Epidemiologic Reviews 24:228-247 (2002)
© 2002 by the Johns Hopkins Bloomberg School of Public Health
Prevention of Lower Extremity Stress Fractures in Athletes and Soldiers: A Systematic Review
1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. 2 Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA. 3 National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Received for publication July 3, 2002; accepted for publication November 27, 2002.
Abbreviations: CI, confidence interval; CSMI, cross-sectional moment of inertia; IDF, Israeli Defense Force; RR, relative risk.
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INTRODUCTION |
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Stress fractures represent one of the most common and potentially serious overuse injuries (1–5). The first cited reports on stress fracture were case studies of soldiers incurring such fractures in the 19th and early 20th centuries (2, 4, 6–9). By the mid-1900s, the condition was being reported in nonmilitary populations with increasing frequency (10–15). Although almost any athlete or exerciser who engages in frequent, repetitive activity may develop a stress fracture (3, 16), repetitive weight-bearing activities such as running and marching are the most frequently reported causes of stress fracture (2, 3, 6, 16, 17). Stress fractures have been reported in most bones of the extremities, as well as the ribs and the spine (3), but the most common location is the lower extremities (
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REVIEW PROCESS |
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CASE SERIES |
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Diagnostic case series
Clinical case series
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EPIDEMIOLOGY AND RISK FACTORS |
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STUDIES OF INTRINSIC RISK FACTORS |
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Demographic factors
Sex. Age. Race. Anatomic factors
Bone characteristics
Physical fitness
Aerobic fitness. Muscle strength and endurance. Flexibility. Body composition and stature. Health risk behaviors and medical history
Sedentary lifestyle. Smoking. Oral contraceptives. Past injuries.
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STUDIES OF EXTRINSIC RISK FACTORS |
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Type of sport or activity
Current physical training
Equipment and environmental factors
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INTERVENTION TRIALS FOR STRESS FRACTURE PREVENTION |
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Modifications of training
Modifications of footwear
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QUALITY OF REPORT INTERVENTIONS |
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DISCUSSION |
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