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.

每年超过49万美国人的胫骨（Shinbone），需要手术。但是，患者康复1 手术后的一年很差，与2/3的患者不一致，报告无法进行受伤前休闲 活动和1/2仍然没有恢复到恢复工作。胫骨轴后临床医生的关键作用 骨折手术是开出一项康复运动计划，使每个患者的胫骨暴露于增加 力量逐渐恢复进行受伤前活动的能力。但是，主要限制阻碍了 该领域的进展是缺乏关于每天胫骨武力经历多少的知识 活动，在整个恢复过程中的康复计划中，以及恢复早期的胫骨力如何影响 长期功能恢复。这项工作的总体目标是生成知识库和工具 这将使我们能够在胫骨骨折后重新构想并提高个人的护理标准 手术，通过监测和管理日常生活中的胫骨力量。我们建议完成总体 通过以下目标进行客观。 AIM 1：在第一个患者中表征患者的胫骨骨力 手术后的一年。 AIM 2：创建第一个临床参考指南，该指南通常在通常 规定的康复练习。目标3：评估早期恢复期间较高的胫骨力是否相对应 在6个月和12个月的随访中，更好的功能结果。如果我们的假设得到了支持，那么这些结果 将告知新的临床准则（目标骨力阈值）和生物反馈干预措施以监测 并在恢复中促进健康的骨力。这种可穿戴的监视范例具有无与伦比的潜力 适应以提升从众多肌肉骨骼疾病中恢复的护理。