下肢功能测试在评估前十字韧带重建术后安全返回赛场中的应用

下肢功能测试（单脚跳远、单脚侧向跳、单脚箱跳和单脚8字跳）可较好评估前十字韧带功能不良，但目前相关应用研究较少。本研究对15名接受前十字韧带重建术重返赛场的女子运动员，平均年龄（22.3±3.5） 岁，重返时间为术后9~12个月依次完成KOOS量表、等速肌力测试和下肢功能测试，采用配对T检验比较手术腿与健侧腿的下肢功能测试和等速肌力成绩的差异。采用皮尔逊积差相关系数检验全部测试结果的相关性。结果发现，单脚跳远成绩患侧腿明显低于健侧腿，箱跳成绩患侧腿低于健侧腿，8字跳和侧向跳成绩两侧无差异； 60°/s伸展、180°/s屈曲峰力矩患侧腿与健侧腿存在差异；单腿跳远成绩与60°/s伸展峰力矩具有相关性（r=0.605），箱跳成绩与180°/s屈曲峰力矩具有相关性（r=0.560）。表明ACLR术后9~12个月重返赛场的女子运动员仍普遍存在股四头肌力量和腘绳肌力量耐力对称性不良，应避免全力的制动和起跳落地动作；运动员重返赛前应该通过膝关节等速肌力和下肢功能测试完整了解膝关节功能的恢复情况；而KOOS评分量表用于运动员ACLR术后重返赛场决策敏感度不佳。     

功能测试算法在前交叉韧带重建术后重返运动中的应用

前交叉韧带重建术后重返运动时机是运动医学关注的焦点。目前观点认为前交叉韧带术后重返运动时机选择应基于功能测试结果，而非单纯由术后时间决定。功能测试算法（Functional Testing Algorithm，FTA）是一种基于康复结果来评估膝关节功能恢复的测试体系。本文通过对现有文献中相关功能测试指标的测试时间和数据进行梳理，旨在为患者系统使用FTA体系提供可借鉴的参考依据。     

3D打印技术在膝前交叉韧带重建中的应用

目的：探讨3D打印技术对关节镜前交叉韧带重建手术的辅助价值。方法：对2017年12月-2018年5月收治的15例因运动损伤导致前交叉韧带断裂且需进行韧带重建的患者，术前进行膝关节CT扫描，Mimcs图像处理，通过3D打印膝关节模型，进行模型上股骨骨隧道定位，并进行预手术，测量隧道长度，术前及术后6个月进行膝关节Lysholm 评分以评估膝关节功能。结果：通过3D打印模型预手术，均较准确地定位了前交叉韧带股骨止点，预手术测量股骨骨隧道平均长度为（43.2±2.13） mm，术中测量（43.7±1.75） mm，术后再次CT测量骨隧道长度为（42.4±3.25） mm，差异无显著性意义（P>0.05），术前Lysholm评分（46.2±5.73） 分，术后Lysholm 评分（88.4±6.25） 分，差异有显著性意义（P＜0.05）。结论：3D打印模型预手术可以辅助关节镜术中较快速、准确地定位前交叉韧带股骨止点，模型与实体骨隧道契合度高，术后疗效优良。     

MRI评估前交叉韧带重建术后腱骨愈合情况的研究

目的：采用自体四股腘绳肌重建前交叉韧带（Anterior Cruciate Ligament, ACL）术后腱骨愈合程度与临床疗效的相关性研究目前报导较少。本研究的目的是明确自体四股腘绳肌重建ACL术后腱骨愈合程度与临床膝关节功能评分之间是否存在相关性。方法：前瞻性研究我院在2013年4月至2014年4月，30例采用自体四股腘绳肌重建ACL术后腱骨愈合程度及临床功能评分情况。所有患者在术后3、6、12个月分别进行Tegner、Lysholm、国际膝关节功能委员会评分（International Knee Documentation Committee，IKDC）主观评分以及KT-1000检查，同时进行MRI检查，评估腱骨愈合情况。根据MRI表现将腱骨愈合程度由高向低分为5级，对不同时间点的腱骨愈合程度进行评分。结果：所有患者术后Tegner、Lysholm、IKDC评分随着时间推移逐渐改善，腱骨愈合程度也逐渐增高；腱骨愈合程度的高低与患者临床功能评分有明显相关性。结论：随着时间的推移，自体四股腘绳肌重建ACL术后腱骨愈合程度逐渐提高，临床功能评分逐渐改善，腱骨愈合水平与临床膝关节功能评分之间存在明显相关性。     

