Subacromial space reductions in rotator cuff disease: Effects on soft tissue

肩袖疾病的肩峰下间隙缩小：对软组织的影响

• 批准号: 7313830
• 负责人: PAULA Marie LUDEWIG
• 金额: $ 7万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-26 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7313830
• 关键词: Address; Affect; Anatomy; Blinded; Cadaver; Clinical; Complex; Condition; Data; Data Set; Dimensions; Disease; Dissection; Effectiveness; Elevation; Exposure to; Foundations; Functional disorder; Goals; Healed; Image; Link; Localized; Location; MRI Scans; Measurable; Measurement; Measures; Methods; Modeling; Motion; Movement Disorders; Numbers; Occupational Exposure; Operative Surgical Procedures; Orthopedic Surgery procedures; Pain; Pathology; Persons; Population; Prevalence; Public Health; Randomized Controlled Clinical Trials; Rate; Rehabilitation therapy; Relative (related person); Risk; Rotator Cuff; Scanning; Schedule; Shoulder; Shoulder Pain; Spinal cord injury; Stroke; Structure; Surgeon; Techniques; Tendon structure; Testing; Three-Dimensional Image; Three-Dimensional Imaging; Tissues; Upper Extremity; Upper arm; Validation; Work; X-Ray Computed Tomography; base; bone; bone imaging; clinical application; cost effective; design; disability; healing; image processing; improved; kinematics; novel; rehabilitation strategy; soft tissue

DESCRIPTION (provided by applicant): The PIs' long-term objective is to develop and test the effectiveness of biomechanically-based rehabilitation strategies for improving upper extremity function and reducing pain and disability in persons with shoulder pathologies. Rotator cuff pathologies have up to 50% prevalence rates across several populations including persons with spinal cord injury, stroke, occupational exposure to repetitive overhead work, and athletes with repetitive overhead motion exposure. There is increasing evidence linking altered shoulder kinematics with pain and dysfunction in these populations. The altered kinematics is hypothesized to reduce the subacromial space, resulting in impingement of the musculotendinous structures. With sustained or repeated impingement, tissue damage can result, and healing is compromised. The goal of this R03 application is to validate a method to measure the soft tissue geometry and volume of the subacromial space and to establish the relation between this space and tendon pathology. The general hypotheses are that soft tissue data derived from 3D imaging can be accurately registered, and that one can predict when reduction in the subacromial space will generate shoulder pathology. MR scans will be registered to CT scan and bone-fixed motion data from the same subjects. Determination of soft tissue origin/insertion and volume data from imaging data sets will be validated against direct measurement on cadaver shoulders. Additionally, measurement predictions of the location of rotator cuff tissue affected by subacromial reductions during motion will be tested against musculotendinous disease identified operatively. These data will enhance understanding of how rotator cuff tissue is impacted by subacromial space reductions. Addition of soft tissue data will allow for a comprehensive linked data set of precise 3D shoulder complex anatomy and motion across subjects with and without shoulder pathology, and serve as input to enhance existing mathematical shoulder models. This work is novel in its dynamic, comprehensive measurement of the subacromial space, and validation of soft tissue effects with operative data. Subsequent proposals will use these data and derived models to address clinical applications, including design and testing of rehabilitation and surgical interventions through randomized controlled clinical trials. Rotator cuff tendon pathology is the most common of all tendon disorders. The proposed work will improve the understanding of how shoulder movement disorders relate to rotator cuff pathology and provide a foundation for optimizing conservative rehabilitation approaches. Improving cost effective treatment is relevant to public health.

描述（由申请人提供）：PI 的长期目标是开发和测试基于生物力学的康复策略的有效性，以改善肩部病变患者的上肢功能并减少疼痛和残疾。肩袖病变在多个人群中的患病率高达 50%，包括脊髓损伤、中风、职业性重复性高举作业人员以及经常从事重复性过头运动的运动员。越来越多的证据表明肩部运动学的改变与这些人群的疼痛和功能障碍有关。假设运动学的改变会减少肩峰下空间，导致肌腱结构受到撞击。如果持续或反复撞击，可能会导致组织损伤，并且愈合受到影响。该 R03 应用的目标是验证一种测量软组织几何形状和肩峰下间隙体积的方法，并建立该间隙与肌腱病理之间的关系。一般假设是，可以准确记录从 3D 成像获得的软组织数据，并且可以预测肩峰下间隙的缩小何时会产生肩部病变。 MR 扫描将与来自同一受试者的 CT 扫描和骨固定运动数据进行配准。来自成像数据集的软组织起源/插入和体积数据的确定将根据尸体肩部的直接测量进行验证。此外，对运动过程中受肩峰下缩小影响的肩袖组织位置的测量预测将针对手术中发现的肌腱疾病进行测试。这些数据将加深对肩袖组织如何受到肩峰下间隙缩小影响的理解。添加软组织数据将允许在有或没有肩部病理的受试者之间建立精确的 3D 肩部复杂解剖结构和运动的全面链接数据集，并作为增强现有数学肩部模型的输入。这项工作的新颖之处在于对肩峰下间隙进行动态、全面的测量，并用手术数据验证软组织效果。后续提案将使用这些数据和衍生模型来解决临床应用问题，包括通过随机对照临床试验设计和测试康复和手术干预措施。肩袖肌腱病理学是所有肌腱疾病中最常见的。拟议的工作将提高对肩部运动障碍与肩袖病理学关系的理解，并为优化保守康复方法提供基础。改善具有成本效益的治疗与公共卫生相关。