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

项目摘要/摘要 每年约有850万高中和大学运动员参加竞技体育运动。而当 竞技体育提供了许多好处，但它也给长期健康带来了被低估的风险。竞争性 体育运动极大地增加了受伤(如膝盖受伤)的风险，并可能使运动员过早地患上慢性病 疾病(如骨关节炎)、慢性疼痛、与健康相关的生活质量差，以及残疾。初步 有证据表明，中年退役运动员(平均年龄53岁)在机能测试中的表现比非运动员差 同龄人，但没有说明以前的受伤情况。有无病史前运动员量化功能的研究 因此，伤害和非运动员控制对于提供有针对性的干预措施并最终增加 健康跨度和生活质量。一个可修改的因素可以解释运动与运动之间的联系 参与和长期健康不良是体力活动(PA)的模式，包括长时间久坐不动 举止(某人)即使在符合PA推荐指南的成年人中，SB也与 许多不良后果，包括慢性病和各种原因造成的死亡。现任男性职业运动员 与非运动员相比，他们在训练时间以外坐着的时间要多得多，但这是否有害 在业余运动员(如高中、大学)或女运动员中也存在或持续存在SB的模式 运动员不为人所知。长期的研究目标是改善肌肉骨骼、心脏代谢和一般情况 男性和女性前运动员的健康和机能，强调早期行为 通过以下方式防止这一代表性不足和高危人群患上慢性病的干预措施 中年。最重要的假设是，以前的运动员，特别是那些以前受伤的运动员，会有更差的 中年的机能和健康，以及现任和前任运动员将从事更大的全面和更长的时间 与相匹配的非运动员进行对比。使用横截面设计，目标1将比较功能， 有或无膝关节损伤的前运动员和无膝关节损伤的前运动员的力量和心脏代谢指标 运动员在中年与对照组(45岁-)配对。假设1是以前受伤的前运动员会有 最差的(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 体力和(1c)心脏代谢指标(身体成分、心血管疾病风险)。目标2将 比较现役运动员(18-25岁)和中年前运动员与非运动员的SB和PA模式 控制。假设2.1是现在的运动员将有更大的SB，更长的SB回合，和更高的水平 中度至剧烈的PA。假设2.2以前的运动员在中年会有更大的SB，更长的SB 比赛，和较低的PA水平。识别并最终干预早期慢性病的风险因素将 不仅使数百万男性和女性前运动员受益--这是一个少数民族日益增多的群体 比美国总人口更具代表性，但也提供了一种有效的手段来预防 或延缓整个人群的慢性病发展，这是美国国立卫生研究院最近强调的(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).