Lower Limb Injury Clinical Trial
Official title:
Longitudinal Evaluation of Muscle Quality in Patients With Fractures - A Prospective Observational Study
The aim of the study is to longitudinally evaluate patient muscle quality in trauma patients with bed rest or altered weight-bearing with the help of a consumer approved non-proprietary muscle impedance-measuring device. Secondary objectives are to identify patient characteristics or treatment protocols that are predictive of poor muscle quality.
The study investigators will identify eligible patients through patient consultations from
the Emergency Room. There are 100 patients expected to be enrolled in the study. This study
will be carried out at the Montreal General Hospital. Inclusion criteria include patients
that have had a trauma requiring admission to orthopedic surgery, that have the ability and
willingness to participate that were in a steady state medical condition before trauma.
Although the study investigators may discuss the study with the patient, the consent and
enrolment will be performed exclusively by the study assistant who is not directly implicated
in the patient's care.
This is an observational study, therefore, there will be no randomization and no study
intervention.
The following baseline patient characteristics will be recorded for each enrolled
participant: age, sex, occupation, smoker, medical comorbidities, AO classification of the
fractures and muscle trauma, the date of the injury and date of the surgery if performed.
A consumer approved non-proprietary muscle impedance-measuring device (Electrical Impedance
Myography unit or "EIM") will be applied to the muscle groups of interest. The device is
self-contained, battery-powered and certified for use on humans. When applied to the skin, a
very weak electrical current is passed between the outer two electrodes. This current is high
frequency and alternating in nature. As the current moves through the skin, the subcutaneous
fat and the muscle, it loses a little bit of energy due to the resistance of the tissue and
this change is then measured. This will be done as soon as possible after the trauma and
admission during a daytime visit. The EIM will be used every two days until discharge or the
patient has reached a recovery plateau in a physical rehabilitation program. Patients' muscle
quality will also be measured at each follow-up visit for 100 weeks and patients will be
asked to complete two questionnaires.
Each patient will have a unique identification number used to link the patient information,
device and data together.
It is expected for most patients to have decreasing muscle quality and increasing fat
percentage as a result of deconditioning. There is no longitudinal data on the time period
over which this would occur. There is also little data on how recovery occurs after the
period of healing.
This study utilizes new technology that permits objective insight into the post-operative
period by providing qualitative measurements. It has been used previously in clinical studies
on patients with neuromuscular degenerative disease with reproducible and consistent results.
The research team anticipates being able to pinpoint specific targets for mobilization goals
and rehabilitation techniques depending on the time frame and muscle groups involved with
deconditioning.
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