Work-related musculoskeletal disorders account for 30% of lost work time illnesses, yet, the pathophysiological mechanisms underlying their development and persistence over time is incompletely understood. The long term goal of this work is to use an innovative model of upper limb overuse injury in the rat to identify and characterize cellular mechanisms underlying tissue changes and behavioral sequelae associated with the performance of repetitive and/or forceful reaching.
The specific aims for this project are: 1) To determine the mechanisms whereby long-term exposure to two task regimens, medium repetition-low force (MRLF) and high repetition-high force (HRHF), leads to bone resorption and pathological changes, and articular cartilage damage, and if the mechanism underlying these changes is inflammatory, mechanical overuse, or both. 2) To determine the mechanisms whereby long-term exposure to two task regimens, MRLF and HRHF, leads to fibrosis and pathological degeneration in musculotendinous and neural tissues and if the mechanism underlying these changes is inflammatory, mechanical overuse, or both. 3) To determine if there is a relationship between biomarkers of tissue changes and sensorimotor function after exposure to two task regimens, MRLF and HRHF. Rats will be trained to perform a voluntary reaching and grasping task at MRLF (8 reaches per minute @ 5% maximum voluntary pulling force, MPF), or HRHF (12 reaches per minute at 60% MPF). Two experimental groups will receive either anti-tumor necrosis factor alpha or interleukin-1 receptor antagonist prophylactically in order to block inflammation. Musculoskeletal tissues, peripheral nerve and serum will be analyzed for cellular and biochemical markers of tissue inflammation and degeneration using a post-test control group design. Median nerve function will be tested and analyzed also using a post-test control group design. Behavioral variables indicative of reach performance and movement coordination will be analyzed for changes over time using a repeated measures design. To determine the association between serum and behavioral variables, a multiple regression analysis will be used. The 2 experimental groups will perform either the MRLF or HRHF task for 16 or 22 weeks. At each weekly endpoint, all animals will undergo sensorimotor performance testing and will then be split randomly into 3 subgroups for microscopic examination, protein analysis and median nerve conduction velocity testing (n=5-10 per group per analysis type at all weekly endpoints). Trained controls, matched by age, diet, and weight, will be sacrificed at matched time points for comparison to experimental animals. Forelimb tissues will be collected bilaterally and prepared for the various analyses These experiments will enhance our understanding of the effects of long-term exposure to combinations of risk factors (repetition and force) on tissue and function, as well as mechanisms (mechanical overload, or inflammation-induced catabolism/fibrosis) underlying those responses (degeneration, pain and loss of function).
This rat model of WMSD is uniquely able to draw parallels between tissue pathophysiology and behavioral responses resulting from exposure to a range of tasks that are clinically meaningful, because they have been derived from the clinical and epidemiological literature concerning this important occupational health problem. The data generated by these studies in the rat will ultimately contribute to the development of new strategies for effective prevention and management of overuse injuries by providing insights into and a framework for future translational studies of clinical populations.
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