Establishing the Relationship Between Muscle Quality and Joint Loading for Individuals with Transtibial Amputation

建立小腿截肢患者的肌肉质量和关节负荷之间的关系

• 批准号: 10677236
• 负责人: Meredith Owen
• 金额: $ 6.91万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-24 至 2026-04-23
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677236
• 关键词: Activities of Daily Living; Affect; Amputation; Anisotropy; Award; Biomechanics; Biomedical Engineering; Clinical Research; Collaborations; Computer Models; Data; Degenerative polyarthritis; Development; Devices; Diffusion Magnetic Resonance Imaging; Educational workshop; Environment; Evaluation; Event; Fellowship; Fiber; Fibrosis; Foundations; Functional disorder; Future; Gait; Goals; Grant; Health; Image; Imaging Techniques; Individual; Infiltration; Injury; Institution; Intervention; Isometric Exercise; Joints; Kinetics; Knee; Knee joint; Length; Life; Limb structure; Lower Extremity; Magnetic Resonance Imaging; Maps; Measures; Mechanics; Medical Imaging; Mentors; Mentorship; Modeling; Morphology; Motion; Movement; Muscle; Muscle Fibers; Muscle function; Musculoskeletal; National Research Service Awards; Orthopedics; Outcome; Participant; Patient Self-Report; Postdoctoral Fellow; Property; Quality of life; Relaxation; Research Personnel; Risk; Scientist; Side; Statistical Data Interpretation; Surveys; Technical Expertise; Techniques; Testing; Thigh structure; Time; Tissues; Training; United States; Walking; Work; Writing; career; career development; clinically relevant; design; functional improvement; functional outcomes; image processing; improved; insight; instrument; joint loading; kinematics; limb amputation; limb loss; long-term sequelae; loss of function; muscle strength; novel; novel imaging technique; novel therapeutic intervention; prosthesis wearer; prosthetic socket; quadriceps muscle; research data dissemination; residual limb; skill acquisition; skills; statistics; success; translational scientist

ABSTRACT The loss of function following an amputation is profound and life altering. To date, interventions to improve long term functional abilities and limit detrimental secondary injuries (e.g. osteoarthritis) have not been effective. While multifactorial, the effect of altered muscle quality, specifically of the quadriceps, on functional outcomes for individuals with transtibial amputation is poorly understood. Work by our group in other conditions shows that muscle quality changes after injury and is directly related to loss of function, including protracted strength deficits. My long-term career goal is to combine my background in bioengineering with the skills developed through this F32 training grant to develop novel therapeutic strategies and devices to improve function and quality of life for individuals with lower limb loss. This training award will allow me to 1) assess the muscle quality of the thigh of the intact and residual limbs with novel magnetic resonance imaging sequences, 2) predict the relationship between thigh muscle quality and muscle strength, and finally 3) characterize the relationship between muscle quality, muscle strength, and knee joint loading for individuals with transtibial amputation. Muscle quality will be assessed using novel magnetic resonance imaging techniques including T1rho mapping and diffusion tensor imaging. These techniques will provide new insights on the muscle tissue morphology, including any increases in fibrotic tissue or decreases in pennation angle and fiber tract length, that affect the muscle's overall ability to function properly and efficiently. To evaluate muscle strength and mobility, participants will complete maximum voluntary isometric knee flexion and validated surveys targeting self-reported mobility. Finally, joint contact forces of the intact limb will be assessed through a computational musculoskeletal model. Through the work proposed for this NRSA F32, I will refine and gain skills critical for a successful career as an independent translational researcher seeking to collaborate with clinician scientists. Training will include skills development in medical imaging acquisition and analysis, clinically relevant strength assessment, instrumented motion analysis, musculoskeletal modeling, clinical research management, and statistical analysis. Including in the training plan are accessory career development activities including related course work (e.g. biomechanics, statistics, medical imaging), grant writing workshops, opportunities for research dissemination, and mentorship that will all be key components to developing a well-rounded skill set for a future academic career. My selected sponsor, institution, and mentors will provide the perfect environment for encouraging success.

抽象的 截肢后的功能丧失是深远的，并且会改变生活。迄今为止，改善长期的干预措施 长期功能能力和限制有害的继发性损伤（例如骨关节炎）效果不佳。 虽然是多因素的，但肌肉质量改变（特别是股四头肌）对功能结果的影响 对于经过胫骨截肢的人来说，人们知之甚少。我们小组在其他条件下的工作表明 肌肉质量在受伤后发生变化，与功能丧失直接相关，包括持久的力量 赤字。我的长期职业目标是将我的生物工程背景与所开发的技能结合起来 通过这项 F32 培训补助金来开发新的治疗策略和设备，以改善功能和 下肢丧失患者的生活质量。该训练奖将使我能够 1) 评估肌肉 使用新型磁共振成像序列评估完整肢体和残肢的大腿质量，2) 预测大腿肌肉质量和肌肉力量之间的关系，最后3）表征 跨胫骨患者的肌肉质量、肌肉力量和膝关节负荷之间的关系 截肢。将使用新型磁共振成像技术评估肌肉质量，包括 T1rho 映射和扩散张量成像。这些技术将为肌肉组织提供新的见解 形态学，包括纤维化组织的任何增加或羽状角和纤维束长度的减少， 影响肌肉正常有效运作的整体能力。评估肌肉力量和 活动性，参与者将完成最大限度的自愿等长膝关节屈曲和针对目标的经过验证的调查 自我报告的流动性。最后，完整肢体的关节接触力将通过计算进行评估 肌肉骨骼模型。通过为 NRSA F32 提出的工作，我将完善并获得对 NRSA F32 至关重要的技能 作为一名独立转化研究人员，寻求与临床科学家合作，取得了成功的职业生涯。 培训将包括医学成像采集和分析方面的技能发展、临床相关实力 评估、仪器化运动分析、肌肉骨骼建模、临床研究管理，以及 统计分析。培训计划中包括辅助职业发展活动，包括相关的 课程作业（例如生物力学、统计学、医学成像）、资助写作研讨会、 研究传播和指导都是发展全面技能的关键组成部分 为了未来的学术生涯。我选择的赞助商、机构和导师将提供完美的 鼓励成功的环境。