Clifton Daniel R, Koldenhoven Rachel M, Hertel Jay, Onate James A, Dompier Thomas P, Kerr Zachary Y
Division of Athletic Training, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
Department of Kinesiology, Curry School of Education, University of Virginia, Charlottesville, Virginia, USA.
Am J Sports Med. 2017 Feb;45(2):417-425. doi: 10.1177/0363546516667914. Epub 2016 Oct 8.
Variations in ankle injury rates and distributions among competition levels are unclear, but such data may help inform strategies to prevent ankle sprains during American football.
To describe the epidemiological patterns of ankle sprains in youth, high school (HS), and collegiate American football.
Descriptive epidemiological study.
Data regarding youth, HS, and college football athletes were collected from 3 injury surveillance programs: (1) the Youth Football Safety Study (YFSS), (2) the National Athletic Treatment, Injury and Outcomes Network (NATION), and (3) the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). During the 2012-2014 seasons, the YFSS, NATION, and NCAA ISP included 310, 184, and 71 football team-seasons, respectively. Athletic trainers (ATs) attended each practice and game and reported injuries and athlete-exposures (AEs) via their preferred injury documentation application. Ankle sprain rates for each type of ankle sprain were calculated overall, by event type (ie, practices and games), and specifically for severe injuries (ie, participation restriction time >21 days) and recurrent injuries (as defined by ATs). Rate ratios (RRs) were used to compare ankle sprain rates by competition level and event type. Injury proportion ratios (IPRs) were used to compare differences in severity, surgical needs, recurrence, injury mechanism, and injury activity by competition level. RRs and IPRs with 95% confidence intervals excluding 1.00 were considered statistically significant.
A total of 124, 897, and 643 ankle sprains were reported in youth, HS, and college football, respectively. This led to respective rates of 0.59, 0.73, and 1.19 sprains per 1000 AEs. The ankle sprain rate in college football was higher than the rates in HS (RR = 1.64; 95% CI, 1.48-1.82) and youth (RR = 2.01; 95% CI, 1.65-2.43) football. The proportion of ankle sprains that were recurrent in youth football was higher than the proportions in HS (IPR = 2.73; 95% CI, 1.68-4.50) and college (IPR = 2.19; 95% CI, 1.33-3.61) football.
Ankle sprain rates were highest in college athletes. However, level-specific variations in ankle sprain severity and recurrence may highlight the need to develop level-specific policies and prevention strategies to reduce injury incidence.
踝关节损伤率及在不同竞技水平间的分布差异尚不清楚，但此类数据可能有助于为美式橄榄球运动中预防踝关节扭伤的策略提供参考。
描述青少年、高中（HS）和大学美式橄榄球运动中踝关节扭伤的流行病学模式。
描述性流行病学研究。
从3个损伤监测项目收集有关青少年、高中和大学橄榄球运动员的数据：（1）青少年橄榄球安全研究（YFSS），（2）国家运动治疗、损伤与结果网络（NATION），以及（3）全国大学体育协会（NCAA）损伤监测项目（ISP）。在2012 - 2014赛季，YFSS、NATION和NCAA ISP分别涵盖310、184和71个橄榄球队赛季。运动训练师（AT）参与每次训练和比赛，并通过他们首选的损伤记录应用程序报告损伤情况和运动员暴露次数（AE）。计算每种类型踝关节扭伤的总体发生率、按赛事类型（即训练和比赛）计算的发生率，以及专门针对严重损伤（即参与受限时间>21天）和复发性损伤（由AT定义）的发生率。率比（RR）用于比较不同竞技水平和赛事类型的踝关节扭伤发生率。损伤比例比（IPR）用于比较不同竞技水平在严重程度、手术需求、复发情况、损伤机制和损伤活动方面的差异。RR和IPR的95%置信区间不包括1.00被认为具有统计学意义。
青少年、高中和大学橄榄球运动中分别报告了124、897和643例踝关节扭伤。这导致每1000次AE的扭伤发生率分别为0.59、0.73和1.19。大学橄榄球运动中的踝关节扭伤发生率高于高中（RR = 1.64；95%CI，1.48 - 1.82）和青少年（RR = 2.01；95%CI，1.65 - 2.43）橄榄球运动。青少年橄榄球运动中踝关节扭伤的复发比例高于高中（IPR = 2.73；95%CI，1.68 - 4.50）和大学（IPR = 2.19；95%CI，1.33 - 3.61）橄榄球运动。
大学运动员的踝关节扭伤发生率最高。然而，踝关节扭伤严重程度和复发情况的特定水平差异可能凸显出制定特定水平政策和预防策略以降低损伤发生率的必要性。
