IDENTIFYING FEMALE ATHLETES AT HIGH RISK FOR ACL INJURY

识别 ACL 损伤高风险的女性运动员

• 批准号: 6827460
• 负责人: Timothy E Hewett
• 金额: $ 59.48万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-21 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6827460
• 关键词: adolescence (12-20); biomechanics; body composition; body height; body physical activity; body weight; bone development; clinical research; disease /disorder proneness /risk; female; functional ability; gender difference; human puberty; human subject; injury prevention; joint ligament; knee; longitudinal human study; mechanical stress; muscle function; muscle strength; musculoskeletal disorder diagnosis; musculoskeletal injury; neuromuscular function; questionnaires; sports injury

DESCRIPTION (provided by applicant): It is now widely recognized that gender-based differences can play a major role in the predisposition to disease and injury, yet this remains an understudied phenomenon. Adolescent females who participate in jumping and pivoting sports suffer anterior cruciate ligament (ACL) injury at a 4 to 6-fold greater rate than adolescent males participating in the same sports. The reason(s) for this ACL injury disparity remain(s) obscure. Prior to puberty, male and female injury risk appears equal. Our long-term objectives are to determine how female athletes become more susceptible to non-contact ACL injury, prospectively identify those female athletes who are more susceptible to injury and to determine the underlying mechanistic cause(s) of increased risk at the biomechanical and biochemical levels and to optimize the effectiveness of treatments designed to prevent ACL injuries. Towards these goals, we propose to test the central hypothesis that the increases in lower extremity bone length and body mass that occur during puberty, without the neuromuscular performance spurt that most males demonstrate, will increase dynamic valgus, knee joint loading and injury risk in a subset of female athletes. It will also test the hypothesis that measures relating to dynamic valgus will prove predictive of ACL injury risk in high-risk female athletes. Specific Aim 1 will determine if following the onset of pubertal growth, increases in tibia and femur length and body mass, in the absence of increases in strength and recruitment of the musculature at the hip and knee that controls knee position and load, will lead to decreased neuromuscular control as measured by increased dynamic valgus in a subset of maturing female athletes. Specific Aim 2 will determine if objective biomechanical measures can predict relative ACL injury risk in female athletes. We hypothesize that a model that incorporates measures of dynamic valgus and variables that contribute to neuromuscular control of valgus (hip adduction moment) and increased knee joint load (knee abduction moment) will prove both sensitive and specific predictors of ACL injury risk in female athletes. These data should provide a foundation for approaching both the mechanistic questions underlying risk disparity, as well as increase our ability to direct high-risk athletes to effective, targeted interventions, which are proposed. Prevention of female rates from 5 times to equal males' would allow >30,000 females annually to continue the benefits of sports participation and to avoid the long-term complications of osteoarthritis, which may occur with a 10-fold greater incidence in the ACL-injured population.

描述（由申请人提供）：现在人们普遍认识到，基于性别的差异在疾病和损伤的易感性中发挥着重要作用，但这仍然是一个尚未得到充分研究的现象。参加跳跃和旋转运动的青春期女性遭受前十字韧带 (ACL) 损伤的几率是参加相同运动的青春期男性的 4 至 6 倍。这种 ACL 损伤差异的原因仍然不清楚。在青春期之前，男性和女性受伤风险似乎相同。我们的长期目标是确定女运动员如何变得更容易受到非接触性 ACL 损伤，前瞻性地识别那些更容易受伤的女运动员，并确定生物力学和生化风险增加的根本原因。水平并优化旨在预防 ACL 损伤的治疗的有效性。为了实现这些目标，我们建议检验一个中心假设，即青春期期间下肢骨长度和体重的增加，如果没有大多数男性表现出的神经肌肉性能突增，将增加动态外翻、膝关节负荷和受伤风险。女运动员的子集。它还将检验以下假设：与动态外翻相关的测量结果可以预测高风险女运动员的 ACL 损伤风险。具体目标 1 将确定青春期生长开始后，在控制膝关节位置和负荷的髋关节和膝关节的力量和肌肉组织没有增加和募集的情况下，胫骨和股骨长度和体重的增加是否会导致通过一组成熟女性运动员的动态外翻增加来衡量神经肌肉控制能力下降。具体目标 2 将确定客观的生物力学测量是否可以预测女运动员的相对 ACL 损伤风险。我们假设，一个包含动态外翻测量和有助于神经肌肉控制外翻（髋内收力矩）和增加膝关节负荷（膝外展力矩）的变量的模型将被证明是女运动员 ACL 损伤风险的敏感且特异的预测因子。这些数据应该为解决风险差异背后的机制问题提供基础，并提高我们指导高风险运动员采取有效、有针对性的干预措施的能力。将女性发病率从 5 倍降至男性的同等水平，将使每年超过 30,000 名女性继续受益于体育参与，并避免骨关节炎的长期并发症，在 ACL 损伤的患者中，骨关节炎的发生率可能高出 10 倍人口。