Winter Sara, Gordon Susan, Watt Kerrianne
Department of Physiotherapy, James Cook University, Townsville, Queensland, Australia -
School of Health Sciences, Flinders University, Bedford Park, Australia.
J Sports Med Phys Fitness. 2017 Jun;57(6):887-899. doi: 10.23736/S0022-4707.16.06339-8. Epub 2016 Apr 13.
Understanding kinematic and kinetic changes with fatigue during running is important to assess changes that may influence performance and injury. The aim of this systematic review was to identify, critique and summarize literature about the effects of fatigue on kinematics and kinetics during a fatiguing overground run and present the reported influence on performance and injury.
An electronic search was conducted of MEDLINE, SPORTDiscus, CINAHL and PubMed databases. Two reviewers assessed articles for inclusion, and evaluated the quality of articles included using a modified version of the Downs and Black Quality Index.
A total of twelve articles were identified for review. The mean quality assessment score was seven out of a possible 12. Kinematic and kinetic changes reported to affect performance included decreased speed, step or stride frequency and length, increased trunk flexion, lower leg position at heel strike, mediolateral acceleration, changes in hip and knee ranges, and decreased stride regularity, heel lift, maximum knee rotation and backward ankle velocity. Alterations reported to increase risk of injury included decreased step frequency, increased upper body rotation and lower leg position at heel strike, and decreased knee flexion during stance. Reduced risk of injury has been linked to decreased step length and hip ranges, and increased trunk flexion.
This review found limited evidence regarding changes in kinematic and kinetic during a fatiguing run in relation to performance and injury. Higher quality studies are warranted, with a larger sample of homogenous runners, and type of run carefully selected to provide quality information for runners, coaches and clinicians.
了解跑步过程中疲劳状态下的运动学和动力学变化对于评估可能影响运动表现和受伤风险的变化至关重要。本系统评价的目的是识别、批判性评价和总结关于疲劳对地面疲劳跑运动学和动力学影响的文献，并呈现所报道的对运动表现和受伤风险的影响。
对MEDLINE、SPORTDiscus、CINAHL和PubMed数据库进行了电子检索。两名评审员评估文章是否纳入，并使用修改后的唐斯和布莱克质量指数评估纳入文章的质量。
共识别出12篇文章进行综述。平均质量评估得分为满分12分中的7分。据报道，影响运动表现的运动学和动力学变化包括速度降低、步频或步幅频率及长度减小、躯干前屈增加、足跟触地时小腿位置、内外侧加速度、髋部和膝部活动范围变化，以及步幅规律性、足跟抬起、最大膝关节旋转和踝关节后向速度降低。据报道，增加受伤风险的改变包括步频降低、上身旋转增加和足跟触地时小腿位置，以及站立时膝关节屈曲减少。受伤风险降低与步幅长度和髋部活动范围减小以及躯干前屈增加有关。
本综述发现，关于疲劳跑过程中运动学和动力学变化与运动表现和受伤风险之间关系的证据有限。需要开展更高质量的研究，纳入更多同质跑步者样本，并仔细选择跑步类型，以便为跑步者、教练和临床医生提供高质量信息。
