Neuroplastic Mechanisms for Acquisition and Transfer of Injury-Resistant Movement Patterns Assessed in VR Simulated Sport

VR 模拟运动中评估的抗损伤运动模式的获取和转移的神经可塑性机制

• 批准号: 10437035
• 负责人: Dustin Robert Grooms
• 金额: $ 31.83万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-17 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437035
• 关键词: Adolescent; Adult; Affect; Applications Grants; Athletic; Award; Biofeedback; Biological Assay; Biomechanics; Brain; Child; Clinical; Data; Degenerative polyarthritis; Development; Direct Costs; Dose; Ensure; Facilities and Administrative Costs; Feedback; Female; Goals; Health; Immersion; Incidence; Individual; Injury; Intervention; Investments; Knee; Knee Injuries; Knee joint; Knowledge; Laboratories; Lead; Link; Lower Extremity; Measures; Mechanics; Medical Care Costs; Methods; Mission; Motor; Motor Cortex; Movement; Nervous system structure; Neuronal Plasticity; Parents; Participant; Pattern; Play; Population; Positioning Attribute; Prevention program; Prevention strategy; Process; Psychological Transfer; Public Health; Publishing; Quality of life; Reality Testing; Research; Resistance; Risk; Risk Factors; Societies; Sports; Technology; Testing; Time; Training; Treatment Efficacy; United States National Institutes of Health; Visuospatial; Work; Youth; active lifestyle; anterior cruciate ligament injury; biomechanical test; clinical application; disability; evidence base; healthy lifestyle; high risk; improved; injury prevention; innovation; musculoskeletal injury; neuroimaging; neuromechanism; neuromuscular; neuromuscular training; novel; parent grant; prevent; preventive intervention; relating to nervous system; response; standard of care; therapeutic target; virtual reality; virtual reality simulator; young adult

Project Summary/Abstract Anterior cruciate ligament (ACL) injury is a common activity-related knee injury with a substantial negative impact on individuals and society. Annual direct costs exceed $13 billion, and the long-term indirect costs far exceed that figure, as ACL injury is also linked to the accelerated development of disabling osteoarthritis within a few years after injury. The National Public Health Agenda for Osteoarthritis recommends expanding and enhancing evidence-based ACL injury prevention to reduce this burden. We have identified modifiable movement patterns that increase ACL injury risk in young female athletes. While neuromuscular training targets those injury risk movement patterns and shows statistical efficacy in high-risk athletes, a meaningful transfer of low-risk mechanics to the field of play has been limited. This inability of current approaches to ensure injury-resistant movement pattern transfer to sport is readily apparent as there has not been a decrease in national ACL injury rates in young female athlete despite efficacy of standard neuromuscular training to modify biomechanics in the lab. The key knowledge gap to ensure effective injury prevention transfer to sport is understanding the mechanisms the nervous system engages to acquire and transfer injury-resistant movement patterns from the intervention or laboratory to the athletic field. Thus, the overall objective of this proposal is to determine the neural mechanisms underpinning the transfer of injury-resistant movement patterns to realistic sport scenarios. Our published and recent preliminary data on the neuroplasticity related to injury risk and following neuromuscular training demonstrate a specific neural mechanism underlies the transfer of injury-resistant movement patterns. These preliminary data support this proposal's central hypothesis that changes in brain activity underlie the acquisition and transfer of injury-resistant movement patterns to realistic sport scenarios. Importantly this work indicates the neuroplasticity can be targeted by augmented biofeedback and other clinical methods to optimize brain activation patterns for movement that promote injury-resistant movement pattern acquisition and transfer. The ability to target the neural mechanisms of injury risk factor reduction could revolutionize ACL injury prevention strategies. Once the objectives of this application are achieved, we will be able to enhance the efficacy of neuromuscular training with the identified neuro-therapeutic targets. This contribution will be significant to improve ACL injury prevention training transferability to reduce injury incidence and thus avoid the associated long-term negative health consequences. This is especially relevant to young female athletes as they are the population at highest risk for non-contact sensorimotor error related ACL injury. This unique opportunity to enhance ACL injury prevention by targeting neural mechanisms of neuromuscular adaptation and transfer highlights the exceptional opportunity afforded by this ancillary project to the parent U01 NIH investment.

项目摘要/摘要 前交叉韧带（ACL）损伤是常见的与活动相关的膝关节损伤，具有重大的负面影响 关于个人和社会。年度直接成本超过130亿美元，长期间接费用远远超过 这一数字，因为ACL损伤也与少数几个禁用骨关节炎的加速发展有关 受伤几年。国家公共卫生骨关节炎议程建议扩大和增强 基于证据的ACL伤害预防以减轻这种负担。我们已经确定了可修改的运动模式 这增加了年轻女运动员的ACL伤害风险。而神经肌肉训练针对这些伤害风险 运动模式并显示高风险运动员的统计功效，这是低风险的有意义的转移 游戏领域的机械被限制了。这种目前的方法无法确保受伤 运动模式转移到运动很明显，因为国家ACL受伤没有减少 尽管标准神经肌肉训练有效地改变了年轻女运动员的比率 实验室。确保有效预防运动转移到运动的关键知识差距是了解 神经系统的机制参与从中获取和转移抗伤害运动模式 干预或实验室运动场。因此，该提议的总体目的是确定 神经机制是将抗伤害运动模式转移到现实运动情景的基础。 我们发表的有关与伤害风险有关的神经塑性和遵循的神经可塑性的初步数据 神经肌肉训练证明了一种特定的神经机制是抗损伤的转移的基础 运动模式。这些初步数据支持该提案的中心假设，即大脑的变化 活动的基础是将抗伤害运动模式的获取和转移到现实的运动场景中。 重要的是，这项工作表明神经可塑性可以通过增强的生物反馈和其他临床来针对 优化促进抗损伤运动模式运动大脑激活模式的方法 收购和转移。靶向减少伤害风险因素的神经机制的能力可能 彻底改变了ACL伤害预防策略。一旦实现了此应用程序的目标，我们将 能够通过确定的神经治疗靶标提高神经肌肉训练的功效。这 贡献对于改善ACL伤害预防训练性的转移性将是重要的，以减少伤害发生率 因此避免了相关的长期负面影响。这与年轻人特别相关 女运动员是与ACL损伤相关的非接触式感觉运动误差风险的最高风险。 通过靶向神经肌肉的神经机制来增强ACL损伤预防的独特机会 适应和转移突出了这个辅助项目给家长U01提供的非凡机会 NIH投资。