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有髋部和腹股沟症状或既往损伤的职业足球运动员,其髋关节活动范围较低,与凸轮畸形无关。

Hip Range of Motion Is Lower in Professional Soccer Players With Hip and Groin Symptoms or Previous Injuries, Independent of Cam Deformities.

作者信息

Tak Igor, Glasgow Philip, Langhout Rob, Weir Adam, Kerkhoffs Gino, Agricola Rintje

机构信息

Sports Rehabilitation and Manual Therapy Department, Physiotherapy Utrecht Oost, Utrecht, the Netherlands Department of Orthopaedics, Academic Medical Centre, Amsterdam, the Netherlands Academic Centre for Evidence based Sports Medicine (ACES), Amsterdam, the Netherlands Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, the Netherlands

Sports Institute of Northern Ireland, Belfast, Northern Ireland Sports Medicine Department, Ulster University, Belfast, Northern Ireland.

出版信息

Am J Sports Med. 2016 Mar;44(3):682-8. doi: 10.1177/0363546515617747. Epub 2015 Dec 16.

Abstract

BACKGROUND

Soccer (football) players often have hip and groin symptoms (HGS), and a previous groin injury is a risk factor for a relapse. Decreased hip range of motion (HROM) has been related to both hip and groin pain and the presence of a cam deformity. How these factors interact is unknown.

PURPOSE

The first aim was to study whether HGS are associated with HROM. The second aim was to study the association of the presence of a cam deformity with HROM. Additionally, the influence of a cam deformity on the relationship between HGS and HROM was examined.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

Seasonal screening data of 2 professional soccer clubs were used. Variables for HGS were current hip or groin pain, the Copenhagen Hip and Groin Outcome Score (HAGOS), and previous hip- and groin-related time-loss injuries (HGTIs). HROM was determined for hip internal rotation (IR), external rotation, and total rotation (TR) in the supine position and for the bent knee fall out (BKFO) test. A cam deformity was defined by an alpha angle >60° on standardized anteroposterior pelvic and frog-leg lateral radiographs.

RESULTS

Sixty players (mean [±SD] age, 23.1 ± 4.2 years) were included. All were noninjured at the time of screening. Current hip or groin pain was not associated with HROM. Hips of players in the lowest HAGOS interquartile range (thus most affected by complaints; n = 12) showed less IR (23.9° ± 8.7° vs 28.9° ± 7.8°, respectively; P = .036) and TR (58.2° ± 13.5° vs 65.6° ± 11.8°, respectively; P = .047) than those in the highest interquartile range (n = 29). No such differences were found for BKFO (P = .417). Hips of players with a previous HGTI showed less IR (21.1° ± 6.8° vs 28.3° ± 8.9°, respectively; P < .001) and TR (56.0° ± 8.2° vs 64.5° ± 13.6°, respectively; P < .001) than those without a previous HGTI. This was independent of the presence of a cam deformity. BKFO did not differ between groups (P = .983). Hips with a cam deformity showed less but nonsignificant IR (25.5° ± 10.3° vs 29.0° ± 7.1°, respectively; P = .066) and TR (P = .062) and higher but nonsignificant BKFO values (17.1 cm ± 3.4 cm vs 14.2 cm ± 4.6 cm, respectively; P = .078) than those without a cam deformity.

CONCLUSION

Decreased HROM in professional soccer players is associated with more hip- and groin-related symptoms and with previous injuries, independent of the presence of a cam deformity.

摘要

背景

足球运动员经常出现髋部和腹股沟症状(HGS),既往腹股沟损伤是复发的危险因素。髋关节活动范围(HROM)减小与髋部和腹股沟疼痛以及凸轮畸形的存在有关。这些因素如何相互作用尚不清楚。

目的

第一个目的是研究HGS是否与HROM相关。第二个目的是研究凸轮畸形的存在与HROM的关联。此外,还研究了凸轮畸形对HGS与HROM之间关系的影响。

研究设计

横断面研究;证据等级,3级。

方法

使用了2个职业足球俱乐部的季节性筛查数据。HGS的变量包括当前的髋部或腹股沟疼痛、哥本哈根髋部和腹股沟结果评分(HAGOS)以及既往与髋部和腹股沟相关的失能性损伤(HGTIs)。在仰卧位测定髋关节内旋(IR)、外旋和总旋转(TR)以及屈膝外展试验(BKFO)的HROM。通过标准化的骨盆前后位和蛙腿侧位X线片上α角>60°定义凸轮畸形。

结果

纳入60名运动员(平均[±标准差]年龄,23.1±4.2岁)。所有运动员在筛查时均未受伤。当前的髋部或腹股沟疼痛与HROM无关。HAGOS四分位间距最低范围(即受症状影响最严重;n = 12)的运动员的髋关节IR(分别为23.9°±8.7°和28.9°±7.8°;P = 0.036)和TR(分别为58.2°±13.5°和65.6°±11.8°;P = 0.047)低于四分位间距最高范围(n = 29)的运动员。BKFO未发现此类差异(P = 0.417)。既往有HGTI的运动员的髋关节IR(分别为21.1°±6.8°和28.3°±8.9°;P < 0.001)和TR(分别为56.0°±8.2°和64.5°±13.6°;P < 0.001)低于无既往HGTI的运动员。这与凸轮畸形的存在无关。两组之间BKFO无差异(P = 0.983)。有凸轮畸形的髋关节的IR(分别为25.5°±10.3°和29.0°±7.1°;P = 0.066)和TR(P = 0.062)略低但无统计学意义,BKFO值略高但无统计学意义(分别为17.1 cm±3.4 cm和14.2 cm±4.6 cm;P = 0.078)。

结论

职业足球运动员HROM降低与更多的髋部和腹股沟相关症状以及既往损伤有关,与凸轮畸形的存在无关。

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