Bertelsen M L, Hulme A, Petersen J, Brund R K, Sørensen H, Finch C F, Parner E T, Nielsen R O
Section for Sports Science, Department of Public Health, Aarhus University, Aarhus C, Denmark.
Australian Collaboration for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Vic., Australia.
Scand J Med Sci Sports. 2017 Nov;27(11):1170-1180. doi: 10.1111/sms.12883. Epub 2017 Apr 20.
The etiology of running-related injury is important to consider as the effectiveness of a given running-related injury prevention intervention is dependent on whether etiologic factors are readily modifiable and consistent with a biologically plausible causal mechanism. Therefore, the purpose of the present article was to present an evidence-informed conceptual framework outlining the multifactorial nature of running-related injury etiology. In the framework, four mutually exclusive parts are presented: (a) Structure-specific capacity when entering a running session; (b) structure-specific cumulative load per running session; (c) reduction in the structure-specific capacity during a running session; and (d) exceeding the structure-specific capacity. The framework can then be used to inform the design of future running-related injury prevention studies, including the formation of research questions and hypotheses, as well as the monitoring of participation-related and non-participation-related exposures. In addition, future research applications should focus on addressing how changes in one or more exposures influence the risk of running-related injury. This necessitates the investigation of how different factors affect the structure-specific load and/or the load capacity, and the dose-response relationship between running participation and injury risk. Ultimately, this direction allows researchers to move beyond traditional risk factor identification to produce research findings that are not only reliably reported in terms of the observed cause-effect association, but also translatable in practice.
考虑与跑步相关损伤的病因很重要，因为特定的与跑步相关损伤预防干预措施的有效性取决于病因因素是否易于改变且符合生物学上合理的因果机制。因此，本文的目的是提出一个基于证据的概念框架，概述与跑步相关损伤病因的多因素性质。在该框架中，提出了四个相互排斥的部分：(a) 开始跑步时特定结构的能力；(b) 每次跑步时特定结构的累积负荷；(c) 跑步过程中特定结构能力的下降；以及 (d) 超过特定结构的能力。然后，该框架可用于为未来与跑步相关损伤预防研究的设计提供信息，包括研究问题和假设的形成，以及对与参与相关和与不参与相关暴露的监测。此外，未来的研究应用应侧重于解决一种或多种暴露的变化如何影响与跑步相关损伤的风险。这需要研究不同因素如何影响特定结构的负荷和/或负荷能力，以及跑步参与与损伤风险之间的剂量反应关系。最终，这个方向使研究人员能够超越传统的风险因素识别，产生不仅在观察到的因果关联方面有可靠报告，而且在实践中可转化的研究结果。
