Integrating Biomechanics and Experimental Pain to Understand Compensatory Mechanisms in Symptomatic Carpometacarpal Osteoarthritis

项目摘要/摘要 腕掌骨关节炎(CMC OA)是一种致残性疾病，可导致剧烈疼痛，力量下降， 和有限的运动范围。这些因素会导致生活质量的下降，并导致其他伴随因素 精神状态下降等情况。不幸的是，目前还没有可以阻止病情发展的治疗方法。 或恢复细小和粗大的运动功能。了解骨性关节炎的病理生理学机制对 开发改进的治疗方案，可以在不损害身体功能的情况下消除疼痛。 该提案的主要目的是通过确定补偿机制之间的关系来理解补偿机制 运动和疼痛。这项工作的目标是比较疼痛阈值、肌肉控制策略和 终末期CMC骨性关节炎患者和年龄匹配的健康成人之间的关节运动学。定量感官 测试将用于测量痛阈值(目标1)。这些结果将为我们提供疼痛基线，识别 与症状性骨性关节炎相关的疼痛表型--疼痛以及CMC骨性关节炎是否引起对其他部位的敏感化 在身体上。肌肉内电极将被用来测量肌肉活动和量化神经肌肉 补偿(目标2)。这些结果将突显肌肉控制策略如何改变以防止进一步的疼痛 或损伤，并可能提供信息，是否需要在手术治疗中考虑肌肉。运动捕捉 将在一系列运动任务中测量关节角度，以量化疼痛对运动的影响(目标3)。这个 结果将突出相邻关节如何适应以补偿疾病引起的运动限制和 可以通知物理治疗练习，以防止进一步的限制。为了进一步强调……的重要性 将疼痛测量整合到生物力学研究中，运动诱发疼痛测量(目标2和3) 将强调运动如何影响疼痛。这些结果将为补充未来的研究奠定基础 检查疾病进展或评估当前治疗方法的疗效。最重要的是，理解 补偿机制和疼痛的复杂性是开发改进治疗方法的第一步 和靶向治疗。 通过这项建议，申请者将获得有效的教学和指导培训，并在 跨学科团队，向科学和临床受众传播研究成果。申请者将会 还获得了设计和执行涉及人类受试者的实验的经验，并使用 肌肉骨骼模型对实验结果的补充。这些经历将增强 申请人的技术和专业技能，从而提供成功的职业生涯所需的培训 作为研究人员的学术界。

PROJECT SUMMARY/ABSTRACT Carpometacarpal osteoarthritis (CMC OA) is a disabling disease that can cause severe pain, decreased strength, and limited range of motion. These factors lead to a loss in quality of life and contribute to other concomitant conditions such as decline in mental. Unfortunately, there are no current treatments that will stop the progression of OA or restore both fine and gross motor function. Understanding the pathophysiology of OA is critical to developing improved treatment options that can eliminate pain without compromising physical function. This proposal broadly aims to understand compensatory mechanisms by identifying the relationship between movement and pain. The objective of this work is to compare pain thresholds, muscle control strategies, and joint kinematics between patients with end-stage CMC OA and age-matched healthy adults. Quantitative sensory testing will be used to measure pain thresholds (Aim 1). These results will provide us with a pain baseline, identify pain phenotypes associated with symptomatic OA-pain and whether CMC OA causes sensitization to other parts of the body. Intramuscular electrodes will be used to measure muscle activity and quantify the neuromuscular compensations (Aim 2). These results will highlight how muscle control strategies change to prevent further pain or injury and could inform whether muscles need to be considered during surgical treatments. Motion capture will measure joint angles during range of motion tasks to quantify the effect of pain on movement (Aim 3). The results will highlight how neighboring joints adapt to compensate for disease-induced movement limitations and could inform physical therapy exercises to prevent further restrictions. To further highlight the importance of integrating pain measurements in biomechanical studies, movement-evoked pain measurement (Aim 2 and 3) will emphasize how movement affects pain. The results will create the foundation to supplement future studies examining disease progression or assessing the efficacy of current treatments. Above all, understanding the compensatory mechanisms and the complex nature of pain is the first step to developing improved treatments and targeted therapies. Through this proposal, the applicant will obtain training on teaching and mentoring effectively, collaborating on interdisciplinary teams, and disseminating research to both scientific and clinical audiences. The applicant will also gain experience designing and performing experiments that involve human subjects and using musculoskeletal modeling to complement the experimental results. These experiences will enhance the applicant’s technical and professional skills, thereby providing the training needed for a successful career in academia as research faculty.