Hormone Mediated Knee Joint Laxity and Neuromechanics

激素介导的膝关节松弛和神经力学

• 批准号: 7904345
• 负责人: SANDRA JANINE SHULTZ
• 金额: $ 15.51万
• 依托单位: UNIVERSITY OF NORTH CAROLINA GREENSBORO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-18 至 2010-09-17
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7904345
• 关键词: Accounting; Affect; Age; Algorithms; Anterior; Biomechanics; Consensus; Deceleration; Degenerative polyarthritis; Development; Exhibits; Female; Femur; Future; Goals; Gonadal Steroid Hormones; Health; Hormones; Individual; Injury; Intervention; Joint Laxity; Joints; Knee; Knee joint; Knowledge; Lateral; Lead; Leg; Life; Ligaments; Link; Luteal Phase; Measures; Mediating; Menstrual cycle; Menstruation; Muscle; Neuromechanics; Ovulation; Physical activity; Plants; Positioning Attribute; Prevention; Procedures; Property; Prospective Studies; Reconstructive Surgical Procedures; Recruitment Activity; Rehabilitation therapy; Relative (related person); Research; Research Design; Research Personnel; Risk; Risk Factors; Role; Rotation; Sampling; Sensory Receptors; Serum; Sex Characteristics; Specific qualifier value; Sports; Testing; Time; Training; Translations; Variant; Weight-Bearing state; Woman; Women' s Health; Work; aged; base; college; early onset; expectation; experience; foot; high school; injured; innovation; male; neuromuscular; neuromuscular function; programs; rehabilitation strategy; restraint; sex; tibia

DESCRIPTION (provided by applicant): Greater knee laxity has been identified as a predictor of ACL injury risk in females, and there is now sufficient evidence that sex hormones mediate cyclic changes in knee laxity across the menstrual cycle and in large part account for greater knee laxity in females compared to males. Our objective for this proposal is to determine the consequence of both greater absolute baseline anterior knee laxity (ABSAKi.) and cyclic increases in anterior knee laxity (CYCAKi.) on knee joint neuromechanics during functional activities. Our approach will be to recruit males and females with a broad range of baseline knee laxity values, then track females across their menstrual cycle to identify the specific days in their early follicular and luteal phases when knee laxity values are at their minimum and maximum respectively. We will then measure males and females on weight bearing knee joint neuromechanics at these specified time points to examine the independent and combined effects of sex, absolute baseline knee laxity and cyclic increases in knee laxity on knee joint neuromechanics. Our central hypothesises that greater absolute baseline and greater cyclic increases in knee laxity will independently and in combination predict greater anterior tibial translation during the transition from non-weight bearing to weight bearing, and greater "functional valgus collapse" of the knee during a single leg weight bearing perturbation. Our rationale for examining the effects of both greater absolute baseline and cyclic increases in knee laxity on weight bearing knee joint neuromechanics is that the successful completion of this work will advance our understanding of the factors contributing to "at risk" joint positions that are known to strain and injure the ACL. Because we expect that cyclic increases in knee laxity will be a significant predictor of at risk knee joint neuromechanics, we also plan to develop a predictive algorithm that will better enable clinicians and researchers in future prospective studies to reliably identify female hormone responders (those who experience cyclic increases in knee laxity > 3mm) based on several key hormone measures. ACL injury can profoundly impact on health and physical activity, both immediately following injury and reconstructive surgery, and later in life as a consequence of the early onset of osteoarthritis. These complications are of greatest concern in young active females, who are at a 2 to 9 times greater risk of suffering ACL injury compared to equivalently trained males. Advancing our knowledge of the underlying pathophysiological mechanism(s) of ACL injuries will further the development of optimal prevention, rehabilitation and training strategies to reduce the risk of sport-related injury, thereby enhancing the beneficial effects of physical activity on women's health for all ages.

