Automated Connective Tissue Torque Sensor

描述(申请人提供)：该项目的长期目标是开发一种生物标记物--针扭矩试验(NTT)--能够检测与肌肉骨骼疾病相关的结缔组织异常。实施NTT的方法是将针刺针插入结缔组织，并使用自动针扭矩传感器通过旋转向针探头提供精确的生物力学刺激。组织对这种刺激的反应被量化为扭矩。我们的具体目标是：1)证明自动针刺扭矩传感器装置和针刺扭矩测试程序的体外可靠性。这将通过进行结构和方法改进来确保测量的一致性，并记录设备在模拟临床条件下相对于已知扭矩的性能，从而实现这一点。2)记录在体扭矩测试/复测的可靠性。为了实现这一目标，我们将对100名没有肌肉骨骼疼痛或病理的健康受试者进行纵向研究，在三个时间点(时间0、30分钟和1周)重复测试股二头肌、股直肌和肱二头肌的6个点。3)确认NTT是能够识别结缔组织异常的生物标志物，方法是：a)建立NTT/结缔组织紊乱的联系。我们将收集并比较15名硬皮病患者和15名表现为结缔组织过度松弛的遗传性结缔组织疾病患者的NTT评分，与目标2中年龄和性别频率匹配的30名对照组进行比较，b)建立NTT/肌肉骨骼疾病之间的联系。我们将收集并比较15名腿部肌腱柔韧性受限的受试者的NTT分数，与年龄和性别频率匹配的15名腿部肌腱柔韧性正常的对照组受试者进行比较。 公共卫生相关性：慢性肌肉骨骼疼痛是相当大的残疾、旷工和医疗费用的来源。将按摩和脊椎手法等手动疗法纳入我们的保健系统的一个主要障碍是缺乏客观衡量治疗效果的方法。该项目正在开发的自动针扭矩传感器技术将可能使与肌肉骨骼疼痛相关的结缔组织异常的客观测量成为可能。这将有助于1)通过改进的研究确定人工治疗的有效性，2)加强对临床实践中患者进展的客观监测，3)支持所需的证据，以证明保险报销是合理的。

DESCRIPTION (provided by applicant): The long term goal of this project is to develop a biomarker - the Needle Torque Test (NTT) - capable of detecting connective tissue abnormalities associated with musculoskeletal disorders. The NTT is administered by inserting an acupuncture needle into connective tissue and using the Automated Needle Torque Sensor to deliver a precise biomechanical stimulus to the needle probe via rotation. The tissue response to this stimulus is quantified as torque. Our Specific Aims are: 1) Document Automated Needle Torque Sensor device and Needle Torque Test procedural reliability in vitro. This will be achieved by making structural and methodological refinements designed to insure measurement consistency, and documenting device performance under simulated clinical conditions against known torques. 2) Document the Needle Torque test/retest reliability in vivo. To fulfill this aim, we will perform a longitudinal study in 100 healthy human subjects without musculoskeletal pain or pathology, repeating testing of 6 points on the biceps femoris, rectus femoris, and biceps brachii at three time points (time 0, 30 minutes and 1 week). 3) Validate the NTT as a biomarker capable of identifying connective tissue abnormalities by: a) establishing an NTT/connective tissue disorder link. We will collect and compare NTT scores in 15 subjects with scleroderma, and 15 subjects with inherited connective tissue disorders manifesting as connective tissue hyperlaxity, compared with 30 control subjects from Aim 2 that are frequency-matched for age and sex and b) establishing an NTT/musculoskeletal disorder link. We will collect and compare NTT scores in 15 subjects with restricted hamstring flexibility, compared with 15 control subjects from Aim 2 with normal hamstring flexibility who have been frequency-matched for age and sex. PUBLIC HEALTH RELEVANCE: Chronic musculoskeletal pain is the source of considerable disability, work absenteeism and health care costs. A major obstacle to the incorporation of manual therapies such as massage and spinal manipulation into our health care system is the lack of methods to objectively measure the effect of treatments. Automated Needle Torque Sensor technology under development in this project will potentially enable objective measurement of connective tissue abnormalities associated with musculoskeletal pain. This will 1) help establish the efficacy of manual treatments through improved research, 2) enhance the objective monitoring of patient progress in clinical practice and 3) bolster the evidence needed to justify insurance reimbursement.