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: 10731349
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10731349
• 关键词: Accelerometer; Acoustics; Aging; Algorithms; Animal Model; Arthritis; Award; Biomechanics; Characteristics; Clinic Visits; Clinical; Collaborations; Complex; Computers; Consumption; Custom; Data; Data Storage and Retrieval; Degenerative polyarthritis; Development; Device Designs; Devices; Diagnosis; Disease; Disease Progression; Doctor of Philosophy; Early Diagnosis; Early identification; Engineering; Evaluation; Exercise; Funding; Future; General Population; Goals; Head; Health; Image; Immunology; Incidence; Intervention; Investigation; Joints; K-Series Research Career Programs; Knee; Knee Osteoarthritis; Lesion; Longevity; Magnetic Resonance Imaging; Measurement; Measures; Medical Device; Medical center; Memory; Mentors; Mentorship; Methods; Minnesota; Modernization; Movement; Noise; Office Visits; Operative Surgical Procedures; Opiate Addiction; Orthotic Devices; Outcome Measure; Pathologic; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pilot Projects; Population; Populations at Risk; Prevalence; Process; Prosthesis; Provider; Publications; Recording of previous events; Regenerative capacity; Rehabilitation therapy; Research; Research Personnel; Risk; Roentgen Rays; Role; Signal Transduction; Source; Standardization; Symptoms; System; Technology; Testing; Time; Translational Research; United States; United States Department of Veterans Affairs; Universities; Veterans; Walking; Work; active duty; advanced disease; career; clinical encounter; clinical investigation; combat wound; cost; cost effective; design; disability; disabling disease; early screening; electronic sensor; experience; high risk; individualized medicine; innovative technologies; inter-institutional; interest; iterative design; joint injury; knee replacement arthroplasty; microphone; mid-career faculty; miniaturized device; non-invasive monitor; novel; palliative; pharmacologic; point of care; portability; professor; programs; prototype; radiological imaging; rehabilitation research; rheumatologist; sensor; service member; side effect; symptom treatment; symptomatic improvement; wearable device; wireless; wireless electronic

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.

这是申请康复研究小型项目（SPIRE）授予医学博士David Ewart博士的申请 明尼阿波利斯弗吉尼亚州医学中心的流变学家和大学助理教授 明尼苏达州。 Ewart博士拥有生物力学，免疫学和动物的研究和出版物史 关节炎的模型，并正在过渡到关注关节损害的治疗和康复。博士 Ewart是一名早期职业调查员，有受保护时间建立独立投资线的时间。这 Spire Award将为Ewart博士提供支持：1）建立独特的机构间合作 用综合麦克风建立矫形器，以测量膝盖的声学发射 护理2）使用声学排放识别膝盖射射术前骨关节炎患者3）建立一个 在繁忙的研究小组中指导的角色，并生成申请职业的初步数据 发展奖（CDA-2）。为了实现这些目标，Ewart博士建立了一个心态团队 明尼阿波利斯自适应设计与工程（制造）计划负责人安德鲁·汉森（Andrew Hansen）博士 明尼阿波利斯VA和电气和计算机工程副教授Omer Inan博士 佐治亚理工学院。 Ewart博士将与制造计划合作执行膝盖的技术结构 矫形器，将麦克风整合到其中，并与Inan博士进行远程合作，以分析和 优化可穿戴设备中功能的麦克风系统。 骨关节炎（OA）是一种普遍且残疾的疾病。症状的药理和手术治疗 OA的许多患者不足，并且没有疗法会停止甚至延迟结构性 疾病的进展。这种疗法的研究一个困难是早期鉴定患者 足够的疾病阶段，对关节的损害可能可逆。在有OA风险的患者中 在X射线上没有它的迹象，MRI已被证明能够识别膝盖的变化 随后的OA发展。但是，这些发现在所有情况下都不是具体的，MRI是 昂贵，耗时，并且无法在护理点上使用。测量来自 带有现代，微型麦克风的膝盖可以将膝盖健康与疾病区分开，并将提供 早期OA筛查的新方法。在AIM 1中，Ewart博士将与Made计划和Inan博士合作 组到原型和迭代设计具有集成麦克风系统的便携式矫形器 在护理点上测量膝盖的声学排放。在AIM 2中，Ewart博士将在 发生膝盖骨关节炎的风险，但没有射线照相迹象，晚期疾病和 比较从膝盖到健康对照的声学排放。如果声发射在AT-中异常 风险组，将获得其膝盖的MRI，以评估预测射线照相发展的发现 以及对OA的症状进展，验证了声学排放诊断早期OA的能力。 拟议项目的总体目标是开发能够测量声学的便携式矫形器 护理点的膝盖排放量以识别早期射照前OA的患者。 Ewart博士 长期目标是开发技术，用于非侵入性监测联合健康和功能 向提供者提供有用的临床信息，从而导致特定于患者的疗法，定制矫形器， 最终改善了症状，功能和关节寿命。这项工作将构成进一步的基础 机械，临床和转化研究对病理声学排放的基础及其 应用于骨关节炎。这些研究将在CDA-2奖申请中提出 尖顶资金期。