不同预防措施对军事训练伤影响的系统综述

A Systematic Review of the Effects of Different Preventive Strategies on Military Training-related Injuries

目的:军事训练伤高发备受关注,目前缺乏有效预防措施。对现有训练伤预防干预研究的相关文献进行系统综述,为军事训练伤预防方案制定提供依据。方法:在PubMed、Web of Science、Cochrane library、Google Scholar数据库检索截止2019年7月的训练伤预防干预研究的英文原始文献资料,结局指标限定为损伤发病率。由1名作者按照拟定方案对纳入文献进行数据提取和质量评分,再由另1名作者进行复核。对符合标准的文献进行系统综述。结果:共43篇文献符合纳入标准,所涉及训练伤预防措施包括:针对性体能训练、合理安排训练负荷、防护装备、防伤知识教育、营养支持和神经生物反馈训练6种类型。结果显示在日常训练中增加针对性体能训练的训练内容和合理安排训练负荷均可有效降低训练伤的发病率,而防护装备能够有效预防部分训练伤高危人群的训练伤。其它预防措施的干预研究较少,且多为多因素综合干预,不能得出明确结论。结论:1)针对性体能训练和合理安排训练负荷作为训练伤的有效预防措施可推广应用于预防军事训练伤,部分军事训练伤高危人群可采用损伤防护装备来辅助预防训练伤;2)针对性体能训练干预对训练伤发病率的效应因训练内容设置的不同而不同,应以流行病学调查为基础,依据军事训练伤的类型特点和致伤因素针对性设置训练内容;3)应进一步探讨防伤知识教育、营养支持等干预措施的训练伤预防效果,探寻最有效预防措施,研究建立系统的军事训练伤预防机制和综合干预方案。

Objective: The high incidence of military training related-injury has attracted much attention. However, there are a lack of effective preventive measures at present. The existing intervention studies investigating the prevention of training related-injuries were systematically reviewed to establish the evidence base on making recommendations to prevent military training related-injuries. Methods: Search English original literature on training injury prevention intervention research as of July 2019 among PubMed, Web of Science, Cochrane Library and Google Scholar with incidence of injury as outcome. Data extraction and quality assessment were performed by one author according to the proposed scheme and reviewed by another. The studies met the inclusion criteria were systematically reviewed. Result: 43 studies were chosen and the retrieved articles were broadly categorized into 6 injury prevention strategies: Targeted physical training, appropriate training load, protective equipment, injury preventive education, nutritional supplement and neurobiological feedback training. The targeted physical training and appropriate training load can effectively prevent the incidence of training related injuries. And the protective equipment can effectively prevent the incidence of training related injuries for high-risk individuals. It is hard to draw a determined conclusion through few studies on other prevention strategies, and most of them are multifactorial comprehensive interventions. Conclusion: 1)The targeted physical training and appropriate training load could be applied in military training as the effective preventive strategies of military training-related injuries. It could take the protective equipment as a preventive measure for high-risk individuals of training injury;2)The effects of the targeted physical training on the incidence of military training related-injury should depend on the training content, and its content design should be based on the epidemiological characteristics of military training related-injuries and according to the type characteristics of military training injuries and injury factors to set up training content based on epidemiological investigation;3) The effects of the injury preventive education and nutritional supplement on the incidence of military training related-injuries are needed further study in order to explore the most effective preventive measures for studing the establishment of a systematic military training injury prevention mechanism and integrated intervention programme.