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青少年舞者外侧踝关节扭伤的内在预测因素:一项前瞻性队列研究。

Intrinsic predictors of lateral ankle sprain in adolescent dancers: a prospective cohort study.

作者信息

Hiller Claire E, Refshauge Kathryn M, Herbert Robert D, Kilbreath Sharon L

机构信息

School of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia.

出版信息

Clin J Sport Med. 2008 Jan;18(1):44-8. doi: 10.1097/JSM.0b013e31815f2b35.

Abstract

OBJECTIVE

To identify intrinsic predictors of lateral ankle sprain.

DESIGN

Prospective cohort study.

SETTING

A performing arts secondary school and a dance school.

PARTICIPANTS

One hundred fifteen adolescent dancers (94 female and 21 male) entered the study. One ankle of each dancer was randomly assigned to a test group (n = 114), and the other was assigned to a validation group (n = 112).

PREDICTORS

Eighteen measures, including age, dance history, previous ankle sprain, ankle and foot laxity and range of motion, and balance from test ankles were entered into a backwards stepwise Cox regression model. The model generated with the test group was used to predict ankle sprains in the validation group.

MAIN OUTCOME MEASURE

Time to first lateral ankle sprain.

RESULTS

An increased risk of sprain in the test group was predicted by younger age [hazard ratio (HR) = 0.65, 95% CI 0.45-0.94], previous sprain of the contralateral ankle (HR = 3.76, CI 1.24-11.40), increased passive inversion range (HR = 1.06, CI 1.00-1.12), and inability to balance on demipointe (HR = 3.75, CI 1.02-13.73). Of these predictors, only previous sprain of the contralateral ankle significantly predicted ankle sprain in the validation group (HR = 3.90, CI 1.49-10.22). The predictive accuracy of this variable was not strong (positive likelihood ratio of 2.01 and negative likelihood ratio of 0.45).

CONCLUSION

A history of previous lateral ankle sprain is associated with an increase in the risk of future sprain of the contralateral ankle.

摘要

目的

确定外侧踝关节扭伤的内在预测因素。

设计

前瞻性队列研究。

地点

一所表演艺术中学和一所舞蹈学校。

参与者

115名青少年舞者(94名女性和21名男性)参与了该研究。每位舞者的一只脚踝被随机分配到测试组(n = 114),另一只脚踝被分配到验证组(n = 112)。

预测因素

将18项测量指标,包括年龄、舞蹈史、既往踝关节扭伤情况、踝关节和足部的松弛度及活动范围,以及测试脚踝的平衡能力,纳入向后逐步Cox回归模型。用测试组生成的模型来预测验证组的踝关节扭伤情况。

主要观察指标

首次外侧踝关节扭伤的时间。

结果

测试组中,年龄较小[风险比(HR)= 0.65,95%可信区间(CI)0.45 - 0.94]、对侧踝关节既往扭伤(HR = 3.76,CI 1.24 - 11.40)、被动内翻范围增加(HR = 1.06,CI 1.00 - 1.12)以及无法在半脚尖站立时保持平衡(HR = 3.75,CI 1.02 - 13.73),均提示扭伤风险增加。在这些预测因素中,只有对侧踝关节既往扭伤在验证组中显著预测了踝关节扭伤(HR = 3.90,CI 1.49 - 10.22)。该变量的预测准确性不强(阳性似然比为2.01,阴性似然比为0.45)。

结论

既往外侧踝关节扭伤史与对侧踝关节未来扭伤风险增加相关。

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