男性业余马拉松运动员跑步支撑阶段跟腱负荷参数与膝关节损伤风险的相关性

Correlation between Achilles tendon load parameters and risk of knee joint injury in male amateur marathon runners during running support stage

摘要

目的 探讨男性业余马拉松运动员跑步支撑阶段跟腱负荷参数与膝关节损伤风险的相关性。方法 于2022年5月至2023年1月随机招募180名男性业余马拉松运动员作为研究对象，采用三维测力台、红外高速运动捕捉系统、超声影像仪采集运动员跑步支撑阶段跟腱负荷参数（最大跟腱力、跟腱冲量、跟腱应力、跟腱应变）、膝关节负荷参数[峰值膝关节内收力矩（knee adduction moment，KAM）、峰值膝关节屈曲力矩（knee flexion moment，KFM）]，分析跟腱负荷参数与膝关节损伤的相关性，以及跟腱负荷参数对膝关节损伤的预测价值。结果 首先将180名运动员的年龄、体质量指数、跑鞋类型、着地方式、周跑量作为协变量进行整体的倾向性评分匹配，共筛选出150名运动员作为研究对象。依据跑步支撑阶段跟腱负荷参数，将运动员分为低负荷组（47名）、中负荷组（61名）、高负荷组（42名）。其中跑步支撑阶段最大跟腱力、跟腱冲量、跟腱应力、跟腱应变、KAM值为高负荷组＞中负荷组＞低负荷组，KFM值为高负荷组＜中负荷组＜低负荷组（P＜0.05）；跑步支撑阶段最大跟腱力、跟腱冲量、跟腱应力、跟腱应变与KAM呈正相关，与KFM呈负相关（P＜0.05）；膝关节损伤发生率高负荷组＞中负荷组＞低负荷组（P＜0.05）；发生膝关节损伤的运动员跑步支撑阶段最大跟腱力、跟腱冲量、跟腱应力、跟腱应变高于无膝关节损伤的运动员（P＜0.05）；跑步支撑阶段最大跟腱力、跟腱冲量、跟腱应力、跟腱应变与膝关节损伤呈正相关（P＜0.05）；跑步支撑阶段最大跟腱力、跟腱冲量、跟腱应力、跟腱应变预测男性业余马拉松运动员膝关节损伤风险的AUC为0.754、0.742、0.770、0.764，均对男性业余马拉松运动员膝关节损伤有一定预测价值。结论 男性业余马拉松运动员跑步支撑阶段跟腱负荷参数与膝关节负荷情况有关，可有效预测膝关节损伤风险，为男性业余马拉松运动员日常训练提供指导。

Abstract

Objective To explore the correlation between Achilles tendon load parameters and risk of knee joint injury in male amateur marathon runners during running support stage. Methods A total of 180 male amateur marathon runners were randomly recruited from May 2022 to January 2023 as the research objects. Three-dimensional force platform，infrared high-speed motion capture system and ultrasonic imager were used to measure the Achilles tendon load parameters （maximum Achilles tendon force，Achilles tendon impulse，Achilles tendon stress，Achilles tendon strain） and knee joint load parameters [ knee adduction torque （KAM），knee flexion torque （KFM）] in the running support stage of athletes. The correlation between Achilles tendon load parameters and knee joint injury was analyzed，and the predictive value of Achilles tendon load parameters on knee joint injury was analyzed. Results Firstly，the age，body mass index，type of running shoes，landing mode and weekly running volume of 180 athletes were used as covariates to carry out the overall propensity score matching，and a total of 150 athletes were selected as the research objects. According to the Achilles tendon load parameters in the running support stage，the athletes were divided into low load group （47 cases），medium load group （61 cases） and high load group （42 cases）. The maximum Achilles tendon force，Achilles tendon impulse，Achilles tendon stress，Achilles tendon strain and KAM in the running support stage of the high load group were higher than those in the medium load group and the low load group，the medium load group was higher than the low load group，the KFM was lower than the medium load group and the low load group，and the medium load group was lower than the low load group （P＜0.05）. The maximum Achilles tendon force，Achilles tendon impulse，Achilles tendon stress and Achilles tendon strain in the running support stage were positively correlated with KAM and negatively correlated with KFM （P＜0.05）. The incidence of knee joint injury in the high load group was higher than that in the middle load group and the low load group，and that in the middle load group was higher than that in the low load group （P＜0.05）. The maximum Achilles tendon force，Achilles tendon impulse，Achilles tendon stress and Achilles tendon strain of athletes with knee joint injury during running support stage were higher than those of athletes without knee joint injury （P＜0.05）. The maximum Achilles tendon force，Achilles tendon impulse，Achilles tendon stress and Achilles tendon strain in the running support stage were positively correlated with knee joint injury （P＜0.05）. The AUC of the maximum Achilles tendon force，Achilles tendon impulse，Achilles tendon stress and Achilles tendon strain in the running support stage to predict the risk of knee joint injury of male amateur marathon runners was 0.754，0.742，0.770 and 0.764，respectively，which had certain predictive value for knee joint injury of male amateur marathon runners. Conclusion The Achilles tendon load parameters of male amateur marathon runners in the running support stage are related to the knee joint load，which can effectively predict the risk of knee joint injury and provide guidance for the daily training of male amateur marathon runners.

关键词

膝关节损伤 / 男性 / 业余马拉松运动员 / 跑步支撑阶段 / 跟腱负荷参数 / 预测价值

Key words

knee joint injury / male / amateur marathon runner / running support stage / Achilles tendon load parameter / predictive value

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基金资助

国家社会科学基金资助项目(2023BTY002)