Grant: $348,940 - National Institutes of Health - Apr. 30, 2009
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Award Description: Female urinary incontinence has been recently termed a silent epidemic, requiring systematic attention and a multidisciplinary approach towards economically ameliorating its impact. In this study we examine the role of the pelvic floor (PF) in maintaining urinary continence by evaluating the dynamics produced during voluntary and reflex activation. As a result of preparatory work just completed under an R21 study we were able to develop the technology and procedures to attempt to undertake the proposed evaluation as an R01 study. Enabling our approach is the development of criteria and unique new parameters that define the kinematics of PF function. Principal among these parameters, and in addition to the mechanical closure forces are displacement, velocity, acceleration and the trajectory of pelvic floor landmarks. Objectives are to facilitate the visualization of these parameters using a graphical user interface to test the hypothesis that continent older women will present different visualization values than older women with stress incontinence. Movement detection, including motion tracking algorithms and segmentation algorithms will be developed to acquire new parameters of trajectory, displacement, velocity and acceleration, of pelvic structures during different maneuvers. In order to enhance the ultrasound imaging and highlight the timing of the movement and deformation to fast and stressful maneuvers, which are important for understanding the neuromuscular control mechanisms in urinary continence, 2D animation will be applied. Parameters will be derived from imaging of trans-perineal scanning from asymptomatic volunteers as well as patients presenting with relevant pathology. Additional software innovation in the analysis of these parameters is the ability to define the timing sequences associated with pelvic floor responses. Preliminary observations suggest that timing of response are a significant factor separating the continent from the incontinent subjects. Consequent to evidence generated so far we propose to consider the hypothesis that reflex pelvic floor responses prevent stress urinary incontinence during fast and stressful maneuvers such as coughing are age and parity dependent. Before generalizing this hypothesis we propose to first obtain evidence that spans the age and parity. On the basis of data obtained from ultrasound imaging, we propose to develop a model to simulate the control systems involved in maintaining continence by introducing the Artificial Neural Network (ANN) approach for analysis of the data. ANN will be trained by adjusting the weights of the connections using different algorithms to solve problems including classification and pattern identification. Treatment of urinary incontinence, now a silent epidemic in older women, requires a systematic evaluation of female pelvic floor function by accurately evaluating its voluntary activation and reflex response to stress. Using ultrasound imaging, we plan to provide a visualization platform to facilitate the clinical evaluation of patients focusing on the identification of the timing and deformation parameters which are important for an understanding the neuromuscular control mechanisms of continence.
Project Description: As defined in the Award Description field.
Jobs Summary: One full time and one .75 FTE Biomedical Engineer position have been created. (Total jobs reported: 2)
Project Status: Less Than 50% Completed
This award's data was last updated on Apr. 30, 2009. Help expand these official descriptions using the wiki below.