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近端神经肌肉控制可预防男性足球运动员的腘绳肌损伤:一项在最大冲刺过程中进行肌电图时间序列分析的前瞻性研究。

Proximal Neuromuscular Control Protects Against Hamstring Injuries in Male Soccer Players: A Prospective Study With Electromyography Time-Series Analysis During Maximal Sprinting.

作者信息

Schuermans Joke, Danneels Lieven, Van Tiggelen Damien, Palmans Tanneke, Witvrouw Erik

机构信息

Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.

出版信息

Am J Sports Med. 2017 May;45(6):1315-1325. doi: 10.1177/0363546516687750. Epub 2017 Mar 1.

Abstract

BACKGROUND

With their unremittingly high incidence rate and detrimental functional repercussions, hamstring injuries remain a substantial problem in male soccer. Proximal neuromuscular control ("core stability") is considered to be of key importance in primary and secondary hamstring injury prevention, although scientific evidence and insights on the exact nature of the core-hamstring association are nonexistent at present.

HYPOTHESIS

The muscle activation pattern throughout the running cycle would not differ between participants based on injury occurrence during follow-up.

STUDY DESIGN

Case-control study; Level of evidence, 3.

METHODS

Sixty amateur soccer players participated in a multimuscle surface electromyography (sEMG) assessment during maximal acceleration to full-speed sprinting. Subsequently, hamstring injury occurrence was registered during a 1.5-season follow-up period. Hamstring, gluteal, and trunk muscle activity time series during the airborne and stance phases of acceleration were evaluated and statistically explored for a possible causal association with injury occurrence and absence from sport during follow-up.

RESULTS

Players who did not experience a hamstring injury during follow-up had significantly higher amounts of gluteal muscle activity during the front swing phase ( P = .027) and higher amounts of trunk muscle activity during the backswing phase of sprinting ( P = .042). In particular, the risk of sustaining a hamstring injury during follow-up lowered by 20% and 6%, with a 10% increment in normalized muscle activity of the gluteus maximus during the front swing and the trunk muscles during the backswing, respectively ( P < .024).

CONCLUSION

Muscle activity of the core unit during explosive running appeared to be associated with hamstring injury occurrence in male soccer players. Higher amounts of gluteal and trunk muscle activity during the airborne phases of sprinting were associated with a lower risk of hamstring injuries during follow-up. Hence, the present results provide a basis for improved, evidence-based rehabilitation and prevention, particularly focusing on increasing neuromuscular control of the gluteal and trunk muscles during sport-specific activities (eg, sprint drills, agility drills).

摘要

背景

由于其持续高发的发病率以及对功能的不利影响,腘绳肌损伤在男子足球运动中仍然是一个严重的问题。近端神经肌肉控制(“核心稳定性”)被认为在腘绳肌原发性和继发性损伤的预防中至关重要,尽管目前关于核心与腘绳肌关联的确切性质的科学证据和见解尚不存在。

假设

根据随访期间的损伤发生情况,参与者在整个跑步周期中的肌肉激活模式不会有所不同。

研究设计

病例对照研究;证据等级,3级。

方法

60名业余足球运动员在从最大加速度到全速冲刺的过程中参与了多肌肉表面肌电图(sEMG)评估。随后,在1.5个赛季的随访期内记录腘绳肌损伤的发生情况。对加速过程中空中和支撑阶段的腘绳肌、臀肌和躯干肌肉活动时间序列进行评估,并进行统计学探索,以寻找与随访期间损伤发生和缺赛可能存在的因果关系。

结果

在随访期间未发生腘绳肌损伤的运动员在前摆阶段的臀肌活动量显著更高(P = 0.027),在冲刺后摆阶段的躯干肌肉活动量更高(P = 0.042)。特别是,随访期间发生腘绳肌损伤的风险分别降低了20%和6%,臀大肌在前摆阶段和躯干肌肉在后摆阶段的标准化肌肉活动分别增加了10%(P < 0.024)。

结论

在爆发性跑步过程中,核心单元的肌肉活动似乎与男子足球运动员腘绳肌损伤的发生有关。冲刺空中阶段较高的臀肌和躯干肌肉活动量与随访期间较低的腘绳肌损伤风险相关。因此,目前的结果为改进基于证据的康复和预防提供了依据,尤其侧重于在特定运动活动(如冲刺训练、敏捷训练)中增加对臀肌和躯干肌肉的神经肌肉控制。

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