Muscle function and compensation following rotator cuff tear in older adults

老年人肩袖撕裂后的肌肉功能和代偿

• 批准号: 8521025
• 负责人: Meghan Elise Vidt
• 金额: $ 4.04万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8521025
• 关键词: Activities of Daily Living; Affect; Age; Aging; Aging-Related Process; Anthropometry; Articular Range of Motion; Atrophic; Axilla; Caring; Clinical; Comb animal structure; Computer Simulation; Dependence; Elderly; Fatty acid glycerol esters; Financial compensation; Goals; Hair; Individual; Individual Differences; Infiltration; Injury; Intramuscular; Joints; Knowledge; Life; Linear Models; Living Wills; Magnetic Resonance Imaging; Measurement; Measures; Metric; Modeling; Motor; Movement; Muscle; Muscle function; Musculoskeletal; Outcome; Outcome Measure; Patients; Pattern; Performance; Population; Rehabilitation therapy; Reliance; Reporting; Role; Rotator Cuff; Shoulder; Simulate; Skeletal Muscle; Techniques; Thick; Time; Torque; Upper Extremity; Work; design; experience; functional improvement; functional outcomes; healthy aging; improved functioning; in vivo; injured; interest; kinematics; muscle strength; muscular structure; rehabilitation strategy; simulation

DESCRIPTION (provided by applicant): Approximately 20-50% of older adults (age > 65 years) are living with a rotator cuff tear, and this number increases with advanced age. A rotator cuff tear is associated with decreased muscle volume and shoulder strength, fatty infiltration, reduced range of motion, and limited mobility. These deficits can impact older adults ability to perform activities of daily living (ADLs), resulting in a loss of independence. It has been suggested that individuals with a torn rotator cuff will employ compensatory movements or deviations from the desired movement with a greater reliance on unimpaired muscles, to complete tasks. However, the aging process induces changes to skeletal muscle which may affect motor coordination and muscle strength, contributing to compensation seen in healthy aging. Therefore, it is essential to identify the extent to which upper limb compensation is necessary with age to further explore the functional changes occurring in older adults with a rotator cuff tear. Clinically, standardized functional outcome scores are used to assess functional ability and improvements following treatment for patients with a rotator cuff tear. However, it is not well understood how these clinical metrics relate to compensation in ADL tasks. To better understand the relationships between healthy aging, rotator cuff tears, and functional ability, it is necessary investigate compensation in ADLs and identify the strength and activation of primary muscles contributing to these movements. These objectives will be accomplished by obtaining kinematics for 6 ADL tasks from healthy and rotator cuff injured older adults and developing subject-specific musculoskeletal models for these subjects. These models will be used to simulate the ADL movements to identify the forces and activation patterns of muscles contributing to these tasks. Specifically, this study will 1) evaluate the effet of rotator cuff tear on muscle volume, fatty infiltration and functional outcome scores, 2) identif differences in joint kinematics for 6 ADLs and evaluate the range of motion, and force and activation of contributing muscles, and 3) evaluate the dependence of range of motion and muscle force on muscle volume, fatty infiltration, and functional outcome score. It is of interest o study compensation in older adults with a rotator cuff tear to further understand the functional consequences of this injury. The long term goal of this study is to identify weak muscles that contribute to compensation or the inability to complete a functional task. This information will be used to design rehabilitation strategies to strengthen muscles and improve function after injury. The outcomes of this work will provide further understanding of the mechanism of injury in older adults with a rotator cuff tear. This information may have a substantial impact as the US population continues to age.

描述（由申请人提供）：大约20-50％的老年人（年龄> 65岁）生活在肩袖撕裂中，这一数字随着年龄的增长而增加。肩袖撕裂与肌肉的体积和肩部强度减少，脂肪浸润，运动范围减少以及迁移率有限有关。这些缺陷会影响老年人进行日常生活活动（ADL）的能力，从而导致独立性丧失。有人建议，肩袖撕裂的个体将采用补偿运动或与所需运动的偏差，更依赖于未损坏的肌肉来完成任务。但是，衰老过程会导致骨骼肌的变化，这可能会影响运动配位和肌肉力量，从而有助于在健康衰老中看到的补偿。因此，必须确定随着年龄的增长，必须确定上肢补偿的程度，以进一步探索肩袖撕裂的老年人发生的功能变化。在临床上，标准化功能结果评分用于评估肩袖撕裂患者治疗后的功能能力和改进。但是，尚不清楚这些临床指标与ADL任务中的补偿有何关系。为了更好地了解健康的衰老，肩袖撕裂和功能能力之间的关系，有必要研究ADL中的补偿，并确定对这些运动有助于这些运动的主要肌肉的强度和激活。这些目标将通过从健康和肩袖受伤的老年人中获得6个ADL任务的运动学来实现，并为这些受试者开发特定主体的肌肉骨骼模型。这些模型将用于模拟ADL运动，以识别有助于这些任务的肌肉的力和激活模式。具体而言，这项研究将1）评估肩袖撕裂对肌肉体积，脂肪浸润和功能性结果评分的影响，2）确定6个ADL的关节运动学的差异，并评估运动的运动范围，肌肉的力和激活肌肉的力和激活，以及3）评估运动和肌肉效果的依赖性肌肉和肌肉的范围，脂肪和肌肉降低的依赖性。这是o肩袖撕裂的老年人的研究补偿，以进一步了解这种伤害的功能后果。这项研究的长期目标是确定有助于补偿或无法完成功能任务的弱肌肉。这些信息将是 用于设计康复策略，以增强肌肉并改善受伤后的功能。这项工作的结果将进一步了解肩袖撕裂的老年人的损伤机制。随着美国人口的持续年龄，此信息可能会产生重大影响。