Asymmetric Walking Protocol for Optimal Post-ACL Reconstruction Rehabilitation

项目摘要 拟议工作的主要目标是为PI提供高级生物医学研究培训， 卓越的指导能力，以及成为后前路手术领域领先的独立研究人员的时间保障 十字韧带重建(ACLR)康复。约250,000人的重大后果 在美国每年发生的前十字韧带损伤是未解决的神经肌肉损伤 损伤通常会导致有害的膝骨性关节炎和其他衰弱。 合并症。尽管进行了广泛的康复，但步态机制方面的长期缺陷仍然直接存在。 会造成有害的膝部负荷。然而，中风研究的一个有希望的发现是，不对称的 步行协议可以破坏不适应的步态机制，并导致采用新的、健康的步态模式。 虽然非对称协议在纠正不利步态模式方面的成功通常由 肢体间步态速度扰动的幅度，据我们所知，这种新的干预措施从未 已用于ACLR术后患者。因此，我将采用实验步态分析，计算建模， 生物信号处理和机器学习，以恢复ACLR术后健康的步态机制并减少膝盖 以下目标概述了装车： 目的1.评估非对称步行协议步态扰动幅度在 恢复ACLR术后患者的健康步态。 目的2.建立针对患者的模型来评估不对称步行协议步态的影响 扰动的大小不能减少ACLR术后患者有害的膝关节负荷。 目的3.生成个性化的数据驱动的临床算法，以快速、无创地预测膝关节 在临床环境中的负荷。 这项研究的结果将产生新的治疗干预和治疗指导，以改善术后 ACLR康复结果。 拟议工作的成功执行将涉及一支强大的跨学科研究团队， 具备信号处理、机器学习、医学、生物医学工程、计算机建模和 理疗。PI组建了一支充满活力的团队，以指导他人和 他们将为她提供研究指导，除了职业和专业发展方向和 支持。这种指导与强有力的机构支持、最先进的资源和设施相结合， 专门的保护时间将使她能够成功地执行所述的研究和培训活动 在她的K01指导研究科学家发展奖。

Project Abstract The primary goal of the proposed work is to provide the PI with advanced biomedical research training, outstanding mentorship, and protected time to become a leading independent researcher in post-anterior cruciate ligament reconstruction (ACLR) rehabilitation. A significant consequence of the approximately 250,000 anterior cruciate ligament injuries that occur annually in the United States is that unresolved neuromuscular impairments often lead to the development of detrimental knee osteoarthritis and other debilitating comorbidities. Despite extensive rehabilitation, protracted deficits in gait mechanics remain and directly contribute to detrimental knee loading. Yet, a promising finding from stroke research is that an asymmetric walking protocol can disrupt maladaptive gait mechanics and lead to the adoption of new, healthy gait patterns. While the success of the asymmetric protocol in correcting adverse gait patterns is often assessed by the magnitude of the between-limb gait speed perturbation, this novel intervention to our knowledge has never been employed in post-ACLR patients. Thus, I will employ experimental gait analysis, computational modeling, biosignal processing, and machine learning to restore healthy post-ACLR gait mechanics and reduce knee loading as outlined by the following aims: Aim 1. Evaluate the effectiveness of asymmetric walking protocol gait perturbation magnitudes in restoring healthy gait in post-ACLR individuals. Aim 2. Develop patient-specific models to evaluate the impact asymmetric walking protocol gait perturbation magnitude has on reducing detrimental knee loading in post-ACLR individuals. Aim 3. Generate personalized data-driven clinical algorithm to rapidly and non-invasively predict knee loads in a clinical setting. The results of this research will yield new therapeutic interventions and treatment guidance to improve post- ACLR rehabilitation outcomes. The successful execution of the proposed work will involve a strong team of interdisciplinary researchers with skills in signal processing, machine learning, medicine, biomedical engineering, computational modelling, and physical therapy. The PI has assembled a dynamic team with a superb reputation for mentoring others and they will provide her with research guidance in addition to career and professional development direction and support. This mentorship combined with strong institutional support, state-of-the-art resources, and facilities, and dedicated protected time will allow her to successfully perform the research and training activities outlined in her K01 Mentored Research Scientist Development Award.