前交叉韧带重建术后重返运动相关因素的研究进展

本文旨在综述近年来关于前交叉韧带重建术后重返运动的相关报道成果，归纳与分析重要的相关因素。前交叉韧带重建术后重返运动是运动医学普遍关注和争议的问题，本文从重返运动时间、下肢肌力和功能恢复情况、手术相关因素、心理因素、不可调整的背景因素入手讨论影响前交叉韧带重建术后重返运动的具体因素，以期制定合理的前交叉韧带治疗策略，让患者能够更安全、更快速地重返目标水平的运动。     

不同康复训练对膝关节侧副韧带损伤后本体感觉恢复的作用研究

目的：探讨膝关节内外侧副韧带扭伤后本体感觉恢复的康复训练方法。方法：将膝关节侧副韧带扭伤者21例分为本体感觉强化组（11例）和对照组（10例），本体感觉强化组应用本体感觉强化训练，对照组应用一般康复训练方法；实验前后膝关节位置觉测定。结果：在再成角测试中，实验前两组位置觉偏差基本一致，伤膝平均偏差（4．32°±2．17°）、健膝（2．70°±1．53°），伤膝大于健膝（P〈0．05）：伤膝各角度之间平均偏差无明显差异（P〉0．05）。实验后本体感觉强化组伤膝的平均偏差为（2．52°±1．51°），对照组为（3．01°±1．51°）；两组之间平均偏差存在明显差异（P〈0．01）。结论：本体感觉强化的康复训练使膝关节功能恢复，损伤组织愈合，位置觉偏差正常。     

运动员前交叉韧带损伤与重建术后的重返赛场：早期与安全的相关问题

前交叉韧带损伤和手术后重返赛场一直是运动员、教练员、医疗团队、运动队管理者共同关注的问题，重返赛场问题决定着运动员的职业生涯、价值实现和经济收入等，其中的关键问题是“早期”和“安全”。文章阐述了运动员重返赛场过程中“早期”与“安全”两方面的影响因素，对损伤后是否需进行手术治疗，如何早期重返赛场，何时重返赛场更为安全，采用何种重建方式、移植物，以及重返赛场的评判标准等问题进行解答。认为确定重返赛场的时间需要对损伤类型做出准确判断，兼顾运动项目特点，了解术后常规重返时间。从安全角度应该防止前交叉韧带再次损伤，了解对运动员更合适的手术方式、移植物和重返赛场测试指标，在重视康复的同时，不要忽略移植物的生物愈合特性。     

前交叉韧带重建术后的康复训练

对前交叉韧带重建术后康复训练的文献进行分析研究，了解该领域的发展趋势。应用计算机检索Medline和Cnki1989—2006年间关于前交叉韧带相关文献。研究表明：股四头肌和胭绳肌肌力训练对膝关节功能恢复具有重要的作用，闭合运动链训练适合于康复训练早期，开放运动链训练适合于康复训练晚期；前交叉韧带损伤后，其本体感觉也受到破坏，而术后本体感觉促进训练对膝关节功能的完善至关重要；康复训练方案变得越来越激进，但激进的康复训练也有不利的一面，采用胭绳肌腱和异体肌腱重建前交叉韧带的术后康复训练应更趋于保守。     

排球运动员急停起跳环节的生物力学分析

以 12 名女排队员 4 号位扣球前的急停起跳为研究对象。通过测力台、摄像机和肌电多机同步测试来收集运动员急停起跳中的运动学、动力学以及肌电数据。结果表明：（1）排球运动员急停起跳中,膝关节缓冲幅度在 40°~50°之间时起跳高度较高,建议将急停起跳环节进行专项化训练,并采用 40°~50°的缓冲幅度;（2）排球运动员急停起跳中,蹬伸阶段关节的发力顺序为髋、膝、踝,因此训练时应形成合理的发力顺序;（3）排球运动员的膝、踝关节在急停起跳的蹬伸阶段先进行离心收缩后进行向心收缩,所以训练形式应符合伸肌群先拉长后缩短的特点;（4）排球运动员在急停起跳 环节中,采用足尖着地能取得更好的起跳效果,建议队员急停起跳中采用足尖着地;（5）排球运动员在重视大肌肉群训练的同时也要重视胫骨前肌、 腓肠肌等小肌肉群的专门化训练。     

