Rocha Emannuel Alcides Bezerra, Costa de Assis Sanderson Josć, Maia Dean Felipe Maciel, Barbosa Germanna de Medeiros, Neto Leonidas de Oliveira, Silva Rodrigo Scattone
1Postgraduate Program in Rehabilitation Sciences (PPGCREAB), School of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, RN, Brazil.
2Postgraduate Program in Public Health, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
J Athl Train. 2024 Jul 15. doi: 10.4085/1062-6050-0526.23.
The main cause for attrition of military training is musculoskeletal injuries to the knee, such as patellofemoral pain (PFP).
The purpose of this systematic review was to identify which factors increase the risk of occurrence of PFP in military personnel.
Systematic review with meta-analysis.
Searches were performed in Medline/PubMed, CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, and OpenGray.
We included studies that were prospective cohorts including military personnel and had at least one variable assessing a risk factor for PFP.
Extraction was performed by the same two independent evaluators and the data was separated between the military personnel who developed PFP and those who did not.
Meta-analyses were performed using standardized mean differences (SMD) and 95% confidence intervals (95%CI) and the levels of recommendation were determined.
From 11 articles, this review grouped 7,518 military personnel, of which 572 developed PFP, characterizing a prevalence of 7.61%. We found moderate evidence that isokinetic knee extensor weakness predicts PFP in the military (SMD -0.69, 95%CI -1.02, -0.35). A higher frontal plane knee projection angle (FPKPA) during single-leg squat was also identified as a risk factor for PFP in this population (SMD 0.55, 95%CI 0.14, 0.97) with moderate level of evidence. We found moderate evidence that sex, body mass index, isometric knee extensors strength, and isokinetic knee flexors strength do not predict PFP in military personnel. Finally, there is strong evidence that age and body mass do not predict PFP in this population.
Deficits in isokinetic knee extensor strength and a greater FPKPA are risk factors for PFP in military personnel. Since these are modifiable factors, these aspects should be considered in injury prevention interventions in the military.
军事训练中人员流失的主要原因是膝关节的肌肉骨骼损伤，如髌股疼痛（PFP）。
本系统评价的目的是确定哪些因素会增加军事人员发生PFP的风险。
系统评价与荟萃分析。
在Medline/PubMed、CINAHL、Embase、SPORTDiscus、Web of Science、Scopus和OpenGray中进行检索。
我们纳入了前瞻性队列研究，研究对象为军事人员，且至少有一个变量评估PFP的危险因素。
由两名独立评估人员进行提取，数据在发生PFP的军事人员和未发生PFP的军事人员之间进行分类。
使用标准化均值差（SMD）和95%置信区间（95%CI）进行荟萃分析，并确定推荐等级。
从11篇文章中，本评价纳入了7518名军事人员，其中572人发生PFP，患病率为7.61%。我们发现中等证据表明等速膝关节伸肌力量不足可预测军事人员发生PFP（SMD -0.69，95%CI -1.02，-0.35）。单腿深蹲时较高的额面膝关节投影角（FPKPA）也被确定为该人群发生PFP的危险因素（SMD 0.55，95%CI 0.14，0.97），证据水平中等。我们发现中等证据表明性别、体重指数、等长膝关节伸肌力量和等速膝关节屈肌力量不能预测军事人员发生PFP。最后，有强有力的证据表明年龄和体重不能预测该人群发生PFP。
等速膝关节伸肌力量不足和较大的FPKPA是军事人员发生PFP的危险因素。由于这些是可改变的因素，在军事预防损伤干预中应考虑这些方面。
