ACL injury mechanisms & offaxis neuromuscular diagnosis & training

ACL损伤机制

• 批准号: 7736012
• 负责人: Li-Qun Zhang
• 金额: $ 37.11万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7736012
• 关键词: 3-Dimensional; Anterior Cruciate Ligament; Clinical; Control Groups; Custom; Data; Devices; Diagnosis; Diagnostic; Educational Intervention; Evaluation; Exercise; Female; Goals; Incidence; Individual; Intervention; Joint Laxity; Knee; Lateral; Leg; Ligaments; Lower Extremity; Measurement; Measures; Modeling; Motion; Movement; Neuromechanical Changes; Neuromechanics; Outcome Measure; Participant; Performance; Positioning Attribute; Predisposition; Property; Proprioception; Reaction Time; Research; Research Design; Risk; Rotation; Schools; Sex Characteristics; Simulate; Slide; Sports; Stress; Time; Torque; Training; Woman; Youth; base; foot; high school; improved; injured; interest; intervention program; ligament injury; male; men; muscle strength; neuromuscular; notch protein; novel; pressure; public health relevance; tool

DESCRIPTION (provided by applicant): ACL is the most commonly injured knee ligament in sports-related activities, especially in pivoting sports. ACL injury mechanisms, including factors contributing to the 2-9 times higher incident rate in female athletes than their male counterparts, are still not very clear. Considering off-axis knee motions (tibial rotation and valgus/varus) are rather limited and there may be gender differences in off-axis properties, ACL injuries are often associated with excessive off-axis loadings. Objectives: To investigate off-axis neuromechanical and anatomical properties of noncontact ACL injuries in men and women, and to conduct intervention training based on the diagnosis to improve neuromuscular control of risky, potentially injurious off-axis movements. Hypothesis 1: Females have lower stability, stiffness and strength, greater joint laxity, and less sensitive proprioception in external and internal tibial rotations and in valgus and varus than males. Specific Aim 1: To perform a pre-training diagnosis of knee off-axis neuromechanical properties in females and males using custom knee devices for off-axis evaluations and a novel pivoting-sliding elliptical machine. Clinical/functional measures will also be conducted. Hypothesis 2: Females are more likely to have ACL impingement than males under external tibial rotation and valgus loading, characterized by a subject-specific FE impingement modeling. Specific Aim 2: To determine the susceptibility of ACL impingement against the lateral notch wall during external tibial rotation and valgus in individuals using a 3-D FE ACL-impingement model. Hypothesis 3: Subject-specific training on a pivoting-sliding elliptical exercise machine based on the diagnosis improves off-axis neuromuscular control. Specific Aim 3: To conduct subject-specific pivoting-sliding elliptical training and improve off-axis neuromuscular control, based on the pre-training diagnosis. Specific Aim 4: To determine training-induced neuromechanical and functional changes. Study Design Setting: Off-axis neuromechanical properties will be determined for individual subjects. An intervention program will be conducted accordingly. Setting: A research lab for neuromechanical evaluations, and school gym for training/evaluation. Participants: 60 female and 60 male athletes from local high school and youth sports teams. Interventions: Training off-axis neuromuscular control using a novel pivoting-sliding elliptical machine. Training will be done in three 40-minute training session per week for 6 weeks. Outcome Measures: Stability, muscle strength, stiffness, laxity, proprioception, and reaction time in tibial rotation (pivoting) and in valgus/varus, functional activities, and incidence of ACL injuries. PUBLIC HEALTH RELEVANCE: The proposed studies will conduct subject-specific diagnosis on off-axis neuromechanical properties in internal and external rotations and in valgus/varus in individual female and male subjects, and perform subject-specific intervention training of off-axis neuromuscular control based on the diagnosis, using a novel pivoting-sliding elliptical machine.

描述（由申请人提供）：ACL是运动有关的活动中最常见的膝盖韧带，尤其是在运动中。 ACL损伤机制，包括女运动员的入射率高2-9倍的因素，仍然不太清楚。考虑到膝关节外运动（胫骨旋转和外翻/变量）相当有限，并且离轴性质可能存在性别差异，因此ACL损伤通常与过度的离轴载荷相关。目的：研究男性和女性非连接ACL损伤的神经力学和解剖学特性，并基于诊断进行干预培训，以改善神经肌肉控制风险，潜在的有害外轴运动的神经肌肉控制。假设1：女性的稳定性，刚度和强度较低，关节松弛性更大，并且在外部和内部胫骨内部旋转以及反外形和变异中的敏感性较低，而不是男性。具体目标1：使用定制的膝盖装置进行术前训练，对女性和男性的膝关节神经力学特性进行训练前诊断，以进行离轴评估以及新颖的旋转透视椭圆机。还将进行临床/功能措施。假设2：在外部胫骨旋转和外向载荷下，女性更可能患有ACL撞击，其特征是特定于受试者的Fe撞击建模。具体目标2：使用3-D FE ACL-IMPIMENDEND模型确定外部胫骨旋转和个人外侧旋转期间对ACL撞击在外侧缺口壁上的敏感性。假设3：基于诊断的旋转椭圆运动机上的特定主体训练可改善神经肌肉肌的离轴控制。特定目的3：根据训练前诊断，进行主体特异性的旋转椭圆训练并改善神经肌肉的外轴控制。特定目标4：确定训练引起的神经力学和功能变化。研究设计设置：将确定针对个别受试者的神经力学特性。干预计划将相应地进行。设置：用于神经力学评估的研究实验室，以及用于培训/评估的学校健身房。参加者：来自当地高中和青年运动队的60名女运动员和60名男运动员。干预措施：使用新型旋转滑动椭圆机的训练神经肌肉控制。培训将在每周3个40分钟的培训课程中进行6周。结局指标：胫骨旋转（枢转）和外向/变量，功能活动和ACL损伤的发生率的稳定性，肌肉强度，僵硬，僵硬，本体感受和反应时间。 公共卫生相关性：拟议的研究将对内部和外部旋转的外轴神经力学特性以及单个男女受试者的外径/杂种/变量进行特定于主体的诊断，并使用新型的纤维传动透射的Elliptical机器对基于轴心神经肌肉闭轴神经肌肉控制的受试者进行特定的干预培训。