中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (17): 2775-2781.doi: 10.12307/2022.550

• 组织构建综述 tissue construction review • 上一篇    下一篇

预防序列模型框架下前交叉韧带损伤的筛查、干预与评估

袁浩翔，徐  菁，曾锦树，陈  浩，闫业磊，陈佳豪，刘庆山，徐  飞   

  1. 杭州师范大学体育与健康学院，浙江省杭州市   311122
  • 收稿日期:2021-04-27 修回日期:2021-04-28 接受日期:2021-05-27 出版日期:2022-06-18 发布日期:2021-12-27
  • 通讯作者: 刘庆山，男，副教授，博士，杭州师范大学体育与健康学院，浙江省杭州市 311122 徐飞，副教授，博士，杭州师范大学体育与健康学院，浙江省杭州市 311122
  • 作者简介:袁浩翔，男，1996年生，安徽省蚌埠市人，汉族，杭州师范大学在读硕士。 徐菁，女，1998年生，汉族，浙江省温州市人，杭州师范大学在读硕士。
  • 基金资助:
    浙江省自然科学基金面上项目(LY18C110002)，项目主持人：徐飞

Sequence of prevention for anterior cruciate ligament injury: screening, intervention and assessment

Yuan Haoxiang, Xu Jing, Zeng Jinshu, Chen Hao, Yan Yelei, Chen Jiahao, Liu Qingshan, Xu Fei   

  1. School of Physical Education and Health, Hangzhou Normal University, Hangzhou 311122, Zhejiang Province, China
  • Received:2021-04-27 Revised:2021-04-28 Accepted:2021-05-27 Online:2022-06-18 Published:2021-12-27
  • Contact: Liu Qingshan, MD, Associate professor, School of Physical Education and Health, Hangzhou Normal University, Hangzhou 311122, Zhejiang Province, China Xu Fei, MD, Associate professor, School of Physical Education and Health, Hangzhou Normal University, Hangzhou 311122, Zhejiang Province, China
  • About author:Yuan Haoxiang, Master candidate, School of Physical Education and Health, Hangzhou Normal University, Hangzhou 311122, Zhejiang Province, China Xu Jing, Master candidate, School of Physical Education and Health, Hangzhou Normal University, Hangzhou 311122, Zhejiang Province, China Yuan Haoxiang and Xu Jing contributed equally to this work.
  • Supported by:
    the Natural Science Foundation of Zhejiang Province (General Project), No. LY18C110002 (to XF)

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摘要：

文题释义：
预防序列模型：van Mechelen 等于1992年提出，包括从认识肌肉骨骼损伤的发生率、严重性，分析病因学因素到制定和评估预防性干预措施，旨在对肌肉骨骼损伤的预防流程实行程序化监控。
神经肌肉突增期：指进入青春期后，伴随着激素水平和形态学上的变化，男性的力量、爆发力和协调性都自然发生适应性地增强的现象。

背景：前交叉韧带损伤是运动者常见的运动损伤之一，并受多种因素的影响。损伤会导致患者短期的身体功能活动受限和长期的膝骨关节炎的高发风险，“预防”是减小前交叉韧带损伤率的最佳途径。
目的：在“损伤预防序列”模型框架下，全面审视损伤预防的研究进展，初步构建前交叉韧带损伤的程序化预防流程。
方法：对2000-01-01/2020-12-31发表在PubMed，Embase，Google Scholar，Web of Science和SPORTDiscuss数据库的文献进行检索，经过筛选后最终纳入68篇文献。从确定损伤机制，识别损伤风险因素，筛查具有高风险的运动者，到制定前交叉韧带损伤预防计划与评估，建立起对于前交叉韧带损伤预防的全面认识。
结果与结论：①前交叉韧带损伤机制的研究方法众多，目前，利用“膝关节有限元模型”模拟的研究范式整合了体内、体外和计算机研究的优势，为未来特定个体研究提供新思路。②前交叉韧带损伤的病因学因素较为复杂，但通过综合性神经肌肉控制训练能有效改善个体异常的生物力学特性，特别是对于青春期前女性，还可能会诱导“神经肌肉突增”现象，建议尽早纳入少年儿童课程内容中，降低损伤风险。③文章整理了几套较为成熟的预防训练方案，其中FIFA11+是现阶段应用最广泛的足球赛前热身方案。但这些方案对于不同年龄、运动项目和特定损伤风险个体预防效果的特异性还有待进一步研究。④有研究团队开发出基于“诺模图”的风险评分工具、落地危险评分系统、抱膝跳评估以及QASLS评分系统，包括定量和定性的评估方式，具有操作便捷且低成本的特点，可用于大规模筛查与训练效果的即时评估，同时也为未来开发各类高风险运动场景下的筛查评估工具指明方向。

https://orcid.org/0000-0001-5885-1332 (袁浩翔)；https://orcid.org/0000-0001-8989-9603 (徐飞 ) 

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 前交叉韧带损伤, 损伤机制, 预防策略, 筛查, 评估工具, 干预训练, 神经肌肉突增

Abstract: BACKGROUND: Anterior cruciate ligament (ACL) injury is one of the common sports injuries in athletes and is affected by many factors. Injuries can lead to short-term physical function limitations and long-term sequelae, and all patients face a high risk of osteoarthritis after an anterior cruciate ligament injury. “Prevention” is an optimal choice at this stage.
OBJECTIVE: Under the framework of the “Sequence of Prevention” model, to comprehensively review the prevention of anterior cruciate ligament injury and to preliminarily construct a programmatic prevention process for anterior cruciate ligament injury.
METHODS: A systematic review of the literature was undertaken from January 1, 2000 to December 31, 2020 using the following databases: PubMed, Embase, Google Scholar, Web of Science, and SPORTDiscuss. Finally 68 articles were included for further review. The procedure incorporates determining the mechanism of injury, identifying injury risk factors, screening high-risk athletes, formulating the prevention plans and assessments of anterior cruciate ligament injury, so as to establish a comprehensive understanding of the prevention of anterior cruciate ligament injury.
RESULTS AND CONCLUSION: There are many research methods that focus on the mechanism of anterior cruciate ligament injury. A current research paradigm of “knee joint finite element model” simulation integrates the advantages of in vivo, in vitro and computer research, and provides new ideas for future specific individual research. The etiological factors of anterior cruciate ligament injury are more complicated, but comprehensive neuromuscular control training can effectively improve the abnormal biomechanical properties of individuals. Especially for pre-pubertal women, it may also induce the phenomenon of “neuromuscular spurt.” Therefore, comprehensive neuromuscular control training is recommended to be included in the curriculum for children as soon as possible to reduce the risk of injury. This review compiles several sets of relatively mature prevention training programs, among which FIFA11+ is the most popular pre-football warm-up program at this stage. However, the specificity of these programs for the prevention of individuals of different ages, sports events and specific injury risks needs to be further studied. A research team has developed a risk scoring tool based on the “nomogram”, the “landing hazard scoring system”, the “tuck jump evaluation” and the “QASLS scoring system,” including quantitative and qualitative evaluation methods, which are easy to operate and has low cost. These tools can be used for large-scale screening and real-time evaluation of training effects, and also point out the direction for the future development of screening and evaluation tools in various high-risk sports scenarios.

Key words: anterior cruciate ligament injury, injury mechanism, prevention strategy, screening, assessment tool, intervention program, neuromuscular spurt

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