IDENTIFYING FEMALE ATHLETES AT HIGH RISK FOR ACL INJURY

描述(由申请人提供)：现在人们普遍认识到，基于性别的差异可以在疾病和伤害的易感性中发挥重要作用，但这仍然是一个研究不足的现象。参加旋转和跳跃运动的青少年女性遭受前十字韧带(ACL)损伤的比例是参加相同运动的青少年男性的4到6倍。自《教育援助法》第九条通过以来，男性在高中的参与率增加了不到3%(从370万增加到380万)，而女性的参与率增加了800%，大约每10年翻一番(从30万增加到270万)。参赛人数的几何级数增长，加上伤害率增加了4到6倍，伴随而来的是女性运动员前交叉韧带损伤数量的惊人增加。造成这一前交叉韧带伤情差距的原因(S)还不清楚(S)。在青春期之前，男性和女性受伤的风险大致相等。我们的长期目标是确定女运动员如何变得更容易受到非接触性前交叉韧带损伤，前瞻性地确定哪些女运动员更容易受伤，并从生物力学和生化水平确定增加风险的潜在机制原因(S)。为了达到这些目标，我们建议检验这一中心假设，即青春期伴随的生物力学变化，包括身高、身体节段长度和体重的增加，如果缺乏男性在青春期表现出的神经肌肉表现，可能会导致生物力学-神经肌肉失衡，从而导致许多女运动员膝关节动态稳定性差和膝关节损伤风险增加。特定的AIM 1将确定青春期伴随的生物力学变化是否是导致女运动员膝关节动态稳定性下降的原因。特定的AIM 2将确定特定的膝关节动力稳定性的神经肌肉测量是否可以预测前交叉韧带损伤的风险。这些数据应该为探讨潜在风险差异的机制问题，以及提高我们引导高危运动员进行适当的神经肌肉训练计划的能力提供基础。

DESCRIPTION (provided by applicant): It is now widely recognized that gender-based differences can play a major role in the predisposition to disease and injury, yet this remains an understudied phenomenon. Adolescent females who participate in pivoting and jumping sports suffer anterior cruciate ligament (ACL) injury at a 4 to 6-fold greater rate than adolescent males participating in the same sports. Since the passage of Title IX of The Educational Assistance Act, male participation at the high school level has increased less than 3 percent (from 3.7 to 3.8 million), while female participation has increased 800 percent, roughly doubling every 10 years (from 0.3 to 2.7 million). This geometric growth in participation, coupled with the 4 to 6-fold higher injury rate, has been accompanied by an alarming increase in the number of ACL injuries in female athletes. The reason(s) for this ACL injury disparity remain(s) obscure. Prior to puberty, male and female injury risk is more or less equal. Our long-term objectives are to determine how female athletes become more susceptible to non-contact ACL injury, prospectively identify those female athletes who are more susceptible to injury and to determine the underlying mechanistic cause(s) of increased risk at the biomechanical and biochemical levels. Towards these goals, we propose to test the central hypothesis that the biomechanical changes that accompany puberty, including increased height, body segment length and weight, in the absence of the neuromuscular performance spurt that males demonstrate during puberty may lead to biomechanical-neuromuscular imbalances that result in poor dynamic knee stability and high knee injury risk in many female athletes. SPECIFIC AIM 1 will determine if the biomechanical changes that accompany puberty underlie the decreased dynamic knee stability in female athletes. SPECIFIC AIM 2 will determine if specific neuromuscular measures of dynamic knee stability can predict ACL injury risk. These data should provide a foundation for approaching both the mechanistic questions underlying risk disparity, as well as increasing our ability to direct high-risk athletes into appropriate neuromuscular training programs