Leveraging Wearables to Transform Patient Recovery after Tibial Fracture Surgery

利用可穿戴设备改变胫骨骨折手术后患者的康复

• 批准号: 10658494
• 负责人: Brian Noehren
• 金额: $ 55.94万
• 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: 2023-08-10 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10658494
• 关键词: Address; Affect; Algorithms; American; Back; Biofeedback; Biological Markers; Caring; Clinic; Clinical; Data; Data Set; Dose; Early Intervention; Ensure; Exercise; Fill-It; Fracture; Future; Goals; Guidelines; Health Care Costs; Home; Hospitals; Individual; Injury; Intervention; Journals; Knowledge; Laws; Leisure Activities; Length of Stay; Life; Limb structure; Link; Longitudinal Studies; Measurement; Measures; Modeling; Monitor; Muscle; Musculoskeletal Diseases; Office Visits; Operative Surgical Procedures; Outcome; Pain; Pathway interactions; Patient-Focused Outcomes; Patients; Physical therapy; Postoperative Period; Publishing; Reaction; Recovery; Recovery of Function; Rehabilitation therapy; Reporting; Risk; Severities; Shoes; System; Techniques; Testing; Tibial Fractures; Time; Training; Walking; Work; bone; demographics; design; empowerment; exercise program; exercise rehabilitation; experience; follow-up; functional outcomes; improved; in vivo; innovation; knowledgebase; light weight; limb injury; mechanotransduction; novel; pressure; programs; remote monitoring; sample fixation; sensor; standard of care; tibia; tool; wearable device; wearable monitor; wearable sensor technology

Over 490K Americans fracture their tibia (shinbone) yearly, and require surgery. However, patient recovery 1 year following surgery is poor and inconsistent with 2/3 of patients reporting an inability to do pre-injury leisure activities and 1/2 still not having recovered enough to return to work. A key role of clinicians after tibial shaft fracture surgery is to prescribe a rehabilitation exercise program that exposes each patient's tibia to increasing forces to gradually recover the ability to do pre-injury activities. However, major limitations holding back progress in the field are the lack of knowledge on how much tibial force patients experience during daily activities, in their rehabilitation program throughout recovery, and how tibial force early in recovery affects longer-term functional recovery. The overarching goal of this work is to generate the knowledgebase and tools that will enable us to reimagine and elevate the standard of care for individuals after tibial shaft fracture surgery, by monitoring and managing tibial bone forces in daily life. We propose to accomplish the overarching objective through the following aims. Aim 1: Characterize tibial bone force in patients at home over the first year following surgery. Aim 2: Create the first clinical reference guide that ranks tibial forces during commonly- prescribed rehabilitation exercises. Aim 3: Assess if higher tibial forces during early recovery correspond with better functional outcomes at 6- and 12-month follow up. If our hypothesis is supported then these results would inform new clinical guidelines (target bone force thresholds) and biofeedback interventions to monitor and promote healthy bone forces in recovery. This wearable monitoring paradigm has unparalleled potential to be adapted to elevate care for recovery from numerous musculoskeletal disorders.

每年有超过490,000美国人胫骨骨折，需要手术治疗。然而，患者康复1 手术后一年的表现不佳，与三分之二的患者报告无法进行受伤前的休闲活动不一致 另有1/2的人仍未恢复足够的恢复能力，无法重返工作岗位。临床医生在胫骨骨干术后的关键作用 骨折手术是开出一个康复锻炼计划，使每个患者的胫骨暴露在增加的风险中。 部队逐渐恢复做伤前活动的能力。然而，主要的限制阻碍了 这一领域的进展是缺乏关于患者每天经历多少胫骨力量的知识 在整个康复计划中的活动，以及康复早期的胫骨力量如何影响 较长期的功能恢复。这项工作的首要目标是生成知识库和工具 这将使我们能够重新想象和提高对胫骨骨折后患者的护理标准 手术，通过监测和管理日常生活中的胫骨力。我们计划实现这一总体目标 目的通过以下几个目标。目的1：在家中第一次描述患者的胫骨力 手术后一年。目标2：创建第一个临床参考指南，对通常情况下的胫骨力量进行排名 规定的康复运动。目标3：评估早期康复期间较高的胫骨力量是否与 在6个月和12个月的随访中，功能恢复较好。如果我们的假设得到支持，那么这些结果 将为新的临床指南(目标骨力阈值)和生物反馈干预提供信息以进行监测 并促进健康骨力的恢复。这种可穿戴式监控模式具有无与伦比的潜力 适应于提高对从众多肌肉骨骼疾病中恢复的护理。