Epidemiology of Jump-landing Movements and ACL Injury

跳跃着陆动作和 ACL 损伤的流行病学

• 批准号: 6870947
• 负责人: Stephen William Marshall
• 金额: $ 56.91万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6870947
• 关键词: biomechanics; body movement; clinical research; disease /disorder proneness /risk; exercise; gender difference; human subject; interview; joint ligament; knee; longitudinal human study; muscle strength; musculoskeletal disorder diagnosis; musculoskeletal injury; neuromuscular function; questionnaires; sports injury; university student

DESCRIPTION (provided by applicant): Despite intensive research efforts, the cause of Anterior Cruciate Ligament (ACL) injury remains elusive, beyond the simple observation that women are at higher risk than men. We hypothesize that the etiology of ACL injury is multifactorial in nature, with neuromuscular risk factors playing a critical role. This hypothesis is suggested by biomechanical studies indicating that the increased risk in women may be largely due to neuromuscular risk factors, such as gender differences in muscle strength and human movement. These neuromuscular differences between women and men are particularly evident in the landing phase of a jump. We therefore propose poor technique when landing from a jump (jump-landing) as a useful marker of neuromuscular risk factors associated with both gender and ACL injury. A standardized tool for scoring poor jump-landing technique, the Landing Error Scoring System (LESS), has been developed. It has been validated and has good reliability. This study will utilize the LESS, 3-D motion analysis, and muscle strength testing to examine the association between neuromuscular risk factors and ACL injury. The study will also examine other risk factors (demographic, hormonal, and anatomical) identified in the literature as potentially associated with ACL injury, and will compare the prevalence and determinants of poor jump-landing technique between women and men. The study will use a prospective cohort design. It will enroll 4,800 male and female cadets at the three largest U.S. military academies over a 4 year period. Each study participant will undergo a baseline assessment that includes measurement of neuromuscular risk factors using motion analysis, muscle strength testing, and assessment of jumplanding technique using the LESS. The participants will be followed for up to 4 years with prospective identification and verification of ACL injuries. The subject recruitment and baseline testing procedures have been successfully piloted. This focus of this prospective cohort study is on neuromuscular risk factors for ACL injury, with an emphasis on neuromuscular risk factors that exhibit gender differences. The study will also investigate demographic, hormonal, and anatomical risk factors that have been advanced in the literature as causes of the excess of ACL injuries in women. Ultimately, the research will make a significant contribution to our understanding of the causes of ACL injury, with particular regard to those risk factors that appear to predispose women to ACL injury. Unlike some of the anatomical and hormonal risk factors discussed in the literature, neuromuscular risk factors are readily modifiable and are amenable to intervention.

描述（由申请人提供）：尽管进行了深入的研究工作，但前交叉韧带（ACL）受伤的原因仍然难以捉摸，除了简单的观察结果，即女性的风险要高于男性。我们假设ACL损伤的病因本质上是多因素的，神经肌肉风险因素起着至关重要的作用。生物力学研究表明，这一假设表明，女性的风险增加可能主要是由于神经肌肉风险因素，例如肌肉力量和人类运动的性别差异。在跳跃的着陆阶段，男女之间的这些神经肌肉差异尤为明显。因此，从跳跃（跳线）降落时，我们建议技术不佳，这是与性别和ACL损伤相关的神经肌肉风险因素的有用标记。已经开发了一种标准化的工具，用于得分不良的跳线技术，即登陆错误评分系统（LINS）。它已经过验证，并具有良好的可靠性。这项研究将利用较少的3-D运动分析和肌肉力量测试来检查神经肌肉风险因素与ACL损伤之间的关联。该研究还将检查文献中发现的其他危险因素（人口统计学，荷尔蒙和解剖学）可能与ACL损伤相关，并将比较男女之间不良跳跃技术的流行率和决定因素。该研究将使用前瞻性队列设计。它将在4年的美国三个最大的美国军事学院招募4,800名男子学员。每个研究参与者将接受基线评估，其中包括使用运动分析，肌肉力量测试以及使用较少的肌肉力量测试以及对jumplanding技术评估的神经肌肉风险因素的测量。参与者最多将遵循4年的前瞻性识别和ACL伤害验证。受试者的招聘和基线测试程序已成功进行。这项前瞻性队列研究的重点是ACL损伤的神经肌肉风险因素，重点是表现出性别差异的神经肌肉危险因素。该研究还将研究文献中已提出的人口，荷尔蒙和解剖危险因素，原因是女性过度ACL损伤的原因。最终，这项研究将为我们对ACL损伤原因的理解做出重大贡献，特别是关于似乎使女性造成ACL损伤的那些危险因素。与文献中讨论的一些解剖和激素危险因素不同，神经肌肉风险因素很容易修改，并且可以进行干预。