Leveraging Wearables to Transform Patient Recovery after Tibial Fracture Surgery

利用可穿戴设备改变胫骨骨折手术后患者的康复

基本信息

批准号：
10658494
负责人：
Brian Noehren
金额：
$ 55.94万
依托单位：
UNIVERSITY OF KENTUCKY
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：
2023-08-10 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10658494
关键词：
Address Affect Algorithms American Back Biofeedback Biological Markers Caring Clinic Clinical Data Data Set Dose Early Intervention Ensure Exercise Fill-It Fracture Future Goals Guidelines Health Care Costs Home Hospitals Individual Injury Intervention Journals Knowledge Laws Leisure Activities Length of Stay Life Limb structure Link Longitudinal Studies Measurement Measures Modeling Monitor Muscle Musculoskeletal Diseases Office Visits Operative Surgical Procedures Outcome Pain Pathway interactions Patient-Focused Outcomes Patients Physical therapy Postoperative Period Publishing Reaction Recovery Recovery of Function Rehabilitation therapy Reporting Risk Severities Shoes System Techniques Testing Tibial Fractures Time Training Walking Work bone demographics design empowerment exercise program exercise rehabilitation experience follow-up functional outcomes improved in vivo innovation knowledgebase light weight limb injury mechanotransduction novel pressure programs remote monitoring sample fixation sensor standard of care tibia tool wearable device wearable monitor wearable sensor technology

项目摘要

Over 490K Americans fracture their tibia (shinbone) yearly, and require surgery. However, patient recovery 1 year following surgery is poor and inconsistent with 2/3 of patients reporting an inability to do pre-injury leisure activities and 1/2 still not having recovered enough to return to work. A key role of clinicians after tibial shaft fracture surgery is to prescribe a rehabilitation exercise program that exposes each patient's tibia to increasing forces to gradually recover the ability to do pre-injury activities. However, major limitations holding back progress in the field are the lack of knowledge on how much tibial force patients experience during daily activities, in their rehabilitation program throughout recovery, and how tibial force early in recovery affects longer-term functional recovery. The overarching goal of this work is to generate the knowledgebase and tools that will enable us to reimagine and elevate the standard of care for individuals after tibial shaft fracture surgery, by monitoring and managing tibial bone forces in daily life. We propose to accomplish the overarching objective through the following aims. Aim 1: Characterize tibial bone force in patients at home over the first year following surgery. Aim 2: Create the first clinical reference guide that ranks tibial forces during commonly- prescribed rehabilitation exercises. Aim 3: Assess if higher tibial forces during early recovery correspond with better functional outcomes at 6- and 12-month follow up. If our hypothesis is supported then these results would inform new clinical guidelines (target bone force thresholds) and biofeedback interventions to monitor and promote healthy bone forces in recovery. This wearable monitoring paradigm has unparalleled potential to be adapted to elevate care for recovery from numerous musculoskeletal disorders.

每年有超过 49 万美国人的胫骨骨折，需要手术治疗。然而，患者康复1 术后一年的恢复情况较差且不一致，2/3 的患者报告无法进行受伤前休闲活动活动，1/2 仍未恢复到足以返回工作岗位的程度。胫骨干术后临床医生的关键作用骨折手术的目的是制定一个康复锻炼计划，使每个患者的胫骨受到越来越多的锻炼。力量逐渐恢复进行受伤前活动的能力。然而，主要的限制阻碍了该领域的进展在于缺乏关于患者每天经历多少胫骨力的了解整个康复过程中的康复计划中的活动，以及康复早期的胫骨力量如何影响更长期的功能恢复。这项工作的总体目标是生成知识库和工具这将使我们能够重新设想和提高胫骨干骨折后个人的护理标准通过在日常生活中监测和管理胫骨骨力来进行手术。我们建议完成总体目标通过以下目标来实现目标。目标 1：表征患者在家中的胫骨骨力手术后一年。目标 2：创建第一个临床参考指南，对常见情况下的胫骨力进行排名规定的康复练习。目标 3：评估早期恢复期间较高的胫骨力是否与 6 个月和 12 个月随访时获得更好的功能结果。如果我们的假设得到支持，那么这些结果将告知新的临床指南（目标骨力阈值）和生物反馈干预措施以监测并促进健康的骨力恢复。这种可穿戴监控范例具有无与伦比的潜力适合提高对多种肌肉骨骼疾病康复的护理。