Virtual Functional Anatomy

虚拟功能解剖学

基本信息

批准号：
10928542
负责人：
frances t sheehan
金额：
--
依托单位：
CLINICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10928542
关键词：
3-Dimensional Activities of Daily Living Adolescent Adult Agreement Anatomy Animals Ankle Architecture Area Athletic Injuries Award Cadaver Cartilage Cerebral Palsy Child Childhood Clinical Data Clinical Research Clinical Treatment Collaborations Computer Models Connective Tissue Data Data Analyses Databases Development Diagnosis Diagnostic Diagnostic radiologic examination Discipline Disease Dislocations Ehlers-Danlos Syndrome Engineering Evaluation Femur Foundations France Future Goals Image Impairment Individual Injury International Intervention Joints Kinetics Knee Knee joint Knowledge Ligaments Magnetic Resonance Imaging Matched Group Measurement Medical Methodology Methods Modeling Movement Muscle Musculoskeletal Musculoskeletal System Natural History Neurologic Orthopedics Pain Paper Patellar Dislocation Pathology Patients Pattern Population Positioning Attribute Preparation Process Property Protocols documentation Publishing Queensland Recording of previous events Recovery of Function Recurrence Research Research Personnel Resolution Role Shapes Shoulder Stress Structure Surface Syndrome System Tendon structure Tissues United States National Institutes of Health Universities Validation Work Wrist anterior cruciate ligament injury automated segmentation bone clinical diagnosis cohort design digital imaging disability education research experimental study functional loss functional restoration hamstring improved in vivo joint function kinematics millimeter motor impairment musculoskeletal injury neuromuscular neuromusculoskeletal physically handicapped segmentation algorithm skeletal soft tissue three-dimensional visualization tool tool development two-dimensional virtual

