Article(id=1322211147227443859, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322210968248107603, articleNumber=null, orderNo=null, doi=10.16016/j.2097-0927.202412067, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1733932800000, receivedDateStr=2024-12-12, revisedDate=1741017600000, revisedDateStr=2025-03-04, acceptedDate=null, acceptedDateStr=null, onlineDate=1793169302993, onlineDateStr=2026-10-28, pubDate=1747238400000, pubDateStr=2025-05-15, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793169302993, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793169302993, creator=13701087609, updateTime=1793169302993, updator=13701087609, issue=Issue{id=1322210968248107603, tenantId=1146029695717560320, journalId=1319373162502258839, year='2025', volume='47', issue='9', pageStart='893', pageEnd='1028', issueExtLink='null', onlineDate='null', pubDate='1747238400000', pubDateStr='2025-05-15', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793169260321, creator='13701087609', updateTime=1793325292291, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322865413818536367, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322210968248107603, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322865413818536368, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322210968248107603, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1003, endPage=1009, ext={EN=ArticleExt(id=1322211147877560981, articleId=1322211147227443859, tenantId=1146029695717560320, journalId=1319373162502258839, language=EN, title=Role of joint function screening and correction in preventing training injuries for new recruits: a randomized controlled trial, columnId=1320435151990014650, journalTitle=Journal of Army Medical University, columnName=Military Medicine, runingTitle=null, highlight=null, articleAbstract=
Objective‍

To investigate the effects of joint function screening and correction on intervention efficacy of prevention and assessment score of training injuries in new recruits.

Methods‍

A randomized controlled study was conducted on 265 new recruits subjected from two organizational units of an army unit with cluster sampling. Based on entire organizational unit, the participants were randomly divided into a control group (n=132) and an experimental group (n=133). The experimental group received joint function screening and corrective movement training, which was subsequently applied in the new recruit training, while the control group underwent training according to conventional methods. Joint function were collected before and after training. The demographic data, assessment score of training, and incidence of training injuries were collected through the participant’s own organizational unit. Receiver operating characteristic (ROC) curve was plotted to evaluate the efficacy of joint function screening in predicting training injuries, and binary logistic regression and general linear regression analyses were applied to verify the correlation of joint function screening score with training injuries and assessment score of training.

Results‍

After new training, the score of joint function screening was significantly higher in the experimental group than the control group (16.62±1.87 vs 14.92±2.58, P<0.001). And the score was obviously increased in the experimental group (16.62±1.87 vs 12.82±1.98, P<0.001) and the control group (14.92±2.58 vs 12.95±1.81, P<0.001) when compared with the corresponding score before training. The area under the ROC curve (AUC) of joint function screening in predicting training injuries was 0.762 (95%CI: 0.694~0.830), indicating good predictive efficacy. During the new training process, the incidence of training injuries in the experimental group (13.53%) was significantly lower than that in the control group (24.24%, Chi-square=4.963, P=0.026). Binary logistic regression analysis showed that the pre-training assessment score of joint function screening was an important influencing factor for training injuries in new recruits (OR=0.552, 95%CI: 0.413~0.660, P<0.001). The experimental group obtained notably higher mean assessment score than the control group [733.00(716.00,752.75) vs 728.79(710.46,744.28), P=0.027]. Linear regression analysis revealed a correlation between post-training score of joint function screening and the assessment score of newly trained personnel (P<0.001).

Conclusion‍

Joint function screening and correction for newly trained personnel can effectively prevent training-related injuries during the new training period, and correcting joint function through training can effectively improve the assessment score of newly trained personnel.

