Schley Stacey, Buser Anna, Render Ally, Ramirez Mario E, Truong Caleb, Easley Kirk A, Shenvi Neeta, Jayanthi Neeru
Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Emory Sports Medicine Center, Atlanta, Georgia.
Sports Health. 2025 Jan-Feb;17(1):202-213. doi: 10.1177/19417381241285865. Epub 2024 Oct 18.
Overuse injuries in youth athletes are associated with risks, including sports specialization, biological maturation, female sex, and workload measures. As no assessment tool exists to evaluate risk accumulation, we developed a novel risk factor scoring system (Sport Training Assessment of Risk [STAR]) to assess participants' risk of overuse injury and explore association with return-to-play (RTP) time periods.
(1) STAR will reach an acceptable predictive threshold in the assessment of overuse injury in youth athletes. (2) Higher STAR scores will be associated with increased RTP time periods after injury.
Longitudinal cohort study.
Level 3.
Youth athletes with an injury sustained during competitive sport completed questionnaires. Association of questionnaire variables with injury risk type was evaluated via logistic regression analyses, and unweighted and weighted versions of a total risk score were developed. RTP was defined by physician clearance per electronic medical record review. Mantel-Haenszel chi-square tests and Kendall's rank correlation coefficients were used to assess the relationship between weighted total risk score and RTP time periods. The weighted STAR model was analyzed with receiver operating characteristic (ROC) curves.
The weighted STAR model trended toward an acceptable level of prediction for overuse (nonserious + serious) injury (area under the ROC curve [AUC], 0.66; 95% CI, 0.61-0.71), but was less predictive for serious overuse injury (AUC, 0.63; 95% CI, 0.55-0.71). Weighted total risk score was weakly associated with return to full play (ρ = 0.11; < 0.01), and potentially with return to modified play (ρ = -0.08; = 0.04).
STAR may be a feasible tool for assessing overuse injury risk and RTP time periods in youth athletes but requires further development, as it did not reach an acceptable predictive threshold in this preliminary study.
Clinicians can use STAR to assess overuse injury risk in youth athletes.
青少年运动员的过度使用损伤与多种风险因素相关，包括运动专项化、生物成熟度、性别以及训练负荷量度。由于目前尚无评估风险累积的工具，我们开发了一种新型风险因素评分系统（运动训练风险评估 [STAR]），以评估参与者发生过度使用损伤的风险，并探讨其与恢复参赛（RTP）时间段的关联。
（1）在评估青少年运动员的过度使用损伤时，STAR 将达到可接受的预测阈值。（2）较高的 STAR 分数与受伤后更长的 RTP 时间段相关。
纵向队列研究。
3 级。
在竞技运动中受伤的青少年运动员完成问卷调查。通过逻辑回归分析评估问卷变量与损伤风险类型的关联，并制定了总风险评分的未加权和加权版本。RTP 通过电子病历审查中医生的许可来定义。使用 Mantel-Haenszel 卡方检验和 Kendall 秩相关系数来评估加权总风险评分与 RTP 时间段之间的关系。对加权 STAR 模型进行受试者操作特征（ROC）曲线分析。
加权 STAR 模型在预测过度使用（非严重 + 严重）损伤方面趋向于可接受的水平（ROC 曲线下面积 [AUC]，0.66；95% CI，0.61 - 0.71），但对严重过度使用损伤的预测性较低（AUC，0.63；95% CI，0.55 - 0.71）。加权总风险评分与完全恢复参赛的关联较弱（ρ = 0.11；P < 0.01），与恢复修改后参赛可能存在关联（ρ = -0.08；P = 0.04）。
STAR 可能是评估青少年运动员过度使用损伤风险和 RTP 时间段的可行工具，但由于在这项初步研究中未达到可接受的预测阈值，因此需要进一步改进。
临床医生可使用 STAR 评估青少年运动员的过度使用损伤风险。
