| Summary: | 博士 === 國立成功大學 === 生物醫學工程學系 === 102 === Video-based walking track systems have been developed for gait analysis in rat models in recent years. Those video-based gait analysis systems could determine not only the spatial parameters but also the temporal parameters. However, there is no previous study using video-based tracking systems has addressed the issue of gait analysis in evaluating of the recovery of Achilles tendon rupture model. From the clinical aspect, the functional recovery is more important than the anatomical recovery, but most of the relative animal studies were mainly assessed the anatomy recovery condition. Which could not be fully satisfied the clinical goals. Therefore, two main specific aims are included in this study. The first aim of this study is to set up a video-based gait analysis system for functional evaluation of healing Achilles tendon in rats. After system reliability and validity are established, the sensitivity between the Achilles functional index (AFI) and gait parameters using a video-based walking track gait analysis system is further analyzed. The second aim of this study is applying the video-based gait analysis system to evaluate two tendon healing models: hyperglycemic rats and tissue engineering treated rats, respectively.
The experimental animals underwent single limb Achilles tendon transection. In aim 1, the animals were randomly assigned to four interventional conditions: normal, sham surgery, Achilles tendon repair, and Achilles tendon defect. In aim 2, the animals were randomly assigned to two groups in hyperglycemic rats (defect and repair groups), and to three groups in tissue engineering treated rats (hyaluronic acid with cell, hyaluronic acid without cell, and normal saline injection groups). All animals were evaluated using a video-based gait analysis system after surgery, the gait parameters and AFI were further analyzed.
The video-based gait analysis system exhibited great reliability and validity. In spatial gait parameter analysis, similar trend of step length changes were found between sham-operated rats and the Achilles tendon injured rats. In temporal gait parameter analysis, different asymmetric levels of the hindlimb swing time were found between shame-operated rats and the Achilles tendon injured rats. The ankle joint angles of the injury side at mid-stance and pre-swing were highly correlated with AFI. Lack of sensitivity was found in the AFI, whereas better measurement sensitivity in different Achilles tendon healing condition was found in ankle joint angle of the injury limb at the pre-swing and asymmetric levels of the hindlimb joint position. The overall sensitivity of ankle motion analysis was significantly higher than that of AFI.
Due to the poor healing ability, the locomotion ability of the healing Achilles tendon in hyperglycemic rats was generally worse than the normal rats, especially the Achilles tendon defect in hyperglycemic rats. Therefore, the repair of the ruptured Achilles tendon might be more important in the hyperglycemic rats.
A significant difference in the recovery condition was found in the injured tendon injected with the hyaluronic acid solution with tenocytes compared with the other groups. The locomotion abilities of the rats with healing Achilles tendons were improved in the hyaluronic acid with tenocyte transplantation group. The acceleration of the inflammatory phase in rats with the hyaluronic acid with tenocyte injections might be the major reason for the better functional outcomes.
A video-based walking track system had been established in this study, which could be comprehensively and reproducibility evaluation the functional recovery condition of the experimental animal through the spatial, temporal, and joint movement parameters analysis. The reliability and validity of this gait analysis apparatus was verified by a healing Achilles tendon rat model. Compare to the traditional paw-based functional assessment, the gait analysis exhibited more sensitivity than the Achilles functional index. In the healing Achilles tendon relative hyperglycemic and cell therapy animal mode, the gait analysis also showed the excellent evaluation sensitivity. Compare to the evaluation methods that utilized in most of the relative studies, the gait analysis could be more directly reflected the real functional recovery condition of the healing Achilles tendon rats with different management protocols. Beside the good reliability, validity, and sensitivity of the video-based gait analysis, the amount of the experimental animal usage could be reduced by the long term follow up via gait function evaluation. Therefore, the video-based gait analysis would have great potential to be a standard assessment tool for the locomotion disability relative animal model.
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