髋关节损伤预防训练对女性篮球运动员前交叉韧带损伤减少的效果：一项 12 年的前瞻性干预研究。
Effect of Hip-Focused Injury Prevention Training for Anterior Cruciate Ligament Injury Reduction in Female Basketball Players: A 12-Year Prospective Intervention Study.
机构信息
Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan.
Department of Rehabilitation, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan.
出版信息
Am J Sports Med. 2018 Mar;46(4):852-861. doi: 10.1177/0363546517749474. Epub 2018 Jan 23.
BACKGROUND
Programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players are scarce. Also, ACL injury prevention training that focuses on hip joint function has not been reported.
PURPOSE
To determine the effectiveness of a hip-focused ACL injury prevention program in female basketball players.
STUDY DESIGN
Cohort study; Level of evidence, 2.
METHODS
A prospective intervention study was conducted for 12 years. Incidence rates of ACL injuries were collected in the first 4 years (observation period) from college female basketball players. After the observation period, a hip-focused ACL injury prevention program was implemented for 8 years (intervention period). A total of 309 players (mean ± SD age, 19.6 ± 1.2 years; height, 163.7 ± 5.6 cm; weight, 59.1 ± 5.1 kg; body mass index, 22.0 ± 1.4) were tracked in the observation period and compared with 448 players (age, 19.6 ± 1.1 years; height, 162.6 ± 5.8 cm; weight, 58.0 ± 5.7 kg; body mass index, 21.9 ± 1.5) who participated in the intervention period. Athlete-exposures (AEs), ACL numbers and mechanisms of injury (MOIs), relative risk (RR), absolute risk reduction (ARR), numbers needed to treat (NNT), and compliance were analyzed.
RESULTS
There were 16 ACL injuries (13 noncontact MOIs) in the 4-year observation period, whereas 9 ACL injuries (8 noncontact MOIs) were recorded in the 8-year intervention period. The overall ACL injury incidence was 0.25/1000 AEs in the 4-year observation period compared with 0.10/1000 AEs in the 8-year intervention period, respectively. Compared with the 4-year observation period, significant RR reduction was observed (0.38; 95% CI, 0.17-0.87; P = .017) with ARR and NNT of 0.032 (95% CI, 0.027-0.037) and 31.6 (95% CI, 27.1-37.7), respectively, in the 8-year intervention period. The noncontact ACL injury incidence was 0.21 per 1000 AEs during the 4-year observation period compared with 0.08/1000 AEs in the 8-year intervention period, which also showed significant RR reduction (0.37; 95% CI, 0.15-0.92; P = .026), with ARR and NNT of 0.024 (95% CI, 0.020-0.029) and 41.3 (95% CI, 34.6-51.3), respectively. The mean compliance rate during the intervention periods (8 years) was 89%.
CONCLUSION
A hip-focused injury prevention program demonstrated significant reduction in the incidence of ACL injury in female collegiate basketball players.
背景
针对女性篮球运动员前交叉韧带（ACL）损伤的预防计划很少。此外，还没有报道过专门针对髋关节功能的 ACL 损伤预防训练。
目的
确定针对女性篮球运动员的髋关节为重点的 ACL 损伤预防计划的有效性。
研究设计
队列研究；证据水平，2 级。
方法
进行了为期 12 年的前瞻性干预研究。在最初的 4 年（观察期）中收集了大学女子篮球运动员 ACL 损伤的发生率。在观察期之后，实施了为期 8 年的以髋关节为重点的 ACL 损伤预防计划（干预期）。在观察期内共跟踪了 309 名运动员（平均年龄±标准差，19.6±1.2 岁；身高，163.7±5.6cm；体重，59.1±5.1kg；体重指数，22.0±1.4），并与 448 名运动员（年龄，19.6±1.1 岁；身高，162.6±5.8cm；体重，58.0±5.7kg；体重指数，21.9±1.5）进行了比较，这些运动员参加了干预期。分析了运动员暴露量（AE）、ACL 数量和损伤机制（MOI）、相对风险（RR）、绝对风险降低（ARR）、需要治疗的人数（NNT）和依从性。
结果
在 4 年的观察期内，共有 16 例 ACL 损伤（13 例非接触性 MOI），而在 8 年的干预期内，有 9 例 ACL 损伤（8 例非接触性 MOI）。在 4 年的观察期内，ACL 损伤总发生率为 0.25/1000 AE，而在 8 年的干预期内，ACL 损伤总发生率为 0.10/1000 AE。与 4 年观察期相比，干预期的 RR 显著降低（0.38；95%CI，0.17-0.87；P=0.017），ARR 和 NNT 分别为 0.032（95%CI，0.027-0.037）和 31.6（95%CI，27.1-37.7）。在 4 年的观察期内，非接触性 ACL 损伤的发生率为 0.21/1000 AE，而在 8 年的干预期内，非接触性 ACL 损伤的发生率为 0.08/1000 AE，RR 也显著降低（0.37；95%CI，0.15-0.92；P=0.026），ARR 和 NNT 分别为 0.024（95%CI，0.020-0.029）和 41.3（95%CI，34.6-51.3）。干预期间（8 年）的平均依从率为 89%。
结论
针对女性大学生篮球运动员的髋关节为重点的损伤预防计划可显著降低 ACL 损伤的发生率。
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