Virtual Reality Mindfulness Meditation in Patients after Anterior Cruciate Ligament Reconstruction

前十字韧带重建后患者的虚拟现实正念冥想

• 批准号: 10190321
• 负责人: Shelby Baez
• 金额: $ 13.11万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10190321
• 关键词: 3-Dimensional; Activities of Daily Living; Address; Anterior Cruciate Ligament; Anxiety; Applications Grants; Attention; Auditory; Biological Factors; Biomechanics; Brain; Brain region; Complex; Data; Data Analyses; Data Collection; Development; Exhibits; Fright; Functional Magnetic Resonance Imaging; Future; Goals; Grant; Health; Healthcare; Imagination; Incidence; Individual; Injury; Intervention; Knee; Knee Osteoarthritis; Knowledge; Learning; Literature; Measures; Mental Depression; Methods; Mind; Mission; Motion; Movement; Neurological outcome; Outcome; Pain; Patient Self-Report; Patients; Pattern; Physical activity; Population; Positioning Attribute; Psychological Factors; Quality of life; Questionnaires; Randomized; Real-Time Systems; Recording of previous events; Rehabilitation therapy; Reporting; Research Personnel; Risk; Scientist; Series; Sex Differences; Sports; Surrogate Endpoint; Techniques; Testing; Time; Training; Training Programs; Treatment Efficacy; United States National Institutes of Health; Visual; Woman; Work; anterior cruciate ligament injury; anterior cruciate ligament reconstruction; career; career development; chronic musculoskeletal pain; chronic pain patient; efficacy evaluation; emotion regulation; experience; flexibility; functional MRI scan; group intervention; improved; innovation; mental practice; mindfulness; mindfulness meditation; muscle strength; neuroimaging; neuromuscular training; novel; patient oriented; placebo group; psychologic; return to sport; skills; treatment strategy; virtual reality

Injury-related fear after anterior cruciate ligament (ACL) injury significantly contributes to decreased return to sport, decreased physical activity engagement, and increased ACL reinjury risk in previously high functioning, physically active individuals. Injury-related fear is also associated with poor jump-landing movement patterns in patients after ACL reconstruction (ACLR). Unfortunately, current rehabilitation practices do not specifically address injury-related fear in patients after ACLR. Virtual reality mindfulness meditation is a mental practice that involves focusing your mind on your experiences in the present moment and has been used to address depression, anxiety, and chronic musculoskeletal pain. Additionally, mindfulness meditation has led to positive changes in brain activity in individuals with depression, anxiety, and chronic musculoskeletal pain. Patients after ACLR exhibit poor brain activity similar to individuals with depression, anxiety, and chronic musculoskeletal pain; thus, patients after ACLR may also benefit from mindfulness meditation. To evaluate the effect of virtual reality mindfulness meditation on patients after ACLR, we will determine the effect of virtual reality mindfulness meditation to 1) decrease self-reported injury-related fear, 2) improve poor jump-landing movement patterns, and 3) improve brain activity in women 9-months post-ACLR when compared to a virtual reality sham group. Injury-related fear and poor jump-landing movement patterns have been associated with ACL reinjury risk. Women were selected for this study as previous literature has demonstrated sex differences in brain activity and women also have a higher incidence of ACL injury and ACL reinjury risk. All patients in the study will complete an 8-week advanced rehabilitation training program to improve lower-body muscle strength, power, and flexibility. Patients in the intervention group will complete 8-weeks of virtual reality mindfulness meditation + the advanced rehabilitation training program. Patients in the sham group will complete 8-weeks of the virtual reality sham + the advanced rehabilitation training program. The central hypothesis is that women 9-months post ACLR who undergo virtual reality mindfulness meditation will demonstrate decreased injury-related fear, improved jump-landing movement patterns, and improved brain activity. The findings from this proposal will address a gap in knowledge about effective psychological interventions to address psychological and biological factors associated with ACL reinjury risk. This proposal also positions an aspiring independent clinician scientist training to learn neuroimaging techniques and complex movement pattern data collection and analyses. With this training, the primary investigator will examine the efficacy of virtual reality mindfulness meditation to mitigate injury-related fear, decrease ACL reinjury risk, and improve quality of life in patients after ACLR throughout her career as a clinician scientist.

前交叉韧带（ACL）损伤后与损伤有关的恐惧显着有助于下降 重返运动，减少体育锻炼的参与度以及以前高的ACL重伤风险增加 功能，身体活跃的个体。与伤害有关的恐惧也与跳跃不良有关 ACL重建后患者的运动模式（ACLR）。不幸的是，目前的康复实践 在ACLR后，请勿特别解决患者损伤有关的恐惧。虚拟现实正念冥想是 精神练习涉及将您的思想集中在当前的经历上，并且已经 用于解决抑郁症，焦虑和慢性肌肉骨骼疼痛。另外，正念冥想 导致抑郁症，焦虑和慢性肌肉骨骼的患者的大脑活动的积极变化 疼痛。 ACLR后的患者表现出类似于抑郁症，焦虑和慢性个体的脑活动不佳 肌肉骨骼疼痛；因此，ACLR后的患者也可能受益于正念冥想。评估 虚拟现实正念冥想对ACLR后患者的影响，我们将确定虚拟的影响 现实的正念冥想1）减少自我报告的与伤害相关的恐惧，2）改善跳跃不良的地面 与虚拟相比，运动模式和3）在ACLR后9个月改善女性的大脑活动 现实假集团。与伤害有关的恐惧和跳线运动模式与不良的恐惧有关 ACL重伤风险。选择妇女进行这项研究，因为以前的文献证明了性别差异 在大脑活动和女性中，ACL损伤和ACL重伤风险的发生率也更高。所有患者 研究将完成为期8周的高级康复训练计划，以改善低身肌肉 力量，力量和灵活性。干预组的患者将完成8周虚拟现实 正念冥想 +高级康复培训计划。假小组中的患者将 完整的8周虚拟现实假手术 +高级康复培训计划。中央 假设是，经历虚拟现实正念冥想的ACLR 9个月后的女性会 表现出减少与伤害有关的恐惧，改善跳跃运动模式和改善大脑的恐惧 活动。该提案的发现将解决有关有效心理学的知识的差距 解决与ACL重伤风险相关的心理和生物学因素的干预措施。这个建议 还定位有抱负的独立临床医生培训，以学习神经影像学技术和 复杂的运动模式数据收集和分析。通过此培训，主要调查员将 检查虚拟现实的正念冥想的功效，以减轻与伤害有关的恐惧，减少ACL Reinjerury的风险，并改善ACLR在整个职业生涯临床科学家职业生涯后的患者生活质量。