Neuromuscular Electrical Stimulation in Individuals with Rheumatoid Arthritis

类风湿关节炎患者的神经肌肉电刺激

• 批准号: 7589911
• 负责人: Sara R. Piva
• 金额: $ 11.56万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7589911
• 关键词: Affect; Area; Arthritis; Award; Basic Science; Biochemical; Clinical; Collaborations; Development; Doctor of Philosophy; Effectiveness; Electric Stimulation; Environment; Enzymes; Exercise; Fatty acid glycerol esters; Goals; Health; Image; Individual; Intervention; Investigation; Isotonic Exercise; Lower Extremity; Master of Science; Mentors; Metabolic; Mitochondria; Muscle; Muscle Fibers; Muscle function; Muscle rehabilitation; Musculoskeletal; Participant; Patient Self-Report; Patients; Performance; Physical Function; Physical therapy; Qualifying; Questionnaires; Randomized; Reading; Rehabilitation therapy; Research; Research Personnel; Rheumatoid Arthritis; Sampling; Skeletal Muscle; Testing; Training; Universities; X-Ray Computed Tomography; base; career; design; enzyme activity; functional outcomes; implementation research; improved; indexing; muscle hypertrophy; muscle strength; neuromuscular; post intervention; professor; programs; rehabilitation science; response; skills; symposium

DESCRIPTION (provided by applicant): Sara Piva, PT, PhD. is Assistant Professor in the Department of Physical Therapy at the University of Pittsburgh. She is an academic Physical Therapist with a Master of Science degree in Musculoskeletal PT and a Ph.D. in Rehabilitation Sciences. Her goal is to become an independent investigator fully qualified in design and implementation of clinical and translational investigations on the effectiveness of rehabilitation to improve muscle function and maximize functional outcome in patients with arthritis. During this KO1 award, she will pursue bench training in the assessment of morphological and metabolic muscle adaptations in response to neuromuscular electrical stimulation (NMES) in patients with rheumatoid arthritis (RA). The candidate will gain skills in assessing skeletal muscle composition with computerized tomography (CT) imaging, and performing histo- and biochemical analyses of quadriceps muscle samples to assess muscle fiber type, fat content, and oxidative capacity (mitochondria content and enzyme activity). This training will make the candidate uniquely cross-trained in clinical and basic science to undertake a comprehensive approach to study muscle rehabilitation. Through the help of her mentors, Dr. Delitto, Dr. Goodpaster, Dr. Wasko, and Dr. Fitzgerald, and through a combination of practical training, coursework, directed readings, participation in symposia, collaboration with consultants, and the implementation of the research proposed in this KO1, the candidate will gain the necessary skills for a career as an independent investigator and fill an important research gap. The primary aim of the research plan is to determine the effect of NMES on functional outcome and muscle hypertrophy in individuals with RA. The secondary aim is to determine the mechanism by which NMES affects muscle hypertrophy and physical function. After baseline testing, 60 individuals with RA will be randomly assigned to a 16-week NMES program or highly intense volitional exercise program. Both programs will be applied based on the best current clinical evidence. Subjects will be re-assessed after intervention. Groups will be compared for differences in performance-based and self-reported lower extremity function, muscle volume, muscle strength, proportion and area of type I and II muscle fibers, fat content, and muscle oxidative capacity from pre- to post-intervention. Changes in physical function, muscle volume, and muscle strength will be correlated with proportion and area of type I and II muscle fibers, fat content, and markers of muscle oxidative capacity. The internationally recognized research environment of the University of Pittsburgh will highly contribute to the development of Dr. Piva's career.

描述（由申请人提供）：Sara Piva，PT，PhD。是匹兹堡大学物理治疗系的助理教授。她是一位学术物理治疗师，拥有肌肉骨骼 PT 理学硕士学位和博士学位。在康复科学领域。她的目标是成为一名完全合格的独立研究者，能够设计和实施有关康复有效性的临床和转化研究，以改善关节炎患者的肌肉功能并最大限度地提高功能结果。在获得 KO1 奖项期间，她将进行台架训练，评估类风湿性关节炎 (RA) 患者对神经肌肉电刺激 (NMES) 的形态和代谢肌肉适应性。考生将获得使用计算机断层扫描 (CT) 成像评估骨骼肌成分的技能，并对股四头肌样本进行组织和生化分析，以评估肌纤维类型、脂肪含量和氧化能力（线粒体含量和酶活性）。该培训将使候选人在临床和基础科学方面接受独特的交叉培训，以采取全面的方法来研究肌肉康复。在她的导师 Delitto 博士、Goodpaster 博士、Wasko 博士和 Fitzgerald 博士的帮助下，通过实践培训、课程作业、定向阅读、参加研讨会、与顾问合作以及实施在此 KO1 中提出的研究中，候选人将获得作为独立研究者的职业所需的技能，并填补重要的研究空白。该研究计划的主要目的是确定 NMES 对 RA 患者功能结果和肌肉肥大的影响。第二个目标是确定 NMES 影响肌肉肥大和身体功能的机制。基线测试后，60 名 RA 患者将被随机分配到为期 16 周的 NMES 计划或高强度意志运动计划。这两个计划都将根据当前最佳的临床证据进行应用。干预后将重新评估受试者。将比较各组干预前后基于表现和自我报告的下肢功能、肌肉体积、肌肉力量、I 型和 II 型肌纤维的比例和面积、脂肪含量和肌肉氧化能力的差异。身体机能、肌肉体积和肌肉力量的变化将与I型和II型肌纤维的比例和面积、脂肪含量和肌肉氧化能力标志物相关。匹兹堡大学国际认可的研究环境将为Piva博士的职业发展做出巨大贡献。