运动表现作为儿童下肢损伤的风险因素
Motor Performance as Risk Factor for Lower Extremity Injuries in Children.
作者信息
Larsen Lisbeth Runge, Kristensen Peter Lund, Junge Tina, Møller Signe Fuglkjær, Juul-Kristensen Birgit, Wedderkopp Niels
机构信息
1University of Southern Denmark, Institute of Regional Health Services Research, Odense, DENMARK; 2Research and Development, Center for Human Movement and Learning, University College Lillebaelt, Odense, DENMARK; 3University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics, Odense, DENMARK; 4Department of Physiotherapy, University College Lillebaelt, Odense, DENMARK; 5Health Sciences Research Centre, University College Lillebaelt, Odense, DENMARK; 6Bergen University College, Institute of Occupational Therapy, Physiotherapy and Radiography, Department of Health Sciences, Bergen, NORWAY; 7Sports Medicine Clinic, Orthopaedic Dep. Hospital of Lillebaelt, Vejle, DENMARK; 8Department of Psychology and Exercise Science, Murdoch University, Perth, AUSTRALIA.
出版信息
Med Sci Sports Exerc. 2016 Jun;48(6):1136-43. doi: 10.1249/MSS.0000000000000877.
PURPOSE
Physical activity-related injuries in children constitute a costly public health matter. The influence of motor performance on injury risk is unclear. The purpose of this study was to examine if motor performance was a risk factor of traumatic and overuse lower extremity injuries in a normal population of children.
METHODS
This study included 1244 participants from 8 to 14 yr old at baseline, all participating in the "Childhood Health, Activity and Motor Performance School Study Denmark." The follow-up period was up to 15 months. The motor performance tests were static balance, single leg hop for distance, core stability tests, vertical jump, shuttle run, and cardiorespiratory fitness test. Lower extremity injuries were registered by clinicians using weekly questionnaires and classified according to the International Classification of Diseases, 10th Revision, system.
RESULTS
Poor balance increased the risk for traumatic injury in the foot region (incidence rate ratio [IRR] = 1.09-1.15), and good performance in single leg hop for distance protected against traumatic knee injuries (IRR = 0.66-0.68). Good performance in core stability tests and vertical jump increased the risk for traumatic injuries in the foot region (IRR = 1.12-1.16). Poor balance increased the risk for overuse injuries in the foot region (IRR = 1.65), as did good performance in core stability tests and shuttle run, especially for knee injuries (IRR = 1.07-1.18).
CONCLUSIONS
Poor balance (sway) performance was a consistent predictor of traumatic injuries, in particular, for traumatic ankle injuries. Good motor performance (core stability, vertical jump, and shuttle run) was positively associated with traumatic and overuse injuries and negatively (single leg hop) associated with traumatic injuries, indicating different influences on injury risk. Previous injury was a confounder affecting the effect size and the significance. More studies are needed to consolidate the findings, to clarify the influence of different performance tests on different types of injuries, and to examine the influence of behavior in relation to injury risk.
目的
儿童与体育活动相关的损伤构成了一个代价高昂的公共卫生问题。运动表现对损伤风险的影响尚不清楚。本研究的目的是检验运动表现是否是正常儿童群体中下肢创伤性和过度使用性损伤的危险因素。
方法
本研究纳入了1244名基线年龄在8至14岁的参与者，他们均参与了“丹麦儿童健康、活动与运动表现学校研究”。随访期长达15个月。运动表现测试包括静态平衡、单腿跳远距离、核心稳定性测试、垂直跳、穿梭跑和心肺适能测试。临床医生使用每周问卷记录下肢损伤情况，并根据国际疾病分类第10版系统进行分类。
结果
平衡能力差会增加足部区域创伤性损伤的风险（发病率比[IRR]=1.09 - 1.15），而单腿跳远距离表现良好可预防创伤性膝关节损伤（IRR = 0.66 - 0.68）。核心稳定性测试和垂直跳表现良好会增加足部区域创伤性损伤的风险（IRR = 1.12 - 1.16）。平衡能力差会增加足部区域过度使用性损伤的风险（IRR = 1.65），核心稳定性测试和穿梭跑表现良好也会增加这种风险，尤其是膝关节损伤（IRR = 1.07 - 1.18）。
结论
平衡能力差（晃动）是创伤性损伤的一致预测因素，尤其是创伤性踝关节损伤。良好的运动表现（核心稳定性、垂直跳和穿梭跑）与创伤性和过度使用性损伤呈正相关，与创伤性损伤呈负相关（单腿跳），表明对损伤风险有不同影响。既往损伤是一个影响效应大小和显著性的混杂因素。需要更多研究来巩固这些发现，阐明不同表现测试对不同类型损伤的影响，并研究行为与损伤风险的关系。
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