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

• 批准号: 10615762
• 负责人: Dustin Robert Grooms
• 金额: $ 15.54万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615762
• 关键词: 3-Dimensional; Acceleration; Address; Adolescent; Adult; Affect; Anterior Cruciate Ligament; Attenuated; Bilateral; Biofeedback; Biomechanics; Brain; Central Nervous System; Cerebellum; Child; Clinical; Clinical Trials; Cognitive; Coupled; Data; Degenerative polyarthritis; Development; Event; Failure; Female; 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; Neuronal Plasticity; Outcome; Output; Pain; Pattern; Physical activity; Populations at Risk; Positioning Attribute; Prevalence; Prevention program; Prevention strategy; Process; Public Health; Publishing; Quality of life; Recommendation; 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; cingulate cortex; cognitive process; disability; frontal lobe; high risk; high risk population; improved; injury prevention; innovation; instrumentation; joint loading; kinematics; learning strategy; mortality; motor control; motor learning; musculoskeletal injury; neural; neuroimaging; neuromuscular; neuromuscular training; neuroregulation; novel; physical inactivity; prevent; prevention effectiveness; prospective; simulation; technology development; virtual reality; virtual reality environment; virtual reality simulation; visual motor; young adult; 3-Dimensional; Acceleration; Address; Adolescent; Adult; Affect; Anterior Cruciate Ligament; Attenuated; Bilateral; Biofeedback; Biomechanics; Brain; Central Nervous System; Cerebellum; Child; Clinical; Clinical Trials; Cognitive; Coupled; Data; Degenerative polyarthritis; Development; Event; Failure; Female; 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; Neuronal Plasticity; Outcome; Output; Pain; Pattern; Physical activity; Populations at Risk; Positioning Attribute; Prevalence; Prevention program; Prevention strategy; Process; Public Health; Publishing; Quality of life; Recommendation; 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; cingulate cortex; cognitive process; disability; frontal lobe; high risk; high risk population; improved; injury prevention; innovation; instrumentation; joint loading; kinematics; learning strategy; mortality; motor control; motor learning; musculoskeletal injury; neural; neuroimaging; neuromuscular; neuromuscular training; neuroregulation; novel; physical inactivity; prevent; prevention effectiveness; prospective; simulation; technology development; virtual reality; virtual reality environment; virtual reality simulation; visual motor; young adult

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个项目摘要/摘要 2前交叉韧带（ACL）损伤是一种令人衰弱的疾病，导致膝盖变性一致 3和降低体育活动能力，累计医疗保健成本超过数十亿美元 4年。 ACL伤害最常见的机制是没有玩家接触球员（称为非接触） 5和继发于运动协调错误，导致膝关节负荷有害。因此，电流 6预防伤害的标准是神经肌肉或运动训练，以纠正导致的特定损伤风险 7机械在受控设置中。但是，减少伤害策略尚未达到足够的效力 8不足以靶向中枢神经系统对可能构成的运动错误的贡献 9在生态有效的环境中传播损伤风险。我们已发表的前瞻性纵向数据和初步 10个生态有效的运动特异性虚拟现实数据，表明ACL损伤的感觉运动大脑活动 - 11风险。因此，该应用的目的是确定与损伤风险电机相关的大脑活动 12在标准和生态上有效的运动特异性虚拟现实设置中控制。我们的初步数据告知 13我们的中心假设是那些具有损伤风险运动模式的人依赖于视觉和认知运动神经 14激活策略，这在生态上有效的运动虚拟现实中进一步强调了。拟议的研究是 15创新性，因为它代表了与先前的工作的新事物，主要是重点是 16生物力学结果，现在确定传播损伤风险膝盖运动控制的神经活动。钥匙 17该提案的突破是实时的膝盖运动控制错误的生物力学仪器 18神经影像学。这项观察性试验的预期结果将是对基础的识别 与ACL损伤风险生物力学有关的19膝运动控制神经活动。成功完成拟议的 20个目标将在战略上定位我们开发有竞争力的R01临床试验应用程序，以评估新颖 21针对该提案确定的神经过程的神经肌肉训练。具体来说，在 22本文确定的神经激活策略，我们将使用新型生物反馈来完善预防计划 23种方法，临床技术和运动学习原理，以促进自适应脑功能减少 24受伤的发生率。因此，避免终身疼痛，骨关节炎和身体活动限制，直接对齐 25 NIH倡议，以减少青年和成人的伤害和身体不活动，这是第四个主要原因 全球死亡率26。 27 28