MINOR SPORTS INJURIES AS PROXY MEASURES OF MAJOR INJURY

本项目的目的是研究轻微运动损伤作为 青春期后期更严重的运动损伤的替代措施。我们 目的是评估：1)重伤的个体是否有更多的轻伤 重伤先于无重伤；2)重伤先行 轻伤；3)特定类型的轻伤与 重伤的具体类型；4)轻伤和 重伤可以通过压力时期来预测；5)医疗记录 是个人受伤经历的可靠和有效的指标。 将审查的方法学问题包括：1)定义 最能预测重伤的轻伤(即 基于受限活动、级别的严重程度评级的比较 治疗、组织损伤)；2)时间段的长度 发生的轻伤最能预测重伤(即重伤 在受伤之前的一周里，两人受了一系列轻伤 重大伤害发生前几周，重大伤害发生前一个月 伤害？)；3)自我报告的伤害数据的可靠性 医疗救治。 我们建议研究轻伤和重伤之间的关系 西点军校(USMA)。USMA提供了一个 研究这一问题的独特机会，因为高度受控和 统一的环境，集中提供和记录健康 护理，运动损伤高发，收集能力强 通过每个学员办公桌上的终端直接自助报告数据，以及 军方对伤害预防有着浓厚的兴趣。 将采用三项研究设计：1)一项回顾性队列研究 1988年进入该学院的1400名学员的医疗记录， 在四年的军校生涯中进行跟踪；2)一年的回顾 年参加校内足球运动学员成绩的队列研究 1991年(N=700)，3)对100名在校学员进行为期一学期的前瞻性研究 足球。生存分析将被用来研究 轻伤和重伤。 如果我们能证明轻微的运动损伤与 重大损伤，无论是一般的，还是特定的解剖部位， 研究人员将能够制定和测试关于过程的假设 将不同严重程度的伤害联系起来，并将能够量化， 针对轻伤的预防干预措施对患病率的影响 严重受伤。

The purpose of this project is to study the use of minor sports injuries as proxy measures for more serious athletic injuries in late adolescence. We aim to assess whether: 1) individuals with major injuries have more minor injuries than those without major injuries; 2) major injuries are preceded by minor injuries; 3) specific types of minor injuries are associated with specific types of major injuries; 4) periods of vulnerability to minor and major injuries can be predicted by periods of stress; 5) medical records are reliable and valid indicators of individual's injury experience. Methodological issues which will be examined include: 1) a definition of minor injuries which will be most predictive of major injuries (i.e., a comparison of severity ratings based on restricted activity, level of treatment, tissue damage); 2) the length of the time period during which minor injuries occur that best predicts major injuries (i.e., are major injuries preceded by a cluster of minor injuries the week before, the two weeks before the occurrence of the major injury, the month before the major injury?); 3) the reliability of self-reported injury data resulting in medical treatment. We propose to study the association between minor and major injuries at the United States Military Academy at West Point (USMA). The USMA offers a unique opportunity to study this issue because of a highly controlled and uniform environment, the centralized provision and recording of health care, a high frequency of athletic injuries, the ability to collect self-report data directly through terminals at each cadet's desk, and the strong interest the military has in injury prevention. Three study designs will be employed: 1) a retrospective cohort study of the medical records of 1400 cadets who entered the academy in 1988, followed over their four year cadet careers; 2) a one year retrospective cohort study of the records of cadets who played intramural football in 1991 (N = 700), 3) a one term prospective study of 100 cadets in intramural football. Survival analysis will be used to study the association between minor and major injuries. If we can demonstrate that minor athletic injuries are associated with major injuries, either in general, or for specific anatomical sites, researchers will be able to formulate and test hypotheses about processes which link injuries of different severity, and will be able to quantify, the effect of preventive interventions aimed at minor injuries on the rate of severe injuries.