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

拟议研究计划的最终目标是继续以前的科学工作，并探讨新的研究问题。该目标旨在更好地了解长期和中期膝关节的力学和神经肌肉控制以及运动类运动期间的ACL应变行为，并最终确定两种性别的ACL损伤机制。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）调查在受控、非预期和扰动运动期间下肢关节的运动学、动力学和神经肌肉控制的性别差异;（3）确定在运动特定运动期间的体内应变行为，特别是女性;（4）开发性别特异性肌肉骨骼模型，通过使用从目标2和3获得的下肢关节的运动学、动力学和神经肌肉参数来预测ACL应变。该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。本研究项目的设计是独特的，它试图通过先前收集的体内数据来验证皮肤标记物优化和肌肉骨骼ACL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中性别差异的确切原因。许多因素确实已经确定，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。虽然相对的肌肉激活和它的时间已经被检查，时间-频率特性还有待探索。因此，通过小波变换进行时频分析，将获得关于男性和女性的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和精确的生物力学分析是必要的，以更好地了解该关节骨骼和肌肉结构的贡献和功能，并反过来使临床医生能够更好地诊断病理运动学膝关节运动，运动治疗师改善他们的治疗，骨科医生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.