, authors=Enyu LEI1, Zhen CHEN2, Bing LI3, Ling ZHANG1, Honghui RONG1, Lu LU1, Chuanfen ZHENG1, Tao MENG2, Ji’an CHEN1, authorsList=Enyu LEI, Zhen CHEN, Bing LI, Ling ZHANG, Honghui RONG, Lu LU, Chuanfen ZHENG, Tao MENG, Ji’an CHEN, authorCompany=null, correspAuthors=Tao MENG, Ji’an CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=© 2025 Journal of Army Medical University, copyrightOwner=Editorial Office of Journal of Army Medical University, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322211150423503514, articleId=1322211147227443859, tenantId=1146029695717560320, journalId=1319373162502258839, language=CN, title=关节功能筛查及纠正在预防新训训练伤中的作用:一项随机对照试验, columnId=1322185581656920707, journalTitle=陆军军医大学学报, columnName=军事医学, runingTitle=null, highlight=null, articleAbstract=
目的

研究关节功能筛查及纠正对新训人员训练伤预防的干预效果和考核成绩的影响。

方法

试验采用随机对照设计,利用整群抽样法抽取陆军某单位2个建制单位新训人员共265人,按照随机数字表法将其分为对照组(132人)和试验组(133人)。试验组接受关节功能筛查及纠正动作培训并用于新训,对照组按照常规方法训练。试验前后分别采集受试者关节功能筛查数据、受试者新训成绩,训练伤发生情况和受训者人口学数据由训练单位提供。利用受试者工作特征(receiver operating characteristic,ROC) 曲线检验关节功能筛查对于训练伤的预测效能,利用二元Logistic回归和线性回归验证关节功能筛查得分与训练伤和训练成绩的关系。

结果

新训后试验组关节功能筛查分数[(16.62±1.87)分]高于对照组[(14.92±2.58)分,P<0.001];新训后试验组关节功能筛查分数高于新训前(12.82±1.98分,P<0.001);对照组新训后关节功能筛查分数亦高于新训前[(12.95±1.81)分,P<0.001];ROC曲线下面积AUC为0.762(95%CI:0.694~0.830),显示关节功能筛查对于训练伤的预测效能良好;新训过程中,试验组训练伤发生率(13.53%)明显低于对照组(24.24%,χ2=4.963,P =0.026);二元Logistic回归分析显示,训练前筛查评估得分是新训训练伤的有效预测指标(OR=0.552,95%CI:0.413~0.660,P<0.001);试验组新训人员考核成绩均值[733.00(716.00,752.75)分]明显高于对照组[728.79(710.46,744.28)分,P=0.027];线性回归分析显示,训练后关节功能筛查得分与新训人员考核成绩具有相关性(P<0.001)。

结论

利用关节功能筛查及纠正对新训人员开展干预可以有效预防新训期的新训训练伤,通过关节功能纠正训练可以有效提升新训人员的考核成绩。

, authors=雷恩宇1, 陈振2, 李冰3, 张玲1, 荣红辉1, 卢路1, 郑传芬1, 孟涛2, 陈济安1, authorsList=雷恩宇, 陈振, 李冰, 张玲, 荣红辉, 卢路, 郑传芬, 孟涛, 陈济安, authorCompany=null, correspAuthors=孟涛, 陈济安, authorNote=

同等贡献者

LEI Enyu and CHEN Zhen contributed equally to the article.

, correspAuthorsNote=
孟 涛,E-mail:
陈济安,E-mail:
MENG Tao,E-mail:
CHEN Ji’an,E-mail:
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指标对照组(n=132)试验组(n=133)tP
年龄/岁20.64+1.3820.83+1.34-1.4550.147
身高/cm171.52±5.99172.14±5.75-0.8510.396
体质量/kg65.77±9.0965.38±9.870.3340.738
BMI/(kg/m2)22.34±2.7922.01±2.720.9900.323
), ArticleFig(id=1322211167662093023, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=CN, label=表1, caption=

