A model for wrist and elbow musculoskeletal disorders

描述：关于各种生物力学的相对作用存在争议。 因素（例如，力、重复、加速度等）在重复性的工作中， 上肢肌肉骨骼疾病的病因。大多数这些 这些因素可以在设计工作时改变。我们将利用我们最近 建立了兔手指屈肌模型，以研究这些因素的作用 引起腕部正中神经的压迫性神经病变， 上髁处的肌腱病此外，该研究将及早发现 基质蛋白和细胞因子的细胞和生化变化。2小时 每天，每周3天，持续10周，大手指屈肌重复 刺激，同时控制指尖负荷。执行加载 在全身麻醉下该系统允许精确控制 重复率、峰值指尖力、负载持续时间和负载率。 三个实验将分别研究重复率、峰值 力和加载速率对组织功能和结构的影响。功（积分） 力随时间的变化）将在整个加载条件下保持恒定。中值 通过测量腕部的远端运动潜伏期来评价神经功能， 神经纤维数、纤维密度和髓鞘化的形态学差异 是量化的。肌腱附着部位的形态学差异 用半定量和定量方法评价上髁 评估细胞结构、细胞形状、胶原纤维线性， 新血管形成、水肿和凋亡。抗原的位置和密度 结构蛋白（胶原蛋白I、II、ifi、核心蛋白聚糖、腱生蛋白、纤连蛋白）， 和各种细胞因子（IL-1b. TNF-α、TGF-β、bFGF、P物质）将被 用免疫组织化学方法进行评估。第四个实验将评估 这些生化终点在早期的接触时间。这项研究有 有可能识别生物力学载荷的特征， 有害的;对职业健康从业人员有价值的信息， 针对重复性工作的人体工程学指南的特异性。这项研究还发现， 确定疾病的生化途径和时间范围的潜力 进展;可能导致新的治疗策略和 预防与工作有关的压迫性神经病和肌腱疾病。

DESCRIPTION: Debate exists regarding the relative role of various biomechanical factors (e.g., force, repetition, acceleration, etc.) during repetitive work in the causation of upper extremity musculoskeletal disorders. Most of these factors can be altered in the design of work. We will use our recently developed rabbit finger flexor model to investigate the role of these factors in causing entrapment neuropathy of the median nerve at the wrist and tendinosis at the epicondyle. In addition, the study will identify early cellular and biochemical changes in matrix proteins and cytokines. For 2 hours per day, 3 days per week for 10 weeks, the large finger flexor is repetitively stimulated while the fingertip load is controlled. The loading is performed under general anesthesia. The system allows for the precise control of repetition rate, peak fingertip force, load duration, and rate of loading. Three experiments will separately investigate the role of repetition rate, peak force, and loading rate on tissue function and structure. Work (integral of force over time) will be held constant across the loading conditions. Median nerve function is evaluated by measuring distal motor latency across the wrist, and morphologic differences in nerve fiber count, fiber density and myeination are quantified. Morphologic differences in the tendon attachment site at the epicondyle are evaluated with semi-quantitative and quantitative methods assessing cellularity, cell shape, collagen fiber linearity, neovascularization, edema, and apoptosis. The antigentic location and density of structural proteins (collagen I,II, ifi, decorin, tenascin, fibronectin), and various cytokines (IL- lb. TNF-a, TGF-B, bFGF, substance P) will be assessed using immunohistochemical methods. A fourth experiment will assess these biochemical endpoints at earlier times of exposure. This study has the potential to identify the characteristics of biomechanical loading, which are injurious; information valuable to occupational health practitioners in adding specificity to ergonomic guidelines for repetitive work. The study also has the potential to identify the biochemical pathways and time-frames of disease progression; information which may lead to new strategies for treating and preventing entrapment neuropathies and tendon disorders related to work.