Integrating Biomechanics and Experimental Pain to Understand Compensatory Mechanisms in Symptomatic Carpometacarpal Osteoarthritis

整合生物力学和实验疼痛来了解症状性腕掌骨关节炎的代偿机制

• 批准号: 10706985
• 负责人: Tamara Ordonez
• 金额: $ 2.56万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-19 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10706985
• 关键词: Academia; Activities of Daily Living; Adult; Advisory Committees; Affect; Age; Articular Range of Motion; Biomechanics; Body part; Carpometacarpal joint structure; Classification; Clinical; Collaborations; Compensation; Complement; Complex; Data; Degenerative polyarthritis; Development; Diagnosis; Disease; Disease Progression; Educational process of instructing; Electrodes; Electromyography; Ensure; Exercise; Exercise Therapy; Foundations; Functional disorder; Future; Hand; Heterogeneity; Hypersensitivity; Individual; Injury; Interdisciplinary Study; Intervention; Intramuscular; Isometric Exercise; Joints; Knowledge; Lateral; Lead; Lower Extremity; Measures; Mentors; Modeling; Motion; Motivation; Motor; Movement; Muscle; Musculoskeletal; Nature; Operative Surgical Procedures; Orthopedics; Orthotic Devices; Outcome Study; Pain; Pain Measurement; Pain Nature; Pain Research; Pain Threshold; Pain intensity; Pain management; Patient Education; Patients; Pattern; Phenotype; Physical Function; Physical therapy exercises; Postmenopause; Psyche structure; Quality of life; Reporting; Research; Research Methodology; Sensory; Severities; Stimulus; Symptoms; System; Techniques; Testing; Thumb structure; Training; Treatment Efficacy; Variant; Woman; Work; adduct; aged; career; cohort; comparison control; design; dexterity; disabling disease; efficacy evaluation; experience; experimental study; functional loss; grasp; human subject; improved; insight; joint destruction; kinematics; mechanical stimulus; motor impairment; neuromuscular; optimal treatments; osteoarthritis pain; pain relief; pain sensitivity; pathomechanics; prevent; professor; radiological imaging; reduce symptoms; research faculty; response; sensory stimulus; skills; somatosensory; success; targeted treatment; treatment strategy; ultrasound

PROJECT SUMMARY/ABSTRACT Carpometacarpal osteoarthritis (CMC OA) is a disabling disease that can cause severe pain, decreased strength, and limited range of motion. These factors lead to a loss in quality of life and contribute to other concomitant conditions such as decline in mental. Unfortunately, there are no current treatments that will stop the progression of OA or restore both fine and gross motor function. Understanding the pathophysiology of OA is critical to developing improved treatment options that can eliminate pain without compromising physical function. This proposal broadly aims to understand compensatory mechanisms by identifying the relationship between movement and pain. The objective of this work is to compare pain thresholds, muscle control strategies, and joint kinematics between patients with end-stage CMC OA and age-matched healthy adults. Quantitative sensory testing will be used to measure pain thresholds (Aim 1). These results will provide us with a pain baseline, identify pain phenotypes associated with symptomatic OA-pain and whether CMC OA causes sensitization to other parts of the body. Intramuscular electrodes will be used to measure muscle activity and quantify the neuromuscular compensations (Aim 2). These results will highlight how muscle control strategies change to prevent further pain or injury and could inform whether muscles need to be considered during surgical treatments. Motion capture will measure joint angles during range of motion tasks to quantify the effect of pain on movement (Aim 3). The results will highlight how neighboring joints adapt to compensate for disease-induced movement limitations and could inform physical therapy exercises to prevent further restrictions. To further highlight the importance of integrating pain measurements in biomechanical studies, movement-evoked pain measurement (Aim 2 and 3) will emphasize how movement affects pain. The results will create the foundation to supplement future studies examining disease progression or assessing the efficacy of current treatments. Above all, understanding the compensatory mechanisms and the complex nature of pain is the first step to developing improved treatments and targeted therapies. Through this proposal, the applicant will obtain training on teaching and mentoring effectively, collaborating on interdisciplinary teams, and disseminating research to both scientific and clinical audiences. The applicant will also gain experience designing and performing experiments that involve human subjects and using musculoskeletal modeling to complement the experimental results. These experiences will enhance the applicant’s technical and professional skills, thereby providing the training needed for a successful career in academia as research faculty.

项目概要/摘要 腕掌骨关节炎 (CMC OA) 是一种致残性疾病，可导致剧烈疼痛、力量下降、 这些因素会导致生活质量下降并导致其他伴随症状。 不幸的是，目前没有任何治疗方法可以阻止病情的进展。 了解 OA 的病理生理学对于 OA 的治疗或恢复精细和粗大运动功能至关重要。 开发改进的治疗方案，可以在不损害身体功能的情况下消除疼痛。 该提案的主要目的是通过确定之间的关系来理解补偿机制 这项工作的目的是比较疼痛阈值、肌肉控制策略和 终末期 CMC OA 患者与年龄匹配的健康成年人之间的关节运动学。 测试将用于测量疼痛阈值（目标 1）。这些结果将为我们提供疼痛基线、识别。 与症状性 OA 疼痛相关的疼痛表型以及 CMC OA 是否会导致其他部位敏感 肌内电极将用于测量肌肉活动并量化神经肌肉。 这些结果将突出显示肌肉控制策略如何改变以防止进一步的疼痛。 或损伤，并可以告知在手术治疗期间是否需要考虑肌肉。 将在运动任务期间测量关节角度，以量化疼痛对运动的影响（目标 3）。 结果将强调邻近关节如何适应以补偿疾病引起的运动限制和限制 可以告知物理治疗练习以防止进一步限制的重要性。 将疼痛测量整合到生物力学研究、运动引起的疼痛测量中（目标 2 和 3） 将强调运动如何影响疼痛，结果将为补充未来的研究奠定基础。 最重要的是，检查疾病进展或评估当前治疗的疗效。 补偿机制和疼痛的复杂性是开发改进治疗方法的第一步 和靶向治疗。 通过该提案，申请人将获得有效的教学和指导培训，并在以下方面进行合作： 跨学科团队，并向科学和临床受众传播研究成果。 还获得设计和执行涉及人类受试者的实验以及使用 这些经验将增强肌肉骨骼建模来补充实验结果。 申请人的技术和专业技能，从而提供成功职业生涯所需的培训 学术界作为研究人员。