Prolonged alterations to muscle following knee surgery and physical therapy

膝盖手术和物理治疗后肌肉的长期改变

• 批准号: 8442451
• 负责人: Brian Noehren
• 金额: $ 12.54万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8442451
• 关键词: Address; Anterior; Architecture; Area; Award; Biology; Biomechanics; Biophysics; Biopsy; Clinical; Clinical Research; Clinical Trials; Coupled; Data; Data Analyses; Degenerative polyarthritis; Development; Diffusion; Disease; Effectiveness; Fascicle; Fiber; Fibrosis; Future; Goals; Growth; Head; Health; Health Sciences; Image; Individual; Intervention; Joints; Kentucky; Knee; Laboratories; Left; Leg; Length; Ligaments; Link; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Microscopic; Molecular; Morphology; Muscle; Muscle Fibers; Muscle Weakness; Muscle function; Operative Surgical Procedures; Outcome; Patient Outcomes Assessments; Patients; Physical therapy; Physiological; Physiology; Positioning Attribute; Process; Production; Property; Protocols documentation; Recovery; Rehabilitation therapy; Research; Research Design; Research Personnel; Scientist; Senior Scientist; Structure; Testing; Time; Tissues; Training; Translating; United States National Institutes of Health; Universities; anterior cruciate ligament reconstruction; base; clinically significant; cohort; college; evidence base; experience; follow-up; functional outcomes; improved; innovation; interest; joint loading; muscular structure; novel; professor; public health relevance; quadriceps muscle; reconstruction; rehabilitation strategy; response to injury; skills; strength training; vastus lateralis

DESCRIPTION (provided by applicant): This is a K23 award application for Dr. Brian Noehren, an Assistant Professor of Physical Therapy at the University of Kentucky. Dr. Noehren is establishing himself as a young investigator focused on patient orientated clinical research dedicated to the study of how rehabilitation strategies restore muscle function in patients to ultimately improve their long term functional outcomes. The K-23 award would provide Dr. Noehren the needed support to become a productive independent scientist who is able to measure the cellular and morphological properties of muscle in response to injury and subsequent physical therapy. Development of these skills will allow him in future studies to assess the effectiveness of new and novel rehabilitation treatments to improve muscle function and joint loading. To achieve these goals Dr. Noehren has assembled a mentorship team of acknowledged leaders in their respective fields. This team is led by the senior mentor Dr. Charlotte Peterson, Associate Dean of Research, College of Health Sciences, and three co-mentors: Dr. Karyn Esser, an expert in muscle health and disease Dr. Bruce Damon, who is an expert in muscle structure and biophysics, and Dr. Leslie Crofford, an expert clinical trialist. Quadriceps strength reductions after an anterior cruciate ligament reconstruction of greater than 20- 40% occur at a critical time when physical therapy is ending and the individual begins to return to activities that require higher muscular demands. The reduction in quadriceps strength during this period of time has been associated with poorer outcomes. The measurement of muscular strength after rehabilitation to date has been limited to gross measurements, with little known of how the individual heads of the quadriceps such as the Vastus Lateralis respond to surgery. Therefore we propose two specific aims: (Aim 1) Assess the quadriceps muscle (vastus lateralis) fascicle length, pennation angle, and physiological cross sectional area before and after rehabilitation for ACL reconstruction. (Aim 2) Characterize muscle morphology through quantification of quadriceps muscle fiber type, fiber cross sectional area, and fibrosis after completing rehabilitation for an ACL reconstruction. In Aim 1, Dr. Noehren will use DTI-MRI established by one his mentors, Dr. Damon, to measure muscle properties strongly linked to maximum force production. In Aim 2, he will perform histo and immuno-histiochemical analysis in Dr. Peterson's laboratory of muscle biopsies taken from the Vastus Lateralis of the same group from Aim 1 to categorize the adaptations to muscle fiber cross sectional area, fiber type, as well as fatty in-growth and fibrosis. Dr. Esser will assist with training for this aim and the interpretation of the results. The aims will couple data from non invasive imaging with detailed cellular analysis of muscle which will inform rehabilitative practice. In addition Dr. Crofford wil provide the training of translating the results into clinical research, clinical trials, and data analysis.

描述（由申请人提供）：这是肯塔基大学物理疗法助理教授Brian Noehren博士的K23奖项申请。 Noehren博士正在建立自己的年轻研究者，专注于针对患者的临床研究，致力于研究康复策略如何恢复患者的肌肉功能，以最终改善其长期功能结果。 K-23奖将为Noehren博士提供所需的支持，以成为一名富有成效的独立科学家，他们能够响应损害和随后的物理疗法来衡量肌肉的细胞和形态学特性。这些技能的发展将使他在以后的研究中能够评估新的和新颖的康复治疗方法的有效性，以改善肌肉功能和关节载荷。为了实现这些目标，Noehren博士在各自领域组成了一个公认的领导者团队。该团队由高级导师夏洛特·彼得森（Charlotte Peterson）博士领导，卫生科学学院研究副院长和三名合伙人：Karyn Esser博士，Karyn Esser博士，肌肉健康与疾病专家Bruce Damon博士，他是肌肉结构和生物物理学专家，以及专家Leslie Crofford，Leslie Crofford博士。 在物理治疗结束并开始重返需要更高肌肉需求的活动的关键时期，股四头肌的强度降低了超过20-40％的前交叉韧带重建大于20-40％。在此期间，股四头肌强度的降低与结果较差有关。迄今为止，康复后的肌肉力量的测量仅限于总测量，鲜为人知的是如何对股四头肌的个体头（例如股外侧）对手术的反应。因此，我们提出了两个具体的目的：（目标1）评估恢复ACL重建之前和之后的肌肌（股外侧）束长度，销钉角度和生理横截面区域。 （AIM 2）通过量化股四头肌纤维类型，纤维横截面区域和纤维化来表征肌肉形态，以完成ACL重建的康复后。在AIM 1中，Noehren博士将使用由他的导师Damon博士确立的DTI-MRI，以测量与最大力量产生的肌肉特性。在AIM 2中，他将在Peterson博士的肌肉活检实验室中进行病史和免疫 - 固定化学分析，从AIM 1的同一群体的股外侧进行，以对肌肉纤维横截面区域，纤维类型，脂肪感内生长和纤维化的适应性进行分类。 Esser博士将协助培训此目标以及对结果的解释。目的将对非侵入性成像的数据以及对肌肉的详细细胞分析，这将为康复实践提供依据。另外，克罗夫德·威尔（Crofford Wil）博士提供了将结果转化为临床研究，临床试验和数据分析的培训。