I Fattori di Rischio nelle Fratture da Stress dell'Arto Inferiore nei Runners: Revisione Sistematica della Letteratura e Meta-Analisi

Objective: This study aims to investigate the Risk Factors, identified in the Literature, for Lower Limb stress Fractures in Runners. Background: Running offers many health benefits, but it is also associated with a high incidence of injuries. Stress fractures, in particolar, are one of the most common overload injuries among runners. For this reason, it is very important to adopt prevention strategies that allow the identification of risk factors and, thus, the possibility of reducing or eliminating them. Materials and Methods: This Study is a Systematic Literature Review with a Meta-Analysis of data. The Review was conducted following the PRISMA guidelines. Articles were reviewed up until August 30, 2024. The search engines used were: PubMed, Scopus and WebOfScience; an advanced search was conducted in all three databases by entering a string of keywords, including: stress fractures, runners and risk factors, linked using Boolean operators. The search string set in three databases was as follows: ((Stress fracture) OR (fatigue fracture) OR (insufficiency fracture) OR (march fracture) OR (overuse fracture) OR (stress lesions) OR (stress injur) OR (stress reaction) OR (bone stress) OR (bone strain) OR (repetitive stress injur) OR (SF) OR (BSI) OR (bone stress injury)) AND ((risk) OR (cohort studies) OR (mortality)) AND ((run) OR (running) OR (runners)) AND ((risk factors) OR (risk) OR (Predisposing factors) OR (Contributing factors) OR (Etiology) OR (causes) OR (determinants) OR (influencing factors) or (Aetiological factors)). The Joanna Briggs Institute (JBI) Critical Appraisal Tool was used for the quality assessment. Results: A total of 4.786 articles were analyzed from the search across the three databases, and of these, 16 articles were included, with a total of 4.052 patients, including 2.470 males and 1.582 females. The quality analysis reported an average score of 8/10 for Case-Control Studies, 8/11 for Cohort studies, 10/13 for RCTs and 8/8 for the only Cross-Sectional study. Meta-Analysis reported a relative risk (RR) of 2.87 (95%CI 1.64-5.02) for prior history of stress fractures. Conclusions: In the present Review, it was shown that among the various risk factors analyzed for stress fractures of the entire lower limb in runners, only previous history of stress fractures was found to be such with a relative risk (RR) of 2.87, with a 95% Confidence Interval (95%CI) ranging from 1.64 to 5.02.

Obiettivo: Questo studio ha lo scopo di investigare quali siano i fattori di rischio, presenti in letteratura, per le fratture da stress dell’arto inferiore nei corridori. Materiali e metodi: questo studio è una Revisione Sistematica della Letteratura con Meta-analisi dei dati. La revisione è stata svolta seguendo le linee PRISMA. Sono stati revisionati gli articoli dal 1° gennaio 2014 al 30 settembre 2024. I motori di ricerca utilizzati sono stati: PubMed, Scopus e WebOfScience; in tutti e tre i database è stata impostata una ricerca avanzata, inserendo una stringa di parole chiave, comprendenti: fratture da stress, runners e fattori di rischio, collegate tramite gli operatori Booleani. La stringa di ricerca impostata nelle tre banche dati è stata la seguente: ((Stress fracture) OR (fatigue fracture) OR (insufficiency fracture) OR (march fracture) OR (overuse fracture) OR (stress lesions) OR (stress injur) OR (stress reaction) OR (bone stress) OR (bone strain) OR (repetitive stress injur) OR (SF) OR (BSI) OR (bone stress injury)) AND ((risk) OR (cohort studies) OR (mortality)) AND ((run) OR (running) OR (runners)) AND ((risk factors) OR (risk) OR (Predisposing factors) OR (Contributing factors) OR (Etiology) OR (causes) OR (determinants) OR (influencing factors) or (Aetiological factors)). Risultati: Conclusioni: