圖1:Oevrevoll賽馬場的跨欄。如果馬匹或騎師在跳躍時出現問題,在外圍設置逃生路線。跨欄較低,上邊緣柔軟
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職業賽馬中的事故和傷害,挪威賽馬運動中一項為期2年的騎師受傷完整登記
Ole Reigstad1、2 *詹姆斯·艾德·麥克弗森1、4Marte Myhre Reigstad1、3
1Oevrevoll賽馬場/挪威騎師協會,Jar,挪威2挪威奧斯陸大學醫院矯形外科
3.挪威奧斯陸大學醫院婦女和兒童科
4挪威Vestre Viken醫院信托眼科
*通訊作者:Ole Reigstad, Oevrevoll賽馬場/挪威騎師協會,Jar,挪威奧斯陸大學醫院骨科外科,電話:+ 4790770648;電子郵件:ole.reigstad@gmail.com
受傷在職業賽馬運動中很常見,嚴重的事故會導致永久性殘疾和死亡。已采取安全措施,以減少騎師和馬匹的受傷。2014年至2015年(4月至11月),挪威賽馬運動中所有跌倒和受傷的前瞻性2年完整登記,以及2016年至2017年嚴重受傷的登記,以確定摔倒和受傷模式,實施預防措施。在前兩個賽季中有34次跌倒和13次受傷(530場比賽,4987次個人跑步),後兩個賽季沒有出現嚴重的受傷,總的摔倒頻率為1/16場比賽,1/147次跑步。跨欄比賽的摔倒頻率最高,但在這些摔倒後沒有受傷記錄。除了尺骨近端骨折,所有的傷都是輕傷,騎師們重新回到了賽場。業餘騎師比職業騎師受傷更多。大多數受傷是由於馬不穩或無法控製。總的來說,在這4個賽季中,我們有一例嚴重的傷病(尺骨骨折),造成了大約1/1000場比賽和1/10000次個人跑的總體頻率。總之,挪威賽馬運動是安全的,而且受傷的頻率很低。
騎馬在休閑和運動中都很受歡迎。與馬有關的傷害很常見,通常會導致骨折和頭部受傷。在騎馬為常見活動的地區,這些損傷可能會對衛生保健係統造成重大負擔[1,2]。據報道,在傳統的騎馬運動中,大約每2000小時就會有1人受傷,或每年每10000名居民中就有4人受傷。職業賽馬是一項風靡全球的體育運動,在許多國家是一項大型觀賞性運動,也是一項重要的經濟產業[4,5]。高速度、純種馬和跨欄比賽的結合使嚴重受傷的風險很高。在澳大利亞等重要的賽馬國家,據估計每240次騎馬就有騎師摔倒,其中三分之一發生受傷[4,6]。死亡是常見的,每年騎師傷亡報告[7]。挪威(500萬居民)是國際賽馬運動中的一個小國。挪威有一條賽馬場,位於首都奧斯陸郊區的Oevrevoll賽馬場。 The races are completed from April through November (closed during the winter season). Oevrevoll has both a dirt and grass track, all hurdle races are performed on grass. The last fatal injury occurred more than 40 years ago, but less serious injuries occur regularly. The emergency medical service at the races is regulated by Oevrevoll Galopp/ Norwegian Jockey Association and Norwegian Rikstoto (the latter are in charge of the bookmaking). A medical doctor and a two-person ambulance are obligatory present on all race days, no races run unless both are in place. As a consequence of numerous injuries afflicting both horses and jockeys, injury preventive measurements have been implemented over the previous years. These have included new and lower hurdles (94 cm) with softer edges and an “escape” opening on the outer perimeter (Figure 1), water jump fences has been removed, and steeplechase fences (higher fences, often with open ditches) are never used. Obligatory safety equipment for the jockeys is demonstrated in figure 2. In addition, strict adherence to the rules were implemented, and include jockeys having to remain in their track during the race, distraction is not accepted, whips are not permitted (special Norwegian rule) [8] and violation of rules leads to a penalty fee or even a ban). Furthermore, a thorough evaluation of the tracks are performed prior to and during race days, resulting in cancellation of races if the track is too wet, slippery or otherwise deemed unsuitable for use.
