Quadriceps Muscle Quality: A Post-Injury Determinant of Knee Function and Health

股四头肌肌肉质量:膝关节功能和健康的损伤后决定因素

基本信息

  • 批准号:
    10743396
  • 负责人:
  • 金额:
    $ 27.37万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-07-26 至 2025-06-30
  • 项目状态:
    未结题

项目摘要

Abstract Persistent quadriceps muscle dysfunction following anterior cruciate ligament (ACL) injury and reconstruction (ACLR) is a critical clinical concern impacting the success of postoperative rehabilitation and prognosis of long- term joint health. Our novel working hypothesis is that worse quadriceps muscle quality, caused by a progressive increase in non-contractile tissue within the muscle, post-ACL injury and ACLR is a critical and understudied mechanism underlying poor clinical outcomes. There is a significant scientific gap in our understanding of the mechanistic pathway linking changes in quadriceps muscle quality to poor clinical outcomes. Our preliminary work using ultrasonography to assess changes in muscle quality supports our working hypothesis, in that patients with an ACL injury demonstrate muscle tissue image signal changes consistent with increased non- contractile tissue makeup in the first 3 months post-ACLR. Furthermore, ultrasonographic muscle tissue signal changes are associated with lesser knee extensor strength and worse physical performance (i.e., hop testing). Unfortunately, rigorous studies to test our working hypothesis have not been conducted to comprehensively evaluate the effect of ACL injury on muscle quality and the impact of poorer muscle quality on clinical outcomes. Recent magnetic resonance imaging (MRI) innovations now allow for high-precision and rapid evaluation of muscle quality throughout the entire muscle volume and in individual quadricep heads. We can be opportunistic and leverage an ongoing rehabilitation-based parent clinical trial already collecting critical clinical outcomes of knee extensor strength, gait biomechanics, physical performance and patient-reported outcomes (PRO), and tibiofemoral cartilage composition at preoperative, and 1-, 6-, and 12-month post-ACLR timepoints. We are proposing to test our working hypothesis with an ancillary R21 by conducting the following specific aims: 1) determine longitudinal changes in quadriceps muscle quality following ACL injury and ACLR preoperatively and at 1-, 6- and 12-months post-ACLR; and 2) determine the associations between changes in muscle quality and a) knee extensor strength; b) gait biomechanics; c) PRO and physical performance; and d) tibiofemoral cartilage composition. Our study is innovative as: 1) we are testing a novel hypothesis that quadriceps muscle quality changes early post-ACL injury and that it is a critical mechanism associated with poor clinical outcomes; 2) we are utilizing a novel MRI technique capable of collecting highly-sensitive measures of muscle quality in individual heads of the quadriceps throughout the entire muscle volume; and 3) associations between muscle quality and a comprehensive host of clinical outcomes (i.e. knee extensor strength, gait biomechanics, physical performance and PRO, and tibiofemoral cartilage composition) can be evaluated as part of the ancillary R21. The proposed R21 is significant as identifying the association between deleterious changes in muscle quality and poor clinical outcomes is the first critical step in developing the next generation of interventions to address the underlying mechanistic muscular changes leading to poor outcomes following ACL injury and ACLR.
摘要 前交叉韧带损伤和重建后持续性股四头肌功能障碍 (ACLR)是影响慢性阻塞性肺疾病术后康复成功和预后的重要临床问题。 关节健康术语。我们新的工作假设是股四头肌肌肉质量变差是由进行性 前交叉韧带损伤后肌肉内非收缩组织的增加和ACLR是一个关键的和未被研究的问题 临床结果不佳的机制。我们对这一现象的理解存在着重大的科学鸿沟 机制途径将股四头肌肌肉质量的变化与不良的临床结果联系起来。我们的预赛 使用超声波来评估肌肉质量变化的研究支持了我们的工作假说,因为 前交叉韧带损伤患者的肌肉组织图像信号变化与增加的非 ACLR术后前3个月的收缩组织组成。此外,超声肌肉组织信号 变化与较弱的膝关节伸肌力量和较差的身体表现(即跳跃测试)有关。 不幸的是,检验我们的工作假设的严格研究还没有全面地进行 评估前交叉韧带损伤对肌肉质量的影响以及较差的肌肉质量对临床结果的影响。 最近的磁共振成像(MRI)创新现在允许高精度和快速地评估 整个肌肉体积和单个股四头肌的肌肉质量。我们可以投机取巧 并利用正在进行的基于康复的父母临床试验,该试验已经收集了 膝关节伸展力量、步态生物力学、身体表现和患者报告的结果(PRO) 术前、术后1个月、6个月和12个月时的胫股软骨成分。我们是 建议通过执行以下具体目标来使用辅助R21来测试我们的工作假设:1) 测定前交叉韧带损伤和前交叉韧带损伤后股四头肌肌肉质量的纵向变化 在ACLR术后1、6和12个月;以及2)确定肌肉质量变化和 A)膝关节伸展力量;b)步态生物力学;c)职业和体能表现;d)胫股软骨 组成。我们的研究具有创新性,因为:1)我们正在测试一个新的假说,即股四头肌的肌肉质量 改变了前交叉韧带损伤后的早期,这是一个与不良临床结果相关的关键机制;2)我们 正在使用一种新的核磁共振技术,能够收集个人肌肉质量的高度敏感的指标 整个肌肉体积的股四头肌的头部;3)肌肉质量和肌肉质量之间的关系 一组全面的临床结果(即膝关节伸肌力量、步态生物力学、体能 和PRO,以及胫股软骨成分)可以作为辅助R21的一部分进行评估。建议数 R21对于确定肌肉质量的有害变化与临床不良之间的联系具有重要意义。 结果是制定下一代干预措施的第一个关键步骤,以解决潜在的 机械性肌肉改变导致前交叉韧带损伤和前交叉韧带损伤后的不良预后。

项目成果

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Brian Pietrosimone其他文献

Brian Pietrosimone的其他文献

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{{ truncateString('Brian Pietrosimone', 18)}}的其他基金

Improving Disability in Knee Osteoarthritis by Targeting Neuromuscular Deficits
通过针对神经肌肉缺陷改善膝骨关节炎的残疾
  • 批准号:
    9131614
  • 财政年份:
    2015
  • 资助金额:
    $ 27.37万
  • 项目类别:

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