Walking Mechanics, Early Osteoarthritis Development, and Neuromuscular Training after Traumatic Knee Injury

步行力学、早期骨关节炎的发展以及膝外伤后的神经肌肉训练

• 批准号: 9759661
• 负责人: Jacob J Capin
• 金额: $ 0.49万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-02 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9759661
• 关键词: Address; Adolescent and Young Adult; Anterior Cruciate Ligament; Area; Attention; Award; Biomechanics; Cartilage; Data; Degenerative polyarthritis; Delaware; Development; Disease; Foundations; Funding; Future; Gait; Goals; Health; Health Care Costs; Imaging Techniques; Individual; Injury; Intervention; Intervention Studies; Joints; Journals; Knee; Knee Injuries; Knee Osteoarthritis; Lead; Magnetic Resonance Imaging; Mechanics; Mentors; Mentorship; Modeling; Muscle; Musculoskeletal; Observational Study; Operative Surgical Procedures; Pain; Pathology; Patients; Peer Review; Play; Postoperative Period; Publications; Publishing; Quality of life; Randomized; Reconstructive Surgical Procedures; Records; Rehabilitation therapy; Relaxation; Replacement Arthroplasty; Research; Risk; Risk Factors; Role; Scientist; Solid; Sports; Symptoms; Time; Training; Training Programs; United States National Institutes of Health; University resources; Walking; Work; Writing; anterior cruciate ligament reconstruction; base; career; clinical practice; control trial; expectation; follow-up; improved; injured; joint destruction; ligament injury; neuromuscular; neuromuscular rehabilitation; novel; prevent; programs; prospective; rehabilitation science; rehabilitation strategy; response; skills; success; young adult

PROJECT SUMMARY/ABSTRACT Hundreds of thousands of adolescents and young adults each year sustain anterior cruciate ligament (ACL) injuries. These injuries often lead to poor knee health, including knee osteoarthritis (OA) that develops within 5- 15 years after the ACL injury when these athletes are still in young adulthood. Knee OA is a painful and debilitating condition that impacts quality of life, function, and overall health. Knee OA develops at similar rates in the tibiofemoral joint and the patellofemoral joint after ACL injury and surgery. Investigating and treating risk factors for both tibiofemoral and patellofemoral OA development is important. One risk factor for tibiofemoral OA is walking mechanics 6 months after ACL surgery, but the effect of walking gait on patellofemoral OA has not been studied early after ACL surgery. It is also unknown if walking mechanics may be improved through neuromuscular rehabilitation after surgery. The applicant’s long-term career goal is to optimize musculoskeletal and general health by investigating and developing interventions that delay or prevent the development of both primary and secondary OA and other musculoskeletal pathologies. The overall objectives of this proposal are to: 1) quantify the relationship between walking mechanics after ACL surgery and early signs of patellofemoral OA; and 2) determine the effects of post-operative neuromuscular training on walking mechanics after ACL surgery. The central hypotheses are that: 1) walking mechanics will correlate to early patellofemoral OA; and 2) walking mechanics will improve after neuromuscular training. Aim 1 will quantify the relationship between walking gait mechanics and patellofemoral (trochlear) cartilage T2 relaxation times (indicative of joint degeneration) 6 months after ACL surgery. Aim 2 will determine the effect of a specialized postoperative neuromuscular training program on the walking mechanics of athletes after ACL surgery. Walking analyses will be conducted 6 months after surgery for Aim 1 and before and after neuromuscular training as well as 1 and 2 years after surgery for Aim 2. Data will be analyzed for both aims using a validated musculoskeletal modeling approach to provide muscle and joint contact forces in addition to joint angles and moments. Quantitative magnetic resonance imaging data will also be collected 6 months after surgery for aim 1, and T2 relaxation times will be used to quantify cartilage health. The results of this project will advance rehabilitation science and clinical practice by critically evaluating the development of knee OA and rehabilitation strategies targeting a known risk factor for OA development. Findings will help improve musculoskeletal health, function, and quality of life. This proposal will also provide the applicant the foundation to conduct high quality longitudinal interventional and observational studies in rehabilitation, write compelling and impactful proposals, take research to its ultimate conclusion, publish in peer-reviewed journals, and prepare for a career as an independent clinician-scientist.

项目总结/摘要 每年有数十万青少年和年轻人因前交叉韧带（ACL） 受伤这些损伤通常会导致膝关节健康状况不佳，包括在5- 10天内发生的膝关节骨关节炎（OA）。 在ACL受伤15年后，这些运动员仍然处于年轻的成年期。膝关节OA是一种疼痛， 影响生活质量、功能和整体健康的衰弱性疾病。膝关节OA的发生率相似 ACL损伤和手术后胫股关节和髌股关节的变化。调查和处理风险 胫股和髌股OA发展的因素是重要的。胫股动脉的一个风险因素 膝关节骨性关节炎是ACL术后6个月的步行力学，但步行步态对髌股关节骨性关节炎的影响 在ACL手术后早期未进行研究。也不知道是否可以通过 术后神经肌肉康复申请人的长期职业目标是优化肌肉骨骼 通过调查和制定干预措施，延迟或防止两者的发展， 原发性和继发性OA以及其他肌肉骨骼病变。本建议的总体目标是 目的：1）量化ACL手术后行走力学与髌股关节早期体征之间的关系， OA; 2）确定术后神经肌肉训练对ACL术后步行力学的影响 手术中心假设是：1）行走力学与早期髌股OA相关; 2)经过神经肌肉训练后，步行力学会得到改善。目标1将量化 步行步态力学和髌股（trophemiar）软骨T2松弛时间（指示关节 ACL手术后6个月。目标2将确定专门的术后效果 神经肌肉训练计划对ACL手术后运动员步行力学的影响。步行分析将 在目标1手术后6个月以及神经肌肉训练前后以及目标1和目标2进行 Aim 2手术后3年。将使用经验证的肌肉骨骼模型分析两个目标的数据 这种方法除了提供关节角度和力矩外，还提供肌肉和关节接触力。定量 还将在术后6个月收集aim 1和T2弛豫的磁共振成像数据 时间将用于量化软骨健康。该项目的成果将促进康复科学和 通过批判性评估膝关节OA的发展和针对膝关节OA的康复策略进行临床实践 已知的OA发展风险因素。研究结果将有助于改善肌肉骨骼健康，功能和质量 生命该提案还将为申请人提供进行高质量纵向研究的基础。 康复的干预性和观察性研究，撰写令人信服和有影响力的建议， 研究的最终结论，发表在同行评议的期刊，并准备作为一个职业生涯， 独立临床科学家