Virtual Reality Mindfulness Meditation in Patients after Anterior Cruciate Ligament Reconstruction

前十字韧带损伤后的损伤相关恐惧显著减少 回归运动，减少体力活动，增加以前高水平的前交叉韧带再损伤风险 功能正常、身体活跃的个体。与受伤相关的恐惧也与糟糕的跳跃着陆有关。 前交叉韧带重建术后患者的运动模式。不幸的是，目前的康复实践 不要特别针对ACLR术后患者与伤害相关的恐惧。虚拟现实正念冥想是一种 一种心理练习，包括将你的注意力集中在你当下的经历上，并且已经 用于治疗抑郁、焦虑和慢性肌肉骨骼疼痛。此外，正念冥想 导致患有抑郁症、焦虑症和慢性肌肉骨骼疾病的人的大脑活动发生积极变化 疼痛。ACLR后的患者表现出与抑郁、焦虑和慢性疾病患者相似的大脑活动不良 肌肉骨骼疼痛；因此，ACLR后的患者也可能受益于正念冥想。要评估 虚拟现实正念冥想对ACLR患者的影响，我们将确定虚拟冥想的效果 现实正念冥想1)减少自我报告的受伤相关恐惧，2)改善糟糕的跳跃着陆 运动模式，以及3)与虚拟运动相比，ACLR术后9个月女性的大脑活动得到改善 现实伪装团体。与受伤相关的恐惧和糟糕的跳跃着陆运动模式与 前交叉韧带有再次受伤的风险。女性被选入这项研究，因为之前的文献已经证明了性别差异 在脑活动方面，女性也有较高的前交叉韧带损伤发生率和前交叉韧带再损伤风险。医院里所有的病人 这项研究将完成为期8周的高级康复训练计划，以改善下半身肌肉 力量、力量和灵活性。干预组患者将完成为期8周的虚拟现实 正念冥想高级康复训练计划。假手术组的患者将 完成为期8周的虚拟现实假高级康复训练计划。中环 假设是ACLR后9个月接受虚拟现实正念冥想的女性将 减少与受伤相关的恐惧，改善跳跃着陆运动模式，改善大脑 活动。这项提案的发现将解决关于有效心理学知识的空白。 应对与前交叉韧带再损伤风险相关的心理和生物因素的干预措施。这项建议 还定位了一名有抱负的独立临床医生科学家，接受培训以学习神经成像技术和 复杂运动模式的数据采集和分析。通过这次培训，首席调查员将 检查虚拟现实正念冥想对减轻损伤相关恐惧、减少前交叉韧带的疗效 在她作为临床科学家的整个职业生涯中，她可以提高ACLR术后患者的再损伤风险，提高患者的生活质量。

Injury-related fear after anterior cruciate ligament (ACL) injury significantly contributes to decreased return to sport, decreased physical activity engagement, and increased ACL reinjury risk in previously high functioning, physically active individuals. Injury-related fear is also associated with poor jump-landing movement patterns in patients after ACL reconstruction (ACLR). Unfortunately, current rehabilitation practices do not specifically address injury-related fear in patients after ACLR. Virtual reality mindfulness meditation is a mental practice that involves focusing your mind on your experiences in the present moment and has been used to address depression, anxiety, and chronic musculoskeletal pain. Additionally, mindfulness meditation has led to positive changes in brain activity in individuals with depression, anxiety, and chronic musculoskeletal pain. Patients after ACLR exhibit poor brain activity similar to individuals with depression, anxiety, and chronic musculoskeletal pain; thus, patients after ACLR may also benefit from mindfulness meditation. To evaluate the effect of virtual reality mindfulness meditation on patients after ACLR, we will determine the effect of virtual reality mindfulness meditation to 1) decrease self-reported injury-related fear, 2) improve poor jump-landing movement patterns, and 3) improve brain activity in women 9-months post-ACLR when compared to a virtual reality sham group. Injury-related fear and poor jump-landing movement patterns have been associated with ACL reinjury risk. Women were selected for this study as previous literature has demonstrated sex differences in brain activity and women also have a higher incidence of ACL injury and ACL reinjury risk. All patients in the study will complete an 8-week advanced rehabilitation training program to improve lower-body muscle strength, power, and flexibility. Patients in the intervention group will complete 8-weeks of virtual reality mindfulness meditation + the advanced rehabilitation training program. Patients in the sham group will complete 8-weeks of the virtual reality sham + the advanced rehabilitation training program. The central hypothesis is that women 9-months post ACLR who undergo virtual reality mindfulness meditation will demonstrate decreased injury-related fear, improved jump-landing movement patterns, and improved brain activity. The findings from this proposal will address a gap in knowledge about effective psychological interventions to address psychological and biological factors associated with ACL reinjury risk. This proposal also positions an aspiring independent clinician scientist training to learn neuroimaging techniques and complex movement pattern data collection and analyses. With this training, the primary investigator will examine the efficacy of virtual reality mindfulness meditation to mitigate injury-related fear, decrease ACL reinjury risk, and improve quality of life in patients after ACLR throughout her career as a clinician scientist.