Life After Sport: Prior Injury and Sedentary Behavior as Mechanisms of Later Poor Health

项目总结/摘要 每年大约有850万高中和大学运动员参加竞技体育。而 竞技体育提供了许多好处，但它也对长期健康构成了未被充分认识的风险。竞争 运动极大地增加了受伤的风险（例如，膝关节损伤），并可能使运动员处于慢性 疾病（例如，骨关节炎）、慢性疼痛、健康相关生活质量差和残疾。初步 有证据表明，中年（平均年龄53岁）的前运动员在功能测试中的表现比非运动员差 同行，但没有考虑到以前的伤害状态。前运动员有无先验知识的量化功能 因此，伤害和非运动员控制对于提供有针对性的干预措施至关重要， 健康寿命和生活质量。一个可以改变的因素可以解释体育运动之间的联系 参与和长期健康状况不佳是身体活动（PA）模式，包括长期久坐 行为（SB）。即使在符合推荐的PA指南的成年人中，SB也与 包括慢性病和全因死亡率在内的一系列不良后果。现役男子职业运动员 比非运动员在练习时间外更久坐，但这是否有害？ SB模式也存在于业余（例如，高中，大学）或女运动员或坚持在前 运动员不详。长期的研究目标是改善肌肉骨骼，心脏代谢和一般 健康和功能在男性和女性前运动员的生命周期，强调早期行为 采取干预措施，防止这一代表性不足和高危人群患上慢性病， 中年最重要的假设是，前运动员，特别是那些先前受伤的运动员， 功能和健康在中年，现任和前任运动员将从事更全面和更长的 与非运动员相比，SB的发作次数。使用横截面设计，目标1将比较功能， 力量和心脏代谢指标，在有和没有以前的膝盖受伤的前运动员和非 运动员在中年（45-64岁）与对照组相匹配。假设1是，以前受伤的前运动员将有 最差（1a）功能（30秒椅子站立，6分钟步行，爬楼梯），（1b）股四头肌和腿筋 力量，和（1c）心脏代谢指标（身体成分，心血管疾病风险）。目标2将 比较当前（18-25岁）和中年前运动员与匹配的非运动员的SB和PA模式 对照假设2.1是，目前的运动员将有更大的SB，更长的SB回合，和更高的水平， 中度至重度PA。假设2.2是中年的前运动员将有更大的SB，更长的SB 以及较低的PA水平。识别并最终干预早期慢性病的风险因素将 不仅使数百万男女前运动员受益--少数民族越来越多地 比美国总人口更有代表性，但也提供了一种有效的手段， 或延迟慢性疾病在人群中的发展，最近NIH强调（例如，PA-18-849）。

PROJECT SUMMARY/ABSTRACT Approximately 8.5 million high school and collegiate athletes engage annually in competitive sport. While competitive sport offers many benefits, it also poses underappreciated risks to long-term health. Competitive sport profoundly increases risk for injury (e.g., knee injury) and may position athletes for early onset of chronic diseases (e.g., osteoarthritis), chronic pain, poor health-related quality of life, and disability. Preliminary evidence indicates former athletes in mid-life (mean age 53) perform worse on functional tests than non-athlete peers, but did not account for prior injury status. Quantifying function in former athletes with and without a prior injury and non-athlete controls is therefore critical to informing targeted interventions and ultimately increasing healthspans and quality of life. One modifiable factor that may explain the association between sports participation and poor long-term health is physical activity (PA) patterns including prolonged sedentary behavior (SB). Even among adults who meet recommended PA guidelines, SB is strongly associated with a host of poor outcomes including chronic disease and all-cause mortality. Current male professional athletes are substantially more sedentary outside their practice times than non-athletes, but whether this harmful pattern of SB also exists in amateur (e.g., high school, collegiate) or female athletes or persists in former athletes is unknown. The long-term research goal is to improve musculoskeletal, cardiometabolic, and general health and function across the lifespan of male and female former athletes, emphasizing early behavioral interventions that prevent this underrepresented and at-risk population from developing chronic diseases by mid-life. The overarching hypothesis is that former athletes, especially those with a prior injury, will have poorer function and health in mid-life and that current and former athletes will engage in greater overall and longer bouts of SB compared to matched non-athletes. Using a cross-sectional design, Aim 1 will compare function, strength, and cardiometabolic indicators among former athletes with and without prior knee injury and non- athlete matched controls in mid-life (age 45-64). Hypothesis 1 is that former athletes with a prior injury will have the poorest (1a) function (30-second chair stand, 6-minute walk, stair climb), (1b) quadriceps and hamstring strength, and (1c) cardiometabolic indicators (body composition, cardiovascular disease risk). Aim 2 will compare SB and PA patterns in current (age 18-25) and mid-life former athletes to matched non-athlete controls. Hypothesis 2.1 is that current athletes will have greater SB, longer SB bouts, and higher levels of moderate-to-vigorous PA. Hypothesis 2.2 is that former athletes in mid-life will have greater SB, longer SB bouts, and lower PA levels. Identifying and ultimately intervening on risk factors for early chronic disease will not only benefit many millions of male and female former athletes—a group in which minorities are increasingly more represented than in the overall United States population—but also provide an efficient means to prevent or delay chronic disease development in the population at large, a recent NIH emphasis (e.g., PA-18-849).