THE INFLUENCE OF SEX AND PUBERTY ON KNEE JOINT NEUROMUSCULAR CONTROL, LOADING AND STABILISATION

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Over the past six years, my multidisciplinary team of trainees has developed new methods to improve the measurement and application of research related to knee joint kinematics, neuromuscular control and loading in the healthy adult population. This has led to a fully funded Visiting Professorship (U of Copenhagen) and over 50 presentations, 26 publications (including an Editor's Pick), 5 submitted manuscripts, 3 prize nominated theses, and an award-winning 3D printed knee brace. This next phase of my research program focuses on the paediatric population, in part due to the lack of research surrounding their neuromuscular control strategies during functionally demanding tasks, and in part due to the significant and continuous rise of knee injuries in the early pubescent population. For context, as many as 1 in 20 young competitive basketball or soccer players will sustain a significant knee injury per year of exposure, yet there is no consensus on sex and developmental activation and movement strategies in the normally developing population and paediatric knee injury mechanisms are poorly defined. Furthermore, existing literature on puberty- and sex-related changes in neuromuscular control and biomechanics is derived from cross-sectional cohort studies, limiting the level of evidence used to form our understanding of developmental changes (i.e. cause and effect cannot be assumed). I therefore propose a longitudinal program to investigate the Influence of Sex and Puberty on Knee Joint Neuromuscular Control, Loading and Stabilisation through puberty. We will assess 160 young healthy males and females from T1 (age 11/12) to T2 (age 13/14) with the following aims: (1)Describe the functional capacity of pre- and early pubescent males and females: We will measure functional capacity including spatio-temporal measures during hoping tasks, strength, muscular endurance, neuromuscular control and whole body kinematics and kinetics during landing tasks. (2)Model knee ligament and contact forces in pre- and early pubescent males and females: We will develop a novel, scalable MRI-based neuromusculoskeletal model to contrast paediatric joint and ligament forces from T1 and T2. (3)Identify knee joint control strategies in pre- and early pubescent males and females: We will use a combination of principal component and linear discriminant analyses on the pooled Aim1 and 2 data to extract variables that predict optimal or failed knee joint control strategies during landing tasks. My trainees will gain transferable skills in movement analysis, data science and modeling while working with a diverse young population from our community. We will provide insights into potential sex differences and injury mechanisms in an increasingly vulnerable population. My long term goal of characterising the evolution of functional capacity, neuromuscular control and knee stabilisation through puberty will be achieved with a third evaluation (age 15/16) beyond this application.