Hamstring and Quadriceps Isokinetic Strength Deficits Are Weak Risk Factors for Hamstring Strain Injuries
Hamstring and Quadriceps Isokinetic Strength Deficits Are Weak Risk Factors for Hamstring Strain Injuries
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腿筋和股四头肌等速力量缺陷是腿筋拉伤损伤的弱风险因素
DOI：
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发表时间：
2016
影响因子：
4.8
通讯作者：
E. Witvrouw
中科院分区：
文献类型：
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作者：
N. van Dyk;R. Bahr;R. Whiteley;J. Tol;B. Kumar;B. Hamilton;A. Farooq;E. Witvrouw
背景：腿筋拉伤（HSI）已成为足球运动中最常见的非接触性损伤。等速肌力不足被认为是HSI的风险因素。然而，由于样本量小，无法确定小相关性的研究力度不足，导致关于HSI中等速力量和力量测试的作用的结果不确定。目的：在一个有充分把握度的研究设计中，在一个大的职业足球运动员队列中，检查膝关节屈曲和伸展的等速力量测量值的差异是否代表腘绳肌损伤的风险因素。研究设计：队列研究;证据等级2。方法：对14支球队的614名职业足球运动员进行季前筛选时的等速肌力测试。测试包括以60 °/s和300 °/s的速度进行的同心膝关节屈曲和伸展以及以60 °/s的速度进行的偏心膝关节伸展。采用聚类多元逻辑回归分析确定与HSIs风险相关的变量。计算受试者工作特征（ROC）曲线，以确定灵敏度和特异性。结果：在614名运动员中，190人在4个赛季中患有HSI。调整体重后，60度/s时股四头肌向心力（比值比[OR]，1.41; 95%CI，1.03-1.92; P = .03）和60度/s时腘绳肌离心力（OR，1.37; 95%CI，1.01-1.85; P = .04）与损伤风险独立相关。受伤运动员与未受伤运动员之间的绝对差分别为6.9N·m和9.1N·m，效应量较小（d < 0.2）。ROC分析显示股四头肌向心力和腘绳肌离心力的曲线下面积分别为0.54和0.56，表明在logistic回归模型中识别的2个力量变量的组合灵敏度和特异性失败。结论：本研究确定了在组水平上的小的绝对强度差异和绝对强度测量的广泛重叠。小腿肌肉离心力量和股四头肌向心力量与HSI之间的小相关性只能被认为是弱风险因素。确定这些风险因素仍然无法确定面临风险的个别行为者。不支持使用等速测试来确定强度差异与HSI之间的关联。
Background: A hamstring strain injury (HSI) has become the most common noncontact injury in soccer. Isokinetic muscle strength deficits are considered a risk factor for HSIs. However, underpowered studies with small sample sizes unable to determine small associations have led to inconclusive results regarding the role of isokinetic strength and strength testing in HSIs. Purpose: To examine whether differences in isokinetic strength measures of knee flexion and extension represent risk factors for hamstring injuries in a large cohort of professional soccer players in an adequately powered study design. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 614 professional soccer players from 14 teams underwent isokinetic strength testing during preseason screening. Testing consisted of concentric knee flexion and extension at 60 deg/s and 300 deg/s and eccentric knee extension at 60 deg/s. A clustered multiple logistic regression analysis was used to identify variables associated with the risk of HSIs. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity. Results: Of the 614 players, 190 suffered an HSI during the 4 seasons. Quadriceps concentric strength at 60 deg/s (odds ratio [OR], 1.41; 95% CI, 1.03-1.92; P = .03) and hamstring eccentric strength at 60 deg/s (OR, 1.37; 95% CI, 1.01-1.85; P = .04) adjusted for bodyweight were independently associated with the risk of injuries. The absolute differences between the injured and uninjured players were 6.9 N·m and 9.1 N·m, with small effect sizes (d < 0.2). The ROC analyses showed an area under the curve of 0.54 and 0.56 for quadriceps concentric strength and hamstring eccentric strength, respectively, indicating a failed combined sensitivity and specificity of the 2 strength variables identified in the logistic regression models. Conclusion: This study identified small absolute strength differences and a wide overlap of the absolute strength measurements at the group level. The small associations between lower hamstring eccentric strength and lower quadriceps concentric strength with HSIs can only be considered as weak risk factors. The identification of these risk factors still does not allow the identification of individual players at risk. The use of isokinetic testing to determine the association between strength differences and HSIs is not supported.