Development and Validation of a Cost-Effective Protocol for Objective Quantification of Muscle/Tendon Function in Chronic Tendinopathy
Abstract
This proposal will address clinical measurement of muscle and tendon problems, such as weakness and stiffness, in individuals with long-standing symptoms of pain, swelling, and activity limitation due to an injury to tendon tissue. Tendons are the tissues that connect muscle to bone, and they are very commonly injured, sometimes by a single event and sometimes due to overuse. In some cases, these injuries heal normally with rest or treatment, but often they do not, turning into a problem known as chronic tendinopathy. This proposal will develop and validate a new way to measure the muscle problems associated with chronic tendinopathy in medical and rehabilitation clinics, called the Comprehensive Tendinopathy Assessment Protocol (CTAP). The protocol will use a cost-effective and valid measurement tool (kiio Sensor®, Kiio Inc., Madison, WI) and software program that will advance the way this problem is managed by healthcare providers. While combat-related injuries are often devastating, the most common and expensive injuries in the military are actually non-combat neuromusculoskeletal injuries. This includes low back pain, ankle sprains, knee pain (often called jumper s knee), and Achilles tendon soreness. They are the leading cause of limited duty days and disability in the United States military, resulting in over 5 million limited duty days annually. Diseases and injuries of the muscles, tendons, and joints affected almost a million Service members in 2014, and resulted in nearly 4 million medical encounters. Among these disorders, chronic tendinopathy is exceedingly common and presents significant clinical challenges. The optimal way to treat these injuries is not known. Part of the reason for this is that measurement of the problems associated with chronic tendinopathy is inconsistent and difficult to accomplish. This is acknowledged by the solicitation focus area "Inadequate measures for standardized assessment of relevant activity performance and participation," which this proposal will address. The ultimate applicability of this research will be in clinical settings. The patient groups directly involved in this proposal are individuals with chronic Achilles and patellar (knee) tendinopathy. Currently, when an individual is treated for these disorders, measurement of the status of the muscle/tendon at the start and end of treatment is not as informative as it could be. Some measures are not objective or repeatable. Some measures only focus on how the patient feels with regard to pain, which does not always match how they can perform physically. Other measures focus entirely on whether or not the individual can complete certain tasks, with little regard to how it was done or what compensations may have existed. What is missing is a good, cost-effective measure of the muscle and tendon itself, which focuses entirely on the important elements of individual muscle function. Examples of this include how strong the muscle is, how fast it can create force, how long it can hold against force, and whether or not the muscle is flexible or stiff. With this information, clinicians will be able to tell patients when they are appropriate for more advanced, difficult testing such as the Army Physical Fitness Test, and when they may be safe to return to duty. The information can also alert a clinician to when a treatment is not working as intended, thereby signaling a need to try something else. In this way, clinical efficiency and economical management can be greatly enhanced. While improved healthcare economics are the primary military benefit of the CTAP, other benefits are expected. With better measurement comes better understanding of both successful and unsuccessful treatments, thus we expect to decrease unsuccessful treatment and subsequently reduce unnecessary medication usage (and potential side effects), injections, surgical interventions, and supervised rehabilitation. This will improve quality
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610789
Entities
People
- David Grandin
Organizations
- Kiio (United States)
- United States Army