Dynamic Perturbation Training System for ACL Rehabilitation

ACL 康复动态扰动训练系统

• 批准号: 8057566
• 负责人: JEFFREY J. CHU
• 金额: $ 17.24万
• 依托单位: SIMBEX, LLC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8057566
• 关键词: Address; Adopted; Algorithms; Anterior Cruciate Ligament; Cartilage; Clinical; Clinical Trials; Computer software; Contralateral; Cost Analysis; Data; Degenerative polyarthritis; Delaware; Development; Devices; Equilibrium; Equipment; Feedback; Female; Funding; Goals; Health Care Costs; Impairment; Individual; Injury; Intervention; Joints; Knee; Knee Osteoarthritis; Laboratories; Lateral; Lead; Life; Limb structure; Manuals; Meniscus structure of joint; Methods; Metric; Motion; Operative Surgical Procedures; Outcome; Patients; Performance; Phase; Pilot Projects; Population; Protocols documentation; Publishing; Rehabilitation Outcome; Rehabilitation therapy; Research; Research Methodology; Running; Simulate; Small Business Innovation Research Grant; Sports; Surface; System; Technology; Testing; Therapeutic; Time; Training; Translating; Translations; United States National Institutes of Health; Universities; Validation; Walking; Woman; anterior cruciate ligament reconstruction; anterior cruciate ligament rupture; base; clinical application; clinical practice; clinically relevant; commercialization; comparative effectiveness; cost effective; design; human subject; improved; injured; kinematics; ligament injury; male; man; meetings; model design; neuromuscular; novel; patient population; prevent; prototype; quadriceps muscle; strength training; user-friendly

DESCRIPTION (provided by applicant): Anterior cruciate ligament (ACL) injuries are a significant problem for athletes, and women in particular. Both surgical and non-surgical treatment options exist, with the ultimate goal of regaining joint stability, knee kinematics, and quadriceps strength compared to the uninjured contralateral limb to allow full return of function and activity level and to prevent additional injury to the cartilage and the meniscus in the knee which might lead to an increased likelihood of osteoarthritis (OA). Published research has demonstrated clinically relevant effects of perturbation of support surface training for both ACL-deficient and ACL-reconstructed populations for improving dynamic knee stability, particularly in females. The clinically available methods of delivering the desired perturbations are currently limited to static balance boards that are manually pushed or pulled by the physical therapist. These perturbations may not simulate real-life perturbations that would occur during walking or running. The Principal Objective of this Fast Track SBIR project is to develop and validate a cost-effective commercial product, ActiveStep-Sport", for providing task-specific, neuromuscular, dynamic perturbation training to improve outcomes for both conservative and surgical treatment of ACL injury (ACL), particularly in young athletes and women. PUBLIC HEALTH RELEVANCE: The proposed ActiveStep-Sport system provides the enabling technology for large-scale application of clinically relevant perturbation of support surface training for anterior cruciate ligament (ACL) injury rehablitiation. Approximately 100,000-175,000 ACL reconstructions performed annually in the US annually, with females significantly more likely to suffer an ACL rupture than males. Perturbation training in certain ACL injured populations has been shown to reduce episodes of giving way and to reduce abnormal knee kinematics, both of which often lead to an inability to regain functional levels of sports participation and increase the potential for developing knee osteoarthritis. Use of perturbation training is hypothesized to improve knee kinematics compared to strengthening alone, and to improve outcomes for ACL rehabilitation. The technology developed here represents a translation of validated laboratory-based research methodology to a system more suited for widespread clinical use. If technically and economically feasible, ActiveStep-Sport will help reduce the overall health care costs associated with the treatment and rehabilitation of ACL injuries and the onset of osteoarthritis.

描述（由申请人提供）：前交叉韧带（ACL）损伤是运动员的一个重大问题，尤其是女性。存在手术和非手术治疗选择，最终目标是与未受伤的对侧肢体相比，恢复关节稳定性、膝关节运动学和股四头肌力量，以允许功能和活动水平完全恢复，并防止对膝关节软骨和半月板的额外损伤，这可能导致骨关节炎（OA）的可能性增加。已发表的研究已经证明了支撑表面训练扰动对ACL缺陷和ACL重建人群的临床相关影响，以改善动态膝关节稳定性，特别是女性。临床上可用的传递所需扰动的方法目前限于由物理治疗师手动推动或拉动的静态平衡板。这些扰动可能不会模拟在步行或跑步期间发生的真实扰动。这个快速SBIR项目的主要目标是开发和验证一种具有成本效益的商业产品，ActiveStep-Sport，用于提供特定任务的神经肌肉动态扰动训练，以改善ACL损伤（ACL）的保守治疗和手术治疗的结果，特别是在年轻运动员和女性中。 公共卫生相关性：所提出的ActiveStep-Sport系统为大规模应用前交叉韧带（ACL）损伤修复的临床相关支撑表面训练扰动提供了使能技术。在美国，每年进行大约100，000 - 175，000次ACL重建，女性ACL断裂的可能性明显高于男性。在某些ACL损伤人群中，扰动训练已被证明可以减少屈服事件并减少膝关节运动学异常，这两者通常导致无法恢复运动参与的功能水平并增加患膝关节骨关节炎的可能性。假设与单独加强相比，使用扰动训练可以改善膝关节运动学，并改善ACL康复的结果。这里开发的技术代表了将经过验证的基于实验室的研究方法转化为更适合广泛临床使用的系统。如果在技术和经济上可行，ActiveStep-Sport将有助于降低与ACL损伤和骨关节炎发作的治疗和康复相关的整体医疗保健成本。