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: 10443822
• 负责人: Nathaniel Andrew Bates
• 金额: $ 69.26万
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10443822
• 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; 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; effectiveness evaluation; experience; girls; group intervention; hamstring; health care delivery; high risk; intervention program; kinematics; men; neuromuscular; neuromuscular training; 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.

项目总结 该项目的总体目标是预防脆弱人群第二前十字韧带(ACL)损伤的风险 人口，其中包括年轻、活跃的男子、妇女、女孩和男孩。具体地说，我们建议1)分层 将患者分为二次前交叉韧带损伤的危险组，2)确定辨证治疗对 前交叉韧带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，该算法将对第二个ACL的患者风险进行分类 伤害，以便于将实验室的研究结果转化为临床。区别对待将包括 家庭专用计划、标准临床康复计划和新的有针对性的神经肌肉训练 旨在增强核心和臀部力量以及促进最佳、低风险运动的计划 两条腿的治疗策略。高度活跃的男性和女性，年龄在14岁≥24岁之间 遭受急性、孤立的原发前交叉韧带损伤的患者将被招募参加研究。当病人进入时 他们手术后的最后康复阶段将接受包括自我报告功能在内的测试， 跳跃、跳跃测试、力量评估和平衡评估的表现。经过检测，患者 将被随机分成三个干预组之一，进行为期六周、十二节的训练计划。 训练结束后，患者将重复同样的一系列测试。确定以下各项的相对风险 第二前交叉韧带损伤后，进行聚类分析统计检验。风险组之间的差异将 使用额面髋关节和膝关节运动进行验证，这将被用作前交叉韧带损伤的替代物。 将进行重复测量ANOVA检验，以确定测试前后的差异 确定每种干预方案对临床表现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危患者 最适合接受强化治疗的人，包括有针对性的神经肌肉训练，这可能 降低第二个ACL风险。风险较低的二次前交叉韧带损伤的患者可能会从 干预力度较小。因此，不同的干预措施可能会降低随后受伤的风险，增强 提高一大批年轻人的生活质量，并更有效地提供医疗保健 ACLR之后的资源。

项目成果

Effects of compliance on trunk and hip integrative neuromuscular training on hip abductor strength in female athletes.

• DOI: 10.1097/jsc.0000000000000228
• 发表时间: 2014-05
• 期刊: Journal of strength and conditioning research
• 影响因子: 3.2
• 作者: Sugimoto D;Myer GD;Bush HM;Hewett TE
• 通讯作者: Hewett TE

Prediction and prevention of musculoskeletal injury: a paradigm shift in methodology.

• DOI: 10.1136/bjsm.2009.065482
• 发表时间: 2009-12
• 期刊: British journal of sports medicine
• 影响因子: 18.4
• 作者: Quatman CE;Quatman CC;Hewett TE
• 通讯作者: Hewett TE

In vivo evidence for tibial plateau slope as a risk factor for anterior cruciate ligament injury: a systematic review and meta-analysis.

• DOI: 10.1177/0363546512442307
• 发表时间: 2012-07
• 期刊: The American journal of sports medicine
• 作者: Wordeman SC;Quatman CE;Kaeding CC;Hewett TE
• 通讯作者: Hewett TE

Prospectively identified deficits in sagittal plane hip-ankle coordination in female athletes who sustain a second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport.

• DOI: 10.1016/j.clinbiomech.2015.08.019
• 发表时间: 2015-12
• 期刊: Clinical biomechanics (Bristol, Avon)
• 作者: Paterno MV;Kiefer AW;Bonnette S;Riley MA;Schmitt LC;Ford KR;Myer GD;Shockley K;Hewett TE
• 通讯作者: Hewett TE

Analysis of Lower Extremity Proprioception for Anterior Cruciate Ligament Injury Prevention: Current Opinion.

• DOI: 10.1007/s40279-018-0889-1
• 发表时间: 2018-06
• 期刊: Sports medicine (Auckland, N.Z.)
• 作者: Nagai T;Schilaty ND;Strauss JD;Crowley EM;Hewett TE
• 通讯作者: Hewett TE