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CAN NEUROMUSCULAR TRAINING ALTER MOVEMENT PATTERNS?

神经肌肉训练可以改变运动模式吗？

基本信息

批准号：
8830200
负责人：
LYNN SNYDER-MACKLER
金额：
$ 39.72万
依托单位：
UNIVERSITY OF DELAWARE
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-04-15 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8830200
关键词：
Age American Anterior Cruciate Ligament Biomechanics Chronic Clinical Clinical Markers Degenerative polyarthritis Development Evidence based treatment Financial compensation Gender Goals Individual Injury Joints Knee Knee Injuries Knee Osteoarthritis Knee joint Lateral Lead Medial Modeling Movement Muscle Muscle Weakness Operative Surgical Procedures Outcome Patients Pattern Play Population Postoperative Period Prevalence Reconstructive Surgical Procedures Recovery Rehabilitation therapy Risk Rupture Time Training Training Programs Woman Work anterior cruciate ligament reconstruction anterior cruciate ligament rupture base cohort disability experience functional outcomes high risk improved injured insight joint loading ligament injury men neuromuscular programs public health relevance quadriceps muscle reconstruction standard care

项目摘要

DESCRIPTION (provided by applicant): Anterior cruciate ligament (ACL) injury is prevalent and often leads to instability, quadriceps muscle weakness and osteoarthritis. (OA) Weakness and instability experienced by those who do not compensate well for ACL deficiency (non-copers) independently lead to compensation strategies that could precipitate or worsen knee OA. These poor compensation strategies do not uniformly resolve after surgical reconstruction and those who undergo reconstruction also have an increased risk of developing knee OA. The overall goal of this work is to determine whether effective rehabilitation programs to dynamically stabilize the knee improve outcome and reduce mal adaptations after ACL reconstruction in a population at great risk for the development of knee OA. Our work of the past five years has provided considerable evidence in support of our primary hypothesis that a specialized form of neuromuscular training called perturbation training can allow some non-copers to develop normal movement patterns and joint forces and result in better functional outcomes. Recent work from our group and our collaborators has shown the adaptability of non-copers, but also variable outcomes. Additionally, we have uncovered a strong gender effect in non-copers; women respond similarly to men to training, but recover much more slowly after surgery and continue to demonstrate aberrant movement patterns and knee joint loads. Women are more likely to be non-copers and more likely to have persistent maladaptive patterns after surgery. The specific aims of this competitive renewal application are to investigate whether:1) Responsiveness to preoperative rehabilitation that includes perturbation training predicts better clinical and functional outcome and the development of OA over time; 2) Women continue to demonstrate aberrant loads, persistent maladaptive patterns, have poorer clinical and functional outcome and develop more OA over time than men; and 3) The addition of a post-operative neuromuscular training program results in lower loading, better movement patterns and clinical and functional outcomes than standard care. The information derived from this project will provide valuable insight into the management of the approximately 150,000-175,000 Americans who rupture their ACL's each year and undergo reconstructive surgery. More importantly, if perturbation training can facilitate both improved patient outcomes and a reduction in mal adaptions following reconstructive ACL surgery, these findings may have applications for individuals with an extensive range of knee injuries.

描述（由申请人提供）：前十字韧带 (ACL) 损伤很常见，常常导致不稳定、股四头肌无力和骨关节炎。 (OA) 那些不能很好地补偿 ACL 缺陷的人（非应对者）所经历的虚弱和不稳定独立地导致可能导致或恶化膝关节 OA 的补偿策略。这些不良的补偿策略在手术重建后并不能统一解决，并且接受重建的患者发生膝关节骨关节炎的风险也会增加。这项工作的总体目标是确定动态稳定膝盖的有效康复计划是否可以改善结果并减少 ACL 重建后在膝关节 OA 发展风险较高的人群中的不良适应。我们过去五年的工作提供了大量证据来支持我们的主要假设，即一种称为扰动训练的特殊形式的神经肌肉训练可以让一些非训练者发展正常的运动模式和关节力，并产生更好的功能结果。我们小组和合作者最近的工作显示了非应对者的适应性，但也显示了可变的结果。此外，我们还发现，对于不遵守规则的人来说，性别存在着强烈的影响。女性对训练的反应与男性相似，但手术后恢复速度慢得多，并且继续表现出异常的运动模式和膝关节负荷。女性更有可能不适应，并且更有可能在手术后出现持续的适应不良模式。这项竞争性更新应用的具体目的是调查是否：1) 对术前康复（包括扰动训练）的反应可以预测更好的临床和功能结果以及随着时间的推移 OA 的发展； 2) 与男性相比，女性继续表现出异常的负荷、持续的适应不良模式、较差的临床和功能结果，并且随着时间的推移，出现更多的 OA； 3) 与标准护理相比，增加术后神经肌肉训练计划可实现更低的负荷、更好的运动模式以及临床和功能结果。该项目获得的信息将为每年大约 150,000-175,000 名 ACL 断裂并接受重建手术的美国人的治疗提供宝贵的见解。更重要的是，如果扰动训练可以改善患者的治疗效果并减少重建 ACL 手术后的不良适应，那么这些发现可能适用于患有广泛膝关节损伤的个体。