تمرینات پیشگیری از آسیب لیگامان صلیبی قدامی ناشی از ریسک فاکتورهای درونی و قابل تعدیل در زنان ورزشکار (مقاله مروری)

نوع مقاله : مقاله مروری

نویسندگان

1 1. دانشجوی دکتری دانشکده تربیت بدنی وعلوم ورزشی، دانشگاه خوارزمی

2 2. دکترای بیومکانیک ورزشی، استاد تمام دانشکده تربیت بدنی وعلوم ورزشی، دانشگاه خوارزمی

چکیده

مقدمه و اهداف
مطالعات اپیدمیولوژیکی نشان داده­اند که زنان ورزشکار 2 تا 10 برابر بیشتر از مردان ورزشکار در معرض آسیب ACL قرار دارند. عوامل عصبی عضلانی و بیومکانیکی در آسیب لیگامان صلیبی قدامی جزء ریسک فاکتورهای قابل تعدیل هستند. هزینه های بالای درمان ، افزایش پتانسیل از دست دادن فصل مسابقه و ناتوانی­­های طولانی­مدت و همچنین ایجاد آسیب­های ثانویه­ای لزوم بکارگیری برنامه­های پیشگیری از آسیب را پررنگ­تر کرده­است. در این مطالعه مروری، پیشینه تحقیقات مرتبط با ریسک فاکتورهای قابل تعدیل و تمرینات پیشگیری از آسیب لیگامان صلیبی قدامی بررسی شده است.
مواد و روش ها
برای شناسایی تحقیقات از بانک های اطلاعاتیMedline Pubmed، Science Direct، SPORTDiscuss و SCOPUS با کلید واژه های  "ACL"، "Knee injuries"، "modifiable risk factor  "، "neuromuscular risk factor"، "biomechanical risk factor"، "training prevention program"استفاده شد. در مجموع 8500 مقاله یافته شد. بعد از خروج مقالات غیر انگلیسی، با نتایج کاملا مشابه، مقالات مشابه ایندکس شده، تحقیقات غیر انسانی، با نمونه های آسیب دیده، با اهداف درمانی، بدون مداخلات تمرینی، 60 مقاله  در این تحقیق مورد بررسی قرار گرفت.
یافته ها
ضعف در کنترل و ایمبالانس عصبی عضلانی تنه و اندام تحتانی در زنان موجب افزایش بروز آسیب لیگامان صلیبی قدامی می شود. تمرینات پیشگیری از آسیب نیز در دو سطح با هدف اصلاح ریسک فاکتورها و کاهش نرخ آسیب لیگامان صلیبی قدامی قرار دارند. بیشتر تمرینات مداخله ای تاثیر گذار، تمرینات چند جانبه، با شروع برنامه در پیش از فصل برای حداقل زمان شش هفته و به صورت مداوم در طول فصل با تعداد تکرار حداقل یک تا دو تکرار در هفته و با مربیان ناظر بر تمرین هستند.
نتیجه گیری
شناسایی ایمبالانسهای عصبی عضلانی می تواند در غربالگری ورزشکاران در خطر و طراحی تمرینات مداخله ای مورد استفاده قرار بگیرد. اگرچه، هنوز برنامه استانداردی با هدف پیشگیری برای هر یک از رشته های ورزشی خاص معرفی نشده است.

کلیدواژه‌ها

عنوان مقاله [English]

ACL injury prevention programs due to intrinsic and modifiable risk factors in female Athletes

نویسندگان [English]

  • Naghmeh Gheidi 1
  • Heidar Sadeghi 2
1 1- PhD Candidate in sport biomechanics, Department of Sport Biomechanics, Faculty of physical education and Sport science, Kharazmi University, Tehran, Iran.
2 2- PhD in Sport Biomechanics, Full Professor of Faculity of physical education and Sport science, Department of Sport Biomechanics, Kharazmi University, Tehran, Iran
چکیده [English]

Background and Aim: Epidemiological studies have shown that female athletes are vulnerable to ACL injuries 2 to 10 times more than male athletes. Neuromuscular and biomechanical factors in anterior cruciate ligament injuries are among modifiable risk factors. The high cost of treatment, increasing the potential loss of the competitive season and long-term disability and secondary damage have made the application of injury prevention programs more prominent. In this literature review, related research regarding modifiable risk factors and ACL injury prevention training was studied.
Materials and Methods: To identify the research, databases such as Medline Pubmed, Science Direct, SPORTDiscuss and SCOPUS using the keywords "ACL", "Knee injuries", "modifiable risk factors", "neuromuscular risk factor", "biomechanical risk factor", "training prevention program " were used. Finally, 8500 studies were identified. After exclusion of non-English, duplicated, similar indexed studies, animal studies, studies with injured subjects, studies focused on clinical treatment, and studies without any intervention, 60 articles remained eligible for studying.
Results: Weakness and imbalance of the trunk and lower limb neuromuscular control increase prevalence of ACL injuries in female. Prevention training was categorized in two levels with the aim to modify the risk factors and reduce the rate of ACL injury.  Majority of the effective intervention training exercises are multilateral program for at least 6 weeks in advance of the season and continued throughout the season with a repetition of at least once or twice a week with a trainer in the practice.
Conclusion: Identifying neuromuscular imbalance can be used for screening the athletes at risk and designing the intervention training. However, a standard program aimed at preventing for a specific sport has not been introduced, yet.

کلیدواژه‌ها [English]

  • Anterior Cruciate ligament
  • injury risk factors and internal modifiable risk factor
  • prevention training
  • female athletes

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دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 3، شماره 3 - شماره پیاپی 3
مهر و آبان 1393
صفحه 89-108

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سابقه مقاله

  • تاریخ دریافت: 17 اسفند 1392
  • تاریخ بازنگری: 25 خرداد 1393
  • تاریخ پذیرش: 21 مرداد 1393
  • تاریخ اولین انتشار: 01 مهر 1393

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