IDENTIFYING FEMALE ATHLETES AT HIGH RISK FOR ACL INJURY

识别 ACL 损伤高风险的女性运动员

• 批准号: 6951859
• 负责人: Timothy E Hewett
• 金额: $ 51.96万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-21 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6951859
• 关键词: adolescence (12-20); biomechanics; body composition; body height; body physical activity; body weight; bone development; clinical research; disease /disorder proneness /risk; female; functional ability; gender difference; human puberty; human subject; injury prevention; joint ligament; knee; longitudinal human study; mechanical stress; muscle function; muscle strength; musculoskeletal disorder diagnosis; musculoskeletal injury; neuromuscular function; questionnaires; sports injury

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 jumping and pivoting sports suffer anterior cruciate ligament (ACL) injury at a 4 to 6-fold greater rate than adolescent males participating in the same sports. The reason(s) for this ACL injury disparity remain(s) obscure. Prior to puberty, male and female injury risk appears 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 and to optimize the effectiveness of treatments designed to prevent ACL injuries. Towards these goals, we propose to test the central hypothesis that the increases in lower extremity bone length and body mass that occur during puberty, without the neuromuscular performance spurt that most males demonstrate, will increase dynamic valgus, knee joint loading and injury risk in a subset of female athletes. It will also test the hypothesis that measures relating to dynamic valgus will prove predictive of ACL injury risk in high-risk female athletes. Specific Aim 1 will determine if following the onset of pubertal growth, increases in tibia and femur length and body mass, in the absence of increases in strength and recruitment of the musculature at the hip and knee that controls knee position and load, will lead to decreased neuromuscular control as measured by increased dynamic valgus in a subset of maturing female athletes. Specific Aim 2 will determine if objective biomechanical measures can predict relative ACL injury risk in female athletes. We hypothesize that a model that incorporates measures of dynamic valgus and variables that contribute to neuromuscular control of valgus (hip adduction moment) and increased knee joint load (knee abduction moment) will prove both sensitive and specific predictors of ACL injury risk in female athletes. These data should provide a foundation for approaching both the mechanistic questions underlying risk disparity, as well as increase our ability to direct high-risk athletes to effective, targeted interventions, which are proposed. Prevention of female rates from 5 times to equal males' would allow >30,000 females annually to continue the benefits of sports participation and to avoid the long-term complications of osteoarthritis, which may occur with a 10-fold greater incidence in the ACL-injured population.

描述（由申请人提供）：现在已广泛认识到，基于性别的差异可以在疾病和损伤的倾向中起主要作用，但这仍然是一种研究的现象。参加跳跃和旋转运动运动的青春期女性遭受前交叉韧带（ACL）受伤，比参加同一运动的青少年男性高4至6倍。这种ACL损伤差异的原因仍然是晦涩的。在青春期之前，男性和女性受伤风险似乎相等。我们的长期目标是确定女运动员如何更容易受到非接触ACL损伤的影响，前瞻性地确定那些更容易受到伤害的女运动员，并确定生物力学和生物化学水平上风险增加的潜在机理原因，并优化旨在预防ACL损伤的治疗效率。朝向这些目标，我们建议测试中心假设，即在青春期期间发生的下肢骨长度和体重的增加，而没有大多数男性证明的神经肌肉表现，将增加动态气门，膝盖关节载荷，膝关节负荷和损伤风险。它还将检验以下假设：与动态外翻有关的措施将证明高危女运动员的ACL损伤风险。具体的目标1将确定在青春期生长开始，胫骨和股骨长度和体重的增加，如果没有增加膝关节和膝盖的肌肉的力量和肌肉的增加，以控制膝关节的位置和负荷，这将导致神经肌肉对照减少，因为该神经肌肉对照是通过增加动态瓣膜的增加的动态瓣膜来测量的。具体目标2将确定客观生物力学措施是否可以预测女运动员的相对ACL损伤风险。我们假设一个模型结合了动态外翻的度量和变量，这些模型有助于神经肌肉控制外翻（髋关节内收时力矩）和增加的膝关节负载（膝关节外展矩），将证明女性运动员对ACL损伤风险的敏感和特定预测指标。这些数据应为解决风险差异的基础问题提供基础，并提高我们将高危运动员引导到有效，有针对性干预措施的能力。预防女性率从5次到男性的率将允许每年> 30,000名女性继续运动的益处，并避免骨关节炎的长期并发症，而骨关节炎可能会发生10倍，而ACL受伤的人群发生率更高。