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わが国のハンドボール競技における傷害および疼痛発生の実態

眞下, 苑子 筑波大学 DOI:10.15068/0000055011

2020.07.21

概要

スポーツ活動は,身体的・社会的側面において良い効果をもたらす一方,傷害発生の危険性を高めることが報告されている1.特に競技スポーツにおいては,傷害を予防し,パフォーマンスを向上させることが求められる.

スポーツ傷害予防を実践するためには,van Mechelenら2により4段階の予防戦略(図1)に基づくことが提唱されている.第1段階は,傷害調査を実施し,傷害発生の実態を把握することである.第2段階は調査の結果を元に傷害発生要因とメカニズムを解明すること,第3段階は傷害発生要因に対する予防介入を行うこと,第4段階は介入効果の検証を行うこととしている.そのため,第1段階で行われる傷害調査は,傷害予防を実践するための最初に行われるものであり,その後の傷害発生要因やメカニズムの解明,傷害予防策の導入のためには必須である.

傷害発生の実態把握のために行われる傷害調査は,各競技団体やInternational Olympic Committee(以下,IOC)から調査方法に関する合意声明が出されており,傷害の定義や傷害部位の分類など合意声明に基づいて調査を行うことが推奨されている.合意声明は,クリケット競技3,4が最初であり,その後サッカー競技5,ラグビー競技6,7など複数の競技団体から出されている8–11.また,1つのスポーツ種目のみならず複数のスポーツ種目を調査する方法としてIOCより合意声明が出されている12.これらの合意声明に基づいて調査を行うことで,調査結果の比較ができ,傷害発生の実態を把握することが可能となる.

傷害調査を実施する際に,傷害の定義の選択が調査結果に最も影響を与えるとされる13.上述した合意声明5,6では,「Any physical complaint」,「Medical attention injury」,「Time loss injury」の3つの定義の中から目的に適した定義を選択することが推奨されている.「Any physical complaint」は,医療行為の有無やスポーツ活動への不参加の有無に関わらず,スポーツ活動によって生じた全ての身体の不調と定義されている5,6.この定義を用いて調査を行った場合,疼痛や腫脹,可動域制限など身体に起こる全ての不調を記録することができるため,最も広義の定義となる(図2)14,15.一方,「Medical attention injury」は身体の不調の中でも医療従事者による医療行為を必要としたもの,「Time loss injury」は次に予定されている練習または試合に参加できないものと定義されており5,6,より狭義の定義となる14,15.

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