Anterior cruciate ligament (ACL) injuries are a significant problem for athletes, and the prevalence has increased exponentially due to the 10-fold increase in sports participation by women. Despite demonstrated ability to decrease injury rates through the use of neuromuscular training programs, the incidence of ACL injuries remains high due to poor adoption, and subsequent integration, of these programs into traditional strength and performance training routines. Ideally, a prophylactic training program would incorporate training features that address both intrinsic and extrinsic factors associated with ACL injury risk without increasing athlete training time, supervision, or specialized training requirements for the coach. Perturbation training, in particular, has been shown to cause adaptation in the sensorimotor system and restoration of normal neuromuscular coordination that results in improved dynamic postural stability, postural control, and enhanced muscle activation patterns that actively stabilize the knee during unanticipated movements. To date, adoption of perturbation training has been limited because it requires specialized equipment, additional training time, and additional resources. The Principal Objective of this Phase IIB SBIR project is to complete product development and demonstrate usability in the field of a cost-effective and fully automated perturbation platform that improves an athlete's neuromuscular response due to unanticipated perturbations for the prevention of ACL injuries.
More than 100,000 Anterior Cruciate Ligament (ACL) injuries occur annually in the US and approximately 70% of these are non-contact related. There are a disproportionate number of injuries in female athletes when compared to their male counterparts, with females having a 3 times higher incidence rate than males and increased from 10.36 to 18.06 per 100,000 person- years from 1994 to 2006. The largest increases over this time period occurred in female athletes younger than 20 years and likely related to the increase in female participation in high school and college sports. For each ACL injury, the lifetime costs can range from $38,000 to over $90,000 depending on surgical and non-surgical interventions. Due to other structural damage to the knee that often accompanies ACL injuries, 59% of ACL injured patients will eventually show radiographic evidence of osteoarthritis (OA), requiring additional costs and potential surgeries. Despite demonstrated ability to decrease injury rates through the use of neuromuscular training programs, the incidence of ACL injuries remains high. The technology developed here represents a translation of validated clinic-based training approach for ACL rehabilitation to a system more suited for widespread use for ACL prevention.
