞻性随访。将在12周时测量临床结局，包括强度、肌腱形态和自我报告结局。基线足部运动学将使用三段足部模型（第一跖骨、跟骨、胫骨）收集，而踝关节动力学数据将从运动学数据和地面反作用力中得出。影响：目前在II期PTTD保守治疗中使用的各种器械之间没有头对头比较。拟议研究将提供必要的受控数据，以确定选定器械的运动学和动力学效应以及优化器械设计所需的特定组件。结果将用于确定哪些设计可成功用于临床。公共卫生关系：由于缺乏高质量的证据来指导胫骨后肌腱功能障碍（PTTD）患者的保守治疗，导致了对临床治疗的争议。有许多矫正装置可用于避免昂贵和使人衰弱的手术，但对使用哪种没有达成共识。本研究旨在将选定器械的生物力学测试与PTTD受试者佩戴器械12周后的临床结局联系起来。