圖2a和圖2b:騎師必須使用安全裝備,包括頭盔、眼鏡、軀幹保護和賽靴
這項研究的主要目的是記錄在Oevrevoll賽車場比賽期間發生的所有摔倒和受傷。其次,作為負責任的醫生,我們想要分類和識別傷害模式,以便在可能的情況下實施預防措施。
2014年和2015年賽道賽季中發生的所有跌倒和受傷都是由負責的醫生預先登記的,包括68個比賽日的530場比賽。比賽長度從900米到3650米不等,約有100名騎師騎4987次,總賽程為8300公裏。騎師們在Ovrevoll賽道上跑了1-186次(他們中的許多人也活躍在斯堪的納維亞的其他賽道上;因此,不能僅從他們在挪威的比賽記錄來計算經驗)。我們記錄了騎師身份(職業/業餘),比賽類型(泥土,草地,跳躍),比賽長度(比賽長度因其他原因在期間進行了調整,給出了大量不同長度的數字(18),盡管差異可能隻有20米),並確定了摔倒的位置,摔倒的可能原因。所有損傷均由主治醫生進行檢查和診斷;重傷被送往當地醫院/急診科。賽馬場醫生對騎師進行了跟蹤,以揭示永久性問題/殘疾。損傷分為骨折、挫傷/軟組織損傷和瘀傷。在過去兩個賽季(2016年和2017年),登記僅限於嚴重事件(受傷導致住院或病假時間較長(超過一個月)或永久性殘疾)。
這些數字用頻率表表示。我們比較了事件和傷害的發生,使用比例的比較,與組之間的卡方檢驗。在雙變量分析中,騎師地位(業餘/專業),比賽類型每兩組進行比例比較,比賽長度三種常見長度(1100米,1600米和2400米)相互比較。p值<0.05為有統計學意義。采用SPSS®for windows進行統計分析。
在完整登記的兩個賽季中,共有34次登記跌倒,總發生率為1/16場比賽,1/147次個人跑。跌倒的原因主要是馬匹不穩(18人)、馬匹打滑(8人)、起跑箱問題(3人)和其他各種原因(5人)。跨欄比賽的跌倒率最高(6/16場),低於土地賽(13/261場)和草地比賽(15/253場),p< 0.05。兩個賽季我們有13人受傷。在跨欄比賽中摔倒後沒有受傷記錄(0/16),受傷在泥土比賽(7/261)和草地比賽(6/253)中平均分布。受傷包括骨折(2例);一名患者有兩處肋骨骨折,另一名患者有一處尺骨近端粉碎性骨折。後者是最嚴重的傷勢,致使騎師請了3個月的病假。骨折愈合,無殘留問題(圖3a-3d)。
圖3a- 3d:3a)職業騎師尺骨近端粉碎性骨折的x線片。3b) 3個月後隨訪x線片(肘關節上方石膏保守治療6周)。3c)和3d)隨訪肘部功能良好
其他傷為5處割傷/擦傷和6處挫傷。事故原因包括馬匹不穩定(8例)、馬匹滑倒(1例)、起跑箱問題(2例)及其他(2例)。所有受傷騎師均重返賽場(最長的病假為2.5個月,直至參加尺骨骨折騎師比賽)。業餘選手和職業選手的摔倒率相同,但業餘選手的受傷率高於職業選手(5/50比8/480,p<0.05)。比賽長度對受傷頻率無影響;最常見的長度(約1100米,1600米和2400米)幾乎看到了所有的傷害,頻率相似。在之後的兩個賽季中,我們沒有記錄到嚴重的受傷/事件,但是沒有受傷的摔倒和輕微的事故。在四年的時間裏,我們總共看到一例嚴重損傷(尺骨骨折),發生率約為千分之一。受傷的騎師是一名職業運動員。
挪威的賽道運動是安全的,摔倒和受傷的發生率很低。安全措施得到嚴格執行,從而將事故減少到最低限度。與澳大利亞的賽道相比,我們的摔倒次數更多,但受傷人數更少。Hitchens等人[7]進行了回顧性回顧,發現與我們相比,嚴重損傷的頻率更高。這可能是由於回顧性設計中對受傷情況進行了再現,使得結果受到回憶偏差的影響。對於更嚴重的傷害(容易回憶/記住),該設計可能是準確的,而沒有後果的摔倒或擦傷和挫傷等輕傷可能被低估了。作者還評估了傷害和保險索賠,觀察到平原比賽的騎行頻率為6/10000,跨欄比賽的騎行頻率為65/10000。保險索賠記錄的受傷頻率與我們的不同,在運動員中,肢體骨折的頻率更高(1/3的受傷索賠)。挪威有包括病假和醫療費用的公共福利製度,這意味著保險公司很少被要求報銷病假和醫療費用。因此很難對這些數字進行比較。 Overall we only registered one limb fracture in approximately 1000 races (for the whole four season period), sustaining a very low incidence of these common race track injuries. The frequency of falls during hurdle races in our material was substantially higher than during flat races. This in line with previous studies from horse racing internationally; hurdles are consistently found to result in 10-15 times the number of falls [5,6] compared to flat races. Internationally, injury frequency is similar, also occurring much more frequently in hurdle races. The explanation for the relatively few injuries in Norwegian hurdle races is likely to be multifactorial. Hurdle races comprise a small proportion of the