运动再训练对运动员落地峰值力——一个可调节的前交叉韧带损伤风险标志物——的影响：一项一级预防的系统评价与Meta分析
简介
这项系统评价与Meta分析纳入8项随机对照试验（292名运动员），评估运动再训练对落地时峰值垂直地面反作用力（vGRF）的影响。结果显示，运动再训练可显著降低峰值vGRF（效应量-0.94），但证据质量低、异质性高（I²=63%），且未直接测量ACL损伤发生率。该发现仅具假设生成价值，尚不能指导临床预防策略。
英文摘要
Background: Non-contact anterior cruciate ligament (ACL) injury is common and disabling, often requiring reconstruction and predisposing individuals to early post-traumatic osteoarthritis, making scalable, exercise-based prevention a clinical and public health priority. Excessive peak vertical ground reaction force (vGRF) during landing is a modifiable biomechanical risk marker for ACL injury, although whether reducing it lowers injury incidence is unproven. We evaluated the effect of movement retraining on peak vGRF during landing in pivot-sport athletes and general athletic populations. Methods: MEDLINE (PubMed), Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through to 25 May 2026. Two reviewers independently screened records and extracted data. Random-effects meta-analyses (DerSimonian-Laird) used Hedges' g; risk of bias was assessed with RoB 2 and certainty with GRADE. The protocol was registered in PROSPERO (CRD42025116119). Results: Nine comparisons from eight randomised controlled trials (292 participants) were included. Movement retraining significantly reduced peak vGRF (Hedges' g = -0.94, 95% CI -1.34 to -0.54; I2 = 63%), with larger effects in general athletic populations (g = -1.50) than in pivot-sport athletes (g = -0.66; subgroup difference p = 0.005). Knee flexion angle at initial contact showed a non-significant increasing trend (g = 0.48; p = 0.18). Certainty of evidence (GRADE) was low. Conclusions: Movement retraining was associated with a reduction in peak vGRF during landing, a surrogate biomechanical marker for ACL injury, on the basis of low-certainty evidence with substantial heterogeneity (I2 = 63%). A subgroup difference favouring general over pivot-sport athletes was observed but is exploratory, resting on only three general-athletic comparisons. Because no included trial measured injury incidence, whether these biomechanical changes reduce ACL injury is unknown, and the findings should be regarded as hypothesis-generating.