Discovery of the Neural Drivers Underlying Injury-Risk Biomechanics

损伤风险生物力学背后的神经驱动因素的发现

基本信息

批准号：
10404593
负责人：
Dustin Robert Grooms
金额：
$ 17.77万
依托单位：
OHIO UNIVERSITY ATHENS
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-15 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10404593
关键词：
3-Dimensional Address Adolescent Adult Affect Anterior Cruciate Ligament Attenuated Bilateral Biofeedback Biomechanics Brain Cerebellum Child Clinical Clinical Trials Cognitive Coupled Data Degenerative polyarthritis Development Effectiveness Event Failure Female Foundations Health Health Care Costs Immersion Impairment Incidence Injury Instruction Intervention Joints Knee Knee Injuries Knee joint Knowledge Laboratories Lead Life Ligaments Lower Extremity Mechanics Medical Care Costs Methods Mission Motion Motor Movement Musculoskeletal Diseases Neuraxis Neuronal Plasticity Outcome Output Pain Pattern Persons Physical activity Positioning Attribute Prevalence Prevention program Prevention strategy Process Public Health Publishing Quality of life Research Rest Risk Risk Assessment Risk Factors Secondary to Sensory Sports Standardization Techniques Technology Testing Time Training United States National Institutes of Health Visual Work Youth active lifestyle anterior cruciate ligament injury base cingulate cortex cognitive process disability frontal lobe high risk high risk population improved injury prevention innovation instrumentation joint loading kinematics mortality motor control motor learning musculoskeletal injury neuroimaging neuromuscular neuromuscular training neuroregulation novel physical inactivity prevent prospective relating to nervous system simulation technology development therapeutic target virtual reality virtual reality environment virtual reality simulator visual motor young adult

项目摘要

1 Project Summary/Abstract 2 Anterior cruciate ligament (ACL) injury is a debilitating condition that results in consistent knee degeneration 3 and reduced physical activity capacity, with cumulative health care costs exceeding several billion dollars per 4 annum. The most common mechanism of ACL injury is without player to player contact (termed non-contact) 5 and secondary to motor coordination errors that result in injurious knee joint loading. As such, the current 6 standard for injury prevention is neuromuscular or movement training to correct resultant specific injury-risk 7 mechanics in controlled settings. However, injury reduction strategies have not achieved sufficient efficacy due 8 to inadequate targeting of central nervous system contributions to the motor errors that may underlie and 9 propagate injury-risk in ecologically valid settings. Our published prospective longitudinal data, and preliminary 10 ecologically valid sport-specific virtual reality data, indicates that sensorimotor brain activity underly ACL injury- 11 risk. Thus, the objective of this application is to determine the brain activity associated with injury-risk motor 12 control in standard and ecologically valid sport-specific virtual reality settings. Our preliminary data inform 13 our central hypothesis that those with injury-risk movement patterns rely on a visual and cognitive-motor neural 14 activation strategy, that is further accentuated in ecologically valid sport virtual reality. The proposed research is 15 innovative because it represents a new and substantial departure from prior work that focused primarily on 16 biomechanical outcomes, to now determine the neural activity propagating injury-risk knee motor control. A key 17 breakthrough of this proposal is the biomechanical instrumentation of knee motor control error in real-time during 18 neuroimaging. The expected outcomes from this observational trial will be the identification of the underlying 19 knee motor control neural activity related to ACL injury-risk biomechanics. Successful completion of the proposed 20 Aims will strategically position us to develop a competitive R01 clinical trial application that assesses novel 21 neuromuscular training to target the neural processes identified by this proposal. Specifically, guided by the 22 neural activation strategies identified herein, we will refine prevention programs using novel biofeedback 23 methods, clinical technologies, and motor learning principles to facilitate adaptive brain function that reduces 24 injury incidence. Thus, avoiding the lifelong pain, osteoarthritis, and physical activity limitations, directly aligning 25 with NIH initiatives to reduce injury and physical inactivity in youth and adults, which is the fourth leading cause 26 of global mortality. 27 28

1 项目概要/摘要 2 前十字韧带 (ACL) 损伤是一种使人衰弱的疾病，会导致膝关节持续退化 3、体力活动能力下降，累计医疗费用每次超过数十亿美元 4 年。 ACL 损伤最常见的机制是球员之间没有接触（称为非接触） 5 继发于运动协调错误，导致膝关节损伤。因此，当前 6 预防伤害的标准是通过神经肌肉或运动训练来纠正由此产生的特定伤害风险受控设置中的 7 个机制。然而，由于伤害减少策略尚未取得足够的功效 8 对中枢神经系统的针对性不足可能导致运动错误 9 在生态有效的环境中传播伤害风险。我们发布的前瞻性纵向数据和初步 10 个生态有效的特定运动虚拟现实数据表明感觉运动大脑活动是 ACL 损伤的原因 11 风险。因此，本应用的目的是确定与损伤风险运动相关的大脑活动 12 在标准且生态有效的运动专用虚拟现实设置中进行控制。我们的初步数据告知 13 我们的中心假设是，那些有受伤风险的运动模式依赖于视觉和认知运动神经 14 激活策略，在生态有效的运动虚拟现实中进一步强调。拟议的研究是 15 创新，因为它代表了与之前主要关注的工作的新的实质性背离 16 生物力学结果，现在确定传播损伤风险膝关节运动控制的神经活动。一把钥匙 17. 该提案的突破在于生物力学仪器在膝关节运动过程中实时控制误差 18 神经影像学。这项观察性试验的预期结果将是确定潜在的 19 与 ACL 损伤风险生物力学相关的膝关节运动控制神经活动。顺利完成拟议的 20 Aims 将从战略上定位我们，开发具有竞争力的 R01 临床试验应用程序，评估新颖的 21 针对本提案确定的神经过程的神经肌肉训练。具体来说，在指导下本文确定了 22 种神经激活策略，我们将使用新颖的生物反馈完善预防计划 23 种方法、临床技术和运动学习原理可促进适应性大脑功能，从而减少 24 伤害发生率。因此，避免终生疼痛、骨关节炎和体力活动限制，直接调整 25 NIH 采取举措减少青少年和成人的伤害和缺乏身体活动，这是第四个主要原因占全球死亡率的 26%。 27 号 28