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

摘要 截肢后的功能丧失是深远的，并改变了生活。迄今为止，旨在改善长期经济状况的干预措施 长期的功能能力和限制有害的继发性损伤(如骨关节炎)尚未奏效。 在多因素的情况下，肌肉质量的改变，特别是股四头肌的改变，对功能结果的影响 对于经胫骨截肢的患者，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，并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在生物工程方面的背景与发展出来的技能结合起来。 通过这笔F32培训补助金，开发新的治疗策略和设备，以改善功能和 失足患者的生活质量。这个训练奖将让我对肌肉进行评估 使用新的磁共振成像序列对完整肢体和残肢大腿的质量，2) 预测大腿肌肉质量和肌肉力量之间的关系，并最终描述 经胫骨骨折患者肌肉质量、肌力与膝关节负荷的关系 截肢。肌肉质量将使用新的磁共振成像技术进行评估，包括 T1Rho标测和扩散张量成像。这些技术将为肌肉组织提供新的见解 形态，包括纤维组织的任何增加或羽状角和纤维束长度的减少， 这会影响肌肉正常和高效运作的整体能力。评估肌肉力量和 移动性，参与者将完成最大限度的自愿等长屈膝和经过验证的调查目标 自我报告的移动性。最后，将通过计算评估完整肢体的关节接触力。 肌肉骨骼模型。通过为这款NRSA F32推荐的工作，我将提炼和获得 作为一名寻求与临床医生科学家合作的独立翻译研究员，成功的职业生涯。 培训将包括医学成像采集和分析、临床相关力量方面的技能发展 评估、仪表化运动分析、肌肉骨骼建模、临床研究管理和 统计分析。包括在培训计划中的辅助性职业发展活动包括 课程工作(如生物力学、统计学、医学成像)、助学金撰写研讨会、 研究、传播和指导都将是培养全面技能的关键组成部分 为未来的学术生涯做准备。我选定的赞助商、机构和导师将提供完美的 鼓励成功的环境。

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.