2组新训人员的人口学特征比较(x¯±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
指标对照组(n=132)试验组(n=133)tP
年龄/岁20.64+1.3820.83+1.34-1.4550.147
身高/cm171.52±5.99172.14±5.75-0.8510.396
体质量/kg65.77±9.0965.38±9.870.3340.738
BMI/(kg/m2)22.34±2.7922.01±2.720.9900.323
), ArticleFig(id=1322211167750173408, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
关节功能
筛查项目
训练前训练后对照组前后比较试验组前后比较
对照组
(n=132)
试验组
(n=133)
tP对照组
(n=132)
试验组
(n=133)
tPtPtP
足踝背屈1.50±0.561.55±0.54-0.7220.4712.05±0.712.41±0.49-4.785<0.001-8.000<0.001-16.612<0.001
直膝抬腿2.22±0.572.11±0.381.9290.0551.89±0.632.03±0.51-1.9320.0555.084<0.0011.7820.077
单腿平衡1.78±0.531.91±0.66-1.7670.0781.67±0.681.99±0.65-3.987<0.0012.0100.047-2.5770.011
胸椎旋转1.67±0.561.77±0.45-1.6000.1112.04±0.742.59±0.55-6.871<0.001-5.538<0.001-13.418<0.001
肩部回旋2.15±0.861.96±0.781.8710.0622.19±0.792.59±0.60-4.678<0.001-0.4530.651-10.078<0.001
俯卧推起1.50±0.731.53±0.74-0.2910.7112.57±0.602.55±0.580.2670.790-13.882<0.001-13.486<0.001
四足抗旋2.13±0.621.99±0.741.6170.1072.52±0.642.45±0.620.8290.408-4.905<0.001-5.570<0.001
关节功能
筛查总分
12.95±1.8112.82±1.980.5790.56314.92±2.5816.62±1.87-6.121<0.001-9.228<0.001-21.620<0.001
), ArticleFig(id=1322211167989248737, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=CN, label=表2, caption=

试验组和对照组新训人员关节功能筛查及分项目指标均值比较(x¯±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
关节功能
筛查项目
训练前训练后对照组前后比较试验组前后比较
对照组
(n=132)
试验组
(n=133)
tP对照组
(n=132)
试验组
(n=133)
tPtPtP
足踝背屈1.50±0.561.55±0.54-0.7220.4712.05±0.712.41±0.49-4.785<0.001-8.000<0.001-16.612<0.001
直膝抬腿2.22±0.572.11±0.381.9290.0551.89±0.632.03±0.51-1.9320.0555.084<0.0011.7820.077
单腿平衡1.78±0.531.91±0.66-1.7670.0781.67±0.681.99±0.65-3.987<0.0012.0100.047-2.5770.011
胸椎旋转1.67±0.561.77±0.45-1.6000.1112.04±0.742.59±0.55-6.871<0.001-5.538<0.001-13.418<0.001
肩部回旋2.15±0.861.96±0.781.8710.0622.19±0.792.59±0.60-4.678<0.001-0.4530.651-10.078<0.001
俯卧推起1.50±0.731.53±0.74-0.2910.7112.57±0.602.55±0.580.2670.790-13.882<0.001-13.486<0.001
四足抗旋2.13±0.621.99±0.741.6170.1072.52±0.642.45±0.620.8290.408-4.905<0.001-5.570<0.001
关节功能
筛查总分
12.95±1.8112.82±1.980.5790.56314.92±2.5816.62±1.87-6.121<0.001-9.228<0.001-21.620<0.001
), ArticleFig(id=1322211168089912034, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
关节功能
筛查项目
对照组
(n=132)
试验组
(n=133)
tP
足踝背屈0.55±0.790.86±0.60-3.601<0.001
直膝抬腿-0.33±0.74-0.08±0.49-3.2660.001
单腿平衡-0.11±0.650.08±0.37-3.0200.003
胸椎旋转0.36±0.750.81±0.70-5.023<0.001
肩部回旋0.04±0.960.63±0.72-5.689<0.001
俯卧推起1.07±0.881.02±0.870.4220.673
四足抗旋0.39±0.910.46±0.95-0.6340.526
筛查总分差值1.97±2.453.80±2.02-6.615<0.001
), ArticleFig(id=1322211168169603811, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=CN, label=表3, caption=

