Dynamic muscle function monitoring in older adults: development of a novel wearable device to measure muscle function

随着人们年龄的增长，走路往往变得更加困难。这减少了流动性，增加了跌倒和骨折的风险，这可能会导致丧失独立生活、社会孤立和增加死亡风险。步态随年龄增长而恶化的原因包括循环、神经、肺功能、关节和肌肉的变化。这个项目的重点是与年龄相关的肌肉变化。一种称为骨质疏松症的肌肉疾病在老年人中很常见，65岁以上的成年人中有10%-20%的人会受到影响。骨质疏松症的特征是肌肉萎缩，肌肉力量和功能下降。骨骼减少会降低活动能力，因为肌肉不够强壮，不能有效地移动关节。骨质疏松症还与许多与年龄相关的慢性病和免疫系统有关。2016年，英国与肌肉无力和骨质疏松症直接相关的医疗费用估计为25亿英镑。随着人口老龄化，到2045年，石棺减少症预计将影响1800-3200万欧洲人，比2016年增长%-72%。因此，评估肌肉系统的健康状况并制定适当的石棺减少干预措施，对于促进健康老龄化、长寿和生活质量至关重要。目前还没有可靠的、非侵入性的、低成本的方法来测量肌肉健康和诊断骨质疏松症。我们的多学科团队计划开发一种低成本、非侵入性和易于使用的新型可穿戴设备(MyoSock)。我们将瞄准的该设备的初始用户将是开发药物和非药物干预(例如，锻炼和营养)的研究人员。研究人员将从这一设备中受益，因为他们拥有一种客观的方法来测量肌肉健康并监测治疗的有效性。长期目标是将这种设备商业化地开发用于临床和非临床(一般肌肉活动监测)目的，可与Fitbit或Apple iWatch等智能手表相媲美，测量步数和脉搏频率。本研究由三部分组成：工程部分、实验部分和分析验证部分。工程师们将与一家生产“智能”运动服装的英国小公司一起开发“MyoSock”。它将包含不同类型的传感器，通过压印电路连接在一起，并封装在膝盖长度的压缩袜子中。信号将被发送到电脑或智能手机。这些传感器将测量腿部运动，以及肌肉收缩时产生的压力、温度和电力的变化。实验部分将由两部分组成：在大学运动实验室测试该设备，并使用磁共振(MR)扫描对腿部肌肉进行成像。参与者将包括20名65岁以上的健康老年妇女。女性被选中是因为女性在行动能力方面有更多问题，而且更容易摔倒。运动实验室的测试要求参与者在坐着和走路的五分钟中收缩腿部肌肉。成像将在磁共振中心进行。专门的磁共振扫描将测量肌肉的体积，肌肉中的脂肪量，并指出肌肉纤维的类型(慢/快)。第三个部分，分析验证，将分析来自MyoSock和磁共振扫描的录音。我们将调查“肌肉袜子”的肌肉健康测量与肌肉体积、脂肪渗透和肌肉细胞类型的变化之间的关系。一位资助了3年的早期研究人员也将致力于该设备的开发。该项目具有很高的创新性，因为它涉及不同类型的传感器，从信号中提取新的特征，并将非传统方法应用于信号。详细的磁共振扫描可以让我们“观察”肌肉内部，这将提供强有力的验证。总而言之，这一设备可以通过解决对健康老龄化至关重要的肌肉健康问题来改变老年人口的医疗保健方法。

As people age, walking often becomes more difficult. This reduces mobility which increases the risk of falls and fractures, which may lead to loss of independent living, social isolation, and increased risk of death. Reasons why walking worsens with age including changes in circulation, nerves, lung function, joints, and muscles. This project focuses on age-related changes in muscle. A muscle disease known as sarcopenia is common in older adults, affecting 10% - 20% of adults over 65 years. Sarcopenia is characterized by muscle wasting and decreased muscle strength and function. Sarcopenia reduces mobility as the muscles are not strong enough to move the joints efficiently. Sarcopenia is also associated with many age-related chronic diseases and the immune system. Health care costs directly associated with muscle weakness and sarcopenia were estimated to be £2.5 billion in the UK in 2016. As the population ages, sarcopenia will affect a projected 18-32 million Europeans by 2045, an increase of 64% - 72% from 2016. Assessing the health of the muscular system and developing appropriate interventions for sarcopenia is therefore essential for advancing healthy ageing, longevity, and quality of life. Currently there is no reliable non-invasive, low-cost method of measuring muscle health and diagnosing sarcopenia. Our multidisciplinary team propose to develop a novel wearable device (the 'MyoSock') that is low cost, non-invasive and easy to use. The initial users of the device we will target will be researchers developing pharmaceutical and non-pharmaceutical interventions (e.g. exercises and nutrition). The researchers will benefit from this device by having an objective method of measuring muscle health and of monitoring effectiveness of treatments. The long-term goal is to develop this device commercially for both clinical and nonclinical (general muscle activity monitoring) purposes comparable to smart watches such as fitbits or Apple iwatch measuring steps and pulse rate. The study consists of three elements: an engineering part, an experimental part, and an analytical validation part. Engineers together with a small UK company who produce 'intelligent' sports garments will develop the 'MyoSock'. It will contain different types of sensors connected by imprinted circuits enclosed in a knee length compression stocking. Signals will be sent to a computer or smartphone. The sensors will measure leg movement and changes in pressure, temperature and electricity generated when muscles contract. The experimental component will consist of two parts: testing the device in a university-based Movement Laboratory and imaging the leg muscles with magnetic resonance (MR) scans. Participants will include 20 healthy older women aged over 65 years. Women are selected as women have more problems with mobility and fall more often. The Movement Laboratory testing involves participants contracting leg muscles whilst sitting and walking for five minutes. The imaging will take place at the Magnetic Resonance Centre. The specialized MR scans will measure the volume of muscle, amount of fat in the muscle and indicate types of muscle fibres (slow / fast) present. The third component, analytical validation, will analyse the recordings from the 'MyoSock' and the MR scans. We will investigate relationships between muscle health measurements from the 'Myosock' and changes in muscle volume, fatty infiltration and muscle cell types as assessed by MR scans. An early stage researcher with funding for 3 years will also be working on development of the device. This project is highly innovative as it involves different sensor types, extracts novel features from signals and applies nontraditional methods to the signals. The detailed MR scans which allow us to 'look inside' the muscle will provide strong validation. In summary, this device could transform the approach to health care of the ageing population by addressing muscle health, essential for healthy ageing.