Development of an Orthosis with an Integrated Microphone for Measurement of Knee Acoustic Emissions in Pre-Radiographic Osteoarthritis

开发带有集成麦克风的矫形器，用于测量放射前骨关节炎的膝部声发射

• 批准号: 10311098
• 负责人: David T Ewart
• 金额: --
• 依托单位: MINNEAPOLIS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10311098
• 关键词: Development; Orthosis; Integrated; Microphone; Measurement

This is an application for a Small Projects in Rehabilitation Research (SPiRE) award to Dr. David Ewart, MD, a staff rheumatologist at the Minneapolis VA Medical Center and Assistant Professor at the University of Minnesota. Dr. Ewart has a history of research and publications in biomechanics, immunology, and animal models of arthritis and is transitioning to a focus on the treatment and rehabilitation of joint damage. Dr. Ewart is an early career investigator with protected time to establish an independent line of investigation. This SPiRE award will provide Dr. Ewart with the support to: 1) develop a unique interinstitutional collaboration to build an orthosis with an integrated microphone to measure acoustic emissions from the knee at the point of care 2) use acoustic emissions to identify patients with pre-radiographic osteoarthritis of the knee 3) establish a mentored role in a busy research group and generate the preliminary data with which to apply for a career development award (CDA-2). To achieve these goals, Dr. Ewart has established a mentorship team consisting of Dr. Andrew Hansen, head of the Minneapolis Adaptive Design and Engineering (MADE) program at the Minneapolis VA, and Dr. Omer Inan, PhD, Associate Professor of Electrical and Computer Engineering at Georgia Tech. Dr. Ewart will work with the MADE program to perform the technical construction of the knee orthosis, integrate the microphone into it, and collaborate remotely with Dr. Inan to analyze the data from and refine the microphone system for function in the wearable device. Osteoarthritis (OA) is a prevalent and disabling disease. Pharmacologic and surgical treatments for symptoms of OA are insufficient for many patients and there are no therapies which halt or even delay the structural progression of disease. One difficulty in the study of such therapies is identification of patients at an early enough stage of disease that the damage to the joint is potentially reversible. In patients at risk of OA but with no signs of it on x-rays, MRI has been shown to be able to identify changes in the knee that are predictive of subsequent development of OA. However, these findings are not specific in all circumstances and MRI is expensive, time-consuming, and can’t be used at the point of care. Measurement of acoustic emissions from the knee with a modern, miniature microphone can differentiate health in the knee from disease and would offer novel method of screening for early OA. In Aim 1, Dr. Ewart will work with the MADE program and Dr. Inan’s group to prototype and iteratively design a portable orthosis with an integrated microphone system for measuring acoustic emissions from the knee at the point of care. In Aim 2, Dr. Ewart will identify patients at risk for development of osteoarthritis of the knee but without radiographic signs of advanced disease and compare acoustic emissions from their knees to healthy controls. If acoustic emissions are abnormal in the at- risk group, MRIs of their knees will be obtained to assess for findings that predict development of radiographic and symptomatic progression to OA, validating the ability of acoustic emissions to diagnose early OA. The overall objective of the proposed project is to develop a portable orthosis capable of measuring acoustic emissions from the knee at the point of care to identify patients with early pre-radiographic OA. Dr. Ewart’s long-term goal is to develop technology for non-invasive monitoring of joint health and function that can provide useful clinical information to providers that will result in patient-specific therapies, custom orthotics, and ultimately improved symptoms, function, and joint longevity. This work will form the basis for further mechanistic, clinical, and translational investigation into the basis for pathologic acoustic emissions and their application to osteoarthritis. These studies will be proposed in a CDA-2 award application at the end of the SPiRE funding period.

这是向 David Ewart 博士（医学博士）申请小型康复研究项目 (SPiRE) 奖项的申请。 明尼阿波利斯退伍军人医疗中心的风湿病专家和明尼阿波利斯大学的助理教授 明尼苏达州尤尔特博士在生物力学、免疫学和动物学方面拥有丰富的研究和出版物。 关节炎模型，并正在转向关注关节损伤的治疗和康复。 尤尔特是一名早期职业调查员，有足够的时间建立独立的调查线。 SPiRE 奖将为 Ewart 博士提供以下支持：1) 开展独特的机构间合作， 构建一个带有集成麦克风的矫形器，以测量膝盖处的声发射 护理 2) 使用声发射来识别放射照相前膝骨关节炎的患者 3) 建立一个 在繁忙的研究小组中担任指导角色，并生成用于申请职业的初步数据 为了实现这些目标，Ewart 博士建立了一个由以下人员组成的指导团队。 Andrew Hansen 博士，明尼阿波利斯自适应设计与工程 (MADE) 项目负责人 弗吉尼亚州明尼阿波利斯市和弗吉尼亚州明尼阿波利斯市电气与计算机工程副教授 Omer Inan 博士 佐治亚理工学院的 Ewart 博士将与 MADE 项目合作进行膝盖的技术构建。 矫形器，将麦克风集成到其中，并与 Inan 博士远程协作分析来自和的数据 改进麦克风系统在可穿戴设备中的功能。 骨关节炎 (OA) 是一种常见的致残性疾病，可通过药物和手术治疗症状。 OA 的治疗对于许多患者来说是不够的，并且没有任何疗法可以阻止甚至延迟结构性的 研究此类疗法的一个困难是早期识别患者。 对于有 OA 风险但患有 OA 的患者，疾病已处于足够阶段，关节损伤可能是可逆的。 X 射线上没有任何迹象，MRI 已被证明能够识别膝盖的变化，这些变化可以预测 然而，这些发现并不适用于所有情况，并且 MRI 也有一定的局限性。 昂贵、耗时，并且不能在护理现场测量声发射。 带有现代微型麦克风的膝盖可以区分膝盖的健康状况和疾病，并提供 筛查早期 OA 的新方法 在目标 1 中，Ewart 博士将与 MADE 项目和 Inan 博士的项目合作。 小组原型并迭代设计带有集成麦克风系统的便携式矫形器 在目标 2 中，Ewart 博士将在护理点测量膝盖的声发射。 有发生膝骨关节炎的风险，但没有晚期疾病的放射学迹象，并且 如果膝部声发射异常，则将其膝盖的声发射与健康对照组进行比较。 对于风险组，将获得他们膝盖的 MRI 来评估预测放射学发展的结果 以及 OA 的症状进展，验证了声发射诊断早期 OA 的能力。 拟议项目的总体目标是开发一种能够测量声学的便携式矫形器 Ewart 博士在护理时从膝关节发射出的气体来识别早期放射前 OA 患者。 长期目标是开发非侵入性监测关节健康和功能的技术 向提供者提供有用的临床信息，从而产生针对患者的治疗、定制矫形器、 最终改善症状、功能和关节寿命，这项工作将为进一步的研究奠定基础。 对病理性声发射及其基础的机制、临床和转化研究 这些研究将在项目结束时的 CDA-2 奖励申请中提出。 SPiRE 资助期。