New potential to restore neuromuscular and joint function after ACL injury

ACL 损伤后恢复神经肌肉和关节功能的新潜力

• 批准号: 10980775
• 负责人: Jillian Elizabeth Beveridge
• 金额: $ 20.42万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10980775
• 关键词: New; potential; restore; neuromuscular; joint

The project objective is to determine whether the novel bridge-enhanced anterior cruciate ligament restoration (BEAR) procedure restores biomechanical knee function compared to the standard of care anterior cruciate ligament reconstruction (ACLR), leading to improved patient outcomes after ACL injury. The BEAR procedure differs from ACLR as it uses a scaffold to promote healing of the injured ACL whereas ACLR requires removal of the entire ligament, which severs and then removes neural structures within the native ACL. Clinical studies of BEAR have shown that muscle strength is restored following BEAR but not after ACLR, even at 2 years. BEAR patients also reported superior sports-related quality of life earlier in their recovery. We postulate that these differences are due to the preservation of neural activity and neuromuscular feedback with BEAR. Therefore, our overarching hypothesis is that BEAR preserves the neuromuscular activation patterns about the knee that, in turn, promote normal hop landing joint motion and corresponding patient-reported outcomes compared to ACLR. Three aims are addressed: 1) to use our novel machine learning approach to classify neuromuscular activity patterns as belonging to ACLR, BEAR or healthy control subjects (Controls); 2) to compare the tibiofemoral positions of the knee between ACLR, BEAR, and Controls at ground contact when landing from a 1-leg hop; and 3) to examine the correlation between functional measures and KOOS sports-related patient-reported reported outcomes. Twenty-six subjects enrolled in a parent randomized clinical trial at Rhode Island Hospital (BEAR-MOON) will be enrolled in the proposed study at their 2-year follow-up visit. An age- and sex-matched control group will also be recruited from the community. All 39 subjects will perform a 1-leg hop-for-distance activity while surface electromyography is recorded to assess neuromuscular function (Aim 1), and biplane videoradiography will be performed to evaluate precise tibiofemoral motion (Aim 2). Relationships between patient-reported and biomechanical outcome measures will be tested using regression analyses (Aim 3). If the hypotheses of the proposed study are supported, the results will demonstrate that neurophysiological mechanisms underlying BEAR recovery are fundamentally different from ACLR and that they have a significant impact on patient sports-related quality of life not currently addressed by conventional ACL injury treatments.

该项目的目标是确定新型桥梁增强的前交叉韧带是否 与护理标准相比 前交叉韧带重建（ACLR），导致ACL损伤后患者的预后改善。 Bear程序与ACLR不同，因为它使用脚手架来促进受伤的ACL治愈 而ACLR需要去除整个韧带，该韧带切断然后去除神经结构 在本地ACL中。熊的临床研究表明，肌肉力量已恢复 熊，但不在ACLR之后，即使在2年也是如此。熊患者还报告了与运动相关的优质质量 恢复的早期生活。我们假设这些差异是由于保存神经 活性和神经肌肉反馈。因此，我们的总体假设是 保留膝盖上的神经肌肉激活模式，从而促进正常的啤酒花降落 与ACLR相比，关节运动和相应的患者报告结果。解决了三个目标： 1）使用我们新颖的机器学习方法将神经肌肉活动模式分类为属于 ACLR，熊或健康对照对象（对照）； 2）比较膝盖的胫骨位置 从1腿啤酒花降落时，在ACLR，熊和对照之间进行控制； 3）检查 功能措施与与患者报告相关的患者报告的结果之间的相关性。 在罗德岛医院（Bear-moon）参加父母随机临床试验的26名受试者 将在他们的2年随访访问中参加拟议的研究。年龄和性别匹配的对照组 也将从社区招募。所有39名受试者将执行1腿的跑步活动，而 记录表面肌电图以评估神经肌肉功能（AIM 1）和双翼飞机 视频摄影将进行评估精确的胫骨运动（AIM 2）。之间的关系 将使用回归分析测试患者报告和生物力学结局指标（AIM 3）。如果 支持该研究的假设，结果将证明神经生理学 熊恢复的基本机制与ACLR根本不同，并且它们具有 常规ACL受伤目前未解决与患者体育有关的生活质量的重大影响 治疗。