Towards Precision Rehabilitation for Ventral Hernia

腹疝的精准康复

基本信息

批准号：
10823864
负责人：
Elanna Arhos
金额：
$ 7.61万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-11 至 2025-09-10
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10823864
关键词：
Abdomen Activities of Daily Living Acute Address Characteristics Chronic Clinical Clinical Data Clinical Trials Complex Country Data Development Disease Ensure Environment Expenditure Faculty Fellowship Female Funding Goals Health Healthcare Healthcare Systems Hernia Impairment Individual Intervention Investigation Knowledge Link Machine Learning Measures Mentors Morbidity - disease rate Musculoskeletal System National Institute of Diabetes and Digestive and Kidney Diseases Operative Surgical Procedures Outcome Outcome Measure Pain management Parents Patient Care Patient Outcomes Assessments Patient Self-Report Patient-Focused Outcomes Patients Perioperative Care Persistent pain Physical therapy Physicians Positioning Attribute Postoperative Care Postoperative Pain Postoperative Period Pragmatic clinical trial Preparation Prognosis Prognostic Factor Publishing Qualifying Quality of life Recovery Recovery of Function Recurrence Registries Rehabilitation therapy Reporting Research Research Personnel Risk Sampling Scientist Site Standardization Subgroup Surgeon Therapeutic Therapeutic Intervention Time Training United States United States National Institutes of Health Universities Ventral Hernia Work abdominal wall career cohort cost data registry data standards disability evidence base experience follow-up functional outcomes healing health care model improved insight machine learning algorithm meetings model building novel pre-doctoral predictive modeling prevent repaired restoration skills standard of care treatment arm treatment response

项目摘要

PROJECT SUMMARY Hernia repairs are one of the most common surgeries performed in the United States, with over 350,000 ventral hernia repairs (VHR) performed yearly. Beyond the high health care system expenditure on VHR, patients report poor quality of life, post-operative pain, and time loss at work. Management traditionally includes surgical restoration of the abdominal wall, and short-term physician follow-up to ensure surgical site healing. Even once surgery has restored the abdominal wall, individuals post-operatively demonstrate major impairments of the musculoskeletal system including poor strength and function which contributes to reduced activities of daily living and a lower self-reported quality of life. Participation in physical therapy (PT) post- operatively may directly address and improve overall strength, function, and post-operative pain, in turn improving self-reported quality of life. There is a need to characterize recovery of function after VHR, specifically with the addition of objective measures of function to standard of care. Notably, we do not know the modifiable clinical characteristics of patients who will benefit the most from undergoing standardized post- operative PT. As a step towards this, we must understand the patient- and surgery-specific factors linked to a likelihood of a successful outcome following VHR. This mentored training plan will use data from a CMS Qualified Clinical Data Registry and an NIH/NIDDK funded registry-based clinical trial to understand the complex relationships between patient- and surgical-characteristics as they relate to post-operative function. Findings from this fellowship will provide (1) robust predictive models to understand characteristics of patients who have a good or poor self-reported quality of life 1 year after ventral hernia repair and (2) foundational evidence in understanding treatment response to physical therapy using objective measures of function. This fellowship proposes a paradigm shift of the current approach to hernia disease by considering objective and patient-reported measures of function of as a primary post-operative outcome. Meeting the objectives of this fellowship will afford the applicant the knowledge and skills required of an independent investigator and provide requisite preparation for a faculty position at a research-intensive university.

项目概要疝气修复术是美国最常见的手术之一，有超过 350,000 例手术每年进行腹疝修补术（VHR）。除了医疗保健系统在 VHR 上的高额支出之外，患者报告生活质量差、术后疼痛和工作时间损失。传统管理包括腹壁手术修复，以及短期医生随访以确保手术部位康复。即使手术恢复了腹壁，术后个体也会表现出严重的肌肉骨骼系统损伤，包括力量和功能较差，导致体重下降日常生活活动和自我报告的生活质量较低。术后参与物理治疗（PT）手术上可以直接解决和改善整体力量、功能和术后疼痛，进而改善自我报告的生活质量。需要表征 VHR 后功能恢复的特征，特别是在护理标准中增加客观的功能测量。值得注意的是，我们不知道患者的可改变的临床特征将从标准化术后获益最大手术PT。作为实现这一目标的一步，我们必须了解与患者和手术相关的特定因素。 VHR 后成功结果的可能性。该指导培训计划将使用来自 CMS 的数据合格的临床数据注册和 NIH/NIDDK 资助的基于注册的临床试验，以了解患者特征和手术特征之间的复杂关系，因为它们与术后功能有关。该研究金的研究结果将提供 (1) 强大的预测模型来了解患者的特征腹疝修复术后 1 年自我报告生活质量良好或较差的人以及 (2) 基础使用客观的功能测量来了解物理治疗的治疗反应的证据。这研究金建议通过考虑客观和患者报告的功能测量作为主要术后结果。实现本次活动的目标研究金将为申请人提供独立调查员所需的知识和技能，并提供为研究型大学的教职做好必要的准备。