Hewett Timothy E, Ford Kevin R, Myer Gregory D
Cincinnati Children's Hospital, 3333 Burnet Avenue, MLC 10001, Cincinnati, OH 45229, USA.
Am J Sports Med. 2006 Mar;34(3):490-8. doi: 10.1177/0363546505282619. Epub 2005 Dec 28.
Female athletes have a 4 to 6 times higher incidence of anterior cruciate ligament injury than do male athletes participating in the same landing and pivoting sports. This greater risk of anterior cruciate ligament injury, coupled with a geometric increase in participation (doubling each decade), has led to a significant rise in anterior cruciate ligament injuries in female athletes. The gender gap in anterior cruciate ligament injury, combined with evidence that the underpinnings of this serious health problem are neuromuscular in nature, leads to the development of neuromuscular interventions designed to prevent injury. A systematic review of the published literature yielded 6 published interventions targeted toward anterior cruciate ligament injury prevention in female athletes. Four of 6 significantly reduced knee injury incidence, and 3 of 6 significantly reduced anterior cruciate ligament injury incidence in female athletes. A meta-analysis of these 6 studies demonstrates a significant effect of neuromuscular training programs on anterior cruciate ligament injury incidence in female athletes (test for overall effect, Z = 4.31, P < .0001). Examination of the similarities and differences between the training regimens gives insight into the development of more effective and efficient interventions. The purpose of this "Current Concepts" review is to highlight the relative effectiveness of these interventions in reducing anterior cruciate ligament injury rates and to evaluate the common training components between the training studies. In addition, the level of rigor of these interventions, the costs and the difficulty of implementation, the compliance with these interventions, and the performance benefits are discussed. This review summarizes conclusions based on evidence from the common components of the various interventions to discuss their potential to reduce anterior cruciate ligament injury risk and assess their potential for combined use in more effective and efficient intervention protocols.
在参与相同的落地和转身运动项目时，女性运动员前交叉韧带损伤的发生率比男性运动员高4至6倍。前交叉韧带损伤风险更高，再加上参与人数呈几何级数增长（每十年翻一番），导致女性运动员前交叉韧带损伤的数量大幅上升。前交叉韧带损伤方面的性别差异，再加上有证据表明这一严重健康问题的根源本质上是神经肌肉方面的，促使人们开发旨在预防损伤的神经肌肉干预措施。对已发表文献进行的系统综述得出了6种针对女性运动员预防前交叉韧带损伤的已发表干预措施。其中6种中有4种显著降低了膝关节损伤发生率，6种中有3种显著降低了女性运动员前交叉韧带损伤发生率。对这6项研究的荟萃分析表明，神经肌肉训练计划对女性运动员前交叉韧带损伤发生率有显著影响（总体效应检验，Z = 4.31，P < .0001）。研究这些训练方案之间的异同，有助于深入了解如何开发更有效、更高效的干预措施。本“当前概念”综述的目的是强调这些干预措施在降低前交叉韧带损伤率方面的相对有效性，并评估训练研究之间的共同训练组成部分。此外，还讨论了这些干预措施的严格程度、成本和实施难度、对这些干预措施的依从性以及性能效益。本综述总结了基于各种干预措施共同组成部分的证据得出的结论，以讨论它们降低前交叉韧带损伤风险的潜力，并评估它们在更有效、更高效的干预方案中联合使用的潜力。
