Relationen mellem tibiofemoral ratio samt moment over hoften og overbelastingsskader i knæregionen hos motionsløbere

Petersen, Christine Heyn

4. semester

Klinisk Videnskab og Teknologi, Kandidat (KVT)

2013

2013-06-03

124 pages

Formålet: Finde en relation mellem side-til-side differencen tibiofemoral ratio og moment over hoftens seks muskelgrupper hos motionsløbere med eller uden overbelastningsskade i knæregionen som følge af løb. Design: Retrospektivt studie. Setting: Motionsløbere I Aalborg, Aulum, Holstebro samt Ringkøbing, Danmark, med eller uden tilknytning til organiseret løbeklubber. Deltagere: 19 motionsløbere (12 mænd, 7 kvinder) med selvrapporteret skade i knæregionen og 42 motionsløbere (15 mænd, 27 kvinder) uden skade. Main outcome measures: Selvrapporteret demografisk information om, i særdeleshed, skader i knæregionen. Tibiofemoral ratio blev fundet ved benlængdemåling. Muskelstyrken for hoftens seks muskelgrupper blev testet ved brugen af et håndholdt dynamometer og efterfølgende normaliseret ud fra kropsvægt og højde1-3. Resultater: Den univariate analyse viste ingen signifikant forskel i sidetil- side difference i tibiofemoral ratio og moment over hoften mellem ikke-skadede og skadede motionsløbere. Analysen viste en tendens gående imod nedsat moment i venstre sides hofteabduktor hos gruppen af skadede motionsløbere (p = 0 0,086). Logistisk regressions analyse viste, at højere alder samt øget moment i venstre hofteabduktor nedsatte sandsynligheden for at blive skadet (odds ratioalder = 0,908, 95 % CI = 0,837-0,985; p = 0,020 )(odds ratio v.abd = 0,476, 95 % CI = 0,276-0,821; p = 0,008 ), hvorimod større vægt samt øget moment i højre adduktor øgede sandsynligheden for at blive skadet (odds ratiovægt = 1,070, 95% CI = 1,002-1,142; p = 0,043) (odds ratioh.add = 1,815, 95% CI = 1,094- 3,012; p = 0,021). Konklusion: Selv om der ikke blev fundet en signifikant forskel i sidetil- side differencen for tibiofemoral ratio og moment over hoften, blev nedsat styrke i venstre sides hofteabduktor inkluderet i den endelige logistiske regressionsmodel til at kunne forudsige overbelastningsskader i knæregionen hos motionsløbere. Resultatet skal anvendes med forbehold og indikerer i konsensus med andre studier27,31, at der er behov for lignende studier der i særdeleshed afdækker hvorvidt hofteabduktorerne er associeret med overbelastningsskader hos motionsløbere.

Objective: To investigate relationships between the side-to-side difference in tibiofemoral ratio and torque of the six hip muscle groups, in recreational runners with or without overuse injury in the knee region due to running. Design: Retrospective study. Setting: Recreational runners in Aalborg, Aulum, Holstebro as well as Ringkøbing, Denmark, regardless of association with organized running clubs. Participants: 19 recreational runners (12 men, 7 women) with selfreported injury in the knee region, and 42 recreational runners (15 men, 27 women) without injury. Main outcome measures: Self-reported demographic information of injury specifically in the knee region. Tibiofemoral ratio was determined by leg length measurement. Muscle strength of the six hip muscle groups were tested utilizing a hand-held dynamometer, and were subsequently normalized to body weight and height1-3. Results: Univariate analysis showed no significant difference in sideto- side difference in tibiofemoral ratio and torque of the hip, between injured and non-injured recreational runners. A trend towards a reduced torque in the left hip abductor in the group of injured runners was observed (p = 0 .086). Logistic regression analysis showed that increased age and torque of the left hip abductor reduced the likelihood of injury (odds ratioage = 0.908, 95% CI = 0.837 to .985, p = 0.020) (odds ratiov.abd = 0.476, 95% CI = 0,276 to 0,821, p = 0.008), whereas increased weight and torque of the right adductor increased the likelihood of injury (odds ratioweight = 1.070, 95% CI = 1002 to 1142, p = 0.043)(odds ratioh.add = 1.815, 95% CI = 1094-3012, p = 0.021). Conclusions: Although a significant side-to-side difference in tibiofemoral ratio and torque of the hip was not observed, reduced strength in the left hip abductor was included in the final logistic regression model to predict overuse injury in the knee region in recreational runners. These results should be used tentatively, however, they indicate consensus with other studies27,31. Lastly, these results highlight the need for future studies with a particular focus on whether hip abductors are associated with overuse injury in recreational runners.

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