2组新训人员训练前后关节功能筛查评分差值比较(x¯±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
关节功能
筛查项目
对照组
(n=132)
试验组
(n=133)
tP
足踝背屈0.55±0.790.86±0.60-3.601<0.001
直膝抬腿-0.33±0.74-0.08±0.49-3.2660.001
单腿平衡-0.11±0.650.08±0.37-3.0200.003
胸椎旋转0.36±0.750.81±0.70-5.023<0.001
肩部回旋0.04±0.960.63±0.72-5.689<0.001
俯卧推起1.07±0.881.02±0.870.4220.673
四足抗旋0.39±0.910.46±0.95-0.6340.526
筛查总分差值1.97±2.453.80±2.02-6.615<0.001
), ArticleFig(id=1322211168425456356, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
体能项目对照组(n=132)试验组(n=133)ZP
军事技能课目A90.00(87.00,94.00)90.00(86.25,92.00)-1.4010.161
军事技能课目B100.00(98.00,100.00)100.00(97.00,100.00)-0.8750.382
军事技能课目C87.00(84.00,89.00)88.00(85.00,91.50)-2.7340.006
军事技能课目D88.25(86.50,90.00)93.50(92.50,94.50)-3.221<0.001
自救互救技术95.00(94.31,96.00)94.50(93.50,95.50)-13.5320.001
3 000 m跑步92.00(87.00,95.00)94.00(88.50,99.00)-2.9320.003
单杠94.00(78.00,100.00)92.00(78.00,100.00)-1.0320.302
双杠100.00(90.00,100.00)100.00(94.00,100.00)-1.1760.204
仰卧起坐84.35(73.20,98.50)87.00(74.00,96.50)-0.1710.864
基础体能组合93.50(90.00,98.00)93.00(90.00,97.00)-0.9590.337
考核成绩728.79(710.46,744.28)733.00(716.00,752.75)-2.2120.027
), ArticleFig(id=1322211168526119653, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322211147227443859, language=CN, label=表4, caption=

试验组和对照组新训人员考核成绩及分项指标均值的比较[M(P25,P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
体能项目对照组(n=132)试验组(n=133)ZP
军事技能课目A90.00(87.00,94.00)90.00(86.25,92.00)-1.4010.161
军事技能课目B100.00(98.00,100.00)100.00(97.00,100.00)-0.8750.382
军事技能课目C87.00(84.00,89.00)88.00(85.00,91.50)-2.7340.006
军事技能课目D88.25(86.50,90.00)93.50(92.50,94.50)-3.221<0.001
自救互救技术95.00(94.31,96.00)94.50(93.50,95.50)-13.5320.001
3 000 m跑步92.00(87.00,95.00)94.00(88.50,99.00)-2.9320.003
单杠94.00(78.00,100.00)92.00(78.00,100.00)-1.0320.302
双杠100.00(90.00,100.00)100.00(94.00,100.00)-1.1760.204
仰卧起坐84.35(73.20,98.50)87.00(74.00,96.50)-0.1710.864
基础体能组合93.50(90.00,98.00)93.00(90.00,97.00)-0.9590.337
考核成绩728.79(710.46,744.28)733.00(716.00,752.75)-2.2120.027
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关节功能筛查及纠正在预防新训训练伤中的作用:一项随机对照试验
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雷恩宇 1 , 陈振 2 , 李冰 3 , 张玲 1 , 荣红辉 1 , 卢路 1 , 郑传芬 1 , 孟涛 2 , 陈济安 1
陆军军医大学学报 | 军事医学 2025,47(9): 1003-1009
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陆军军医大学学报 |军事医学 2025 , 47 (9) : 1003 -1009
关节功能筛查及纠正在预防新训训练伤中的作用:一项随机对照试验
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雷恩宇1, 陈振2, 李冰3, 张玲1, 荣红辉1, 卢路1, 郑传芬1, 孟涛2 , 陈济安1
作者信息
  • 1陆军军医大学(第三军医大学):军事预防医学系军队健康教育教研室,重庆
  • 2陆军军医大学(第三军医大学):陆军卫勤训练基地军事共同与部队管理教研室,重庆
  • 3中国人民解放军31651部队,广西 柳州
通讯作者:
孟 涛,E-mail:
陈济安,E-mail:
MENG Tao,E-mail:
CHEN Ji’an,E-mail:
作者简介:

同等贡献者

LEI Enyu and CHEN Zhen contributed equally to the article.

