McGuine Timothy A, Post Eric G, Hetzel Scott J, Brooks M Alison, Trigsted Stephanie, Bell David R
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
University of Wisconsin-Madison, Madison, Wisconsin, USA.
Am J Sports Med. 2017 Oct;45(12):2706-2712. doi: 10.1177/0363546517710213. Epub 2017 Jul 23.
Sport specialization is associated with an increased risk of musculoskeletal lower extremity injuries (LEIs) in adolescent athletes presenting in clinical settings. However, sport specialization and the incidence of LEIs have not been investigated prospectively in a large population of adolescent athletes.
To determine if sport specialization was associated with an increased risk of LEIs in high school athletes.
Cohort study; Level of evidence, 2.
Participants (interscholastic athletes in grades 9-12) were recruited from 29 Wisconsin high schools during the 2015-2016 school year. Participants completed a questionnaire identifying their sport participation and history of LEIs. Sport specialization of low, moderate, or high was determined using a previously published 3-point scale. Athletic trainers reported all LEIs that occurred during the school year. Analyses included group proportions, odds ratios (ORs) and 95% CIs, and days lost due to injury (median and interquartile range [IQR]). Multivariate Cox proportional hazard ratios (HRs) with 95% CIs were calculated to investigate the association between the incidence of LEIs and sport specialization level.
A total of 1544 participants (50.5% female; mean age, 16.1 ± 1.1 years) enrolled in the study, competed in 2843 athletic seasons, and participated in 167,349 athlete-exposures. Sport specialization was classified as low (59.5%), moderate (27.1%), or high (13.4%). Two hundred thirty-five participants (15.2%) sustained a total of 276 LEIs that caused them to miss a median of 7.0 days (IQR, 2.0-22.8). Injuries occurred most often to the ankle (34.4%), knee (25.0%), and upper leg (12.7%) and included ligament sprains (40.9%), muscle/tendon strains (25.4%), and tendinitis/tenosynovitis (19.6%). The incidence of LEIs for moderate participants was higher than for low participants (HR, 1.51 [95% CI, 1.04-2.20]; P = .03). The incidence of LEIs for high participants was higher than for low participants (HR, 1.85 [95% CI, 1.12-3.06]; P = .02).
Athletes with moderate or high sport specialization were more likely to sustain an LEI than athletes with low specialization. Sports medicine providers need to educate coaches, parents, and interscholastic athletes regarding the increased risk of LEIs for athletes who specialize in a single sport.
在临床环境中，运动专项化与青少年运动员下肢肌肉骨骼损伤（LEIs）风险增加相关。然而，尚未在大量青少年运动员群体中对运动专项化和LEIs发病率进行前瞻性研究。
确定运动专项化是否与高中运动员LEIs风险增加相关。
队列研究；证据等级，2级。
在2015 - 2016学年从威斯康星州的29所高中招募参与者（9 - 12年级的校际运动员）。参与者完成一份问卷，确定他们的运动参与情况和LEIs病史。使用先前公布的3分制确定低、中、高运动专项化程度。运动训练师报告学年期间发生的所有LEIs。分析包括组比例、优势比（ORs）和95%置信区间（CIs），以及因伤损失的天数（中位数和四分位间距[IQR]）。计算具有95% CIs的多变量Cox比例风险比（HRs），以研究LEIs发病率与运动专项化水平之间的关联。
共有1544名参与者（50.5%为女性；平均年龄，16.1±1.1岁）参与研究，参加了2843个运动赛季，进行了167,349次运动员暴露。运动专项化被分类为低（59.5%）、中（27.1%）或高（13.4%）。235名参与者（15.2%）共发生276次LEIs，导致他们缺课的中位数为7.0天（IQR，2.0 - 22.8）。损伤最常发生在脚踝（34.4%）、膝盖（25.0%）和大腿（12.7%），包括韧带扭伤（40.9%）、肌肉/肌腱拉伤（25.4%）和肌腱炎/腱鞘炎（19.6%）。中等专项化参与者的LEIs发病率高于低专项化参与者（HR，1.51[95% CI，1.04 - 2.20]；P = 0.03）。高专项化参与者的LEIs发病率高于低专项化参与者（HR，1.85[95% CI，1.12 - 3.06]；P = 0.02）。
与低专项化运动员相比，中等或高运动专项化的运动员更有可能发生LEIs。运动医学提供者需要就单项运动专项化运动员LEIs风险增加的问题对教练、家长和校际运动员进行教育。
