Micheli Center for Sports Injury Prevention, Waltham, MA, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.
Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Gait Posture. 2022 Jul;96:123-129. doi: 10.1016/j.gaitpost.2022.05.025. Epub 2022 May 23.
While there is substantial information available regarding expected biomechanical adaptations associated with adult running-related injuries, less is known about adolescent gait profiles that may influence injury development.
Which biomechanical profiles are associated with prevalent musculoskeletal lower extremity injuries among adolescent runners, and how do these profiles compare across injury types and body regions?
We conducted a cross-sectional study of 149 injured adolescents (110 F; 39 M) seen at a hospital-affiliated injured runner's clinic between the years 2016-2021. Biomechanical data were obtained from 2-dimensional video analyses and an instrumented treadmill system. Multivariate analyses of variance covarying for gender and body mass index were used to compare continuous biomechanical measures, and Chi-square analyses were used to compare categorical biomechanical variables across injury types and body regions. Spearman's rho correlation analyses were conducted to assess the relationship of significant outcomes.
Patients with bony injuries had significantly higher maximum vertical ground reaction forces (bony: 1.87 body weight [BW] vs. soft tissue: 1.79BW, p = 0.05), and a higher proportion of runners with contralateral pelvic drop at midstance (χ =5.3, p = 0.02). Maximum vertical ground reaction forces and pelvic drop were significantly yet weakly correlated (ρ = 0.20, p = 0.01). Foot strike patterns differed across injured body regions, with a higher proportion of hip and knee injury patients presenting with forefoot strike patterns (χ =22.0, p = 0.01).
These biomechanical factors may represent risk factors for injuries sustained by young runners. Clinicians may consider assessing these gait adaptations when treating injured adolescent patients.
虽然有大量关于与成人跑步相关损伤相关的预期生物力学适应性的信息，但对于可能影响损伤发展的青少年步态特征知之甚少。
哪些生物力学特征与青少年跑步者常见的肌肉骨骼下肢损伤有关，这些特征在不同的损伤类型和身体部位之间有何不同？
我们对 2016 年至 2021 年期间在一家医院附属的受伤跑步者诊所就诊的 149 名受伤青少年（110 名女性；39 名男性）进行了横断面研究。生物力学数据来自二维视频分析和仪器化跑步机系统。使用多元方差分析，对性别和体重指数进行协方差，以比较连续的生物力学测量值，使用卡方分析比较不同损伤类型和身体部位的分类生物力学变量。进行 Spearman's rho 相关分析以评估显著结果之间的关系。
患有骨骼损伤的患者的最大垂直地面反作用力显著更高（骨骼：1.87 体重[BW]与软组织：1.79BW，p=0.05），并且在中步时具有对侧骨盆下降的跑步者比例更高（χ=5.3，p=0.02）。最大垂直地面反作用力和骨盆下降之间存在显著但微弱的相关性（ρ=0.20，p=0.01）。受伤身体部位的足触地模式不同，髋关节和膝关节损伤患者的前足触地模式比例更高（χ=22.0，p=0.01）。
这些生物力学因素可能代表年轻跑步者受伤的危险因素。临床医生在治疗受伤的青少年患者时，可以考虑评估这些步态适应性。
