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Biomechanical Treatment of Carpal Tunnel Syndrome

腕管综合症的生物力学治疗

基本信息

批准号：
10047785
负责人：
Zong-Ming Li
金额：
$ 45.4万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10047785
关键词：
Biomechanical Treatment Carpal Tunnel Syndrome

项目摘要

DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is a prevalent hand disorder caused by compression of the median nerve at the wrist. It has an immense impact on national health care, worker productivity, and quality of life. CTS is commonly treated by a surgery that transects the transverse carpal ligament to decompress the median nerve. This surgical concept has existed for nearly a century without fundamental challenges, even though this procedure has a number of complications. Alternative treatments that do not release the ligament have been attempted, but their efficacy remains controversial due to lack of scientific and clinical evidence. Our search for an improved CTS treatment strategy has resulted in the serendipitous finding of a novel mechanism of median nerve decompression by applying transverse compression to the wrist to reshape and enlarge the tunnel space. Our approach to carpal tunnel expansion by shortening the carpal arch width is in contrast to existing methods that try to stretch the carpal tunnel outwards. Our finding and proof-of-concept hold significant potential to non-surgically treat CTS according to biomechanical principles. The overall goal of this proposed project is to design and develop a strategy of carpal tunnel manipulation that achieves treatment efficacy for CTS. Our central hypothesis is that our approach of biomechanical manipulation increases carpal tunnel area, thereby decompressing the median nerve and alleviating CTS symptoms. Three specific aims will be implemented to achieve the objective and confirm the hypothesis: (1) to determine the optimal biomechanical strategy of carpal tunnel manipulation such that the carpal tunnel cross-sectional area is effectively enlarged with the least amount of compressive force; (2) to investigate changes of carpal tunnel morphology, median nerve shape, and carpal tunnel pressure in response to the biomechanical manipulation in individuals with CTS; and (3) to demonstrate the clinical effectiveness of the biomechanical intervention in improving the neurophysiological deficiencies and symptoms associated with CTS. This project combines basic science and clinical translation, elucidating the underlying morphological and physiological mechanisms of the biomechanical intervention for a systematic and rigorous development of an evidence-based strategy for CTS treatment. Completion of this project will accelerate our realization of a novel strategy to biomechanically manage CTS without surgery.

描述（由申请人提供）：腕管综合征（CTS）是一种常见的手部疾病，由腕部正中神经压迫引起。它对国民保健、工人生产力和生活质量产生了巨大影响。腕管综合征通常是通过手术治疗，横切腕横韧带，以恢复正中神经。这种手术概念已经存在了近世纪，没有根本的挑战，即使这种手术有许多并发症。已经尝试了不释放韧带的替代治疗，但由于缺乏科学和临床证据，其疗效仍然存在争议。我们寻找一种改进的CTS治疗策略，偶然发现了一种新的正中神经减压机制，通过对腕部施加横向压迫来重塑和扩大隧道空间。我们通过缩短腕弓宽度来进行腕管扩张的方法与试图向外拉伸腕管的现有方法相反。我们的发现和概念验证具有根据生物力学原理非手术治疗CTS的巨大潜力。本项目的总体目标是设计和开发一种腕管手法治疗策略，以达到治疗CTS的效果。我们的中心假设是，我们的方法的生物力学操作增加腕管面积，从而减压正中神经和减轻CTS症状。本研究将通过三个具体的目标来实现这一目标并证实这一假设：（1）确定腕管手法的最佳生物力学策略，从而以最小的压力有效地扩大腕管横截面积;（2）观察腕管形态、正中神经形态、和腕管压力对CTS个体中生物力学操作的响应;以及（3）证明生物力学干预在改善与CTS相关的神经生理缺陷和症状方面的临床有效性。该项目结合了基础科学和临床翻译，阐明了生物力学干预的基本形态和生理机制，以系统和严格地制定CTS治疗的循证策略。该项目的完成将加速我们实现一种新的战略，生物力学管理CTS没有手术。