Assessment of Achilles Tendon Injury in Adolescents

项目摘要/摘要 跟腱损伤在青少年运动中的发生率有所增加，但在青少年运动中，跟腱的病理改变 对青少年的调查一直很少。而跟腱病的过度使用损伤是临床上的 成年人被诊断为疼痛、负重和功能丧失，青少年的相同症状被取代 被认为是一种称为跟骨顶炎的生长板疾病。跟骨关节突炎和跟腱 肌腱病可能在肌肉骨骼发育过程中的不同时间起病 使他们的肌腱超载。然而，跟腱病变在青少年中的参与 全身性跟痛是未知的。此外，跟腱损伤的病因尚未确定。 青少年人口。据推测，小腿三头肌过度发育会改变跟腱。 结构(即形态和机械性能)，导致在加载过程中脚跟疼痛和丢失 功能。以下患者的突触炎和肌腱病之间没有明确的临床诊断界限 18岁时脚跟疼痛，忽视跟腱病理可能是由于假设诊断为 跟骨隆起炎。跟腱损伤的误诊及治疗 青少年会降低生活质量，并可能阻碍身体活跃的生活方式的发展 成人期。青春期肢体肌腱病和过早退休的发病率上升 从青少年运动伤病谈起，强调要对跟腱有足够的了解 受伤。然而，跟腱病理学研究不成比例地集中在成人人群中，潜在地 使儿科人口面临长期健康问题的风险。 本研究的目的是探讨足跟痛对青少年跟腱的影响。 健康与腿部生物力学。具体来说，这项研究将评估跟腱症状和 下肢损伤(AIM 1)、跟腱结构和小腿三头肌肌力改变(AIM 2)和跟腱负荷曲线(目标3)比较有足跟痛主诉的青少年 健康的青少年。这项工作将为建立肺炎的病因学提供有价值的证据。 青少年足跟痛，这对于正确诊断和治疗青少年足跟痛是必要的，因此他们 可以在成年后保持身体活跃的生活方式。这位奖学金申请者的长期目标是 研究肌肉骨骼损伤的机制，提高临床康复水平。跨学科 申请人将从生物医学专家和临床合作者那里接受培训 在特拉华大学期间提出的奖学金将使她成为一名有价值的研究员，具有熟练的 在临床测试、创新的成像技术和新的计算建模方面。此外，这项提议将 促进申请者博士后培训，为独立临床工作奠定基础 他是一位科学家，也是健康科学领域多样性的坚定倡导者。

PROJECT SUMMARY/ABSTRACT The incidence of Achilles tendon injury in youth sports has increased, yet Achilles tendon pathology in adolescents has been poorly investigated. While the overuse injury of Achilles tendinopathy is clinically diagnosed by pain with loading and loss of function in adults, the same symptoms in adolescents are instead considered a growth plate disorder called calcaneal apophysitis. Calcaneal apophysitis and Achilles tendinopathy may onset at different times during musculoskeletal growth in adolescents who consistently overload their tendons. However, the involvement of Achilles tendon pathology amongst adolescents with general heel pain is unknown. Further, the etiology of Achilles tendon injury has yet to be determined in the adolescent population. It is speculated that an overdevelopment of triceps surae muscle alters Achilles tendon structure (i.e., morphology and mechanical properties), resulting in heel pain during loading and loss of function. With no clear clinical diagnostic delineation between apophysitis and tendinopathy for patients under 18 years old with heel pain, overlooking Achilles tendon pathology may result from an assumed diagnosis of calcaneal apophysitis. Misdiagnosis and subsequent misaligned treatment of Achilles tendon injury in adolescents can reduce quality of life and may impede the development of a physically active lifestyle into adulthood. The growing incidence rates of lower limb tendinopathies in adolescence, and premature retirement from youth sports due to debilitating injury, stress the need for adequate understanding of Achilles tendon injury. Yet, Achilles tendon pathology research is disproportionately focused on the adult population, potentially leaving the pediatric population at risk of long-term health issues. The objective of this proposal is to investigate the effect of heel pain on adolescent Achilles tendon health and lower limb biomechanics. Specifically, this study will evaluate Achilles tendon symptoms and lower limb impairments (Aim 1), Achilles tendon structure and triceps surae muscle strength alterations (Aim 2), and Achilles tendon loading profiles (Aim 3) of adolescents with complaints of heel pain compared to healthy adolescents. This work will contribute valuable evidence for establishing the pathoetiology of adolescent heel pain, which is necessary to properly diagnosis and treat adolescents with heel pain so they can maintain physically active lifestyles into adulthood. The long-term goal of this fellowship applicant is to investigate mechanisms of musculoskeletal injury and improve clinical rehabilitation. The interdisciplinary training this applicant will receive from expert biomedical researchers and clinical collaborators at the University of Delaware during the proposed fellowship will make her a valuable investigator, with proficiencies in clinical testing, innovative imaging techniques, and novel computational modeling. Further, this proposal will facilitate the applicant’s postdoctoral training, laying the foundation for a career as an independent clinical scientist and strong advocate for diversity in health science fields.