total number of races in Norway (16 hurdle races as compared to 514 flat races per 2 seasons), jockeys are carefully selected for these races and amateurs never partake in hurdle races in Norway. Finally, the implementation of modern injury-preventing lower hurdles and removing of water fences is likely to reduce injuries; staple chase is a major contributor to accidents in other countries 5. Not surprising, we found a higher risk of injury among amateurs as compared to professional jockeys, implying the importance of experience as an injury preventive measure. This is in line with existing literature from around the world, which reports a higher incidence of injuries among apprentices and amateurs [9,10]. Since one has to crawl before one can walk, it is difficult to do specific prevention to reduce the amateur injuries. Increasing the hours of training on the track prior to racing could reduce some of the injuries. Hitchens et al [7] found that younger horses (inexperienced) and horses that had taken part in fewer races were risk factors for falls and injuries [10]. Subsequently, a more thorough selection of experienced race track horses for amateur/inexperienced jockeys may be a measure with which to avoid uneasy or uncontrollable horses and thereby reduce injuries. Overall, we could not identify high risk areas where measures could be implemented to reduce the amount of injuries. In the setting where the risk of falls and injuries is relatively low, it is our experience that the jockeys have been hesitant to employ more extensive safety equipment. Measures such as helmets protecting the face, cervical and lumbar spine protection, hip protectors and more advanced safety boots are likely to be perceived to impact their riding abilities. Horse sport is an international sport, where both jockeys and horses change their working location and environment frequently. The health of the jockeys is important to keep attention on, and injury prevention must not be forgotten, especially in order to be able to identify risk factors and injury patterns for early intervention.
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文章類型:研究文章
引用:Reigstad O, MacPherson JE, Reigstad MM(2017)職業賽馬中的事故和傷害,挪威賽馬運動中一項為期2年的騎師傷害完整登記。中華骨科雜誌(1):dx.doi.org/10.16966/ 2576-6449.105
版權:©2017 Reigstad O等。這是一篇開放獲取的文章,根據創作共用署名許可的條款發布,允許在任何媒介上不受限製地使用、分發和複製,前提是要注明原作者和來源。
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