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（由适用提供）：腕管综合征（CTS）是由手腕中位神经压缩引起的普遍手动障碍。它对国家医疗保健，工人生产力和生活质量有影响。 CTS通常通过横向腕韧带进行解压缩的手术来治疗中位神经。这种手术概念已经存在了将近一个世纪的情况，没有根本的挑战，即使该过程有很多并发症。未释放韧带的替代治疗方法已尝试，但是由于缺乏科学和临床证据，它们的效率仍然有争议。我们寻求改进的CTS治疗策略，导致了通过将横向压缩施加到手腕上以重塑和扩大隧道空间的偶然性发现中位神经减压的新机制。我们通过缩短腕弓宽度来扩展腕管的方法与试图向外伸展腕管的现有方法形成鲜明对比。我们的发现和概念验证具有根据生物力学原则对非手术治疗CT的巨大潜力。该拟议项目的总体目标是设计和制定腕管操作策略，该策略可实现CTS的治疗效率。我们的中心假设是，我们的生物力学操纵方法增加了腕管区域，从而减轻了中位神经并减轻CTS症状。将实施三个特定的目标来实现目标并确认假设：（1）确定腕管操作的最佳生物力学策略，以便随着压缩力最少的最少的压缩力有效地增加了腕管横截面区域；（2）研究腕管形态，中值神经形和腕管的变化，以应对CTS个体的生物力学操纵；（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具有临床有效性。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物理机制，以系统地制定基于证据的CTS治疗策略。该项目的完成将加速我们对无需手术的生物力学管理CT的新策略的实现。