柔道运动员的前庭功能：亚临床前庭功能障碍的证据

文献信息

中文摘要

背景： 柔道是一项动态对抗性运动，对平衡能力、敏捷性、姿势控制和动觉意识有很高要求。前庭系统在维持平衡和空间定向方面起着至关重要的作用，并整合对柔道表现至关重要的感觉输入。然而，尽管柔道运动员经常暴露于头部撞击和快速旋转运动，这些可能影响前庭完整性，但很少有研究直接检测柔道运动员的前庭功能。
目的： 本研究旨在比较现役柔道运动员与健康对照者的前庭功能。
研究设计： 采用横断面比较设计。
研究样本： 研究纳入26名职业柔道运动员（年龄18-23岁，训练经验≥5年）和23名年龄、性别匹配的健康对照者。
数据收集与分析： 使用视频头脉冲试验评估半规管功能，并使用颈性和眼性前庭诱发肌源性电位（cVEMP和oVEMP）评估耳石器功能。对运动员施测脑震荡后症状量表（PCSS），以评估与既往轻微头部撞击相关的潜在症状。组间比较采用独立样本t检验分析，Pearson相关分析用于检验前庭结局、PCSS评分和训练年限之间的关系。
结果： 与对照者相比，柔道运动员在所有半规管中的前庭眼反射（VOR）增益均显著降低（p < 0.05）。两组之间在cVEMP和oVEMP参数方面未观察到显著差异（p > 0.05）。PCSS评分与前庭测试结果或训练持续时间无相关性（p > 0.05）。
结论： 这些发现表明，柔道诱导的微创伤可能选择性影响半规管功能，而未累及耳石器反应。运动员中VOR增益的亚临床下降提示，即使没有明显症状，反复头部加速度和旋转运动也可能导致亚临床VOR改变。
临床相关性声明： 运动员中的亚临床前庭改变可能导致平衡不稳并增加损伤风险。对接触性运动运动员进行常规前庭筛查可能有助于早期发现、针对性康复和改善长期姿势控制。

英文摘要

BACKGROUND: Judo is a dynamic combat sport demanding high levels of balance, agility, postural control, and kinesthetic awareness. The vestibular system plays a vital role in maintaining balance and spatial orientation, integrating sensory inputs essential for judo performance. However, few studies have directly examined vestibular function in judo athletes, despite their frequent exposure to head impacts and rapid rotational movements that may affect vestibular integrity.
PURPOSE: This study aimed to compare the vestibular functions of active judo athletes with those of healthy controls.
RESEARCH DESIGN: A cross-sectional comparative design was employed.
STUDY SAMPLE: The study included 26 professional judo athletes (aged 18-23 years, ≥5 years of training experience) and 23 age- and sex-matched healthy controls.
DATA COLLECTION AND ANALYSIS: Vestibular function was assessed using the video head impulse test for semicircular canal function and cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP) for otolith organ function. The Post-Concussion Symptom Scale (PCSS) was administered to athletes to assess potential symptoms related to prior minor head impacts. Group comparisons were analyzed using independent-samples t tests, and Pearson correlation analysis examined relationships between vestibular outcomes, PCSS scores, and years of training.
RESULTS: Judo athletes demonstrated significantly reduced vestibulo-ocular reflex (VOR) gains across all semicircular canals compared with controls (p < 0.05). No significant differences were observed between groups in cVEMP and oVEMP parameters (p > 0.05). PCSS scores were not correlated with vestibular test outcomes or training duration (p > 0.05).
CONCLUSIONS: These findings suggest that judo-induced microtraumas may selectively affect semicircular canal function while sparing otolith organ responses. The subclinical decrease in VOR gains in athletes suggests that repeated head accelerations and rotational movements may lead to subclinical VOR alterations even in the absence of overt symptoms.
CLINICAL RELEVANCE STATEMENT: Subclinical vestibular alterations in athletes may contribute to balance instability and increase injury risk. Routine vestibular screening in contact-sport athletes could support early detection, targeted rehabilitation, and improved long-term postural control.