Walk this Way: Physical Activity and Walking Biomechanics Lead to Early Knee OA Symptoms and Ultrasound-Detected Structural Pathology after ACL Reconstruction

项目摘要 本管理补充文件（NOT-OD-20-54）随附于母公司K 01（K 01 AR 081389; PI：Dr. Harkey） 并要求提供补充支持，为增加研究人员提供资金，以促进研究的连续性， 在哈基博士的儿子出生后的第一年内的关键时刻。对于至少三分之一的年轻人来说， 前交叉韧带重建（ACLR），损伤和手术是导致 慢性疼痛，长期生活质量下降，骨关节炎（OA）风险增加。因为穷 症状和放射学检查前的结构病理学是膝关节OA发展的危险因素， 了解与第1年不良症状和结构性结局相关的可改变风险因素 未来的研究需要ACLR后，以确定预防OA的治疗方法。5年家长的目标 K 01是为了确定如何在3， ACLR后6、9和12个月与ACLR后第1年的不良症状或结构结局相关。 这将是第一项在第1年多次访视时将以下结局应用于年轻成人的研究 ACLR后：1）早期OA症状的分类标准，2）临床上可获得的全膝关节超声检查 评分系统，以检测多种结构性病变。PA将使用研究级加速度计进行评估 量化每天的步数和每周分钟的中度至剧烈PA在7天内， 学习访问。行走生物力学将在动作捕捉实验室进行评估，以量化垂直地面 反作用力和膝内收力矩。我的中心假设是， ACLR后PA和行走生物力学的变化将不太可能有不良的症状和结构 与PA和步行快速增加或无变化的患者相比，第1年的结局 生物力学这项工作的预期结果是确定：1）ACLR后的高危患者， 参与旨在预防不良症状和结构结局的临床试验，以及2）当PA或 在ACLR后的第一年，步行生物力学需要成为目标。这一建议也将提供博士。 哈基与培训和指导，以发展一种新的技能，在全膝超声成像，设备- 基于PA监测、纵向数据分析和临床试验设计。哈基博士的父母K 01 项目和培训按原定时间轴进行，所要求的补充支助将确保 K 01时间轴的连续性。该支持将资助一名研究生，该研究生将协调并继续研究 活动（例如，患者招募和数据收集）期间，需要Harkey博士 增加家庭责任。该补充将支持母公司K 01的研究和培训目标 因为这将有助于哈基博士在休假后无缝返回工作岗位并充分发挥生产力。

PROJECT SUMMARY This administrative supplement (NOT-OD-20-54) accompanies the Parent K01 (K01AR081389; PI: Dr. Harkey) and requests supplementary support to fund additional research staff to promote the continuity of research during the critical time within the first year following the birth of Dr. Harkey’s son. For at least 1 in 3 young adults with an anterior cruciate ligament reconstruction (ACLR), the injury and surgery are pivotal life events that lead to chronic pain, diminished long-term quality of life, and an increased risk for osteoarthritis (OA). Since poor symptoms and pre-radiographic structural pathology are risk factors for the development of knee OA, understanding modifiable risk factors that relate to poor symptomatic and structural outcomes during the 1st year post-ACLR is needed for future studies to identify therapies that prevent OA. The objective of the 5-year Parent K01 is to determine how longitudinal changes in physical activity (PA) and walking biomechanics assessed at 3, 6, 9, and 12 months post-ACLR relate to poor symptomatic or structural outcomes during the 1st year post-ACLR. This will be the first study that applies the following outcomes to young adults at multiple visits during the 1st year post-ACLR: 1) classification criteria for early OA symptoms, 2) clinically accessible whole-knee ultrasound scoring system to detect multiple structural pathologies. PA will be assessed with research-grade accelerometers to quantify steps per day and weekly minutes of moderate to vigorous PA during a 7-day period following each study visit. Walking biomechanics will be assessed in a motion capture laboratory to quantify vertical ground reaction force and internal knee adduction moment. My central hypothesis is that participants with a moderate change in PA and walking biomechanics post-ACLR will be less likely to have poor symptomatic and structural outcomes during the 1st year when compared to people with a rapid increase or no change in PA and walking biomechanics. The expected outcome of this work is to identify: 1) at-risk patients post-ACLR who are the ideal participants for clinical trials aimed at preventing poor symptomatic and structural outcomes, and 2) when PA or walking biomechanics need to be targeted during the 1st year post-ACLR. This proposal will also provide Dr. Harkey with the training and mentoring to develop a novel skill set in whole-knee ultrasound imaging, device- based PA monitoring, longitudinal data analyses, and clinical trial design. To date, Dr. Harkey’s Parent K01 project and training is on track with the original timeline and the requested supplemental support will ensure continuity of the K01 timeline. The support will fund a graduate student that will coordinate and continue research activities (e.g., patient recruitment and data collection) during times when Dr. Harkey is required to tend to his increased family responsibilities. This supplement will support both the parent K01 research and training aims as it will aid in Dr. Harkey’s seamless return to work and full productivity following leave.