Mechanistic assessment of blood flow restricted training for an ACL injury

ACL 损伤血流受限训练的机制评估

基本信息

批准号：
9976451
负责人：
Brian Noehren
金额：
$ 57.25万
依托单位：
UNIVERSITY OF KENTUCKY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-07-22 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9976451
关键词：
3-Dimensional Address Anterior Cruciate Ligament Architecture Area Attenuated Biomechanics Biopsy Blood flow Clinical Data Degenerative polyarthritis Development Effectiveness Electric Stimulation Evidence based intervention Extensor Extracellular Matrix Fatty acid glycerol esters Fiber Fibrosis Frequencies Generations Goals Imaging Techniques Individual Infiltration Injury Knee Lead Limb structure Link Magnetic Resonance Imaging Measurement Measures Mechanics Mediating Microscopic Morphology Multi-Institutional Clinical Trial Muscle Muscle Fibers Muscle Weakness Muscle satellite cell Outcome Patient Care Patients Phenotype Physical therapy Physiological Physiological Adaptation Population Positioning Attribute Procedures Property Quality of life Randomized Reconstructive Surgical Procedures Recovery Rehabilitation therapy Resistance Risk Techniques Testing Thigh structure Time Training Work alternative treatment anterior cruciate ligament injury anterior cruciate ligament reconstruction anterior cruciate ligament rupture base functional outcomes improved knee mechanics muscle strength novel novel strategies premature prevent progenitor quadriceps muscle reconstruction rehabilitation strategy satellite cell stem stem cells strength training treatment as usual treatment strategy vastus lateralis

项目摘要

Abstract: Anterior cruciate ligament reconstruction surgery results in protracted quadriceps weakness that is associated with altered biomechanics and heightened risk of subsequent injuries. Little progress has been made in improving quadriceps strength in the past 15-20 years. Alterations in the morphological and cellular composition of the vastus lateralis muscle promote muscle weakness following an anterior cruciate ligament reconstruction. These features are not responsive to traditional physical therapy techniques. A promising emerging treatment, blood flow restriction training (BFRT) has been shown to address these same alterations in healthy subjects; however, it has never been tested in those with an injury. Pilot data in the current proposal shows that BFRT can lead to a significant increase in muscle strength following an anterior cruciate ligament injury. This project seeks to mechanistically determine the ability of BFRT to address underlying muscle cellular deficits following anterior cruciate ligament reconstruction compared to usual care. Goals in the current proposal are as follows: aim 1 will determine if BFRT is able to significantly improve knee mechanics and quadriceps strength following an anterior cruciate ligament reconstruction compared to usual care. Aim 2 will use advanced magnetic resonance imaging techniques to assess improvements in quadriceps morphology after training with BFRT. Lastly, aim 3 will identify BFRT-mediated improvements in cellular deficits in the quadriceps as the result of BFRT training versus usual care. The expected outcomes will show for the first time that BFRT is an effective mechanistic treatment for normalizing quadriceps strength within individuals following an anterior cruciate ligament reconstruction.

抽象的：前交叉韧带重建手术导致持久的股四头肌无力，与之相关随着生物力学的改变，随后受伤的风险增加。几乎没有进展在过去的15 - 20年中，提高股四头肌的强度。形态和细胞的改变股外侧肌肉的组成促进前交叉韧带后肌肉无力重建。这些特征对传统物理疗法技术没有反应。有希望的新兴治疗，血流限制训练（BFRT）已被证明可以解决这些相同的改变在健康的受试者中；但是，在受伤的人中从未对其进行测试。当前提案中的试点数据表明BFRT可能导致前交叉韧带后肌肉强度显着增加受伤。该项目试图从机械上确定BFRT解决潜在肌肉的能力与通常的护理相比，前交叉韧带重建后的细胞缺陷。目前的目标建议如下：AIM 1将确定BFRT是否能够显着改善膝盖力学和与通常的护理相比，前交叉韧带重建后的股四头肌强度。目标2将使用先进的磁共振成像技术来评估股四头肌形态的改进在接受BFRT训练之后。最后，AIM 3将确定BFRT介导的细胞缺陷改善股四头肌是BFRT培训与常规护理的结果。预期的结果将首次显示该BFRT是一种有效的机械处理，用于使股四头肌的强度正常化。前交叉韧带重建。