Role of joint function screening and correction in preventing training injuries for new recruits: a randomized controlled trial
Enyu LEI1, Zhen CHEN2, Bing LI3, Ling ZHANG1, Honghui RONG1, Lu LU1, Chuanfen ZHENG1, Tao MENG2 , Ji’an CHEN1
Affiliations
  • 1Department of Health Education,Faculty of Military Preventive Medicine, Liuzhou,Guangxi,China
  • 2Department of Military Basic Training and Army Management,Army Medical University (Third Military Medical University),Chongqing, Liuzhou,Guangxi,China
  • 3Troop 31651 of PLA, Liuzhou,Guangxi,China
出版时间: 2025-05-15 doi: 10.16016/j.2097-0927.202412067
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目的

研究关节功能筛查及纠正对新训人员训练伤预防的干预效果和考核成绩的影响。

方法

试验采用随机对照设计,利用整群抽样法抽取陆军某单位2个建制单位新训人员共265人,按照随机数字表法将其分为对照组(132人)和试验组(133人)。试验组接受关节功能筛查及纠正动作培训并用于新训,对照组按照常规方法训练。试验前后分别采集受试者关节功能筛查数据、受试者新训成绩,训练伤发生情况和受训者人口学数据由训练单位提供。利用受试者工作特征(receiver operating characteristic,ROC) 曲线检验关节功能筛查对于训练伤的预测效能,利用二元Logistic回归和线性回归验证关节功能筛查得分与训练伤和训练成绩的关系。

结果

新训后试验组关节功能筛查分数[(16.62±1.87)分]高于对照组[(14.92±2.58)分,P<0.001];新训后试验组关节功能筛查分数高于新训前(12.82±1.98分,P<0.001);对照组新训后关节功能筛查分数亦高于新训前[(12.95±1.81)分,P<0.001];ROC曲线下面积AUC为0.762(95%CI:0.694~0.830),显示关节功能筛查对于训练伤的预测效能良好;新训过程中,试验组训练伤发生率(13.53%)明显低于对照组(24.24%,χ2=4.963,P =0.026);二元Logistic回归分析显示,训练前筛查评估得分是新训训练伤的有效预测指标(OR=0.552,95%CI:0.413~0.660,P<0.001);试验组新训人员考核成绩均值[733.00(716.00,752.75)分]明显高于对照组[728.79(710.46,744.28)分,P=0.027];线性回归分析显示,训练后关节功能筛查得分与新训人员考核成绩具有相关性(P<0.001)。

结论

利用关节功能筛查及纠正对新训人员开展干预可以有效预防新训期的新训训练伤,通过关节功能纠正训练可以有效提升新训人员的考核成绩。

新训人员  /  训练伤  /  关节功能筛查及纠正
Objective‍

To investigate the effects of joint function screening and correction on intervention efficacy of prevention and assessment score of training injuries in new recruits.

Methods‍

A randomized controlled study was conducted on 265 new recruits subjected from two organizational units of an army unit with cluster sampling. Based on entire organizational unit, the participants were randomly divided into a control group (n=132) and an experimental group (n=133). The experimental group received joint function screening and corrective movement training, which was subsequently applied in the new recruit training, while the control group underwent training according to conventional methods. Joint function were collected before and after training. The demographic data, assessment score of training, and incidence of training injuries were collected through the participant’s own organizational unit. Receiver operating characteristic (ROC) curve was plotted to evaluate the efficacy of joint function screening in predicting training injuries, and binary logistic regression and general linear regression analyses were applied to verify the correlation of joint function screening score with training injuries and assessment score of training.

Results‍

After new training, the score of joint function screening was significantly higher in the experimental group than the control group (16.62±1.87 vs 14.92±2.58, P<0.001). And the score was obviously increased in the experimental group (16.62±1.87 vs 12.82±1.98, P<0.001) and the control group (14.92±2.58 vs 12.95±1.81, P<0.001) when compared with the corresponding score before training. The area under the ROC curve (AUC) of joint function screening in predicting training injuries was 0.762 (95%CI: 0.694~0.830), indicating good predictive efficacy. During the new training process, the incidence of training injuries in the experimental group (13.53%) was significantly lower than that in the control group (24.24%, Chi-square=4.963, P=0.026). Binary logistic regression analysis showed that the pre-training assessment score of joint function screening was an important influencing factor for training injuries in new recruits (OR=0.552, 95%CI: 0.413~0.660, P<0.001). The experimental group obtained notably higher mean assessment score than the control group [733.00(716.00,752.75) vs 728.79(710.46,744.28), P=0.027]. Linear regression analysis revealed a correlation between post-training score of joint function screening and the assessment score of newly trained personnel (P<0.001).

