国家自然科学基金项目（ 30870600， 11972242， 11632013）；山西省高等学校哲学社会科学研究项目（ 2017313， 2019W025）； 2018 年教育部人文社会科学研究规划基金项目（ 18YJA890034）；山西省回国留学人员科研资助项目；太原理工大学学科建设经费资助。
1.College of Physical Education,Taiyuan University of Technology;2.China;3.Shanghai Jiao Tong University;4.Beijing Sports University
目的 应用蒙特卡罗模拟技术分析排球运动员ACL损伤危险因素是否受到性别或/和动作的影响。方法 采集排球运动员急停起跳、起跳垂直落地和急停变向跑时的运动生物力学数据，运用模拟得到运动员ACL损伤概率和损伤试跳的生物力学参数。采用2×3混合设计的双因素方差分析验证性别和动作对损伤危险因素的影响。结果 不论男女，急停变向跑ACL损伤危险性最大（P<0.001）。与男子相比，女子运动员变向跑和急停起跳动作ACL损伤危险更大（P<0.001），垂直落地时男子比女子排球运动员更易发生损伤（P<0.001）。排球运动员ACL损伤危险因素均受性别和动作的显著性交互作用（P<0.001）。结论 急停变向跑时，男子排球运动员比女子更可能由于膝关节屈角小、小腿趋于前倾以及足跟着地而增加ACL负荷，而女子运动员则倾向于由于大的地面反作用力和膝关节伸展力矩使其损伤风险增加。女子排球运动员急停起跳时，主要表现为较小的膝关节屈角导致ACL损伤；而男子损伤危险因素包括小腿前倾、足跟着地、大的地面反作用力、膝关节外翻力矩和伸展力矩增加等。完成垂直落地动作时，女子排球运动员损伤危险因素主要是较大的水平向后和垂直地面反作用力、较大的膝关节外翻和伸展力矩以及足跟着地等；较小的膝关节屈角是男子排球运动员ACL损伤主要危险因素。本研究结果可为排球运动员ACL损伤风险评价、个性化损伤预防方案制定、临床与康复治疗等提供依据。
Objective The purposes of study were to verify the effect of gender and maneuvers on Anterior Cruciate Ligament (ACL) injuries risk factors for volleyball players with Monte Carlo simulation. Methods Kinematics, kinetic and EMG were collected for volleyball players during stop-jump, drop landing and sidestep cutting maneuvers. The ACL injury rate and lower extremity biomechanical characteristics of simulated injured jumps were output with Simulation. 2×3 mixed designed two-way ANOVA was used to identify the influence of gender and maneuvers on ACL injuries risk factors. Results Sidestep cutting was the highest risk maneuver of ACL injury for both genders (P<0.001). Compared to males, females had a greater risk of ACL injury during sidestep cutting and stop-jump (P<0.001), while male players were more prone to have ACL injury than females during drop landing (P<0.001). The risk factors of ACL injury obtained by simulation were significantly influenced by gender and maneuvers (P<0.001). Conclusion Male players were more likely to increase ACL load due to smaller knee flexion, forward leg tilt and heel landing than females during sidestep cutting, while females owned larger GRF and knee extension moment. The risk factors for female players was smaller knee flexion angle during stop jump, however the forward leg tilt, heel landing, larger GRF, knee valgus and extension moment contributed to male athletes ACL injuries. Female players with large posterior and vertical GRF, knee valgus and extension moment, and heel-landing were likely to have ACL injury, while the small knee flexion angle was the key risk factor for males. The results could provide evidences for evaluation of volleyball players’ ACL injury risk, individualized injury prevention protocols, and clinical treatment and rehabilitation directions.