Bridging the gap in ACL injury prevention with FAME: Field-based Athlete Motion Evaluation and simulation.

• Applicant: Professorin Dr. Anne Koelewijn
• Subject Area: Medical Physics, Biomedical Technology
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 520189992

Wider research context: There is a gap in research aimed at preventing anterior cruciate ligament (ACL) injuries in sports. Although promising ACL injury prevention exercise programs (IPEPs) have been developed, large-scale adoption and effective usage of these programs has been poor in the real-world. One reason for this gap is that the protective mechanisms underlying current ACL IPEPs are unclear, hindering the flexible implementation of these exercise programs in a given sports context. The ACL IPEP mechanisms remain unclear because the assessment of ACL loading during athletic movements – as an indirect measure of injury risk – is currently restricted to highly-constrained laboratory environments and thus not representative of ACL injury scenarios. The proposed project aims to bridge the gap in ACL injury prevention with FAME – field-based athlete motion evaluation and simulation: Objectives: 1) developing and validating FAME – a wearable system for the assessment of whole-body biomechanics including muscle and ACL forces during athletic movements (objectives 1&2), 2) applying FAME in a football environment to investigate the effects of a current ACL IPEP on movement strategies during real-world change-of-direction movements (CODs, objective 3), and 3) performing ‘virtual athlete’ experiments to identify future neuromuscular training targets to protect the ACL (objective 4). Methods: The FAME system will be able to reconstruct athlete movements based on a scaled, whole-body musculoskeletal model that tracks experimental inputs from wearable inertial measurement units and electromyography sensors in an optimal control simulation. The implementation of a knee ligament model will allow to estimate ACL forces. The system will be validated with respect to gold-standard optical motion capture in a laboratory environment (objective 1) and investigated for usability in a field-based environment (objective 2). Then, we will test the hypothesis that an 8-week ACL IPEP will lead to more effective movement and muscle activation strategies for limiting peak ACL forces during on-field COD movements during small-sided games in football players (objective 3). Finally, we will use predictive simulations to investigate even more effective movement and muscle activation strategies for limiting ACL forces during COD and identify neuromuscular model parameters supporting these strategies (objective 4). Level of originality: This will be the first study to estimate ACL forces during on-field athletic movements. In conjunction, our mixed approach including evidence from experiments and simulation will lead to the necessary understanding for a flexible implementation of ACL IPEPs at a larger scale but also provide new targets for more effective ACL injury prevention training.

• DFG Programme: Research Grants
• International Connection: Austria
• Partner Organisation: Fonds zur Förderung der wissenschaftlichen Forschung (FWF)
• Cooperation Partners: Professor Dr. Peter Federolf; Dr. Dieter Heinrich, Ph.D.; Dr. Maurice Mohr, Ph.D.