Discovery of the Neural Drivers Underlying Injury-Risk Biomechanics

1项目概要/摘要 2前交叉韧带（ACL）损伤是一种使人衰弱的疾病，会导致一致的膝关节退化 3和身体活动能力下降，累计医疗保健费用超过数十亿美元， 四年。ACL损伤最常见的机制是球员之间没有接触（称为非接触） 5和继发于导致损伤性膝关节负荷的运动协调错误。因此，目前 6预防伤害的标准是神经肌肉或运动训练，以纠正由此产生的特定伤害风险 7个机械师在控制设置。然而，减少伤害的策略并没有取得足够的效果， 8到中枢神经系统对运动错误的贡献的靶向不足， 9在生态有效的环境中传播伤害风险。我们发表的前瞻性纵向数据和初步的 10个生态有效的运动特定虚拟现实数据，表明感觉运动脑活动是ACL损伤的基础- 11风险因此，本申请的目的是确定与损伤风险运动相关的脑活动。 12控制在标准和生态有效的体育特定的虚拟现实设置。我们的初步数据表明 13我们的中心假设是，那些有受伤风险的运动模式依赖于视觉和认知运动神经系统。 14激活策略，这是进一步强调生态有效的体育虚拟现实。拟议的研究是 15创新，因为它代表了一个新的和实质性的偏离以前的工作，主要集中在 16生物力学结果，现在确定神经活动传播损伤风险膝关节运动控制。一个关键 17本提案的突破点是生物力学仪器对膝关节运动误差的实时控制 18神经成像。这项观察性试验的预期结果将是确定潜在的 19膝关节运动控制神经活动与ACL损伤风险生物力学相关。圆满完成拟议的 20 Aims将战略性地定位我们，以开发具有竞争力的R 01临床试验应用程序， 21神经肌肉训练，以针对本建议确定的神经过程。具体而言，在 本文确定的22种神经激活策略，我们将使用新的生物反馈改进预防方案。 23种方法，临床技术和运动学习原则，以促进适应性大脑功能， 24受伤事件因此，避免终身疼痛，骨关节炎和体力活动的限制，直接对齐 25与美国国立卫生研究院的倡议，以减少伤害和身体不活动的青年和成年人，这是第四大原因 全球死亡率26。 27 28

1 Project Summary/Abstract 2 Anterior cruciate ligament (ACL) injury is a debilitating condition that results in consistent knee degeneration 3 and reduced physical activity capacity, with cumulative health care costs exceeding several billion dollars per 4 annum. The most common mechanism of ACL injury is without player to player contact (termed non-contact) 5 and secondary to motor coordination errors that result in injurious knee joint loading. As such, the current 6 standard for injury prevention is neuromuscular or movement training to correct resultant specific injury-risk 7 mechanics in controlled settings. However, injury reduction strategies have not achieved sufficient efficacy due 8 to inadequate targeting of central nervous system contributions to the motor errors that may underlie and 9 propagate injury-risk in ecologically valid settings. Our published prospective longitudinal data, and preliminary 10 ecologically valid sport-specific virtual reality data, indicates that sensorimotor brain activity underly ACL injury- 11 risk. Thus, the objective of this application is to determine the brain activity associated with injury-risk motor 12 control in standard and ecologically valid sport-specific virtual reality settings. Our preliminary data inform 13 our central hypothesis that those with injury-risk movement patterns rely on a visual and cognitive-motor neural 14 activation strategy, that is further accentuated in ecologically valid sport virtual reality. The proposed research is 15 innovative because it represents a new and substantial departure from prior work that focused primarily on 16 biomechanical outcomes, to now determine the neural activity propagating injury-risk knee motor control. A key 17 breakthrough of this proposal is the biomechanical instrumentation of knee motor control error in real-time during 18 neuroimaging. The expected outcomes from this observational trial will be the identification of the underlying 19 knee motor control neural activity related to ACL injury-risk biomechanics. Successful completion of the proposed 20 Aims will strategically position us to develop a competitive R01 clinical trial application that assesses novel 21 neuromuscular training to target the neural processes identified by this proposal. Specifically, guided by the 22 neural activation strategies identified herein, we will refine prevention programs using novel biofeedback 23 methods, clinical technologies, and motor learning principles to facilitate adaptive brain function that reduces 24 injury incidence. Thus, avoiding the lifelong pain, osteoarthritis, and physical activity limitations, directly aligning 25 with NIH initiatives to reduce injury and physical inactivity in youth and adults, which is the fourth leading cause 26 of global mortality. 27 28