Tracking Achilles Tendon Compression to Monitor Insertional Achilles Tendonopathy

跟踪跟腱压缩情况以监测插入性跟腱病

• 批准号: 8823271
• 负责人: Mark Raymond Buckley
• 金额: $ 7.68万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8823271
• 关键词: Ankle; Area; Attention; Caring; Clinical; Clinical Research; Data; Debridement; Deformity; Devices; Disease; Epidemiologic Studies; Exercise; Gastrocnemius Muscle; Geometry; Heel; Individual; Information Systems; Institutes; Intervention; Lead; Measurement; Measures; Mechanics; Microscope; Monitor; Muscle; Operative Surgical Procedures; Outcome; Pain; Pathology; Patient Outcomes Assessments; Patient Self-Report; Patients; Physical therapy; Process; Property; Questionnaires; Recovery; Reporting; Role; Severities; Shapes; Side; Sports; Staging; Stress; Techniques; Technology; Tendinopathy; Tendon structure; Testing; Time; Tissues; Ultrasonography; Walking; Work; achilles tendon; base; calcaneum; design; effective therapy; elastography; experience; foot; improved; in vivo; novel; orthotics; public health relevance; standard care; theories; tool

 DESCRIPTION (provided by applicant): Insertional Achilles tendinopathy (IAT) is a painful and common disorder that is difficult to treat. Standard physical therapy interventions that work well for other forms of Achilles tendinopathy are only ~50% effective for IAT, and patients who fail physical therapy require surgeries that are expensive, entail long recovery times and often lead to complications. Thus, there is a need to develop novel and effective treatments to improve clinical outcomes for IAT patients. A critical step in this process is to establish a tool or accurately monitoring the efficacy of conservative and non-conservative care. IAT is thought to be caused by compressive stress due to impingement of the tendon on the heel bone as the ankle rotates, and our preliminary studies support this theory. Thus, we hypothesize that tracking compression of the Achilles tendon against the heel as the ankle rotates is a useful tool for assessing the severity of IAT. In preliminary work, we have shown that we can quantify compression of the Achilles tendon onto the heel by analyzing ultrasound images taken while the ankle rotates. In Aim 1, we propose to apply this technique to test whether the extent of compression in IAT tendons is larger than in healthy tendons. In Aim 2, we will investigate whether the extent of compression in IAT tendons is associated with tissue-scale structural and mechanical alterations. Finally, in Aim 3 we will test whether self-reported function in IAT patients is better correlated with our ultrasound-based measurements of tendon compression than with standard clinical measures of heel geometry and muscle stiffness, two factors that may contribute to impingement of the Achilles tendon on the heel. The findings of this study will define a critical threshold for damaging compression in the Achilles tendon that will guide novel, targeted strategies designed to reverse IAT. Furthermore, the inexpensive and non- invasive tool established in this proposal will enable longitudinal monitoring of treatments for this IAT tht may help improve outcomes for IAT patients. Project Description Page 1

 描述（由申请人提供）：插入性跟腱病（IAT）是一种痛苦且常见的疾病，难以治疗。对于其他形式的跟腱病有效的标准物理治疗干预措施对 IAT 的效果只有约 50%，而物理治疗失败的患者需要进行昂贵的手术，需要很长的恢复时间，并且常常会导致并发症。因此，需要开发新颖有效的治疗方法来改善 IAT 患者的临床结果。此过程中的关键步骤是建立工具或准确监测保守和非保守护理的功效。 IAT 被认为是由脚踝旋转时跟骨上的肌腱撞击所产生的压缩应力引起的，我们的初步研究支持了这一理论。因此，我们假设跟踪脚踝旋转时跟腱对脚后跟的压缩是评估 IAT 严重程度的有用工具。在初步工作中，我们已经证明，通过分析脚踝旋转时拍摄的超声波图像，可以量化跟腱对脚跟的压缩。在目标 1 中，我们建议应用该技术来测试 IAT 肌腱的压缩程度是否大于健康肌腱的压缩程度。在目标 2 中，我们将研究 IAT 肌腱的压缩程度是否与组织尺度的结构和机械变化相关。最后，在目标 3 中，我们将测试 IAT 患者的自我报告功能是否与我们基于超声的肌腱压缩测量值的相关性更好，而不是与足跟几何形状和肌肉硬度的标准临床测量值的相关性更好，这两个因素可能导致跟腱撞击足跟。这项研究的结果将定义跟腱损伤性压缩的关键阈值，这将指导旨在逆转 IAT 的新颖、有针对性的策略。此外，该提案中建立的廉价且非侵入性工具将能够对 IAT 治疗进行纵向监测，这可能有助于改善 IAT 患者的治疗结果。项目描述第1页