马拉松不同水平业余男子选手训练学和肌力特征比较

对完成2016年北京马拉松、上海国际马拉松的258名男性业余选手赛前1周内进行训练学特征问卷和体能测试，将规定时间完成比赛且赛后1周完成伤病排查随访者193人纳入研究。根据2018年新增分级标准：A组118人、B组65人、C组10人。结果显示，周训练平均配速3组间均存在显著差异[A组（9.6±3.4） km/h、B组（11.8±4.0） km/h、C组（13.7±6.4） km/h]；安排抗阻训练A组（56.2%）与B组 （66.2%）和C组（70.7%）存在显著差异；安排间歇训练3组间均存在显著差异（A组40.6%、B组 50.2%、C组69.8%）（P＜0.05）；单腿跳相对值和单腿跳对称性A组（78.53%±12.43%、73%±13%）与B组（85.37%±12.80%、81%±14%）、C组（91.70%±11.43%、87%±12%）间存在显著差异；卷腹次数C组（61.00±62.27）次与A组（24.90±27.91）次、B组（35.95±26.40）次间存在显著差异（P＜0.05）。表明不同级别业余马拉松选手的主要训练差异为抗阻训练和间歇训练的参与度，与成绩相关的肌力特征指标有单脚跳相对值、单脚跳对称性和卷腹次数，下肢刚度未见差异。     

Return to competitive football after major knee surgery: more questions than answers?

Abstract

Despite significant advances in the diagnostics and treatment of knee injuries over the last decade, several challenges related to the subject “return to sport” remain largely unknown. For example, how should “return to sport” be defined precisely? What is the optimal timing and progression to enable a return to sport? Which criteria should be used during this process? What type of training is indicated? Which measurements can support the decision-making process? How do we optimally prepare athletes for competition without risking re-injury?

This paper critically addresses these questions, and proposes a return to play model to prepare football players to compete after major knee surgery (anterior cruciate ligament reconstruction, cartilage repair). The goal is to re-integrate the player gradually into the game, taking into account his individual characteristics. Several evidence-based and empirical criteria are needed to plan and monitor the efficient return to competitive football. Injury-prevention education should be part of this process to maximise the chance of a durable career and decrease the risk of re-injury.

However, because of the paucity of research on “return to sport”, further research is more than warranted.     

Translation,cross-cultural adaptation,validity, reliability and stability of the Dutch Injury - Psychological Readiness to Return to Sport (I-PRRS-NL) scale

The Injury Psychological Readiness to Return to Sport (I-PRRS) scale measures the psychological readiness of injured athletes to resume sports participation. The aim of this study was to translate and culturally adapt the I-PRRS scale into Dutch (I-PRRS-NL) and assess its validity, reliability, and stability in patients after anterior cruciate ligament reconstruction (ACLR). The original I-PRRS was translated and culturally adapted from English into Dutch, and tested for clinimetric quality. To assess concurrent validity, 150 patients completed the I-PRRS-NL scale and five questionnaires measuring related constructs 3–16 months after ACLR. All predefined hypotheses regarding correlations between the I-PRRS-NL scale and these questionnaires were confirmed, indicating good concurrent validity. For test-retest reliability, 107 patients completed the I-PRRS-NL scale again two weeks later. The I-PRRS-NL scale showed good internal consistency (Cronbach’s alpha 0.94) and test-retest reliability (ICC 0.89). Standard error of measurement was 4.2 and smallest detectable change was 11.6. No systematic bias between test and retest was found. As the scale appears unstable at item level, only the total score should be used. Overall, the I-PRRS-NL scale showed sufficient validity and reliability to assess the psychological readiness to resume sports among Dutch-speaking patients after ACLR.     

