Mechanics and neuromuscular dynamic control of the knee joint to prevent ACL injury in healthy and pathological population

提出的研究计划的最终目标是继续以前的科学工作和探索新的研究问题。目的是为了更好地了解长期和中期的力学和神经肌肉控制的膝关节和前交叉韧带拉伤行为在类运动中，并最终确定在男女ACL损伤的机制。为了实现这一目标，必须实现四个操作目标：(1)开发和验证用于模拟运动的三维下肢运动学分析的非侵入性皮肤标记优化技术；(2)研究在受控运动、意外运动和受干扰运动中下肢关节的运动学、动力学和神经肌肉控制的性别差异；(3)确定运动特定动作期间体内应变行为，尤其是女性；(4)利用从目标2和目标3中获得的下肢关节的运动学、动力学和神经肌肉参数，建立一个性别特异性的肌肉骨骼模型来预测前交叉韧带劳损。本研究计划将为深入了解各种模拟运动中膝关节功能的正常、病理和性别差异提供重要信息。这项研究计划的设计是独特的，它试图通过先前收集的体内数据来验证皮肤标记优化和肌肉骨骼前交叉韧带应变。虽然已经进行了许多研究，但尚未确定非接触性前交叉韧带损伤的性别差异的确切原因。许多因素确实已经被确定，包括下肢神经肌肉控制的性别差异。然而，后一个因素需要进一步调查。虽然已经研究了相对肌肉激活及其时间，但时间-频率特性尚未探索。因此，通过小波变换进行时频分析，将获得有关男性和女性神经肌肉控制策略的新信息。显然，对人类膝关节运动进行完整而精确的生物力学分析是必要的，以便更好地了解该关节的骨骼和肌肉结构的贡献和功能，从而使临床医生能够更好地诊断膝关节运动的病理动力学，运动治疗师能够改进他们的治疗方法，骨科医生能够选择理想的手术方法。

The ultimate goal of the proposed research program is to continue previous scientific works and investigate new research problems. The goal aims for a better understanding in the long- and mid-term of the mechanics and neuromuscular control of the knee joint and ACL strain behaviour during sport- like motion, and ultimately to identify the mechanism of ACL injuries in both genders. To reach this goal, four operational objectives must be carried out: (1) develop and validate a non-invasive skin marker optimisation technique for three dimensional lower limb kinematic analyses for simulated sport motions; (2) investigate the gender differences in kinematics, kinetics and neuromuscular control of the lower-limb joints during controlled, unanticipated, and perturbed movements; (3) determine in-vivo strain behaviour, especially in women, during sport specific movements, and; (4) develop a gender-specific musculo-skeletal model to predict ACL strain by using kinematics, kinetics and neuromuscular parameters of lower-limb joints as obtained from Objective 2 and 3. The proposed research program will provide important information for gaining a thorough understanding of normal, pathological and gender differences in knee joint functions during various simulated movements. The design of this research program is unique in its attempt to validate skin-marker optimisation and musculoskeletal ACL strain by in vivo data previously collected. Although many studies have been undertaken, no exact cause for the gender discrepancy in non-contact anterior cruciate ligament injuries has yet been determined. Many factors have indeed been identified, including a gender difference in neuromuscular control of the lower limb. However, this latter factor needs further investigation. Though relative muscle activation and its timing has been examined, the time-frequency characteristic has yet to be explored. Therefore, by performing a time-frequency analysis through wavelet transform, new information regarding the neuromuscular control strategies of men and women will be acquired. Clearly, a complete and precise biomechanics analysis of human knee motion is necessary to better understand the contribution and function of skeletal and muscular structures of this joint, and will in turn allow clinicians to better diagnose pathokinesiological knee motions, sport therapists to improve their treatments, and orthopaedists to choose the ideal surgical procedures.