Assessment of Achilles Tendon Injury in Adolescents

项目总结/摘要 跟腱损伤在青少年运动中的发生率有所增加，但跟腱病理在 对青少年的研究很少。而跟腱过度使用损伤在临床上 在成人中，通过负荷疼痛和功能丧失来诊断，而在青少年中， 被认为是一种叫做跟骨骨骺炎的生长板疾病。跟骨骨骺炎和跟腱 肌腱病可能发生在肌肉骨骼生长的不同时期， 使它们的肌腱过载然而，青少年跟腱病变的参与， 一般足跟痛是未知的。此外，跟腱损伤的病因尚未确定， 青少年人口。据推测，小腿三头肌的过度发育改变了跟腱 结构（即，形态学和机械性能），导致足跟疼痛期间加载和损失 功能对于在以下情况下的患者， 18岁的足跟痛，忽略跟腱病理可能是由于假设的诊断， 跟突炎跟腱损伤的误诊及治疗 青少年可能会降低生活质量，并可能阻碍身体活动的生活方式的发展， 成年青少年下肢肌腱病的发病率不断上升，过早退休 从青少年因运动损伤致残，强调对跟腱需要有足够的了解 损伤然而，跟腱病理学研究不成比例地集中在成年人群中， 使儿科人群面临长期健康问题的风险。 这项建议的目的是调查足跟痛对青少年跟腱的影响 健康和下肢生物力学。具体来说，这项研究将评估跟腱症状， 下肢损伤（目的1）、跟腱结构和小腿三头肌肌力改变（目的 2），跟腱负荷曲线（目标3）的青少年与足跟痛的投诉相比， 健康的青少年这一工作将为确定该病的病因学提供有价值的证据。 青少年足跟痛，这是必要的，以正确诊断和治疗青少年足跟痛，使他们 可以保持积极的生活方式直到成年。本奖学金申请人的长期目标是 研究肌肉骨骼损伤机制，促进临床康复。跨学科 该申请人将从生物医学研究人员和临床合作者那里接受培训， 特拉华州大学在拟议的奖学金将使她成为一个有价值的调查，与教授 在临床测试，创新的成像技术，和新的计算建模。此外，该提案将 有利于申请人的博士后培养，奠定了作为一个独立的临床事业的基础 科学家和健康科学领域多样性的强烈倡导者。

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.