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跑步者胫骨应力性骨折回顾性研究的生物力学预测因素

Biomechanical predictors of retrospective tibial stress fractures in runners.

作者信息

Pohl Michael B, Mullineaux David R, Milner Clare E, Hamill Joseph, Davis Irene S

机构信息

Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA.

出版信息

J Biomech. 2008;41(6):1160-5. doi: 10.1016/j.jbiomech.2008.02.001. Epub 2008 Apr 2.

Abstract

Both kinematics and kinetics of the lower limb have been shown separately to be related with a history of tibial stress fractures (TSFs) in female runners. However, it is likely that these factors interact together to increase the risk of a TSF. This study was conducted to determine which combination of kinematic and kinetic factors are the best predictors of retrospective TSF in female distance runners. Total 30 female runners who had previously sustained a TSF were recruited, along with an age and mileage matched control group (n=30). Subjects ran overground at 3.7m/s while kinematic and kinetic data were recorded. Five trials from each subject were used for data analysis and ensemble means were calculated for both groups. The kinematic variables of peak hip adduction (HADD), peak knee internal rotation (KIR) and knee adduction (KADD), peak rearfoot eversion (RFEV) were entered into a binary logistic regression along with the kinetic variables of vertical instantaneous load rate (VILR) and absolute free moment (FM). The variables HADD, FM and RFEV were able to correctly predict a history of TSF in 83% of cases. Increases in HADD, FM and RFEV (odds ratios of 1.29, 1.37 and 1.18) were associated with an elevated risk of having a history of TSF. The addition of VILR, KIR and KADD did not improve the ability to predict previous injury. Based on these results, HADD, FM and RFEV appear to be the most important of the variables of interest in terms of predicting retrospective TSF in female runners.

摘要

下肢的运动学和动力学因素已分别被证明与女性跑步者的胫骨应力性骨折(TSF)病史有关。然而,这些因素可能共同作用,增加TSF的风险。本研究旨在确定运动学和动力学因素的哪些组合是女性长跑运动员回顾性TSF的最佳预测指标。共招募了30名曾患TSF的女性跑步者,以及一个年龄和里程匹配的对照组(n = 30)。受试者以3.7m/s的速度在地面上跑步,同时记录运动学和动力学数据。每个受试者的五次试验用于数据分析,并计算两组的总体平均值。将峰值髋内收(HADD)、峰值膝内旋(KIR)、膝内收(KADD)、峰值后足外翻(RFEV)等运动学变量与垂直瞬时负荷率(VILR)和绝对自由力矩(FM)等动力学变量一起纳入二元逻辑回归分析。变量HADD、FM和RFEV能够在83%的病例中正确预测TSF病史。HADD、FM和RFEV的增加(优势比分别为1.29、1.37和1.18)与有TSF病史的风险升高相关。加入VILR、KIR和KADD并没有提高预测既往损伤的能力。基于这些结果,就预测女性跑步者回顾性TSF而言,HADD、FM和RFEV似乎是最重要的相关变量。

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