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; 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.

项目摘要/摘要 腕足骨骨关节炎（CMC OA）是一种残疾疾病，可能导致严重的疼痛，强度降低， 和有限的运动范围。这些因素会导致生活质量丧失，并为其他伴随 诸如精神衰落之类的条件。不幸的是，目前没有治疗可以阻止进展 OA或还原精细的运动功能。了解OA的病理生理学对于 开发改进的治疗选择，可以消除疼痛而不会损害身体机能。 该提案广泛地旨在通过确定之间的关系来理解补偿机制 运动和痛苦。这项工作的目的是比较疼痛阈值，肌肉控制策略和 终阶段CMC OA与年龄匹配的健康成年人之间的关节运动学。定量感觉 测试将用于测量疼痛阈值（AIM 1）。这些结果将为我们提供止痛基线，确定 与有症状的OA伴侣相关的疼痛表型以及CMC OA是否引起对其他部位的敏感性 身体。肌内电极将用于测量肌肉活性并量化神经肌肉 补偿（目标2）。这些结果将突出肌肉控制策略如何改变以防止进一步的疼痛 或受伤，可以告知在手术治疗期间是否需要考虑肌肉。运动捕获 将在运动任务范围内测量关节角度，以量化疼痛对运动的影响（AIM 3）。 结果将突出相邻关节如何适应弥补疾病引起的运动局限性和 可以为物理治疗练习提供信息，以防止进一步的限制。进一步强调了 在生物力学研究中整合疼痛测量，运动引起的疼痛测量（AIM 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创造基础 检查疾病进展或评估当前治疗的效率。最重要的是，了解 补偿机制和疼痛的复杂性是开发改进治疗的第一步 和靶向疗法。 通过该建议，申请人将有效地获得有关教学和心理培训的培训 跨学科团队，并将研究传播给科学和临床受众。申请人将 还获得了涉及人类受试者并使用的经验设计和执行实验 肌肉骨骼建模以补充实验结果。这些经验将增强 申请人的技术和专业技能，从而为成功的职业提供了所需的培训 学术界作为研究教师。