Epidemiology of Patellofemoral Pain Syndrome: Identifying Gender Specific Risk Fa

描述（由申请人提供）：髌股疼痛综合征（PFP）是膝关节疼痛的最常见原因之一，影响约25%的体力活动人群，女性发生PFP的可能性是男性的2-3倍。本提案的总体目标是确定与私营部门筹资和伙伴关系有关的机械（结构和生物力学）和非机械（人口和心理社会）风险因素，并确定女性和男性特有的风险因素。该方法将使用前瞻性队列设计来识别与PFP事件相关的风险因素。中心假设是，发生PFP的个体将改变运动模式，下肢解剖学排列异常，下肢力量下降，既往膝关节损伤史，既往参与少量体育活动，耐寒水平降低，以及医疗保健就诊次数增加。第二个假设是，女性和男性将有不同的风险因素。我们将利用基线风险因素的数据，已收集了5690新生（男性=3482，女性= 2208）在2005年至2008年夏天在以下军事院校：美国海军学院，美国军事学院，美国空军学院。通过当前NIH资助的项目（R 01-AR 054061001）（名为JUMP-ACL）收集基线风险因素数据。每个参与者都将为事件PFP贡献后续时间，直到他们从各自的学院毕业。将进行病历审查，以确定在各自随访期间发生PFP的受试者。根据拟定研究的2年时间，2005-2008年入组JUMP-ACL研究的所有受试者的随访时间为4年。将进行Poisson回归分析，以确定PFP的风险因素。此外，将分别分析男性和女性，以确定性别特异性风险因素特征。拟议项目通过增加对JUMP-ACL项目不会调查的新结果（PFP）的分析，有效利用了已经收集的风险因素数据。此外，拟议的调查具有成本效益，因为基线数据收集不需要资金。我们提出的调查的理由是，迫切需要进行前瞻性研究，确定PFP的风险因素，以便制定更有针对性的预防战略，适当地针对性别。 公共卫生相关性：髌股疼痛综合征（PFP）是影响年轻人的最常见慢性膝关节疾病之一，女性发病率较高。患有这种疾病的个体可能会经历持续数十年的症状，限制他们参与体育活动，并使他们容易患上与不活动相关的慢性疾病，如肥胖症，关节炎，冠状动脉疾病，糖尿病和癌症。这项调查的结果可用于识别PFP风险最大的人群，并制定适当的预防计划，以减少这种情况的发生，特别是在女性中。

DESCRIPTION (provided by applicant): Patellofemoral pain syndrome (PFP) is one of the most common causes of knee pain, affecting approximately 25% of the physically active population, with females being 2-3 times more likely to develop PFP compared to their male counterparts. The overall objective of this proposal is to determine the mechanical (structural and biomechanical) and non-mechanical (demographic and psychosocial) risk factors that are associated with PFP and identify the risk factors specific to females and males. The approach will be to use a prospective cohort design to identify risk factors that are associated with incident PFP. The central hypothesis is that individuals who develop PFP will have altered movement patterns, abnormal lower extremity anatomical alignments, decreased lower extremity strength, previous history of knee injury, previous participation in a low number of athletic activities, decreased levels of hardiness, and increased number of healthcare visits. A secondary hypothesis is that females and males will have different risk factor profiles. We will utilize baseline risk factor data that has been collected on 5690 freshman (males=3482, females= 2208) during the summers of 2005- 2008 at the following military academies: United States Naval Academy, United States Military Academy, United States Air Force Academy. Baseline risk factor data was collected through a current NIH funded project (R01-AR054061001), entitled JUMP-ACL. Each participant will contribute follow up time for incident PFP until they graduate from their respective academy. Medical record reviews will be performed to identify those participants who developed PFP during their respective follow-up time. Based on the two years for the proposed investigation, follow up time will be 4 years for all participants enrolled in the JUMP-ACL investigation from 2005-2008. Poisson regression analyses will be performed to determine the risk factors for PFP. Additionally, males and females will be analyzed separately to determine gender specific risk factor profiles. The proposed project is making an efficient use of already collected risk factor data by adding analysis of a new outcome (PFP) that would not otherwise be investigated by the JUMP-ACL project. Additionally, the proposed investigation is cost effective due to no funds being required for baseline data collection. Our rationale for the proposed investigation is that there is a crucial need for prospective studies that identify the risk factors for PFP so that more focused prevention strategies can be developed that are appropriately gender specific. PUBLIC HEALTH RELEVANCE: Patellofemoral pain syndrome (PFP) is one of the most common chronic knee conditions affecting young adults, with an increased occurrence in females. Individuals suffering from this condition may experience symptoms lasting multiple decades, limiting their participation in physical activity, and predisposing them to chronic diseases associated with inactivity such as obesity, arthritis, coronary artery disease, diabetes, and cancer. The results from this investigation may be used to identify those at greatest risk to PFP and develop appropriate prevention programs to decrease the occurrence of this condition, particularly in females.