项目摘要

Although the primary aim of diagnosing and treating musculoskeletal impairments is to restore functional three-dimensional (3D) movements, the majority of the quantitative diagnostic and evaluation tools available to the clinician have remained static and two dimensional. Thus, the current focus is to develop and ultimately validate a combined set of tools that will enable the accurate and precise measurement, analysis and visualization of 3D static and dynamic musculoskeletal anatomy (i.e., bone shape, skeletal kinematics, tendon and ligament strain, muscle force, and joint space). To accomplish this, the MR imaging and analysis capabilities already developed will be combined with highly accurate, imaging-based measurement and registration methodologies in order to non-invasively quantify complete joint anatomy and tissue dynamics during functional movements. Additionally, these tools will enable the quantification of 3D bone shape so that the effect that alterations joint and tissue dynamics have on bone shape can be quantified. Accomplishing the aims of the VFA initiative will fill an important knowledge gap that exists between the relationship of normal or impaired joint structure/function and the functional movement limitations associated with performing activities of daily living. In doing so, it will position the NIH as an international leader in diagnostic evaluation of musculoskeletal impairments by advancing musculoskeletal diagnostic and evaluation tools from primarily static 2D tools to dynamic tools that can quantify 3D musculoskeletal function during dynamic tasks. Due to the natural tiered structure of this research, two primary paths are currently being pursued, one based using the VFA project in its current state to evaluate both normative and impaired joint kinematics and the other is the continued development of the VFA tools so that full musculoskeletal kinetics can be evaluated. The latter requires the development of methodologies for creating 3D digital images of loaded and moving joint tissues (bone, cartilage, and connective tissues) to reveal joint contact patterns and tissue loads. We can then use these capabilities to document and evaluate the function of normal and impaired joint structures (e.g., Cerebral Palsy, Ehlers Danlos syndrome, and patellar tracking syndrome) functional movements. This past year focused on expanding the VFA toolbox in three primary areas; bone shape/muscle volume analysis, automatic segmentation methodological development, and dynamic cartilage contact. This has been augmented by our collaboration with The University of Queensland. We have been able to leverage data collected outside this protocol to extend our study on knee joint shape development in childhood and our tool development work in the area of automatic muscle segmentation. The automatic segmentation tools within the VFA toolbox have been further expanded with collaborations between our group, CIT (NIH), and IMT Atlantique. With the support of our collaborator Dr. Barry Boden (Rockville Orthopeadics), we have expanded the toolbox to incorporate the evaluation of individuals with repeat patellar dislocations. PF Shape in Adults with Recurrent Patellar Dislocation. The role of femoral shape changes in recurrent dislocation is well known. However, past studies in the area have 3 main weaknesses; they primarily ignore patellar shape, they do not use true normative controls, and they do not compensate for the confounding demographic effects. Thus, our study aimed to create new tools for evaluating PF shape in patients with a history of recurrent dislocation. To demonstrate the utility of these tools, PF shape was evaluated in a cohort of patients with a history of recurrent patellar dislocation and the results were compared to a group of matched controls with no history of knee pathology or injury. A paper summarizing these results has been submitted Musculoskeletal Architecture in children with OBPP This study provided a more complete understanding of shoulder musculoskeletal architecture changes in children/adolescents with OBPP, enhancing our understanding of the natural history of OBPP. This work has been completed. Based on a data-sharing agreement with Pierre-Henri Conze of Brest France, these data have been successfully used to develop automated segmentation methods for delineating shoulder muscles from MR images and another paper has been published in this area. These data are now being shared with our CIT collaborators and new segmentation algorithms are being developed. Lastly work is underway with an outside collaborator, Dr. Michael Pearl to add clinical data to our existing database. Two papers are in preparation. PF Dynamic Joint Contact The objective of this study is the continued improvement dynamic joint contact tools within the VFA toolbox. This project established the first validated database defining dynamic, in vivo PF cartilage contact kinematic parameters, acquired during volitional activity in healthy subjects. This provides crucial data for future studies of PF pain and OA. In addition, these data can be used for validation of, or as input to, future computational models. It is a clear advancement over previous studies that have little to no validation and have typically been limited to static analyses, cadaver studies, animal-based methodologies, or generic computational models. Work is continuing in the evaluation of PF contact during various activities and within various populations. These tools are the basis of data analysis for two other protocols. Using MRI and US to Diagnose Hamstring Tears. We are collaborating with Diagnostic Radiology to determine the optimal imaging sequences that will allow for a coordinated evaluation of hamstring tears. We aim to build a combined set of MR-US imaging and analysis tools for the quantification of musculoskeletal injury. An abstract has been accepted at AAPRM Mechanisms of ACL injury & Sports Injury The VFA toolbox was used to support an outside collaboration quantifying the mechanisms of ACL injury and sports injury. This work was awarded the 2021 Kappa Orthopaedic Research Education Foundation (OREF) Clinical Research Award, 1 paper has been published and another is in press