Conclusion‍

Joint function screening and correction for newly trained personnel can effectively prevent training-related injuries during the new training period, and correcting joint function through training can effectively improve the assessment score of newly trained personnel.

new recruits  /  training injuries  /  joint function screening and correction
雷恩宇, 陈振, 李冰, 张玲, 荣红辉, 卢路, 郑传芬, 孟涛, 陈济安. 关节功能筛查及纠正在预防新训训练伤中的作用:一项随机对照试验. 陆军军医大学学报, 2025 , 47 (9) : 1003 -1009 . DOI: 10.16016/j.2097-0927.202412067
Enyu LEI, Zhen CHEN, Bing LI, Ling ZHANG, Honghui RONG, Lu LU, Chuanfen ZHENG, Tao MENG, Ji’an CHEN. Role of joint function screening and correction in preventing training injuries for new recruits: a randomized controlled trial[J]. Journal of Army Medical University, 2025 , 47 (9) : 1003 -1009 . DOI: 10.16016/j.2097-0927.202412067
随着正规化建设工作的推进,在新训周期缩短的同时,新训人员训练强度大幅提升,新训人员新训训练伤的发生也显著增加,并成为影响新训成效的重要因素。研究表明不同军兵种的新训人员训练伤发生率不尽相同[1-5],且膝关节以下部位损伤高发,同时与训练强度和训练课目密切相关[5]。因此,科学预测训练伤病,合理处置相关风险因素便成为预防新训人员新训训练伤的重要抓手。
研究发现,关节功能是训练伤发生的重要相关因素,利用功能性运动筛查(functional movement screening,FMS)可以在训练中较好地预测训练伤的发生[6]。研究表明,利用FMS技术针对关节功能进行干预可以有效降低训练伤的发生率[7-10],且FMS总分可以用于预测训练与运动中的损伤风险[11]。但也有研究显示,FMS技术对男性军事训练伤风险的预测存在缺陷[12],且FMS技术的内部和外部效度都具有一定局限性[13],并未针对性地对我国新训训练内容进行优化。因此,本研究采用针对性的《身体关节功能筛查及纠正》[14]技术,基于该技术对新训人员新训训练进行干预,以期为新训训练伤的防治提供支撑。
试验采用随机对照设计,利用整群抽样法抽取陆军某单位2个建制单位新训人员共265人,按照随机数字表法分为对照组(n=132)和试验组(n=133)。纳入标准:①18~22岁;②无既往骨、关节、肌肉组织伤病史及手术史;③自愿参与研究并签署知情同意书。排除标准:①有其他系统严重疾病或慢性疾病;②无法按时参与并完成测试与考核;③在新训期间由于各种原因编制调整,退出训练。本研究经陆军军医大学医学伦理委员会审批(2023第2-02)。
关节功能筛查及纠正是一套适合于部队军事训练伤防治和训练纠正的早期预警筛查技术,分为足踝背屈、直膝抬腿、单腿平衡、胸椎旋转、肩部回旋、俯卧推起、四足抗旋7个动作,测试动作标准详见《身体关节功能筛查及纠正》[14]。
分别于2023年4月1日至5月28日由课题组成员组织测试,受试者按照足踝背屈、直膝抬腿、单腿平衡、胸椎旋转、肩部回旋、俯卧推起、四足抗旋顺序测试。测试时间均为上午8:00-12:00,地点在该单位室内训练场。按照身体关节功能筛查要求,采用筛查套件(2根直径3 cm、长150 cm的PVC管和1根记号笔)进行筛查测试。测试前不进行热身,左右2侧动作重复;每个动作重复3次,测试中需询问是否有疼痛。每个动作的完成情况根据《身体关节功能筛查及纠正》[14]书中的要求予评0、1、2、3分。除俯卧推起测试不区分左右,其余 6个测试均为双侧筛查,成绩取双侧结果中的最低值。7个筛查动作总分即为关节功能筛查得分,满分为21分[14]。
