Chia Lionel, Myer Gregory D, Hewett Timothy E, McKay Marnee J, Sullivan Justin, Ford Kevin R, Pappas Evangelos
Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
Emory Sport Performance and Research Center, USA; Emory Sports Medicine Center, USA; Department of Orthopaedics, Emory University School of Medicine, USA; The Micheli Center for Sports Injury Prevention, USA.
J Sci Med Sport. 2021 Dec;24(12):1290-1295. doi: 10.1016/j.jsams.2021.07.011. Epub 2021 Aug 3.
Young female athletes involved in high-speed cutting and change-of-direction sports are particularly susceptible to anterior cruciate ligament (ACL) injuries. Little is known if maturational changes in cutting technique contribute to the increased injury risk. Our objective was to examine longitudinal changes in cutting kinematics in female athletes as they matured through puberty.
Longitudinal cohort study METHODS: High school female athletes (n=172) performed an unanticipated 45° cutting task in the biomechanics laboratory across two or more pubertal stages. Pubertal stages were classified using a modified Pubertal Maturational Observational Scale (pre-, mid-, or post-pubertal stages). Generalized linear mixed models were used to compare kinematics across pubertal stages.
As girls matured through puberty, they displayed a decrease in sagittal-plane hip (1.8-2.6°, p<0.03) and knee range-of-motion (ROM) (2.7-2.9°, p≤0.01), and decreased peak hip (2.9-3.2°, p≤0.02) and knee flexion angles (2.7-2.9°, p≤0.01), which is indicative of greater quadriceps dominance. Peak knee abduction angles also increased as girls progressed through puberty (0.9-1.4°, p≤0.02), suggesting greater ligament dominance. In terms of trunk dominance, there were mixed findings with a decrease in trunk frontal- (2.5-5.7°, p≤0.03) and sagittal-plane ROM (2.0°, p≤0.01), but an increase in trunk transverse-plane ROM (2.8-3.6°, p≤0.02) observed as girls mature. Other significant changes in cutting technique were decreased peak trunk flexion (3.8-7.8°, p≤0.01), and decreased hip flexion (2.9-3.3°, p≤0.02) and knee flexion angles (2.0-3.0°, p≤0.03) at initial contact, suggesting a more upright and stiffer cutting posture.
As girls mature through puberty, there is a change in cutting strategy characterized by greater quadriceps and ligament dominance.
参与高速切入和变向运动的年轻女性运动员特别容易受到前交叉韧带（ACL）损伤。对于切入技术的成熟变化是否会增加受伤风险，人们知之甚少。我们的目的是研究女性运动员在青春期成熟过程中切入运动学的纵向变化。
纵向队列研究
高中女运动员（n = 172）在生物力学实验室中跨越两个或更多青春期阶段进行了一项意外的45°切入任务。青春期阶段使用改良的青春期成熟观察量表（青春期前、中期或后期阶段）进行分类。使用广义线性混合模型比较青春期各阶段的运动学。
随着女孩们在青春期成熟，她们在矢状面的髋关节活动度（1.8 - 2.6°，p < 0.03）和膝关节活动度（ROM）（2.7 - 2.9°，p≤0.01）降低，髋关节（2.9 - 3.2°，p≤0.02）和膝关节屈曲峰值角度（2.7 - 2.9°，p≤0.01）降低，这表明股四头肌优势增强。随着女孩们进入青春期，膝关节外展峰值角度也增加（0.9 - 1.4°，p≤0.02），表明韧带优势增强。在躯干优势方面，结果不一，随着女孩成熟，躯干额状面活动度（2.5 - 5.7°，p≤0.03）和矢状面ROM（2.0°，p≤0.01）降低，但躯干横断面ROM增加（2.8 - 3.6°，p≤0.02）。切入技术的其他显著变化包括躯干屈曲峰值降低（3.8 - 7.8°，p≤0.01），以及初始接触时髋关节屈曲（2.9 - 3.3°，p≤0.02）和膝关节屈曲角度（2.0 - 3.0°，p≤0.03）降低，这表明切入姿势更直立、更僵硬。
随着女孩们在青春期成熟，切入策略发生变化，其特征是股四头肌和韧带优势增强。
