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板球运动员非接触性损伤的肌肉骨骼预测因素——寥寥无几?一项纵向队列研究。

Musculoskeletal predictors of non-contact injury in cricketers - Few and far between? A longitudinal cohort study.

作者信息

Olivier Benita, Gray Janine

机构信息

Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa.

Cricket South Africa, Cape Town, South Africa; Exercise Science Camp, Sports Medicine, University of Cape Town, Cape Town, South Africa.

出版信息

Phys Ther Sport. 2018 Nov;34:208-215. doi: 10.1016/j.ptsp.2018.10.014. Epub 2018 Oct 23.

Abstract

OBJECTIVE

To determine the musculoskeletal risk factors for injury amongst professional, domestic cricket players.

DESIGN

Longitudinal cohort study.

SETTING

Medical suites associated with the respective cricket franchises.

PARTICIPANTS

Professional, domestic cricket players (n = 97).

MAIN OUTCOME MEASURES

A pre-participatory musculoskeletal screening battery consisting of 21 tests including flexibility, neural tension, stability, strength, balance and pain provocation tests at the start of the cricket season. Non-contact, low back and lower limb (lower quarter) injuries were monitored throughout the season. Binary logistic regression and receiver operating curves were used to determine predictive value of each test.

RESULTS

During the course of the cricket season, 38 of the 97 (39.2%) cricketers sustained a non-contact low back and/or lower limb injury. Increased hip internal rotation ROM on the dominant side (OR = 1.065; p = 0.036), no symptoms on active slump dominant side (OR = 0.289; p = 0.014), decreased combined elevation (OR = 0.934; p = 0.029), increased shoulder internal rotation ROM on the non-dominant side (OR = 1.022; p = 0.035) and increased GIRD (glenohumeral internal rotation deficit) (OR = 1.026; p = 0.042) predicted in-season non-contact lower quarter injuries. Although statistically significant, none of these variables were strong predictors of injury as shown by the logistic regression models (accuracy in classification rate: 59.8-62.9%), the area under the curve (AUC) of the receiver operating characteristic (ROC) curves (AUC≤0.652) and the cut-off scores which revealed high sensitivity (68.4-86.8%), but low specificity (25.4-54.2%).

CONCLUSION

Although only a few of the many tests included in the battery showed predictive validity, the value of screening procedures should not be underestimated due to other benefits such as building patient rapport, identification of pre-existing injuries, establishing clinical and functional baselines upon which individualised management programmes can be based.

摘要

目的

确定职业和国内板球运动员受伤的肌肉骨骼危险因素。

设计

纵向队列研究。

地点

与各板球特许经营权相关的医疗套房。

参与者

职业和国内板球运动员(n = 97)。

主要观察指标

在板球赛季开始时进行的参与前肌肉骨骼筛查组套,包括21项测试,涵盖柔韧性、神经张力、稳定性、力量、平衡和疼痛激发测试。整个赛季监测非接触性的下背部和下肢(下半身)损伤。采用二元逻辑回归和受试者工作曲线来确定每项测试的预测价值。

结果

在板球赛季期间,97名板球运动员中有38名(39.2%)遭受了非接触性下背部和/或下肢损伤。优势侧髋关节内旋活动度增加(OR = 1.065;p = 0.036)、优势侧主动弯腰试验无症状(OR = 0.289;p = 0.014)、联合抬高减少(OR = 0.934;p = 0.029)、非优势侧肩关节内旋活动度增加(OR = 1.022;p = 0.035)以及盂肱内旋不足(GIRD)增加(OR = 1.026;p = 0.042)可预测赛季内非接触性下半身损伤。尽管具有统计学意义,但逻辑回归模型显示这些变量均不是强有力的损伤预测指标(分类准确率:59.8 - 62.9%),受试者工作特征(ROC)曲线的曲线下面积(AUC)(AUC≤0.652)以及临界值显示出高敏感性(68.4 - 86.8%),但特异性低(25.4 - 54.2%)。

结论

尽管组套中包含的众多测试中只有少数显示出预测有效性,但由于其他益处,如建立医患关系、识别既往损伤、建立个体化管理方案所依据的临床和功能基线等,筛查程序的价值不应被低估。

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