Epidemiologia das lesões musculoesqueléticas e análise do perfil de risco em atletas de futebol feminino

Abstract

Musculoskeletal injuries in women's soccer are highly frequent in all categories. To reduce these risks, epidemiological surveys and integration of multiple factors into preventive interventions are recommended. However, there is a lack of structural and personnel investments, hired professionals, and infrastructure. Furthermore, analyzing the injury profile specifically in each context allows for the development of more effective prevention strategies tailored to the athletes' routine. The aim of this study was to identify, using the CART method, interactions between muscle strength, flexibility, functional stability, and body composition associated with the occurrence of musculoskeletal injuries in the lower limbs in female soccer players throughout the seasons. This retrospective cohort study analyzed clinical data from preseason assessments in 2023 of an elite women's soccer team in Brazil, involving athletes over 18 years of age. The pre-season assessment included measurement of lower limb length, followed by mobility and flexibility tests, such as hamstring flexibility, passive hip internal rotation range of motion, modified Thomas test, and trunk mobility. Muscle strength tests were performed, including maximal muscle torque and power of the hamstrings and quadriceps using an isokinetic dynamometer, lateral trunk flexor strength, and hip adductor strength. To assess muscle power, the Squat Jump and Countermovement Jump (CMJ) were used. Stability and neuromuscular control parameters were assessed using the Hop Test (Single and Triple Hop) and the modified Star Excursion Balance Test (SEBT). Finally, functionality and movement were analyzed with the Lunge Test, Hip Sit, and Thorborg test. Information on sleep quality and perception of recovery from training and matches was also included. Data analysis was performed using Classification and Regression Tree (CART) to identify interactions associated with the occurrence of lower limb musculoskeletal injuries. The area under the ROC (Receiver Operating Characteristics) curve was calculated to verify the accuracy of the models and the odds ratio was calculated for each terminal node. The results indicated that the CART analysis included five independent variables associated with the occurrence of lower limb muscle injuries, mean CMJ height, Single Hop Test asymmetry, hamstring power, Hip Sit strength, and PRQ recovery quality. The CART model correctly classified 84.6% of athletes with musculoskeletal injuries and 100% of athletes without injuries. The study showed that interactions between clinical measures such as CMJ, Single Hop Test, Hip Sit, hip extensor power and PQR were associated with the occurrence of lower limb musculoskeletal injuries during the 2023 season. The combinations and cutoff points of these variables highlight the importance of continuous data monitoring to better understand the evolution of injuries over time.