Ultrasonic analysis of the effects of aging on tendon mechanics

描述（由申请人提供）：肌腱疾病是所有过度使用损伤中最常见的，损伤发生率与年龄有关。例如，肌腱病是一种慢性退行性疾病，常见于跟腱、髌腱和四头肌腱等。肌腱损伤的早期检测极具挑战性，并且终末期治疗的成功率有限，通常会导致废用性萎缩的螺旋式下降。虽然衰老对肌肉形态、强度和组成的影响有很好的记录，但对肌腱中发生的与年龄相关的变化知之甚少。最近，超声已获得使用作为一种技术来评估力学变化的肌腱与老化，但产生了相互矛盾的结果。缺乏确凿的证据可能部分是由于目前的技术准确捕捉体内肌腱力学的能力有限。具体而言，目前的方法是无法测量区域肌腱应变，这已被认为有助于肌腱损伤。因此，本研究的目的是推进定量二维超声弹性成像技术，用于评价区域肌腱应变。肌肉肌腱特异性弹性成像技术将通过新型肌腱模拟体模、有限元模型和体外试验进行验证。在技术确认后，将通过收集三个年龄组（年轻、中年和老年人）健康跟腱动态加载期间的超声数据，评价肌腱区域应变的年龄相关变化。从这项研究中获得的新见解将促进对与年龄相关的肌腱疾病的科学理解，并将引入一种创新技术，用于跟踪与理解，诊断和治疗肌腱损伤相关的应变不均匀性。 公共卫生相关性：本研究的目的是验证和使用一种新的定量超声技术来研究老化如何改变肌腱的特性和变形模式。这项研究将深入了解肌腱病的根本原因，肌腱病是一种在中年和老年人中更常见的慢性疼痛性损伤。此外，超声技术可用于提高肌腱疾病的早期诊断，并监测临床治疗对肌腱功能的影响。

DESCRIPTION (provided by applicant): Tendon disorders are the most common of all overuse injuries, and injury incidence is related to age. Tendinopathy, for example, is a chronic degenerative condition which is common in the Achilles, patellar and quadriceps tendons, among others. Early detection of tendon injuries is extremely challenging, and end-stage treatments have limited success, often leading to a downward spiral of disuse atrophy. Although the effects of aging on muscle morphology, strength and composition are well documented, the age-related changes that occur in tendon are poorly understood. Recently, ultrasound has gained use as a technique to evaluate the mechanical changes in tendon with aging, but have produced conflicting results. The lack of conclusive evidence is likely due in part to the limited capacity of current techniques to accurately capture in vivo tendon mechanics. Specifically, current methods are incapable of measuring regional tendon strains, which have been suggested to contribute to tendon injuries. The purpose of this study, therefore, is to advance the technique of quantitative 2D ultrasound elastography for the evaluation of regional tendon strains. The muscle-tendon- specific elastography technique will be validated with a novel tendon-mimicking phantom, finite element model and ex vivo testing. Following technique validation, the age-related changes in tendon regional strain will be evaluated by collecting ultrasound data during dynamic loading of the healthy Achilles tendon in three age groups: young, middle-aged, and older adults. The novel insights gained from this study will advance the scientific understanding of age-related tendon disorders, and will introduce an innovative technique for tracking strain nonuniformities which are relevant to understanding, diagnosing and treating tendon injuries. PUBLIC HEALTH RELEVANCE: This purpose of this study is to validate and use a new quantitative ultrasound technique to investigate how aging alters tendon properties and deformation patterns. The study will provide insight into the underlying causes of tendinopathy, a chronic painful injury that is more common among middle-aged and older adults. Furthermore, the ultrasound techniques could be used to improve the early diagnosis of tendon disorders, and monitor the effects of clinical treatment on tendon function.