Page 140 - 《运动与健康科学》(英文)2024年第2期

TaggedAPTARAEnd262 W. Chen et al.
other hand, the pain at the insertion site of the Achilles tendon midportion AT. To better understand the association between
could be caused by enthesitis, as a result of axial spondylar- AT and overload, global positioning systems or devices esti-
46
thritis. Axial spondylarthritis is known to have its onset in early mating local Achilles tendon load should be equipped to
47
adulthood (median age 26 years ). Enthesitis, as one of the axial collect more precise data for change in training load. Factors
spondylarthritis features, could cause insertional Achilles tendon associated with metabolic disorders 48 should also be explored
pain on relatively younger individuals, which might explain this to verify their role in the onset of injury.TaggedAPTARAEnd
identified risk factor. Midportion AT was more frequently
observed in participants who were preparing for the marathon
TaggedAPTARAH15. ConclusionTaggedAPTARAEnd
event. However, this was not significantly associated with inser-
tional AT, which might suggest that midportion AT is caused by TaggedAPTARAPThe incidence of AT was 4.2% during 20 weeks of follow-up
higher training loads compared to insertional AT. We should, among recreational runners. Incidence of insertional and
midportion AT was 28% and 64%, respectively (combined
however, be cautious with this conclusion. Even though statistical
type 8%). As AT in the past 12 months was the predominant
differences were found in our analyses, their clinical significance
risk factor for the onset of AT, this emphasizes the need for
needs further confirmation. The average age of participants who
effective prevention of recurrent AT. Insertional AT was
had new-onset insertional AT and midportion AT were in the
associated with younger age, and midportion AT was more
same stage of life, 40 years and 45 years, respectively. Unlike
frequently observed in participants who trained for the mara-
midportion AT, the onset of insertional AT was not significantly
thon. It remains undetermined whether these differences are
associated with the event registered, but the number of insertional
AT subjects was not even a half of midportion cases, which of clinical significance.TaggedAPTARAEnd
limited the statistical power. Our findings on different risk factors
for insertional and midportion AT warrant future research into TaggedAPTARAH1AcknowledgmentsTaggedAPTARAEnd
the etiology of these 2 subtypes. Although, it should also be
TaggedAPTARAPThis work was supported by the Netherlands Organisation
noted that the observed differences in risk factors between
for Health Research and Development (ZonMW) (Grant No.
midportion and insertional AT are limited. It remains opens to
50-53600-98-104) and China Scholarship Council (CSC)
discussion whether there is solid ground for regarding them as
(Grant No. 202106100138).TaggedAPTARAEnd
distinct subcategories from a clinical perspective.TaggedAPTARAEnd
TaggedAPTARAPThe biggest strength of the current study is that it was based on
the largest prospective cohort of recreational runners to date and TaggedAPTARAH1Authors’ contributionsTaggedAPTARAEnd
included runners of a wide range of ages and backgrounds. Hence, TaggedAPTARAPKLAC performed the data collection and data analysis; WC
the results are potentially applicable to the general running popula- conducted data analysis and wrote the manuscript under the
tion. We included 14 risk factors in the model and were able to supervision of SMABZ, MvM, and RJdV. All authors have
detect moderate associations due to the high number (141) of cases read and approved the final version of the manuscript, and
of new-onset AT occurrences during follow-up. Risk factors for
agree with the order of presentation of the authors.TaggedAPTARAEnd
insertional and midportion subtypes were explored separately with
the intention of revealing any discrepancies between them.TaggedAPTARAEnd
TaggedAPTARAH1Competing interestsTaggedAPTARAEnd
TaggedAPTARAPLimitations also exist in the present study. Statistical differ-
ences in age, weight, and years of training were found between TaggedAPTARAPThe authors declare that they have no competing interests.TaggedAPTARAEnd
responders and non-responders. However, the differences seem
to be a result of the large sample size and are small enough that TaggedAPTARAH1Supplementary materialsTaggedAPTARAEnd
they are unlikely to be of clinical relevance. It is possible that
TaggedAPTARAPSupplementary materials associated with this article can be
misdiagnosis of Achilles tendon injury occurred since onset was
self-reported. To improve diagnostic accuracy, a standardized found in the online version at doi:10.1016/j.jshs.2023.03.007.TaggedAPTARAEnd
pain map was used in the present study. A previous study
confirmed a 93% agreement between patient-reported AT with TaggedAPTARAH1ReferencesTaggedAPTARAEnd
the assistance of the pain map and a physician-established diag- TaggedAPTARAListItem TaggedAPTARAListLabel1TaggedAPTARAEnd. Asplund CA, Best TM. Achilles tendon disorders. BMJ 2013;346:f1262.
nosis. 21 Moreover, 82% of the subcategories of AT (insertional/
doi:10.1136/bmj.f1262TaggedAPTARAEnd.TaggedAPTARAEnd
midportion) reported by patients coincided with their diagnosis TaggedAPTARAListItem TaggedAPTARAListLabel2TaggedAPTARAEnd. de Vos R-J, van der Vlist AC, Zwerver J, et al. Dutch multidisciplinary
21
by the physician. This increases the likelihood that self-reported guideline on Achilles tendinopathy. Br J Sports Med 2021;55:1125–34TaggedAPTARAEnd.
AT is consistent with the clinical diagnosis of AT in the vast TaggedAPTARAListItem TaggedAPTARAListLabel3TaggedAPTARAEnd. Strasser NL, Farina KA. Haglund’s syndrome and insertional Achilles
tendinopathy. Oper Tech Sports Med 2021;29:150850. doi:10.1016/j.
majority of cases. Finally, the training-load data from the baseline
otsm.2021.150850TaggedAPTARAEnd.
questionnaire might be imprecise due to recall bias, and no TaggedAPTARAListItem TaggedAPTARAListLabel4TaggedAPTARAEnd. Kujala UM, Sarna S, Kaprio J. Cumulative incidence of Achilles tendon
training-load data was collected during follow-up. Despite these rupture and tendinopathy in male former elite athletes. Clin J Sport Med
limitations, our study took the first step toward understanding the 2005;15:133–5TaggedAPTARAEnd.
association between new-onset AT and changes in training load TaggedAPTARAListItem TaggedAPTARAListLabel5TaggedAPTARAEnd. Sleeswijk Visser TSO, van der Vlist AC, van Oosterom RF, van Veld-
hoven P, Verhaar JAN, de Vos RJ. Impact of chronic Achilles tendinop-
over a lengthy timespan prior to a running event.TaggedAPTARAEnd
athy on health-related quality of life, work performance, healthcare
TaggedAPTARAPFuture prospective studies should focus on the role of utilisation and costs. BMJ Open Sport Exerc Med 2021;7:e001023.
change in load as a risk factor for both insertional and doi:10.1136/bmjsem-2020-001023TaggedAPTARAEnd.