Leiden University Medical Centre, Dept. of Orthopaedics, Netherlands.
Leiden University Medical Centre, Dept. of Orthopaedics, Netherlands.
J Biomech. 2021 Jan 4;114:110084. doi: 10.1016/j.jbiomech.2020.110084. Epub 2020 Oct 24.
Injury prevalence in dancers is high, and misaligned turnout (TO) is claimed to bear injury risk. This systematic review aimed to investigate if compensating or forcing TO leads to musculoskeletal injuries. A systematic literature review was conducted according to the PRISMA Guidelines using the databases of PubMed, Embase, Emcare, Web of Science, Cochrane Library, Academic Search Premier, and ScienceDirect. Studies investigating the relationship between compensated or forced TO and injuries in all genders, all ages, and levels of dancers were included. Details on misaligned TO measurements and injuries had to be provided. Screening was performed by two researchers, data extraction and methodological quality assessment executed by one researcher and checked by another. 7 studies with 1293 dancers were included. Methodological quality was low due to study designs and a general lack of standardised definition of pathology and methods of assessment of misaligned TO. The studies investigating the lower extremities showed a hip-focus only. Non-hip contributors as well as their natural anatomical variations were not accounted for, limiting the understanding of injury mechanisms underlying misaligned TO. As such no definite conclusions on the effect of compensating or forcing TO on musculoskeletal injuries could be made. Total TO is dependent on complex motion cycles rather than generalised (hip) joint dominance only. Objective dual assessment of maximum passive joint range of motion through 3D kinematic analysis in combination with physical examination is needed to account for anatomical variations, locate sites prone to (overuse)injury, and investigate underlying injury mechanisms.
舞者的受伤率很高，而关节排列不齐（TO）据称存在受伤风险。本系统评价旨在探讨补偿或强制 TO 是否会导致肌肉骨骼损伤。根据 PRISMA 指南进行了系统的文献综述，使用了 PubMed、Embase、Emcare、Web of Science、Cochrane 图书馆、学术搜索高级版和 ScienceDirect 数据库。纳入了研究所有性别、所有年龄段和不同舞蹈水平的舞者中补偿或强制 TO 与损伤之间关系的研究。必须提供关于关节排列不齐的测量和损伤的详细信息。由两名研究人员进行筛选，由一名研究人员进行数据提取和方法学质量评估，并由另一名研究人员进行检查。纳入了 7 项研究，共 1293 名舞者。由于研究设计和对病理和关节排列不齐评估方法的标准化定义普遍缺乏，因此方法学质量较低。研究下肢的研究仅集中在髋关节。没有考虑到非髋关节的贡献者及其自然解剖学差异，限制了对关节排列不齐导致损伤机制的理解。因此，无法对补偿或强制 TO 对肌肉骨骼损伤的影响得出明确的结论。总 TO 取决于复杂的运动周期，而不仅仅是广义的（髋关节）关节优势。需要通过 3D 运动分析进行客观的双关节最大被动活动范围评估，并结合体格检查，以考虑到解剖学变异，找到易受伤（过度使用）的部位，并研究潜在的损伤机制。
