Microsensor for Intramuscular Pressure Measurement

描述(申请人提供)：目前，还没有实用的方法来直接测量单个肌肉产生的力量。手动肌肉测试不能给出准确的肌肉力量估计。关节扭矩的测量是不够的，因为几块肌肉通常对扭矩的形成有贡献。在肌腱上植入扣式换能器是一种侵入性很强的方法，对于常规使用是不切实际的。肌电是用来测量休息和收缩肌肉所产生的电活动的模式和数量的临床标准。然而，问题仍然是，肌电活动不能提供肌肉张力的定量测量。相反，我们之前的研究已经证明，肌内压力准确地测量了正常肌肉的主动和被动张力。该项目的总体目标是为活体肌肉力量的量化提供一个有用的临床工具。我们计划进一步发展使用肌肉内压作为一种强大的临床工具的科学基础。这项研究的具体目标是：(A)继续开发用于测量肌肉内压力的光纤微型传感器；(B)进行体内人体实验，以评估肌肉内压力与运动单位招募、活跃运动单元的数量和复合肌肉动作电位大小的关系；(C)在动物模型中确定病理机电耦合条件下肌肉内压力和肌肉张力之间的关系；以及(D)使用基于连续介质力学的骨骼肌三维有限元模型来指导肌肉内压力的临床应用。这种传感器的成功开发将带来一种强大的新临床工具。最终目标是将这种微型传感器用于神经源性疾病(例如运动神经元病、周围神经病)、神经肌肉传导障碍(例如重症肌无力、Lambert-Eaton综合征)和肌肉疾病(例如肌营养不良症、多发性肌炎、代谢性肌病)患者的临床决策和治疗。 公共卫生相关性：肌肉无力是患者常见的主诉。如果怀疑虚弱的具体原因，经常进行肌电检查，以确认肌肉、神经或神经肌肉连接障碍的存在。肌电图术评估肌肉电活动的几个组成部分。然而，肌电图在评估机电耦合的障碍或表现方面是有限的。提出的测量肌肉内压力的解决方案可能会产生一个有用的临床工具，以更好地了解神经、肌肉或神经肌肉传递的障碍。

DESCRIPTION (provided by applicant): Currently, no practical method exists for direct measurement of force production from individual muscles. Manual muscle tests do not give an accurate estimate of muscle strength. Measurements of joint torque are inadequate because several muscles often contribute to torque development. Implantation of a buckle transducer on a tendon is highly invasive and impractical for regular use. The electromyogram is the clinical standard used to measure the patterns and amount of electrical activity generated from resting and contracting muscle. However, the problem remains that electromyographic activity does not provide a quantitative measure of muscle tension. In contrast, our previous research has demonstrated that intramuscular pressure accurately measures both the active and passive tension of normal muscle. The overall objective of this project is to provide a useful clinical tool for in-vivo quantification of muscle force. We plan further development of the scientific foundation for use of intramuscular pressure as a powerful clinical tool. The specific aims of this study are to (a) continue development of a fiber optic microsensor to measure intramuscular pressure, (b) perform in-vivo human experiments to evaluate the relationship of intramuscular pressure to the recruitment of motor units, the number of active motor units, and the size of the compound muscle action potential, c) determine the relationship between intramuscular pressure and muscle tension for pathological electromechanical coupling conditions in an animal mode, and (d) guide clinical applications of intramuscular pressure using a continuum mechanics- based 3D finite element model of skeletal muscle. Successful development of this sensor will result in a powerful new clinical tool. The ultimate goal is to use this microsensor for clinical decision making and treatment of patients with neurogenic disorders (e.g. motor neuron disease, peripheral neuropathy), disorders of neuromuscular transmission (e.g. myasthenia gravis, Lambert-Eaton syndrome) and myopathies (e.g. muscular dystrophies, polymyositis, metabolic myopathies). PUBLIC HEALTH RELEVANCE: Muscle weakness is a common patient complaint. If a specific cause of weakness is suspected, electromyographic studies are frequently performed to confirm the presence of a disorder of muscle, nerve, or neuromuscular junction. Electromyography assesses several components of muscle electrical activity. However, the electromyogram is limited for evaluating disorders or manifestations of electromechanical coupling. The proposed solution to measure intramuscular pressure may yield a useful clinical tool to gain a greater understanding of disorders of nerve, muscle, or neuromuscular transmission.