Muscle function and compensation following rotator cuff tear in older adults

老年人肩袖撕裂后的肌肉功能和代偿

基本信息

批准号：
8396473
负责人：
Meghan Elise Vidt
金额：
$ 4.22万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-07-01 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8396473
关键词：
Activities of Daily Living Affect Age Aging Aging-Related Process Anthropometry Articular Range of Motion Atrophic Axilla Caring Clinical Comb animal structure Computer Simulation Dependence Elderly Fatty acid glycerol esters Financial compensation Goals Hair Individual Individual Differences Infiltration Injury Intramuscular Joints Knowledge Life Linear Models Living Wills Magnetic Resonance Imaging Measurement Measures Metric Modeling Motor Movement Muscle Muscle function Musculoskeletal Outcome Outcome Measure Patients Pattern Performance Population Rehabilitation therapy Reliance Reporting Role Rotator Cuff Shoulder Simulate Skeletal Muscle Techniques Thick Time Torque Upper Extremity Work design experience functional improvement functional outcomes healthy aging improved functioning in vivo injured interest kinematics muscle strength muscular structure rehabilitation strategy simulation

项目摘要

DESCRIPTION (provided by applicant): Approximately 20-50% of older adults (age > 65 years) are living with a rotator cuff tear, and this number increases with advanced age. A rotator cuff tear is associated with decreased muscle volume and shoulder strength, fatty infiltration, reduced range of motion, and limited mobility. These deficits can impact older adults ability to perform activities of daily living (ADLs), resulting in a loss of independence. It has been suggested that individuals with a torn rotator cuff will employ compensatory movements or deviations from the desired movement with a greater reliance on unimpaired muscles, to complete tasks. However, the aging process induces changes to skeletal muscle which may affect motor coordination and muscle strength, contributing to compensation seen in healthy aging. Therefore, it is essential to identify the extent to which upper limb compensation is necessary with age to further explore the functional changes occurring in older adults with a rotator cuff tear. Clinically, standardized functional outcome scores are used to assess functional ability and improvements following treatment for patients with a rotator cuff tear. However, it is not well understood how these clinical metrics relate to compensation in ADL tasks. To better understand the relationships between healthy aging, rotator cuff tears, and functional ability, it is necessary investigate compensation in ADLs and identify the strength and activation of primary muscles contributing to these movements. These objectives will be accomplished by obtaining kinematics for 6 ADL tasks from healthy and rotator cuff injured older adults and developing subject-specific musculoskeletal models for these subjects. These models will be used to simulate the ADL movements to identify the forces and activation patterns of muscles contributing to these tasks. Specifically, this study will 1) evaluate the effet of rotator cuff tear on muscle volume, fatty infiltration and functional outcome scores, 2) identif differences in joint kinematics for 6 ADLs and evaluate the range of motion, and force and activation of contributing muscles, and 3) evaluate the dependence of range of motion and muscle force on muscle volume, fatty infiltration, and functional outcome score. It is of interest o study compensation in older adults with a rotator cuff tear to further understand the functional consequences of this injury. The long term goal of this study is to identify weak muscles that contribute to compensation or the inability to complete a functional task. This information will be used to design rehabilitation strategies to strengthen muscles and improve function after injury. The outcomes of this work will provide further understanding of the mechanism of injury in older adults with a rotator cuff tear. This information may have a substantial impact as the US population continues to age. PUBLIC HEALTH RELEVANCE: Many older adults (age > 65 years) experience a rotator cuff tear, which can affect their performance of daily tasks, like reaching to a shelf or combing their hair. The objective of this study is to better understand the factors contributing to the ability o older adults with a rotator cuff tear to perform daily tasks. As the US population continues to age, the information gained from this study will provide information about the ability of older adults with a rotator cuff tear to function independently.

描述（由申请人提供）：大约 20-50% 的老年人（年龄 > 65 岁）患有肩袖撕裂，并且这一数字随着年龄的增长而增加。肩袖撕裂与肌肉体积和肩部力量减少、脂肪浸润、运动范围缩小和活动能力受限有关。这些缺陷会影响老年人进行日常生活活动 (ADL) 的能力，导致丧失独立性。有人建议，肩袖撕裂的人会采用补偿性运动或偏离所需运动，更多地依赖未受损的肌肉来完成任务。然而，衰老过程会引起骨骼肌的变化，这可能会影响运动协调性和肌肉力量，从而有助于健康衰老中的补偿。因此，有必要确定随着年龄的增长上肢代偿的必要程度，以进一步探讨肩袖撕裂老年人发生的功能变化。临床上，标准化功能结果评分用于评估肩袖撕裂患者治疗后的功能能力和改善情况。然而，人们尚不清楚这些临床指标与 ADL 任务中的补偿有何关系。为了更好地了解健康衰老、肩袖撕裂和功能能力之间的关系，有必要研究 ADL 的补偿并确定有助于这些运动的主要肌肉的力量和激活。这些目标将通过从健康和肩袖受伤的老年人获得 6 项 ADL 任务的运动学数据并为这些受试者开发特定于受试者的肌肉骨骼模型来实现。这些模型将用于模拟 ADL 运动，以确定有助于这些任务的肌肉的力量和激活模式。具体来说，这项研究将 1) 评估肩袖撕裂对肌肉体积、脂肪浸润和功能结果评分的影响，2) 确定 6 个 ADL 的关节运动学差异，并评估运动范围、贡献肌肉的力量和激活， 3) 评估运动范围和肌肉力量对肌肉体积、脂肪浸润和功能结果评分的依赖性。研究肩袖撕裂老年人的补偿对于进一步了解这种损伤的功能后果是有意义的。这项研究的长期目标是识别导致代偿或无法完成功能性任务的薄弱肌肉。该信息将被用于设计康复策略以增强肌肉并改善受伤后的功能。这项工作的结果将有助于进一步了解老年人肩袖撕裂的损伤机制。随着美国人口持续老龄化，这一信息可能会产生重大影响。公共卫生相关性：许多老年人（年龄 > 65 岁）经历过肩袖撕裂，这可能会影响他们日常任务的表现，例如伸手去拿架子或梳理头发。本研究的目的是更好地了解影响肩袖撕裂老年人执行日常任务能力的因素。随着美国人口持续老龄化，从这项研究中获得的信息将提供有关肩袖撕裂的老年人独立运作能力的信息。