Heiderscheit Bryan C, Blemker Silvia S, Opar David, Stiffler-Joachim Mikel R, Bedi Asheesh, Hart Joseph, Mortensen Brett, Kliethermes Stephanie A
Badger Athletic Performance Program, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1685 Highland Avenue, 6136 Medical Foundation Centennial Building, Madison, WI, 53705, USA.
Springbok Analytics, Charlottesville, VA, USA.
BMC Sports Sci Med Rehabil. 2022 Jul 15;14(1):128. doi: 10.1186/s13102-022-00520-3.
The etiology of hamstring strain injury (HSI) in American football is multi-factorial and understanding these risk factors is paramount to developing predictive models and guiding prevention and rehabilitation strategies. Many player-games are lost due to the lack of a clear understanding of risk factors and the absence of effective methods to minimize re-injury. This paper describes the protocol that will be followed to develop the HAMstring InjuRy (HAMIR) index risk prediction models for HSI and re-injury based on morphological, architectural, biomechanical and clinical factors in National Collegiate Athletic Association Division I collegiate football players.
A 3-year, prospective study will be conducted involving collegiate football student-athletes at four institutions. Enrolled participants will complete preseason assessments of eccentric hamstring strength, on-field sprinting biomechanics and muscle-tendon volumes using magnetic-resonance imaging (MRI). Athletic trainers will monitor injuries and exposure for the duration of the study. Participants who sustain an HSI will undergo a clinical assessment at the time of injury along with MRI examinations. Following completion of structured rehabilitation and return to unrestricted sport participation, clinical assessments, MRI examinations and sprinting biomechanics will be repeated. Injury recurrence will be monitored through a 6-month follow-up period. HAMIR index prediction models for index HSI injury and re-injury will be constructed.
The most appropriate strategies for reducing risk of HSI are likely multi-factorial and depend on risk factors unique to each athlete. This study will be the largest-of-its-kind (1200 player-years) to gather detailed information on index and recurrent HSI, and will be the first study to simultaneously investigate the effect of morphological, biomechanical and clinical variables on risk of HSI in collegiate football athletes. The quantitative HAMIR index will be formulated to identify an athlete's propensity for HSI, and more importantly, identify targets for injury mitigation, thereby reducing the global burden of HSI in high-level American football players. Trial Registration The trial is prospectively registered on ClinicalTrials.gov (NCT05343052; April 22, 2022).
美国橄榄球比赛中腘绳肌拉伤损伤（HSI）的病因是多因素的，了解这些风险因素对于建立预测模型以及指导预防和康复策略至关重要。由于对风险因素缺乏清晰认识且缺乏有效方法将再次受伤风险降至最低，许多球员比赛因此受影响。本文描述了将遵循的方案，该方案旨在基于美国国家大学体育协会第一分区大学橄榄球运动员的形态学、结构学、生物力学和临床因素，开发用于HSI和再次受伤的腘绳肌损伤（HAMIR）指数风险预测模型。
将对四所院校的大学橄榄球学生运动员开展一项为期3年的前瞻性研究。入选的参与者将在季前赛完成对腘绳肌离心力量、场上短跑生物力学以及使用磁共振成像（MRI）测量的肌腱体积的评估。运动训练师将在研究期间监测损伤情况和暴露情况。发生HSI的参与者在受伤时将接受临床评估以及MRI检查。在完成结构化康复并恢复无限制的体育活动后，将重复进行临床评估、MRI检查和短跑生物力学测试。通过6个月的随访期监测损伤复发情况。将构建针对首次HSI损伤和再次受伤的HAMIR指数预测模型。
降低HSI风险的最合适策略可能是多因素的，并且取决于每个运动员特有的风险因素。本研究将是同类研究中规模最大的（1200运动员年），以收集有关首次和复发性HSI的详细信息，并且将是第一项同时研究形态学、生物力学和临床变量对大学橄榄球运动员HSI风险影响的研究。将制定定量的HAMIR指数，以确定运动员发生HSI的倾向，更重要的是，确定减轻损伤的目标，从而减轻高水平美国橄榄球运动员中HSI的全球负担。试验注册本试验已在ClinicalTrials.gov上进行前瞻性注册（NCT05343052；2022年4月22日）。