描述（由申请人提供）：较大的膝关节松弛度已被确定为女性前交叉韧带损伤风险的预测因子，现在有足够的证据表明性激素介导整个月经周期中膝关节松弛度的周期性变化，并且在很大程度上解释了女性比男性更大的膝关节松弛度。我们这一建议的目的是确定在功能性活动期间，更大的绝对基线膝前松弛（ABSAKi）和周期性的膝前松弛（CYCAKi）增加对膝关节神经力学的影响。我们的方法是招募具有广泛基线膝关节松弛值的男性和女性，然后在整个月经周期中跟踪女性，以确定其早期卵泡期和黄体期膝关节松弛值分别处于最小和最大的特定日期。然后，我们将在这些指定的时间点测量男性和女性的负重膝关节神经力学，以检查性别、绝对基线膝关节松弛度和膝关节松弛度周期性增加对膝关节神经力学的独立和联合影响。我们的中心假设是，更大的绝对基线和更大的膝关节松弛周期增加将单独或联合预测从非负重到负重过渡期间更大的胫骨前移位，以及在单腿负重扰动期间更大的膝关节“功能性外翻塌陷”。我们研究更大的绝对基线和周期性增加的膝关节松弛度对负重膝关节神经力学的影响的基本原理是，这项工作的成功完成将促进我们对导致“危险”关节位置的因素的理解，这些因素已知会拉伤和损伤前交叉韧带。因为我们预计膝关节松弛度的周期性增加将是危险膝关节神经力学的重要预测指标，我们还计划开发一种预测算法，使临床医生和研究人员在未来的前瞻性研究中能够基于几种关键激素测量可靠地识别女性激素应答者（那些经历膝关节松弛度周期性增加3mm的人）。前交叉韧带损伤会对健康和身体活动产生深远的影响，无论是在受伤和重建手术后立即发生的，还是由于早期发生骨关节炎而导致的。这些并发症是年轻活跃女性最关注的问题，她们患前交叉韧带损伤的风险是同等训练男性的2至9倍。推进我们对前交叉韧带损伤的潜在病理生理机制的了解，将进一步发展最佳的预防、康复和训练策略，以减少运动相关损伤的风险，从而增强体育活动对所有年龄段女性健康的有益影响。

项目成果

Variations in varus/valgus and internal/external rotational knee laxity and stiffness across the menstrual cycle.

• DOI: 10.1002/jor.21243
• 发表时间: 2011-03
• 期刊: JOURNAL OF ORTHOPAEDIC RESEARCH
• 影响因子: 2.8
• 作者: Shultz, Sandra J.;Schmitz, Randy J.;Beynnon, Bruce D.
• 通讯作者: Beynnon, Bruce D.

Anterior tibiofemoral intersegmental forces during landing are predicted by passive restraint measures in women.

通过女性的被动约束措施来预测着陆过程中前胫股节间力。

• DOI: 10.1016/j.knee.2013.04.017
• 发表时间: 2013
• 期刊: The Knee
• 作者: Schmitz,RandyJ;Sauret,JeromeJ;Shultz,SandraJ
• 通讯作者: Shultz,SandraJ

Joint laxity is related to lower extremity energetics during a drop jump landing.

关节松弛与跳伞着陆时的下肢能量有关。

• DOI: 10.1249/mss.0b013e3181bbeaa6
• 发表时间: 2010
• 期刊: Medicine and science in sports and exercise
• 影响因子: 4.1
• 作者: Shultz,SandraJ;Schmitz,RandyJ;Nguyen,Anh-Dung;Levine,BeverlyJ
• 通讯作者: Levine,BeverlyJ

Cyclic variations in multiplanar knee laxity influence landing biomechanics.

多平面膝关节松弛度的周期性变化影响着地生物力学。

• DOI: 10.1249/mss.0b013e31823bfb25
• 发表时间: 2012
• 期刊: Medicine and science in sports and exercise
• 影响因子: 4.1
• 作者: Shultz,SandraJ;Schmitz,RandyJ;Kong,Yanfang;Dudley,WilliamN;Beynnon,BruceD;Nguyen,Anh-Dung;Kim,Hyunsoo;Montgomery,MelissaM
• 通讯作者: Montgomery,MelissaM

Sex differences in coupled knee motions during the transition from non-weight bearing to weight bearing.

从非负重到负重过渡期间膝关节耦合运动的性别差异。

• DOI: 10.1002/jor.20810
• 发表时间: 2009
• 期刊: Journal of orthopaedic research : official publication of the Orthopaedic Research Society
• 作者: Shultz,SandraJ;Beynnon,BruceD;Schmitz,RandyJ
• 通讯作者: Schmitz,RandyJ