女足运动员90°变向时的二维和三维生物力学因素与非接触性前交叉韧带损伤有关。
Two-Dimensional and Three-Dimensional Biomechanical Factors During 90° Change of Direction are Associated to Non-Contact ACL injury in Female Soccer Players.
作者信息
Di Paolo Stefano, Grassi Alberto, Tosarelli Filippo, Crepaldi Matteo, Bragonzoni Laura, Zaffagnini Stefano, Della Villa Francesco
机构信息
Life Quality Studies University of Bologna.
2nd Orthopaedic and Traumatologic Clinic Istituto Ortopedico Rizzoli.
出版信息
Int J Sports Phys Ther. 2023 Aug 1;18(4):887-897. doi: 10.26603/001c.84308. eCollection 2023.
BACKGROUND
The two-dimensional (2D) video-analysis of the change of direction (COD) technique has never been used to attempt to predict the risk of ACL injury in female football players.
HYPOTHESIS/PURPOSE: The purpose of the present pilot study was to prospectively investigate the biomechanical predictors of ACL injury during a COD task in female football players using both gold standard 3D motion capture and a qualitative scoring system based on 2D video-analysis.
STUDY DESIGN
Prospective cohort study.
METHODS
Sixteen competitive female football (soccer) players (age 21.4 ± 4.3) performed a series of pre-planned 90° COD tasks. 3D motion data was recorded through 10 stereophotogrammetric cameras and a force platform. 2D frontal and transverse plane joint kinematics were computed through video-analysis from three high-speed cameras. A scoring system based on five criteria was adopted: limb stability, pelvis stability, trunk stability, shock absorption, and movement strategy. The players were prospectively followed for the next two consecutive football seasons and the occurrence of severe knee injuries was registered.
RESULTS
Four players (25%) experienced an ACL injury. In 3D analysis, ACL-injured players showed greater knee valgus, knee internal rotation, and lower knee flexion (p= 0.017 - 0.029). Lower hip flexion coupled with greater external rotation (p= 0.003 - 0.042), ankle eversion, and contralateral pelvic drop (p<0.001) were also noted. In 2D analysis, ACL-injured players showed greater internal foot rotation, contralateral pelvic drop, lower knee flexion, and contralateral trunk tilt (moderate-to-large effect size). Pelvis stability and trunk stability showed the highest predictive value towards ACL injury. Total score was significantly lower in ACL-injured players with a moderate effect size (d=0.45).
CONCLUSIONS
Both 3D and 2D methodologies depicted biomechanical risk factors and offered predictive insights towards the ACL injury risk. Awareness should rise in women's football regarding the high risk of ACL injury and the strategies to assess and mitigate it.
LEVEL OF EVIDENCE
3©The Author(s).
背景
二维（2D）变向（COD）技术的视频分析从未被用于尝试预测女子足球运动员前交叉韧带（ACL）损伤的风险。
假设/目的：本初步研究的目的是使用金标准三维运动捕捉和基于二维视频分析的定性评分系统，前瞻性地研究女子足球运动员在COD任务期间ACL损伤的生物力学预测因素。
研究设计
前瞻性队列研究。
方法
16名有竞争力的女子足球运动员（年龄21.4±4.3岁）进行了一系列预先计划的90°COD任务。通过10台立体摄影测量相机和一个测力平台记录三维运动数据。通过来自三台高速摄像机的视频分析计算二维额状面和横断面关节运动学。采用基于五个标准的评分系统：肢体稳定性、骨盆稳定性、躯干稳定性、减震和运动策略。对这些运动员在接下来的两个连续足球赛季进行前瞻性随访，并记录严重膝关节损伤的发生情况。
结果
4名运动员（25%）发生了ACL损伤。在三维分析中，ACL损伤的运动员表现出更大的膝外翻、膝内旋和更低的屈膝角度（p = 0.017 - 0.029）。还观察到更低的髋关节屈曲伴更大的外旋（p = 0.003 - 0.042）、踝关节外翻和对侧骨盆下降（p < 0.001）。在二维分析中，ACL损伤的运动员表现出更大的足部内旋、对侧骨盆下降、更低的屈膝角度和对侧躯干倾斜（中到较大效应量）。骨盆稳定性和躯干稳定性对ACL损伤显示出最高的预测价值。ACL损伤运动员的总分显著更低，效应量中等（d = 0.45）。
结论
三维和二维方法都描绘了生物力学风险因素，并提供了关于ACL损伤风险的预测见解。女子足球界应提高对ACL损伤高风险以及评估和减轻该风险策略的认识。
证据水平
3©作者。
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