改革开放以来奥运格局发展态势研究

30年的改革开放,中国由重返奥林匹克大舞台到成功举办北京奥运会,中国体育事业突飞猛进,取得了举世瞩目的成就。30年的历史变迁,世界竞技格局由于受各国政治、经济的发展变化,各国的竞技实力发生了很大的变化,世界竞技格局总体态势演变为由个别国家垄断到遍地开花的分散。以此为契机充分发挥竞技体育的多元功能,让体育回归游戏的本质,保持奥林匹克的游戏本色,体育的发展归根到底还是为了人的解放。     

浅析竞技体育异化成因

竞技体育异化一直是现代体育界的热门话题,因为竞技体育异化问题愈来愈左右着竞技体育的开展。结合我国竞技运动实际,分析造成其异化的各种原因,以实现竞技体育原有精神的回归,促使我国体育事业的和谐发展。     

Heart rate responses of male orienteers aged 21-67 years during competition

Abstract

Orienteering is a sport in which it is common for most participants to be aged over 40 years, but research into the demands of the sport has focused almost exclusively on elite participants aged 21–35 years. The aim of the present study was to examine the heart rate responses of older male orienteers. Thirty-nine competitive male orienteers were divided into three groups: group 1 (international competitive standard, n=11, age 21–67 years), group 2 (national competitive standard, n=15, age 24–66 years) and group 3 (club competitive standard, n=13, age 23–60 years). Each participant had his heart rate monitored during two orienteering races of contrasting technical difficulty. The results were analysed using analysis of covariance, with age as a covariate, and Pearson product-moment correlation coefficients to determine whether age was related to the observed heart rate responses. The groups did not differ in their peak (175±12 beats · min^?1, P=0.643) or mean (159±13 beats · min^?1, P=0.171) heart rates during the races. There was a decline of 6 beats · min^?1 · decade^?1 (P=0.001) for peak heart rate and 5 beats · min ^?1·decade^?1 (P<0.001) for mean heart rate. Mean heart rates were 86±6% of the participants' maximal heart rates and were not associated with age. The orienteers in group 1 displayed a lower (P<0.005) within-race standard deviation in heart rate (6±2 beats · min^?1) than those in groups 2 and 3 (10±3 and 10±4 beats · min^?1, respectively). In conclusion, the mean heart rates indicated that all three groups of orienteers ran at a relative high intensity and the international competitive standard orienteers displayed a less variable heart rate, which may have been related to fewer instances of slowing down to relocate and being able to navigate while running at relatively high speeds.     

奥运会承办国后奥运竞技体育体制研究

对奥运会举办国（美国、日本、韩国）后奥运竞技体育体制变化进行分析,然后从我国竞技体育体制管理模式、人才培养体制、投资主体和运行模式以及法律法规环境等方面对后奥运我国竞技体育体制的改革进行了研究。结果认为：后奥运我国竞技体育的管理模式由政府管理型向政府与体育协会合作型发展;加快竞技体育后备人才培养体制的改革;实现竞技体育由国家投资到市场化运作的转变,进一步开发、完善竞技体育的竞赛市场;进一步完善我国竞技体育的法律、法规。     

A modified TRIMP to quantify the in-season training load of team sport players

Abstract

The aims of the study were to modify the training impulse (TRIMP) method of quantifying training load for use with intermittent team sports, and to examine the relationship between this modified TRIMP (TRIMP_MOD) and changes in the physiological profile of team sport players during a competitive season. Eight male field hockey players, participating in the English Premier Division, took part in the study (mean±s: age 26±4 years, body mass 80.8±5.2 kg, stature 1.82±0.04 m). Participants performed three treadmill exercise tests at the start of the competitive season and mid-season: a submaximal test to establish the treadmill speed at a blood lactate concentration of 4 mmol · l^?1; a maximal incremental test to determine maximal oxygen uptake ([Vdot]O_2max) and peak running speed; and an all-out constant-load test to determine time to exhaustion. Heart rate was recorded during all training sessions and match-play, from which TRIMP_MOD was calculated. Mean weekly TRIMP_MOD was correlated with the change in [Vdot]O_2max and treadmill speed at a blood lactate concentration of 4 mmol · l^?1 from the start of to mid-season (P<0.05). The results suggest that TRIMP_MOD is a means of quantifying training load in team sports and can be used to prescribe training for the maintenance or improvement of aerobic fitness during the competitive season.