目的:探讨如何使用变化点方法分析复杂的纵向数据,并检测康复过程中何时发生有意义的变化(变化点)。
方法:本设计是一项前瞻性的单病例观察性研究,研究对象是一名职业俱乐部的足球运动员,该运动员在高速跑步训练中出现急性下肢肌肉损伤。康复计划是在俱乐部医疗团队的监督下在足球俱乐部完成的。在受伤之前收集了四个健康指标和5个跑步表现指标,直到球员恢复比赛为止。
结果:收集了超过130天的数据。在单变量分析中,压力的变化点,睡眠,心情,和酸痛分别位于第30、47、50和50天。总距离的变化点,加速度,最大速度,减速,和高速运行分别位于第32、34、37、41和41天。多变量分析导致健康指标和运行绩效指标的单个变化点,分别在第50天和第67天。
结论:单变量方法提供了有关变化点的序列和时间点的信息。多变量方法为多个指标提供了一个共同的变化点,这些信息将使临床医生对康复过程中的变化有一个广泛的概述。临床医生可能会考虑使用变化点方法来整合和可视化来自多个来源的数据,以评估运动员沿重返运动连续体的进展。
OBJECTIVE: To explore how the change-point method can be used to analyze complex longitudinal data and detect when meaningful changes (change points) have occurred during rehabilitation.
METHODS: This design is a prospective single-case observational study of a football player in a professional club who sustained an acute lower-limb muscle injury during high-speed running in training. The rehabilitation program was entirely completed in the football club under the supervision of the club\'s medical team. Four wellness metrics and 5 running-performance metrics were collected before the injury and until the player returned to play.
RESULTS: Data were collected over 130 days. In the univariate analysis, the change points for stress, sleep, mood, and soreness were located on days 30, 47, 50, and 50, respectively. The change points for total distance, acceleration, maximum speed, deceleration, and high-speed running were located on days 32, 34, 37, 41, and 41, respectively. The multivariate analysis resulted in a single change point for the wellness metrics and running-performance metrics, on days 50 and 67, respectively.
CONCLUSIONS: The univariate approach provided information regarding the sequence and time point of the change points. The multivariate approach provided a common change point for multiple metrics, information that would benefit clinicians to have a broad overview of the changes in the rehabilitation process. Clinicians may consider the change-point method to integrate and visualize data from multiple sources to evaluate athletes\' progression along the return-to-sport continuum.