Journal of athletic training · 2025
Risk Factors for Patellofemoral Pain in the Military: Systematic Review With Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Rocha Emannuel Alcides Bezerra, Costa de Assis Sanderson José, Maciel Maia Dean Felipe, Barbosa Germanna de Medeiros, Oliveira Neto Leonidas de, Scattone Silva Rodrigo
Аннотация
BACKGROUND: The main cause for military training attrition is musculoskeletal injuries to the knee, such as patellofemoral pain (PFP).
OBJECTIVE: To identify which factors increase the risk of PFP occurrence in military personnel.
DESIGN: Systematic review with meta-analysis.
DATA SOURCES: Searches were performed in MEDLINE/PubMed, CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, and OpenGray databases.
STUDY SELECTION: Included studies included military personnel and had a prospective cohort design investigating at least 1 variable as a risk factor for PFP.
DATA EXTRACTION: Extraction was performed by 2 independent evaluators, and the data were separated between the military personnel who developed PFP and those who did not.
DATA SYNTHESIS: Meta-analyses were performed using standardized mean differences (SMDs) and 95% CIs, and levels of recommendation were determined.
RESULTS: From 11 articles, this review grouped 7518 military personnel, of whom 572 (7.61%) developed PFP. We found moderate evidence that isokinetic knee-extensor weakness at 60°/s predicts PFP in the military (SMD = -0.69; 95% CI = -1.02, -0.35). A larger frontal-plane knee-projection angle during the single-legged squat was also identified as a risk factor for PFP in male military personnel (SMD = 0.55; 95% CI = 0.14, 0.97) with a moderate level of evidence. We found moderate evidence that sex, body mass index, isometric knee-extensor strength, and isokinetic knee-flexor strength do not predict PFP in military personnel. Finally, we found strong evidence that age and body mass do not predict PFP in this population.
CONCLUSIONS: Deficits in isokinetic knee-extensor strength and a greater frontal-plane knee-projection angle are risk factors for PFP in military personnel. Given that these are modifiable factors, these aspects should be considered in injury-prevention interventions in the military.
OBJECTIVE: To identify which factors increase the risk of PFP occurrence in military personnel.
DESIGN: Systematic review with meta-analysis.
DATA SOURCES: Searches were performed in MEDLINE/PubMed, CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, and OpenGray databases.
STUDY SELECTION: Included studies included military personnel and had a prospective cohort design investigating at least 1 variable as a risk factor for PFP.
DATA EXTRACTION: Extraction was performed by 2 independent evaluators, and the data were separated between the military personnel who developed PFP and those who did not.
DATA SYNTHESIS: Meta-analyses were performed using standardized mean differences (SMDs) and 95% CIs, and levels of recommendation were determined.
RESULTS: From 11 articles, this review grouped 7518 military personnel, of whom 572 (7.61%) developed PFP. We found moderate evidence that isokinetic knee-extensor weakness at 60°/s predicts PFP in the military (SMD = -0.69; 95% CI = -1.02, -0.35). A larger frontal-plane knee-projection angle during the single-legged squat was also identified as a risk factor for PFP in male military personnel (SMD = 0.55; 95% CI = 0.14, 0.97) with a moderate level of evidence. We found moderate evidence that sex, body mass index, isometric knee-extensor strength, and isokinetic knee-flexor strength do not predict PFP in military personnel. Finally, we found strong evidence that age and body mass do not predict PFP in this population.
CONCLUSIONS: Deficits in isokinetic knee-extensor strength and a greater frontal-plane knee-projection angle are risk factors for PFP in military personnel. Given that these are modifiable factors, these aspects should be considered in injury-prevention interventions in the military.