青少年手球运动员前交叉韧带损伤风险相关的神经肌肉与神经认知表现：一项前瞻性队列研究
简介
该前瞻性队列研究纳入220名青少年手球运动员（平均年龄16.3岁），通过Back in Action系统进行功能性测试及ImPACT神经认知评估，随访24个月。关键发现：26名运动员发生ACL损伤；多变量逻辑回归显示，增强式训练中较长的地面接触时间与ACL损伤显著相关（p=0.019，AUC=0.63，OR=0.98/ms），女性性别是独立危险因素（OR=5…
英文摘要
BACKGROUND: Anterior cruciate ligament (ACL) injuries in youth athletes are multifactorial, and the relative contributions of neuromuscular and neurocognitive variables remain inadequately comprehended. METHODS: In this prospective cohort study, 220 young handball players (104 girls and 116 boys; mean age 16.3 ± 1.4 years) participated in functional testing with the Back in Action system and baseline neurocognitive evaluation with the ImPACT battery. During the 24-month follow-up period, orthopedic specialists identified ACL damage, which was confirmed by magnetic resonance imaging (MRI). Univariable logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate predictive capability. RESULTS: During the 24-month follow-up, 26 athletes sustained an ACL injury. Prolonged plyometric ground contact time was significantly associated with ACL injury occurrence in logistic regression analysis (p = 0.019) and demonstrated fair discriminatory ability (AUC = 0.63) (OR = 0.98 per ms; 0.98 95% CI: 0.964-0.997). Female sex emerged as a profound and independent risk factor (OR = 5.74). CONCLUSIONS: Neuromuscular performance, specifically plyometric ground contact time and female sex, has predictive ability for ACL damage in youth handball players, while separate cognition assessments failed to independently differentiate injury risk. These findings support the use of objective neuromuscular evaluation in comprehensive injury prevention strategies in youth sport.