Assessing multifactorial etiology of IC/BPS using a novel PFM-Hip-Trunk muscle network analysis

使用新型 PFM-Hip-Trunk 肌肉网络分析评估 IC/BPS 的多因素病因

基本信息

批准号：
10677557
负责人：
Yingchun Zhang
金额：
$ 19.41万
依托单位：
UNIVERSITY OF HOUSTON
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-05 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10677557
关键词：
Age Body mass index Categories Clinical Cluster Analysis Electrodes Electromyography Etiology Female Functional disorder Health Care Costs Hip region structure Impairment Interstitial Cystitis Intervention Leg Lower Extremity Measures Muscle Muscle Tonus Muscle function Musculoskeletal Myofascial Pain Syndromes Myofascial Trigger Point Neuromuscular conditions Outcome Outcome Measure Pain Pathologic Pathology Pathway Analysis Patient Outcomes Assessments Patients Pattern Pelvic Examination Pelvic Floor Muscle Pelvic Pain Pelvic floor structure Phenotype Physical therapy Posture Quality of life Reporting Research Sex Behavior Signal Transduction Stretching Subgroup Surface Techniques Technology Testing Time Woman Work chronic pelvic pain comparison control density digital individualized medicine motor impairment novel parity personalized intervention recruit soft tissue standard care symptomatic improvement

项目摘要

Abstract Interstitial cystitis/ bladder pain syndrome (IC/BPS) is one of the most debilitating chronic pelvic pain (CPP) conditions that negatively impacts the quality of life and sexual activities in 2.7% to 6.5% of women in the US. Pelvic floor muscle (PFM) overactivity, characterized by an increase in the tonic muscle activity, is a condition related to myofascial pain that presents in the majority of CPP conditions, including up to 85% of women with IC/BPS. However, pelvic floor pain is intrinsically a multifactorial dysfunction that is attributed to postural issues, myofascial trigger points, and abnormal muscle tone. Myofascial therapy, including specific pelvic floor muscle soft tissue mobilization and muscle stretching, is standard treatment for patients with IC/BPS and concomitant PFM tenderness. Unfortunately, even among IC/BPS patients with PFM tenderness on exam, only 59% of patients report symptom improvement after myofascial therapy. Pelvic floor myofascial therapy, however, does not address movement impairments of the trunk and hips, which are also associated with pelvic pain. A pelvic floor muscle phenotyping framework would allow IC/BPS patients to be categorized to facilitate individualized treatment. Unfortunately, no technology is currently available for quantitatively and objectively assessing PFM etiologic factors associated with IC/BPS, which, otherwise, would advance the understanding of the underlying mechanisms and allow for phenotyping patients for appropriate intervention. Our team has successfully 1) developed a novel intra-vaginal high-density surface electromyography (HD-sEMG) technique to reliably and quantitatively assess PFM overactivity in women with IC/BPS and 2) developed a novel muscle network analysis technique to reveal, for the first time, the inter-muscular connectivity pattern alterations among patients with neuromuscular conditions, and 3) demonstrated the feasibility to cluster patients with IC/BPS into phenotypic subgroups, depending on the underlying mechanism. This study aims to comprehensively assess the PFM overactivity, hip/trunk muscle activity alteration, PFM-to-Hip/ Trunk inter-muscular connectivity, and distinct PFM phenotypic subtypes in IC/BPS. This research represents the first effort to comprehensively assess the PFM overactivity, hip/trunk muscle activity alteration, PFM-to-Hip/Trunk inter-muscular connectivity, and distinct PFM phenotypic subtypes in IC/BPS. The integration of these multifactorial assessments will advance our understanding of the multifactorial pathology of IC/BPS. The quantification of relative importance of these pathological contributors will allow for IC/BPS patient phenotyping. Identification of PFM phenotypic subtypes may facilitate personalized physical therapy treatments.

抽象的间质性膀胱炎/膀胱疼痛综合征 (IC/BPS) 是最令人衰弱的慢性盆腔疼痛之一 (CPP) 对 2.7% 至 6.5% 的人的生活质量和性活动产生负面影响的状况美国的女性。盆底肌肉 (PFM) 过度活跃，其特征是盆底肌肉增加强直性肌肉活动，是一种与肌筋膜疼痛相关的病症，出现在大多数 CPP 中包括高达 85% 的患有 IC/BPS 的女性。然而，骨盆底疼痛本质上是一种多因素功能障碍，归因于姿势问题、肌筋膜触发点和异常肌张力。肌筋膜治疗，包括特定盆底肌肉软组织动员和肌肉拉伸是 IC/BPS 和伴随 PFM 患者的标准治疗压痛。不幸的是，即使在检查时出现 PFM 压痛的 IC/BPS 患者中，也仅 59% 的患者报告肌筋膜治疗后症状有所改善。盆底肌筋膜然而，治疗并不能解决躯干和臀部的运动障碍，这也是与骨盆疼痛有关。盆底肌肉表型分析框架将允许 IC/BPS 对患者进行分类，便于个体化治疗。不幸的是，没有任何技术可以目前可用于定量、客观地评估与 PFM 相关的病因学因素 IC/BPS，否则将促进对底层机制和允许对患者进行表型分析以进行适当的干预。我们的团队已成功1）开发出一种新型阴道内高密度表面肌电图 (HD-sEMG) 技术可可靠且定量地评估 PFM 过度活动患有 IC/BPS 的女性和 2) 开发了一种新颖的肌肉网络分析技术来揭示，第一次，患者的肌肉间连接模式发生了变化神经肌肉状况，3) 证明了对 IC/BPS 患者进行聚类的可行性根据潜在的机制，分为表型亚组。本研究旨在全面评估 PFM 过度活动、髋部/躯干肌肉活动改变、PFM-to-Hip/ IC/BPS 中躯干肌肉间连接以及不同的 PFM 表型亚型。这项研究代表首次全面评估 PFM 过度活动、臀部/躯干肌肉活动改变、PFM 到髋部/躯干的肌肉间连接以及不同的 PFM 表型亚型 IC/BPS。这些多因素评估的整合将增进我们的理解 IC/BPS 的多因素病理学。这些相对重要性的量化病理学因素将允许 IC/BPS 患者表型分析。 PFM的识别表型亚型可能有助于个性化的物理治疗。