Biomechanical Treatment of Carpal Tunnel Syndrome

腕管综合症的生物力学治疗

基本信息

批准号：
10047785
负责人：
Zong-Ming Li
金额：
$ 45.4万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10047785
关键词：
Biomechanical Treatment Carpal Tunnel Syndrome

项目摘要

DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is a prevalent hand disorder caused by compression of the median nerve at the wrist. It has an immense impact on national health care, worker productivity, and quality of life. CTS is commonly treated by a surgery that transects the transverse carpal ligament to decompress the median nerve. This surgical concept has existed for nearly a century without fundamental challenges, even though this procedure has a number of complications. Alternative treatments that do not release the ligament have been attempted, but their efficacy remains controversial due to lack of scientific and clinical evidence. Our search for an improved CTS treatment strategy has resulted in the serendipitous finding of a novel mechanism of median nerve decompression by applying transverse compression to the wrist to reshape and enlarge the tunnel space. Our approach to carpal tunnel expansion by shortening the carpal arch width is in contrast to existing methods that try to stretch the carpal tunnel outwards. Our finding and proof-of-concept hold significant potential to non-surgically treat CTS according to biomechanical principles. The overall goal of this proposed project is to design and develop a strategy of carpal tunnel manipulation that achieves treatment efficacy for CTS. Our central hypothesis is that our approach of biomechanical manipulation increases carpal tunnel area, thereby decompressing the median nerve and alleviating CTS symptoms. Three specific aims will be implemented to achieve the objective and confirm the hypothesis: (1) to determine the optimal biomechanical strategy of carpal tunnel manipulation such that the carpal tunnel cross-sectional area is effectively enlarged with the least amount of compressive force; (2) to investigate changes of carpal tunnel morphology, median nerve shape, and carpal tunnel pressure in response to the biomechanical manipulation in individuals with CTS; and (3) to demonstrate the clinical effectiveness of the biomechanical intervention in improving the neurophysiological deficiencies and symptoms associated with CTS. This project combines basic science and clinical translation, elucidating the underlying morphological and physiological mechanisms of the biomechanical intervention for a systematic and rigorous development of an evidence-based strategy for CTS treatment. Completion of this project will accelerate our realization of a novel strategy to biomechanically manage CTS without surgery.

描述（由申请人提供）：腕管综合症（CTS）是一种由手腕正中神经受压引起的常见手部疾病，它对国家医疗保健、工人生产力和生活质量产生巨大影响。通过横断腕横韧带以减压正中神经的手术进行治疗，这种手术概念已经存在了近一个世纪，没有遇到根本性的挑战，尽管这种手术有许多无法释放神经的并发症。人们已经尝试过使用韧带进行治疗，但由于缺乏科学和临床证据，其疗效仍然存在争议。我们对改进的 CTS 治疗策略的研究偶然发现了一种通过对手腕施加横向压迫来重塑正中神经减压的新机制。我们通过缩短腕弓宽度来扩大腕管空间的方法与试图向外拉伸腕管的现有方法相反，我们的发现和概念验证具有巨大的潜力。根据生物力学原理非手术治疗 CTS 该项目的总体目标是设计和开发一种腕管治疗策略，以实现 CTS 的治疗效果。减压正中神经并减轻 CTS 症状，从而实现该目标并证实假设的三个具体目标：（1）确定腕管操纵的最佳生物力学策略，从而使腕管恢复正常。以最小的压力有效地扩大横截面积；（2）研究腕管形态、正中神经形状和腕管压力对 CTS 个体的生物力学操作的变化；证明生物力学干预在改善与 CTS 相关的神经生理缺陷和症状方面的临床有效性。该项目结合了基础科学和临床转化，阐明了生物力学干预的潜在形态和生理机制，以进行系统和严格的研究。开发基于证据的 CTS 治疗策略完成该项目将加速我们实现无需手术的生物力学管理 CTS 的新策略。