Neuromuscular Intervention Targeted to Mechanisms of ACL Load in Female Athletes

针对女运动员 ACL 负荷机制的神经肌肉干预

• 批准号: 9746581
• 负责人: Nathaniel Andrew Bates
• 金额: $ 69.63万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9746581
• 关键词: Activities of Daily Living; Acute; Adult; Age; Algorithms; Analysis of Variance; Anterior Cruciate Ligament; Athletic; Biomechanics; Characteristics; Classification; Climacteric; Clinic; Clinical; Clinical Data; Cluster Analysis; Data; Degenerative polyarthritis; Development; Drops; Educational Intervention; Effectiveness; Equilibrium; Evidence based intervention; Exercise; Extensor; Female; Future; Goals; Group Homes; Health; Hip region structure; Home environment; Impairment; Individual; Injury; Intervention; Investigation; Kinetics; Knee; Laboratory Finding; Leg; Ligaments; Limb structure; Lower Extremity; Measures; Mechanics; Mechanoreceptors; Motion; Movement; Muscle; Operative Surgical Procedures; Patient Education; Patient Self-Report; Patient risk; Patients; Pattern; Performance; Phase; Population; Postoperative Period; Posture; Protocols documentation; Quality of life; Randomized; Readiness; Rehabilitation therapy; Relative Risks; Resources; Risk; Risk Factors; Statistical Data Interpretation; Testing; Training; Training Programs; Translations; Vulnerable Populations; Woman; Work; anterior cruciate ligament injury; anterior cruciate ligament reconstruction; base; boys; career; clinical risk; cohort; design; experience; girls; group intervention; hamstring; health care delivery; high risk; intervention program; kinematics; men; neuromuscular; novel; patient stratification; prevent; programs; prospective; quadriceps muscle; reconstruction; recruit; response; return to sport; screening; sensory input; treatment group; treatment strategy; young adult

PROJECT SUMMARY The overall goal of this project is to prevent risk of second anterior cruciate ligament (ACL) injury in vulnerable populations, which consist of young, active men, women, girls and boys. Specifically, we propose to 1) stratify patients into risk groups for second ACL injury, 2) determine the effects of differential treatment on biomechanical measures of ACL injury risk and return to sport readiness after reconstruction (ACLR). Additionally, we will begin the development of a clinical algorithm that will classify patient risk for second ACL injury to facilitate the translation of findings from the laboratory into the clinic. Differential treatment will include a home only program, a standard clinical rehabilitation program, and a novel targeted neuromuscular training program designed to augment core and hip strength as well as promote optimum, low risk movement strategies in both lower extremities. Highly active men and women between the ages of 14 ≥ 24 years who have sustained an acute, isolated primary ACL injury will be recruited for study participation. As patients enter their final phase of rehabilitation after surgery they will undergo testing that includes self-reported function, performance of drop jumps, hop testing, strength assessment, and balance assessment. After testing, patients will be randomized into one of the three intervention groups for a six-week, twelve-session training program. After completion of training the patients will repeat the same battery of tests. To determine relative risk for second ACL injury, cluster-analysis statistical testing will be performed. Differences between risk-groups will be validated using the frontal plane hip and knee motions, which will be used as surrogates for ACL injury. Repeated measures ANOVA testing will be conducted to identify differences before and after testing to determine the effectiveness of each intervention program on clinical performance and biomechanical measures. Results from this proposed work will allow us to prospectively identify high risk patients who are the most appropriate recipients of enhanced treatment, including targeted neuromuscular training, which may reduce second ACL risk. Patients with lower-risk for second ACL injury may achieve optimum benefits from less intensive intervention. Thus, differential interventions may reduce the risk of a subsequent injury, enhance the quality of life for a significant cohort of young adults, and yield a more efficacious delivery of health care resources after ACLR.

项目摘要 本项目的总体目标是预防易受损伤的第二前交叉韧带（ACL）损伤的风险。 这一群体由年轻、活跃的男子、妇女、女孩和男孩组成。具体而言，我们建议：1）分层 将患者分为第二次ACL损伤的风险组，2）确定差异治疗对 ACL损伤风险和重建后恢复运动准备（ACLR）的生物力学测量。 此外，我们将开始开发一种临床算法，该算法将对第二次ACL的患者风险进行分类 损伤，以便于将结果从实验室转化为临床。差别待遇包括 一个家庭计划，一个标准的临床康复计划，和一个新的有针对性的神经肌肉训练 该计划旨在增强核心和髋关节力量，并促进最佳，低风险运动 在两个下肢的策略。年龄在14岁或24岁之间的高活动性男性和女性， 将招募患有急性、孤立性原发性ACL损伤的患者参与研究。当患者进入 在手术后的最后康复阶段，他们将接受包括自我报告功能在内的测试， 跳跳、跳跃测试、力量评估和平衡评估的性能。经过测试，患者 将被随机分配到三个干预组中的一个，进行为期六周的12次训练。 完成培训后，患者将重复相同的测试。为了确定相对风险 第二次ACL损伤，将进行聚类分析统计检验。风险群体之间的差异将 使用额状面髋关节和膝关节运动进行确认，这将用作ACL损伤的替代物。 将进行重复测量ANOVA检验，以确定检验前后的差异， 确定每种干预方案对临床性能和生物力学的有效性 措施这项拟议工作的结果将使我们能够前瞻性地识别高风险患者， 最合适的强化治疗接受者，包括有针对性的神经肌肉训练， 降低第二次ACL风险。第二次ACL损伤风险较低的患者可以从以下方面获得最佳获益： 干预力度较小。因此，不同的干预措施可以降低后续损伤的风险， 一个重要的年轻人群体的生活质量，并产生一个更有效的医疗保健提供 ACLR之后的资源。