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Quantification of Musculoskeletal Structural Adaptations Underlying Functional Deficits in Children and Young Adults with Hemiparetic Cerebral Palsy
Quantification of Musculoskeletal Structural Adaptations Underlying Functional Deficits in...
Quantification of Musculoskeletal Structural Adaptations Underlying Functional Deficits in Children and Young Adults with Hemiparetic Cerebral Palsy

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20250211153036
ISBN  
9798346858713
DDC  
610
저자명  
Joshi, Divya.
서명/저자  
Quantification of Musculoskeletal Structural Adaptations Underlying Functional Deficits in Children and Young Adults with Hemiparetic Cerebral Palsy
발행사항  
[Sl] : Northwestern University, 2024
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2024
형태사항  
146 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-06, Section: B.
주기사항  
Advisor: Dewald, Julius;Ingo, Carson.
학위논문주기  
Thesis (Ph.D.)--Northwestern University, 2024.
초록/해제  
요약Cerebral palsy (CP), the most common movement disorder in childhood, results in progressive limitations in the functional use of the affected limbs. Structural mechanisms at the musculoskeletal level are believed to contribute to functional deficits such as weakness and altered biomechanical properties, particularly in distal joints such as the hand and fingers; however, there is currently limited understanding of this relationship. This dissertation presents a comprehensive investigation of in vivo musculoskeletal adaptations that affect hand and finger function in children and young adults with hemiparetic cerebral palsy (HCP) by using advanced diffusion tensor imaging (DTI) techniques in conjunction with novel mechatronic measurements.First, I completed a sensitivity analysis to determine the optimal DTI parameters that robustly quantified in vivo upper extremity muscle morphology, discovering that probabilistic tractography was superior to deterministic methods in accurately characterizing muscle architecture. Then, I applied these optimized DTI parameters to examine adaptations in forearm flexor muscles of individuals with HCP, finding that significant interlimb differences in muscle size, muscle fiber geometry, and DTI diffusivity profiles contributed substantially to grip strength deficits. Finally, I explored the relationship between DTI-derived measures and passive properties in the wrist and finger joints, showing that increased passive torques during extreme hand extension correlate withreduced diffusivity.Collectively, these findings deepen our understanding of secondary musculoskeletal changes following a brain injury at birth and underscore the need for targeted interventions aimed at addressing structural and associated functional impairments in individuals with CP. This work lays the foundation for future research aimed at improving motor function through integrated imaging and biomechanical assessments of the musculoskeletal system in individuals with HCP.
일반주제명  
Biomedical engineering
일반주제명  
Neurosciences
일반주제명  
Medical imaging
일반주제명  
Physiology
키워드  
Cerebral palsy
키워드  
Diffusion tensor imaging
키워드  
Magnetic resonance imaging
키워드  
Passive torque
키워드  
Pediatric hemiplegia
키워드  
Skeletal muscles
기타저자  
Northwestern University Biomedical Engineering
기본자료저록  
Dissertations Abstracts International. 86-06B.
전자적 위치 및 접속  
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MARC

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■035    ▼a(MiAaPQ)AAI31638105
■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a610
■1001  ▼aJoshi,  Divya.▼0(orcid)0000-0001-6397-0037
■24510▼aQuantification  of  Musculoskeletal  Structural  Adaptations  Underlying  Functional  Deficits  in  Children  and  Young  Adults  with  Hemiparetic  Cerebral  Palsy
■260    ▼a[Sl]▼bNorthwestern  University▼c2024
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2024
■300    ▼a146  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-06,  Section:  B.
■500    ▼aAdvisor:  Dewald,  Julius;Ingo,  Carson.
■5021  ▼aThesis  (Ph.D.)--Northwestern  University,  2024.
■520    ▼aCerebral  palsy  (CP),  the  most  common  movement  disorder  in  childhood,  results  in  progressive  limitations  in  the  functional  use  of  the  affected  limbs.  Structural  mechanisms  at  the  musculoskeletal  level  are  believed  to  contribute  to  functional  deficits  such  as  weakness  and  altered  biomechanical  properties,  particularly  in  distal  joints  such  as  the  hand  and  fingers;  however,  there  is  currently  limited  understanding  of  this  relationship.  This  dissertation  presents  a  comprehensive  investigation  of  in  vivo  musculoskeletal  adaptations  that  affect  hand  and  finger  function  in  children  and  young  adults  with  hemiparetic  cerebral  palsy  (HCP)  by  using  advanced  diffusion  tensor  imaging  (DTI)  techniques  in  conjunction  with  novel  mechatronic  measurements.First,  I  completed  a  sensitivity  analysis  to  determine  the  optimal  DTI  parameters  that  robustly  quantified  in  vivo  upper  extremity  muscle  morphology,  discovering  that  probabilistic  tractography  was  superior  to  deterministic  methods  in  accurately  characterizing  muscle  architecture.  Then,  I  applied  these  optimized  DTI  parameters  to  examine  adaptations  in  forearm  flexor  muscles  of  individuals  with  HCP,  finding  that  significant  interlimb  differences  in  muscle  size,  muscle  fiber  geometry,  and  DTI  diffusivity  profiles  contributed  substantially  to  grip  strength  deficits.  Finally,  I  explored  the  relationship  between  DTI-derived  measures  and  passive  properties  in  the  wrist  and  finger  joints,  showing  that  increased  passive  torques  during  extreme  hand  extension  correlate  withreduced  diffusivity.Collectively,  these  findings  deepen  our  understanding  of  secondary  musculoskeletal  changes  following  a  brain  injury  at  birth  and  underscore  the  need  for  targeted  interventions  aimed  at  addressing  structural  and  associated  functional  impairments  in  individuals  with  CP.  This  work  lays  the  foundation  for  future  research  aimed  at  improving  motor  function  through  integrated  imaging  and  biomechanical  assessments  of  the  musculoskeletal  system  in  individuals  with  HCP.
■590    ▼aSchool  code:  0163.
■650  4▼aBiomedical  engineering
■650  4▼aNeurosciences
■650  4▼aMedical  imaging
■650  4▼aPhysiology
■653    ▼aCerebral  palsy
■653    ▼aDiffusion  tensor  imaging
■653    ▼aMagnetic  resonance  imaging
■653    ▼aPassive  torque
■653    ▼aPediatric  hemiplegia
■653    ▼aSkeletal  muscles
■690    ▼a0541
■690    ▼a0317
■690    ▼a0574
■690    ▼a0719
■71020▼aNorthwestern  University▼bBiomedical  Engineering.
■7730  ▼tDissertations  Abstracts  International▼g86-06B.
■790    ▼a0163
■791    ▼aPh.D.
■792    ▼a2024
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17164727▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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