Faculty of Health, Human Performance Research Centre and School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia.
Arsenal Football Club, London, United Kingdom.
J Athl Train. 2020 Sep 1;55(9):893-901. doi: 10.4085/1062-6050-501-19.
In part 2 of this clinical commentary, we highlight the conceptual and methodologic pitfalls evident in current training-load-injury research. These limitations make these studies unsuitable for determining how to use new metrics such as acute workload, chronic workload, and their ratio for reducing injury risk. The main overarching concerns are the lack of a conceptual framework and reference models that do not allow for appropriate interpretation of the results to define a causal structure. The lack of any conceptual framework also gives investigators too many degrees of freedom, which can dramatically increase the risk of false discoveries and confirmation bias by forcing the interpretation of results toward common beliefs and accepted training principles. Specifically, we underline methodologic concerns relating to (1) measure of exposures, (2) pitfalls of using ratios, (3) training-load measures, (4) time windows, (5) discretization and reference category, (6) injury definitions, (7) unclear analyses, (8) sample size and generalizability, (9) missing data, and (10) standards and quality of reporting. Given the pitfalls of previous studies, we need to return to our practices before this research influx began, when practitioners relied on traditional training principles (eg, overload progression) and adjusted training loads based on athletes' responses. Training-load measures cannot tell us whether the variations are increasing or decreasing the injury risk; we recommend that practitioners still rely on their expert knowledge and experience.
在本临床评论的第二部分，我们强调了当前训练负荷-损伤研究中明显存在的概念和方法学陷阱。这些局限性使得这些研究不适合确定如何使用新的指标，如急性工作量、慢性工作量及其比值来降低受伤风险。主要的总体关注点是缺乏概念框架和参考模型，这使得无法对结果进行适当解释以确定因果结构。缺乏任何概念框架也给研究人员太多的自由度，这可能会通过迫使结果的解释朝着共同的信念和公认的训练原则发展，从而极大地增加假发现和确认偏倚的风险。具体来说，我们强调了与（1）暴露测量、（2）使用比值的陷阱、（3）训练负荷测量、（4）时间窗口、（5）离散化和参考类别、（6）损伤定义、（7）分析不明确、（8）样本量和普遍性、（9）缺失数据以及（10）报告的标准和质量相关的方法学问题。鉴于先前研究的陷阱，我们需要回到这个研究热潮开始之前的实践，那时从业者依赖于传统的训练原则（例如，超负荷进展），并根据运动员的反应调整训练负荷。训练负荷测量并不能告诉我们这些变化是增加还是降低了受伤风险；我们建议从业者仍然依赖他们的专业知识和经验。
