功能动作筛查(FMS)预测新兵军事训练伤的队列研究

孙鲁琨; 范真真; 彭霈; 尚明富; 范维玲; 杨晓娟; 高瑞; 钟萍

doi:10.3969/j.issn.2095-5227.2022.05.019

功能动作筛查(FMS)预测新兵军事训练伤的队列研究

Predicting military training injury in recruits by functional movement screening: A cohort study

摘要

摘要:
背景近年来，新兵军事训练伤的发生率居高不下，严重制约了军队战斗力的形成。然而，目前新兵军事训练伤的预测方法非常有限。功能动作筛查(function movement screening，FMS)可以暴露出受试者灵活性和稳定性的薄弱环节，而这些薄弱环节往往被认为是运动损伤的危险因素。
目的探讨功能动作筛查评分与新兵军事训练伤风险水平的关系，为功能动作筛查评分预测新兵军事训练伤提供依据。
方法 2021年3 - 8月对某训练基地新兵营430名新兵进行功能动作筛查。记录肩部灵活性、主动直腿上抬、旋转稳定性、躯干稳定俯卧撑、直线弓步蹲、跨栏步、深蹲7个动作模式得分和总分，经过6个月的统一新兵训练，记录下新兵训练伤情况。分析功能动作筛查得分与军事训练伤发生风险之间的关系。
结果 430名新兵FMS得分最高18分，最低2分；通过Youden指数确定军事训练伤的FMS损伤风险临界值为13分，预测训练伤的ROC曲线下面积为0.684(P＜0.05)。FMS≤13分组新兵军事训练伤发生率高于＞13分组(31.89% vs 13.47%，P＜0.001)，风险为2.368倍(RR=2.368，95% CI：1.618 ~ 3.465)。Logistic回归分析7种动作模式与军事训练伤的关系，主动抬腿(OR=0.615)、俯卧撑(OR=0.505)、弓步蹲(OR=0.440) 3个动作模式分值越低，发生军事训练伤的风险越高(P＜0.05)，而肩部灵活性、旋转稳定性、跨栏步、深蹲4个动作模式评分与军事训练伤无相关性(P＞0.05)。
结论 FMS可作为新兵军事训练伤预测指标，以13分作为军事训练伤临界值，得分≤13分的新兵发生军事训练伤的风险要高于得分＞13分的新兵。其中主动抬腿、俯卧撑、弓步蹲3个动作模式与军事训练伤风险呈负相关。

Abstract:
Background In recent years, the incidence of military training injuries in new recruits remains high, which seriously restricts the formation of military combat effectiveness. However, methods for predicting military training injuries are still very limited. Functional movement screening (FMS) can expose the weak links of subjects' flexibility and stability, which are often considered as one of the risk factors of military training injury.
Objective To explore the relationship between functional sports screening score and the risk level of military training injury of recruits, so as to provide evidences for predicting military training injury of recruits by using functional sports screening score.
Methods Totally 430 recruits in a boot camp were screened by functional movements screening. The 7 movement patterns scores and total scores were recorded, including shoulder mobility, active straight leg raise, rotary stability, trunk stability push-up, in-line lunge, hurdle step and deep squat. During the 6 months training period, the training injuries of each recruit were recorded. The relationship between FMS score and the risk of military training injury was analyzed.
Results The highest FMS score of the 430 recruits was 18 points and the lowest was 2 points. The cut-off value of FMS for injury risk of military training determined by Youden index was 13 points, and the area under ROC curve was 0.684 (P<0.05). The incidence of military training injuries in the recruits with FMS≤13 was significantly higher than those with FMS＞13 (31.89％ vs 13.47%, P＜0.001), with a relative risk of 2.368 (95%CI , 1.618 to 3.465). Logistic regression analysis showed active leg lift (OR=0.615), trunk stability push-up (OR=0.505), in-line lunge (OR=0.440) were associated with the lower risk of the military training injuries in the recruits (P<0.05). However, there was no correlation between military training injuries and the other four movement patterns including rotation stability, shoulder mobility, hurdle step and deep squat (all P>0.05).
Conclusion FMS can be used as the prediction index of military training injury of recruits, with 13 points as the critical value. The risk of military training injury of recruits with a score of less than 13 points is higher than that of recruits with a score of more than 13 points. Active leg lift, trunk stability push-up, in-line lunge are negatively correlated with the risk of military training injury.

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