J Orthop Sports Phys Ther. 2020 Sep;50(9):476-489. doi: 10.2519/jospt.2020.9705. Epub 2020 Aug 1.
OBJECTIVE: To determine whether neuromuscular deficits in trunk and hip-related function are risk factors for athletic knee injuries. DESIGN: Etiology systematic review with meta-analysis. LITERATURE SEARCH: Six online databases (MEDLINE, Web of Science, Embase, CINAHL, Scopus, and SPORTDiscus) were searched up to April 2019. STUDY SELECTION CRITERIA: Studies assessing trunk and hip neuromuscular function as risk factors for knee injuries in healthy athletic populations were included. DATA SYNTHESIS: Outcomes were synthesized quantitatively using meta-analysis of odds ratios, and qualitatively using best-evidence synthesis. RESULTS: Twenty-one studies met the inclusion criteria. There was very low-certainty evidence that greater hip external rotation strength protected against knee injuries (odds ratio = 0.78; 95% confidence interval: 0.70, 0.87; <.05). There was limited evidence that deficits in trunk proprioception and neuromuscular control, and the combination of excessive knee valgus and ipsilateral trunk angle when landing unilaterally from a jump, may be risk factors for knee injuries. CONCLUSION: Most variables of trunk and hip function were not risk factors for injuries. Further research is required to confirm whether hip external rotation strength, trunk proprioception and neuromuscular control, and the combination of knee valgus angle and ipsilateral trunk control are risk factors for future knee injuries. .
目的:确定躯干和髋关节相关功能的神经肌肉缺陷是否是运动性膝关节损伤的危险因素。
设计:病因学系统评价和荟萃分析。
文献检索:2019 年 4 月前,在 6 个在线数据库(MEDLINE、Web of Science、Embase、CINAHL、Scopus 和 SPORTDiscus)中进行了检索。
研究选择标准:纳入评估躯干和髋关节神经肌肉功能作为健康运动人群膝关节损伤危险因素的研究。
数据综合:使用优势比的荟萃分析对结果进行定量综合,使用最佳证据综合对定性结果进行综合。
结果:有 21 项研究符合纳入标准。有非常低确定性证据表明,更大的髋关节外旋力量可以预防膝关节损伤(比值比=0.78;95%置信区间:0.70,0.87;<.05)。有有限的证据表明,躯干本体感觉和神经肌肉控制的缺陷,以及在从单侧跳跃落地时,同侧膝关节过度外翻和同侧躯干角度的结合,可能是膝关节损伤的危险因素。
结论:大多数躯干和髋关节功能的变量都不是损伤的危险因素。需要进一步研究以确定髋关节外旋力量、躯干本体感觉和神经肌肉控制以及膝关节外翻角度和同侧躯干控制的结合是否是未来膝关节损伤的危险因素。
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