Establishing the Relationship Between Muscle Quality and Joint Loading for Individuals with Transtibial Amputation

摘要 截肢后的功能丧失是深刻的，改变了生活。迄今为止，改善长期 长期功能性能力和有限的有害继发性损伤（例如骨关节炎）尚未有效。 虽然是多因素的，但肌肉质量的改变，特别是股四头肌，对功能结果的影响 对于经胫骨截肢的个体，了解甚少。我们小组在其他条件下的工作表明， 肌肉质量在受伤后发生变化，并与功能丧失直接相关，包括持久的力量 赤字我的长期职业目标是将我在生物工程方面的背景与所开发的技能联合收割机结合起来 通过这项F32培训补助金，开发新的治疗策略和设备，以改善功能， 生活质量的个人与下肢损失。这个训练奖将让我1）评估肌肉 用新的磁共振成像序列对完整和残肢的大腿进行质量评估，2） 预测大腿肌肉质量和肌肉力量之间的关系，最后3）表征 胫骨骨折患者肌肉质量、肌肉力量和膝关节负荷之间的关系 截肢肌肉质量将使用新的磁共振成像技术进行评估，包括 T1rho标测和弥散张量成像。这些技术将为肌肉组织提供新的见解 形态学，包括纤维化组织的任何增加或羽状角和纤维束长度的减少， 影响肌肉正常有效运作的整体能力。评估肌肉力量， 活动，参与者将完成最大的自愿等长膝关节屈曲和验证调查， 自我报告的流动性。最后，将通过计算评估完整肢体的关节接触力。 肌肉骨骼模型通过这项NRSA F32建议的工作，我将完善和获得关键技能， 成功的职业生涯作为一个独立的翻译研究寻求与临床科学家合作。 培训将包括医学成像采集和分析方面的技能发展，临床相关能力 评估、仪器化运动分析、肌肉骨骼建模、临床研究管理，以及 统计分析培训计划中包括辅助职业发展活动， 课程工作（例如生物力学，统计学，医学成像），补助金写作研讨会， 研究传播和导师制，这些都将是发展全面技能的关键组成部分 未来的学术生涯。我选择的赞助商，机构和导师将提供完美的 鼓励成功的环境。

ABSTRACT The loss of function following an amputation is profound and life altering. To date, interventions to improve long term functional abilities and limit detrimental secondary injuries (e.g. osteoarthritis) have not been effective. While multifactorial, the effect of altered muscle quality, specifically of the quadriceps, on functional outcomes for individuals with transtibial amputation is poorly understood. Work by our group in other conditions shows that muscle quality changes after injury and is directly related to loss of function, including protracted strength deficits. My long-term career goal is to combine my background in bioengineering with the skills developed through this F32 training grant to develop novel therapeutic strategies and devices to improve function and quality of life for individuals with lower limb loss. This training award will allow me to 1) assess the muscle quality of the thigh of the intact and residual limbs with novel magnetic resonance imaging sequences, 2) predict the relationship between thigh muscle quality and muscle strength, and finally 3) characterize the relationship between muscle quality, muscle strength, and knee joint loading for individuals with transtibial amputation. Muscle quality will be assessed using novel magnetic resonance imaging techniques including T1rho mapping and diffusion tensor imaging. These techniques will provide new insights on the muscle tissue morphology, including any increases in fibrotic tissue or decreases in pennation angle and fiber tract length, that affect the muscle's overall ability to function properly and efficiently. To evaluate muscle strength and mobility, participants will complete maximum voluntary isometric knee flexion and validated surveys targeting self-reported mobility. Finally, joint contact forces of the intact limb will be assessed through a computational musculoskeletal model. Through the work proposed for this NRSA F32, I will refine and gain skills critical for a successful career as an independent translational researcher seeking to collaborate with clinician scientists. Training will include skills development in medical imaging acquisition and analysis, clinically relevant strength assessment, instrumented motion analysis, musculoskeletal modeling, clinical research management, and statistical analysis. Including in the training plan are accessory career development activities including related course work (e.g. biomechanics, statistics, medical imaging), grant writing workshops, opportunities for research dissemination, and mentorship that will all be key components to developing a well-rounded skill set for a future academic career. My selected sponsor, institution, and mentors will provide the perfect environment for encouraging success.