# Novel precision medicine approach to advance rehabilitation of surgically repaired tendons of the hand

> **NIH NIH F31** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2020 · $45,520

## Abstract

Project Summary
There is no consensus nor strong evidence that identifies the best rehabilitative protocol to optimize outcomes
for patients with surgical repair of a lacerated flexor tendon of the hand. Successful functional recovery
requires tendon coaptation, unimpeded tendon gliding, and adequate tensile strength of the repaired tendon.
Due to limited evidence and variation in practice, adverse healing outcomes (e.g., tendon ruptures, scar
adhesions) occur in a significant number of patients; some patients require a secondary surgery which is
costly, less effective, and oftentimes preventable. The training and research conducted through this fellowship
will support proficiency in three primary areas related to enhancing the recovery process: 1) musculoskeletal
sonography, 2) morphological process of tendon healing, and 3) research methods and data analytic
techniques. This fellowship will examine morphologic biomarkers of tendon coaptation using sonographic
imaging. Sonographic imaging is a relatively inexpensive, widely available, non-invasive, and pain-free imaging
modality that provides real-time images of anatomical structures under the skin. Sonography has been used to
evaluate healthy and injured tendons, and sonographic measures have been shown to correlate with functional
outcomes. However, an approach for utilizing these biomarkers to inform clinical practice has yet to be fully
developed or deployed. As such, this project aims to establish a foundation for the application of sonographic
imaging to aid and advance the rehabilitation of flexor tendons. As a first step, a standardized, reliable, and
valid sonographic imaging protocol to evaluate tendon healing will be developed. Both static and dynamic
imaging techniques will be explored to identify various candidate biomarkers, including macro-morphologic
measures of tendon gapping and adhesions, as well as micro-morphologic measures using spatial frequency
analysis. The timing for initiation and frequency of data collection to adequately capture changes in the healing
tendon, along with the most salient sonographic biomarkers that best indicate healing and functional recovery,
will be identified. These biomarkers will be used to explore recovery patterns and characterize the process of
tendon healing. Establishing a reliable image analysis protocol and identifying the most salient biomarkers will
be a critical step to understanding factors that promote tendon healing with safe and efficient recovery.
Successfully accomplishing these aims will be instrumental in advancing practice by supporting the
development of a precision medicine approach to tendon rehabilitation.

## Key facts

- **NIH application ID:** 9987257
- **Project number:** 5F31AR074894-02
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Sandy Chie Takata
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $45,520
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9987257

## Citation

> US National Institutes of Health, RePORTER application 9987257, Novel precision medicine approach to advance rehabilitation of surgically repaired tendons of the hand (5F31AR074894-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9987257. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*