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，基于性别的差异在疾病和损伤的易感性中起着重要作用，但这仍然是一个未充分研究的现象。参加旋转和跳跃运动的青少年女性遭受前交叉韧带（ACL）损伤的比率比参加相同运动的青少年男性高4至6倍。自《教育援助法》第九条通过以来，高中一级的男性参与率增加了不到3%（从370万增加到380万），而女性参与率增加了800%，大约每10年翻一番（从30万增加到270万）。这种参与的几何增长，加上4至6倍的受伤率，伴随着女性运动员ACL损伤数量的惊人增加。这种ACL损伤差异的原因仍然不清楚。在青春期之前，男性和女性受伤的风险或多或少相等。我们的长期目标是确定女性运动员如何更容易受到非接触性ACL损伤的影响，前瞻性地识别那些更容易受伤的女性运动员，并确定在生物力学和生化水平上风险增加的潜在机械原因。为了实现这些目标，我们建议测试的中心假设，伴随青春期的生物力学变化，包括身高，身体部分的长度和重量增加，在没有的神经肌肉的性能冲刺，男性在青春期表现可能会导致生物力学神经肌肉失衡，导致不良的动态膝关节稳定性和高膝关节损伤的风险，在许多女运动员。具体目标1将确定是否青春期伴随的生物力学变化是女性运动员动态膝关节稳定性下降的基础。SPECIFIC AIM 2将确定动态膝关节稳定性的特定神经肌肉测量是否可以预测ACL损伤风险。这些数据应该为接近潜在风险差异的机械问题提供基础，并增加我们指导高风险运动员进行适当神经肌肉训练计划的能力

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