试验组新训人员进行下肢关节功能的专项干预训练,根据《身体关节功能筛查及纠正》[14]中的足踝背屈纠正训练方案和单腿平衡纠正训练方案,除去重置与整合环节,把准备、强化、放松环节加入该连日常体能训练的热身、训练、放松中;其余关节功能缺陷受试者根据自身情况自行训练。对照组采用常规训练模式。
本试验主要研究终点为训练伤发生率,训练伤诊断按照《军事训练伤诊断标准及防治原则》[15],由训练单位卫生机构及驻营医务人员完成新训期间新训训练伤的诊断与统计,新训人员考核成绩(包括4项军事技能、自救互救技术、基础体能5项)和人口学数据由训练单位直接提供,以上数据由试验人员定期评估检查。
关节功能筛查测试在课题组成员现场指导下进行,测试人员与辅助测试人员由接受过陆军军医大学身体关节功能筛查培训的新训骨干担任,当测试人员与辅助测试人员意见不统一时,由负责现场试验的课题组成员进行评分。试验利用受试者工作特征(receiver operating characteristic,ROC)曲线的预测效能对关节功能筛查测试的准确性进行质量控制。
采用 SPSS 26.0 软件进行统计处理。对于符合正态分布的计量资料采用t检验,成对样本采用配对t检验,采用x¯±s表示,不符合正态分布的计量资料比较采用Mann-Whitney U检验,采用M(P25,P75)表示;率的比较采用χ2检验。两变量相关性检验采用Pearson相关性分析;利用二元Logistic回归分析关节功能筛查得分对训练伤发生情况的影响;利用ROC曲线评估身体关节功能筛查的诊断效果。P<0.05表示差异具有统计学意义。
2组新训人员在年龄及体格特征方面差异均无统计学意义(表1)。
新训人员训练前,试验组关节功能筛查总分与对照组关节功能筛查总分的差异无统计学意义(P=0.563),7个分项平均得分差异均无统计学意义;试验组在新训人员训练期间增加干预训练后,在总分、足踝背屈、单腿平衡、胸椎旋转、肩部回旋项目的平均得分均高于对照组新训人员(P均<0.001); 与新训前比较,对照组的新训人员在足踝背屈、胸椎旋转、俯卧推起、四足抗旋 4个项目上训练后的得分提升(P均<0.001),但在直膝抬腿、单腿平衡 2个项目上训练后的得分降低(P<0.001,P=0.047),关节功能筛查总分高于训练前总分(P<0.001);试验组的新训人员在足踝背屈、单腿平衡、胸椎旋转、肩部回旋、俯卧推起、四足抗旋 6个分项上,训练后的得分均高于训练前(P均<0.05),关节功能筛查的总分显著高于训练前总分(P<0.001,表2)。
试验组通过训练期间增加足踝与膝关节功能的干预训练后,在筛查总分差值以及足踝背屈、直膝抬腿、单腿平衡、胸椎旋转、肩部回旋得分差值上高于对照组新训人员(P均<0.01,表3)。
关节功能筛查得分的ROC曲线位于参考线左上方,曲线下面积(area under curve,AUC)为0.762(95%CI:0.694~0.830),诊断预测具有统计学意义(P<0.05,图1)。
对照组新训人员的全因训练伤发生率(24.24%,32例)显著高于试验组新训人员的全因训练伤发生率(13.53%,18例,χ2=4.963,P=0.026)。
以新训人员新训前关节功能筛查得分作为自变量,以是否发生训练伤作为因变量,进行二元Logistic回归分析。结果显示:训练前关节功能筛查得分是新训人员发生训练伤的有效预测指标(OR=0.552,95%CI:0.413~0.660,P<0.001)。
对照组新训人员考核成绩[728.79(710.46,744.28)分]显著低于试验组的新训人员考核成绩均值[733.00(716.00,752.75)分,P=0.027]。在军事技能课目C、军事技能课目D、自救互救技术、3 000 m跑步分数上,2组新训人员平均得分差异具有统计学意义(P均<0.01),其中军事技能课目C、军事技能课目D、3 000 m跑步 3项成绩试验组优于对照组;而自救互救技术成绩对照组优于试验组。在军事技能课目A、军事技能课目B、单杠、双杠、仰卧起坐、基础体能组合6项成绩上,2组新训人员平均得分差异均无统计学意义(表4)。
