Van Mechelen W, Twisk J, Molendijk A, Blom B, Snel J, Kemper H C
EMGO Institute, Faculty of Medicine, Vriji Universiteit, Amsterdam, The Netherlands.
Med Sci Sports Exerc. 1996 Sep;28(9):1171-9. doi: 10.1097/00005768-199609000-00014.
The purpose of this study was to investigate the importance of subject-related risk factors for sports injuries, taking exposure time into account. At baseline in 182 healthy males and females (27 yr) the following subject-related risk factors were assessed: body mass index (BMI), maximal oxygen uptake (direct treadmill measurement), seven aspects of neuromotor fitness (MOPER fitness test), strength of the hamstring and quadriceps muscles (CYBEX), having sustained a sports injury in the 12 months preceding the baseline measurement ("previous injury"), and 16 psychological and psychosocial factors (measured with 8 standard, valid, and reliable questionnaires). For 1 yr, subjects were asked to make daily entries on a monthly log concerning all sports activities exceeding an intensity of 4 MET and all sustained sport injuries. Completed logs were returned by 139 subjects (75 males and 64 females). Fifty-one injuries were registered in 41 subjects. The overall incidence rate (IR) was 3.7 sports injuries per 1000 h of sports participation (95% confidence interval 2.8-4.9). For various subcategories, the following IR per 1000 h of sports participation were calculated: contact sports IR = 11.0 (95% CI 7.4-16.3); noncontact sports IR = 2.3% (95% CI 1.6-3.3); competition IR = 13.4 (95% CI 8.7-20.6); and training IR = 2.8 (95% CI 1.6-5.1). Data were analyzed by stepwise multiple logistic regression. The following five variables were independent and significant (P < 0.05) predictors of risk in sustaining a sport injury: dominance (odds ratio (OR) = 1.71; 95% CI = 1.44-2.03), vital exhaustion (OR = 1.85; CI = 1.22-2.86), stressful life events (OR = 1.84; 95% CI = 1.10-311); these ORs were calculated for an increase of 10% of the range of obtained scores, starting at minimum value. For total sporting time, the OR was calculated by taking the group with a total sporting time below the median (4050 h) as a reference (OR = 6.87; 95% CI = 2.09-22.55). For previous injury, subjects that had not sustained a sports injury in the 12 months preceding the baseline measurements served as a reference for the calculation of the OR (OR = 9.41; 95% CI = 2.80-31.58). These findings confirm that both exposure time and previous injury are more important predictors of sports injuries than psychological, psychosocial, physiological, and anthropometrical factors.
本研究的目的是在考虑暴露时间的情况下，调查与受试者相关的运动损伤风险因素的重要性。在182名健康男性和女性（27岁）的基线期，评估了以下与受试者相关的风险因素：体重指数（BMI）、最大摄氧量（直接在跑步机上测量）、神经运动能力的七个方面（MOPER体能测试）、腘绳肌和股四头肌力量（CYBEX测试）、在基线测量前12个月内曾遭受运动损伤（“既往损伤”），以及16项心理和社会心理因素（用8份标准、有效且可靠的问卷进行测量）。在1年时间里，要求受试者每天在月度日志中记录所有强度超过4代谢当量的体育活动以及所有持续发生的运动损伤。139名受试者（75名男性和64名女性）返回了完整的日志。41名受试者共记录到51次损伤。总体发病率（IR）为每1000小时运动参与3.7次运动损伤（95%置信区间2.8 - 4.9）。对于各个亚类别，计算了每1000小时运动参与的以下发病率：接触性运动发病率 = 11.0（95%置信区间7.4 - 16.3）；非接触性运动发病率 = 2.3%（95%置信区间1.6 - 3.3）；比赛发病率 = 13.4（95%置信区间8.7 - 20.6）；训练发病率 = 2.8（95%置信区间1.6 - 5.1）。数据通过逐步多元逻辑回归进行分析。以下五个变量是运动损伤风险的独立且显著（P < 0.05）预测因素：优势手（优势比（OR） = 1.71；95%置信区间 = 1.44 - 2.03）、精疲力竭（OR = 1.85；置信区间 = 1.22 - 2.86）、应激性生活事件（OR = 1.84；95%置信区间 = 1.10 - 3.11）；这些优势比是针对从最小值开始获得分数范围增加10%计算得出的。对于总运动时间，以总运动时间低于中位数（4050小时）的组作为参考计算优势比（OR = 6.87；95%置信区间 = 2.09 - 22.55）。对于既往损伤，以在基线测量前12个月内未遭受运动损伤的受试者作为计算优势比的参考（OR = 9.41；95%置信区间 = 2.80 - 31.58）。这些发现证实，与心理、社会心理、生理和人体测量学因素相比，暴露时间和既往损伤都是运动损伤更重要的预测因素。