尽管诊断和治疗肌肉骨骼障碍的主要目的是恢复功能性三维运动，但可用于临床医生可用的大多数定量诊断和评估工具仍然是静态的，并且是二维的。因此，当前的重点是开发并最终验证一组组合的工具，该工具将使3D静态和动态肌肉骨骼解剖结构（即骨骼形状，骨骼运动，肌腱和肌腱和韧带，肌肉力量，肌肉力量以及关节空间）进行准确，精确的测量，分析和可视化。为此，已经开发的MR成像和分析能力将与高度准确，基于成像的测量和注册方法结合使用，以便在功能运动过程中非侵入性地量化完整的关节解剖学和组织动力学。此外，这些工具将实现3D骨形状的定量，以便可以量化关节和组织动力学对骨形的影响。实现VFA计划的目标将填补正常或受损的关节结构/功能之间的关系与与日常生活活动相关的功能运动限制之间存在的重要知识差距。这样一来，NIH将通过将肌肉骨骼诊断和评估工具从主要的静态2D工具推进到可以量化3D肌肉骨骼骨骼功能的动态工具的肌肉骨骼诊断和评估工具来对肌肉骨骼损伤进行诊断评估的国际领导者。由于这项研究的自然阶层结构，目前正在采用两条主要途径，一种基于当前状态的VFA项目来评估规范性和受损的关节运动学，另一个是VFA工具的持续开发，以便可以评估完整的musculoskleoskeletal动力学。后者需要开发用于创建负载和移动关节组织（骨骼，软骨和结缔组织）的3D数字图像的方法，以揭示关节接触模式和组织负载。然后，我们可以使用这些功能来记录和评估正常和受损的关节结构的功能（例如脑瘫，Ehlers Danlos综合征和Patellar Tracking综合征）功能运动。过去的一年，重点是在三个主要领域扩展VFA工具箱。骨形/肌肉体积分析，自动分割方法论发展和动态软骨接触。我们与昆士兰州大学的合作增加了这一点。我们已经能够利用本协议之外收集的数据来扩展我们对童年时期的膝关节形状发展以及我们在自动肌肉分割领域的工具开发工作。 VFA工具箱中的自动分割工具通过我们的小组，CIT（NIH）和IMT Atlantique之间的协作进一步扩展。在我们的合作者Barry Boden博士（Rockville Orthopeadics）的支持下，我们扩展了工具箱，以结合反复的pat骨位错的个人的评估。 pf的PF形状，具有复发性tell骨位错的成年人。股骨形状变化在复发脱位中的作用是众所周知的。但是，该地区过去的研究有3个主要弱点。他们主要忽略了pat骨形状，不使用真正的规范控制，也没有弥补令人困惑的人口影响。因此，我们的研究旨在创建新工具，以评估具有反复脱位病史的患者的PF形状。为了证明这些工具的实用性，在具有复发性tell骨脱位史的一组患者中评估了PF形状，并将结果与没有膝关节病理或损伤病史的一组匹配对照组进行了比较。总结了这些结果的论文已提交 OBPP儿童的肌肉骨骼建筑这项研究为患有OBPP的儿童/青少年的肩部肌肉骨骼结构变化提供了更全面的了解，从而增强了我们对OBPP自然历史的理解。这项工作已经完成。根据与法国布雷斯特的皮埃尔·亨利·科兹（Pierre-Henri Conze）的数据共享协议，这些数据已成功地用于开发自动分割方法，用于从MR图像中描述肩部肌肉，并在该领域发表了另一篇论文。这些数据现在正在与我们的CIT合作者共享，并且正在开发新的细分算法。最后，外部合作者Michael Pearl博士正在进行工作，以在我们现有的数据库中添加临床数据。两篇论文正在准备。 PF动态关节接触这项研究的目的是VFA工具箱中的持续改进动态联合接触工具。该项目建立了第一个经过验证的数据库，该数据库定义了在健康受试者的自愿活动期间获得的动态pf软骨触点运动学参数。这为PF疼痛和OA的未来研究提供了关键数据。此外，这些数据可用于验证或输入未来的计算模型。比以前几乎没有验证，通常仅限于静态分析，尸体研究，基于动物的方法或通用计算模型的研究，这是一个明显的进步。在各种活动和各种人群中对PF接触的评估中，工作仍在继续。这些工具是其他两个协议的数据分析的基础。使用MRI和我们诊断绳肌眼泪。我们正在与诊断放射学合作，以确定最佳的成像序列，该序列将允许对腿筋眼泪进行协调的评估。我们旨在建立一组MR-US成像和分析工具，以定量肌肉骨骼损伤。 AAPRM已接受摘要 ACL伤害和运动损伤机制 VFA工具箱用于支持外部协作，以量化ACL损伤和运动损伤的机制。这项工作获得了2021年Kappa骨科研究教育基金会（OREF）临床研究奖，已发表1篇论文，另一篇是新闻界

项目成果

期刊论文数量（40）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Increased Patellar Volume/Width and Decreased Femoral Trochlear Width Are Associated With Adolescent Patellofemoral Pain.

髌骨体积/宽度增加和股骨滑车宽度减小与青少年髌股疼痛相关。

DOI：
10.1097/corr.0000000000000499
发表时间：
2018
期刊：
Clinical orthopaedics and related research
影响因子：
4.2
作者：
Smith,RichardM;Boden,BarryP;Sheehan,FrancesT
通讯作者：
Sheehan,FrancesT

Three dimensionality of gleno-humeral deformities in obstetrical brachial plexus palsy.

产科臂丛神经麻痹中盂肱畸形的三维性。

DOI：
10.1002/jor.23049
发表时间：
2016-04
期刊：
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子：
0
作者：
Brochard S;Mozingo JD;Alter KE;Sheehan FT
通讯作者：
Sheehan FT

Dynamic sagittal plane trunk control during anterior cruciate ligament injury.