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Exploration of Carpal Tunnel Mechanics for CTS Treatment

CTS治疗的腕管力学探索

基本信息

批准号：
8454457
负责人：
Zong-Ming Li
金额：
$ 16.78万
依托单位：
CLEVELAND CLINIC LERNER COM-CWRU
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：
2012-04-05 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8454457
关键词：
Achievement Address American Area Biomechanics Carpal Tunnel Syndrome Clinical Complement Development Devices Disease Effectiveness Effectiveness of Interventions Foundations Goals Hand Health Care Costs Health Personnel High Prevalence Individual Investigation Knowledge Ligaments Manuals Mechanics Methods Morphology National Institute of Arthritis and Musculoskeletal and Skin Diseases Neuropathy Operative Surgical Procedures Physiological Population Positioning Attribute Principal Investigator Process Productivity Property Public Health Quality of life Recording of previous events Recruitment Activity Research Solutions Specimen Staging Stretching Symptoms Techniques Technology Testing Therapeutic Intervention Treatment Efficacy United States National Institutes of Health Width Wrist clinical practice evidence base human subject improved in vivo innovation median nerve novel pressure programs risk benefit ratio sound treatment strategy

项目摘要

DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is the most common compression neuropathy and has an immense impact on national health care, worker productivity, and quality of life. Despite its high prevalence and public health cost, our understanding of CTS is limited, and the management of CTS awaits improvement. Currently, CTS is routinely treated by carpal tunnel release surgery, which unfortunately has a number of complications. The concept of this surgical procedure has existed for nearly a century without fundamental challenges. Attempts have been made to conservatively treat CTS using manual therapies, but their effectiveness is ambiguous due to the lack of scientific and clinical evidence In our pursuit of CTS management, we have serendipitously discovered a novel mechanism of carpal tunnel manipulation to obtain tunnel enlargement by narrowing the carpal arch width. This discovery has exciting potential for the development of conservative treatment strategies for CTS. Our approach to carpal tunnel manipulation is in sharp contrast to the existing controversial techniques that try to stretch the carpal arch outwards. Therefore, our ultimate goal is to develop a biomechanical treatment for CTS through rigorous scientific studies on the mechanics and pathomechanics of the carpal tunnel. Our central notion is that CTS can be treated by non-surgical, biomechanical manipulation of the carpal tunnel through the narrowing of the carpal arch width. We hypothesize that strategically applied compression on the wrist can increase carpal tunnel cross-sectional area and decrease carpal tunnel pressure, thus relieving the median nerve from mechanical insult. We will test this hypothesis by systematically investigating the biomechanical relationships among transverse compressive force, carpal tunnel pressure, carpal arch width, and carpal tunnel cross-sectional area using cadaveric specimens and human subjects. The implementation of this project will yield novel knowledge on carpal tunnel mechanics and pathomechanics, leading to an evidence-based, novel biomechanical treatment strategy for CTS.

描述（由申请人提供）：腕管综合征（CTS）是最常见的压迫性神经病，对国民保健、工人生产力和生活质量有巨大影响。尽管CTS的患病率和公共卫生成本很高，但我们对CTS的了解有限，CTS的管理有待改进。目前，CTS通常通过腕管松解手术治疗，不幸的是，该手术有许多并发症。这种外科手术的概念已经存在了近世纪，没有根本的挑战。已经尝试使用手动疗法保守治疗CTS，但由于缺乏科学和临床证据，其有效性尚不明确。在我们对CTS管理的追求中，我们偶然发现了一种新的腕管操作机制，通过缩小腕弓宽度来扩大腕管。这一发现对于CTS保守治疗策略的发展具有令人兴奋的潜力。我们的方法腕管手术是在鲜明的对比，现有的争议技术，试图伸展腕弓向外。因此，我们的最终目标是通过对腕管的力学和病理力学进行严格的科学研究，为CTS开发生物力学治疗方法。我们的中心概念是，CTS可以通过非手术治疗，通过腕弓宽度缩小腕管的生物力学操作。我们假设，手腕上的战略应用压缩可以增加腕管横截面积和减少腕管压力，从而减轻正中神经的机械损伤。我们将使用尸体标本和人类受试者，通过系统地研究横向压缩力、腕管压力、腕弓宽度和腕管横截面积之间的生物力学关系来验证这一假设。该项目的实施将产生新的知识腕管力学和病理力学，导致一个循证的，新的生物力学治疗策略的CTS。

项目成果

期刊论文数量（9）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

In vivo study of transverse carpal ligament stiffness using acoustic radiation force impulse (ARFI) imaging.

DOI：
10.1371/journal.pone.0068569
发表时间：
2013
期刊：
PloS one
影响因子：
3.7
作者：
Shen ZL;Vince DG;Li ZM
通讯作者：
Li ZM

Carpal Tunnel Cross-Sectional Area Affected by Soft Tissues Abutting the Carpal Bones.

腕管横截面面积受软组织影响的腕骨骨骼。

DOI：
10.1055/s-0032-1329593
发表时间：
2013-02
期刊：
Journal of wrist surgery
影响因子：
0.7
作者：
Gabra JN;Li ZM
通讯作者：
Li ZM

Elliptical Morphology of the Carpal Tunnel Cross Section.

腕管横截面的椭圆形形态。

DOI：
发表时间：
2015
期刊：
European journal of anatomy : official journal of the Spanish Society of Anatomy
影响因子：
0
作者：
Gabra,JosephN;Kim,DongHee;Li,Zong-Ming
通讯作者：
Li,Zong-Ming

Pressure-morphology relationship of a released carpal tunnel.

DOI：
10.1002/jor.22271
发表时间：
2013-04
期刊：
JOURNAL OF ORTHOPAEDIC RESEARCH
影响因子：
2.8
作者：
Kim, Dong Hee;Marquardt, Tamara L.;Gabra, Joseph N.;Shen, Zhilei Liu;Evans, Peter J.;Seitz, William H.;Li, Zong-Ming
通讯作者：
Li, Zong-Ming

Movement of the distal carpal row during narrowing and widening of the carpal arch width.

腕弓宽度变窄和变宽期间远端腕骨行的运动。