Ultralydsbilleddannelse for myofascial smerte
Udvikling og validering af en ikke-invasiv multimodal ultralydsbaseret billeddiagnostisk biomarkør for myofascial smerte
The goal of this observational study is to develop and validate a biomarker for lumbar myofascial pain (MP) based on ultrasound obtained measurements of the lumbar muscles and fascia. The investigators will use advanced machine learning approaches and validation in a randomized controlled trial. The main questions it aims to answer are:
- Will the deep learning-based marker reliably identify subjects from the 4 different groups: healthy, MP without trigger points, MP with latent trigger points, and MP with active trigger points?
- Will the deep learning-based marker accurately classify/predict the severity of MP in subjects with cLBP?
Participants in the healthy group will be asked to do the following tasks:
- Consent/Enrollment
- Measure Height/Weight
- Complete Questionnaires on REDCap
- Participate in Ultrasound Imaging Experiment Sessions
Participants in the chronic low back pain group will be asked to do the following tasks:
- Consent/Enrollment
- Complete Questionnaires on REDCap
- Measure Height/Weight
- Undergo a Standardized Clinical Exam
- Participate in Ultrasound Imaging Experiment Sessions
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
The investigators propose to use multimodal ultrasound imaging to develop and validate a practical and inexpensive biomarker for lumbar myofascial pain, which shows sensitivity to change in relation to treatment. Myofascial pain (MP) is a frequent contributing factor to chronic low back pain (cLBP). It is associated with a range of tissue abnormalities, such as taught muscle bands, trigger points (TPs), and thoracolumbar fascia motion dysfunction, along with poor tissue elasticity. As a result, a composite biomarker for MP related to components of the syndrome is more likely to be plausible biologically, robust, and useful clinically for diagnosis and treatment. The investigators propose to study: 1. The echogenicity of latent and active trigger points, 2. The dynamic spatial-temporal tissue deformation quantified by strain tensors (compression, extension, and shear) in the thoracolumbar fascia and multifidus muscle, 3. The viscoelastic properties of the fascia and muscles measured by ultrasound shear wave elastography. In the R61 Phase (year 1 to 3) the investigators will use deep learning to integrate these measurements into a predictive biomarker and use established validation methods to test its ability to predict MP.
The investigators will determine the sensitivity and specificity of the biomarker to classify the myofascial components of pain, as well as the response to treatment (a diagnostic and predictive marker).
Undersøgelsestype
Tilmelding (Faktiske)
Kontakter og lokationer
Studiesteder
-
-
Pennsylvania
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Pittsburgh, Pennsylvania, Forenede Stater, 15213
- Kauffman Medical Building
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
The investigators are including healthy normal and cLBP subjects from ages 20 to 70.
Beskrivelse
Inclusion/Exclusion Criteria for Healthy Normals (n=40):
- No history of chronic low back pain, myofascial pain of the neck or shoulders, or fibromyalgia.
- Ages 20-70 to be age appropriate to the cLBP subjects. The investigators will recruit 10 subjects per age decile (10 subjects ages 30-39 yrs., etc.).
- Any clinically unstable systemic illness that is judged to interfere
- with the trial
- Non-ambulatory status
- Not able to complete the questionnaires.
Inclusion Criteria CLBP:
- Age range 20-70 so that the age distribution is likely to roughly match the healthy normals
- Predominantly axial cLBP meeting the NIH definition of cLBP (at least 3 months on a daily basis) with a MP component (determined by a standardized clinical exam)
- Average pain score of > 3/10, with low back pain being the primary pain site
- cLBP meeting Quebec Task Force Classification System categories I-III (from axial pain only to pain radiating beyond the knee without neurological signs).
Exclusion Criteria CLBP:
- Back surgery within the past year
- Active worker's compensation or litigation claims since these patients are more likely to have exaggerated pain behavior
- New pain treatments within 2 weeks of enrollment
- Any clinically unstable systemic illness that is judged to interfere with the trial
- Non-ambulatory status
- Not able to complete the questionnaires.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Observationsmodeller: COHORT
- Tidsperspektiver: PROSPECTIVE
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
|
Healthy Normals
Participants with no chronic pain over a three-year timeframe. |
See above, this is only a phenotyping study but NIH required us to register it as a trial. |
|
MP without TPs
Participants with chronic low back pain who are classified as having myofascial pain and no trigger points. |
See above, this is only a phenotyping study but NIH required us to register it as a trial. |
|
MP with latent TPs
Participants with chronic low back pain who are classified as having myofascial pain and latent trigger points. |
See above, this is only a phenotyping study but NIH required us to register it as a trial. |
|
MP with active TPs
Participants with chronic low back pain who are classified as having myofascial pain and active trigger points. |
See above, this is only a phenotyping study but NIH required us to register it as a trial. |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Diagnosis of one of 3 MP-related categories
Tidsramme: Study Visit 1 (week 1)
|
Participants to be diagnosed as normal, MP with trigger points, or MP with tender points only, as determined by standardized clinical examinations. |
Study Visit 1 (week 1)
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Presence of Substantial MP
Tidsramme: Study Visit 1 (week 1) - Study Visit 2 (week 2)
|
The presence of substantial MP (e.g., # active TPs and pressure pain threshold below 6.5 N/cm2) as determined by the standardized clinical examinations. |
Study Visit 1 (week 1) - Study Visit 2 (week 2)
|
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Kang Kim, PhD, University of Pittsburgh
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- STUDY22090014
- 1R61AT012282-01 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Depends on the specific request from an outside party
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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