采用线性回归对新训人员考核成绩与关节功能筛查最终得分进行相关性分析发现,关节功能筛查最终得分与新训人员考核成绩具有相关性(B=3.341,P<0.001),Pearson相关系数为0.250(P<0.001),属于弱相关范畴。
身体关节功能筛查技术可以用于在军事训练前发现军人身体运动功能缺陷、预测军事训练伤发生风险,是纠正训练开展与效果评估的重要依据[14]。目前,关于军人身体关节功能筛查技术的研究报道较少,但因其与FMS均为通过动作模式评估身体功能的技术手段,且在部分筛查动作与评分标准上具有相近性[14],所以FMS的研究结果一定程度上可以借鉴使用。
试验显示,新训人员入营时关节功能筛查评分[试验组(12.82±1.98)分,对照组(12.95±1.81)分]低于指导用书中的原标准14分,但高于王刚等[16]的研究[(9.46±1.96)分]。同时与FMS评分做比较,刚入营新训人员关节功能筛查评分低于炮兵、特战、勤务支援的FMS评分14.01、14.78、13.62分[10,17-18]。完成新训后,关节功能筛查评分均有提升。提示在新训过程中,新训人员关节功能可以得到提升,而在进行针对性的干预训练后,关节功能提升更加显著。
本研究ROC曲线验证了关节功能筛查对于新训训练伤的预测价值[16];Logistic回归分析确定了关节功能筛查得分可以预测训练伤发生风险[19-20],其回归系数B>0,同时OR<1,表明得分与新训人员罹患新训训练伤的风险呈负相关[6]。然而,本研究ROC曲线预测效率低于王刚等[16]的研究AUC[0.875(95%CI:0.789~0.952)],本研究认为可能是由于测试者经验不足,对动作评分主观性较大所致。
新训开始前,2组新训人员关节功能筛查评分无显著统计学差异,故2组人员训练伤发生的风险大致相当。但经过针对性干预后,对照组新训人员的全因训练伤发生率显著高于试验组新训人员的训练伤发生率。提示本研究采取的干预措施对全因训练伤发生率的降低具有积极意义。但本试验未能证实2组新训人员训练前后关节功能筛查评分差值与训练伤发生间的相关关系,仍有待在后续研究中进一步探索。
本研究利用线性回归模型对关节功能评分与考核成绩进行分析,发现二者存在线性相关关系;但二者的Pearson相关系数仅为0.250,属于弱相关,未能完全证实关节功能筛查技术与新训人员考核成绩的关系。这与BONAZZA等[13]对FMS研究结果近似。本研究认为可能是因为新训人员考核成绩不仅仅取决于关节功能;且关节功能对于体能的贡献并非是均匀线性的,利用简单的线性相关回归难以准确描述其相关关系[21-22]。
综上所述,本研究通过身体关节功能筛查技术对新训人员开展筛查、干预,验证了身体关节功能筛查技术对训练伤的预测效能,同时验证了干预在降低训练伤风险以及提升训练成绩中的有效性。但新训训练伤成因复杂,考虑到本研究样本量较小,存在一定试验误差,调查对象主要来源于陆军新训人员,因此各单位具体使用时宜根据实际情况对做出适当调整。

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2025年第47卷第9期
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doi: 10.16016/j.2097-0927.202412067
  • 接收时间:2024-12-12
  • 首发时间:2026-10-28
  • 出版时间:2025-05-15
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  • 收稿日期:2024-12-12
  • 修回日期:2025-03-04
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    1陆军军医大学(第三军医大学):军事预防医学系军队健康教育教研室,重庆
    2陆军军医大学(第三军医大学):陆军卫勤训练基地军事共同与部队管理教研室,重庆
    3中国人民解放军31651部队,广西 柳州

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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