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棒球运动员的功能性疲劳与上肢感觉运动系统敏锐度

Functional fatigue and upper extremity sensorimotor system acuity in baseball athletes.

作者信息

Tripp Brady L, Yochem Eric M, Uhl Timothy L

机构信息

Florida International University, Miami, FL, USA.

出版信息

J Athl Train. 2007 Jan-Mar;42(1):90-8.

Abstract

CONTEXT

The sensorimotor system controls the balance between upper extremity stability and mobility during athletic performance. Research indicates that fatigue hampers sensorimotor system function; however, few investigators have studied functional fatigue or multijoint, multiplanar measures.

OBJECTIVE

To examine the effect of functional fatigue on upper extremity position reproduction in overhead throwing athletes.

DESIGN

Single-session, repeated-measures design.

SETTING

University musculoskeletal laboratory.

PATIENTS OR OTHER PARTICIPANTS

Sixteen healthy collegiate baseball players (age = 21.0 +/- 1.6 years, height = 175.8 +/- 10.2 cm, mass = 82.8 +/- 4.3 kg).

INTERVENTION(S): Subjects threw a baseball from a single knee with maximum velocity (every 5 seconds) and rated their level of upper extremity exertion after every 20 throws. Subjects stopped after reporting above level 14 on the Borg scale and began posttests immediately.

MAIN OUTCOME MEASURE(S): We measured active multijoint reproduction of 2 positions: arm cock and ball release. Dependent variables were absolute and variable error for 10 joint motions: scapulothoracic internal-external rotation, upward rotation, and posterior tilt; glenohumeral internal-external rotation, horizontal abduction-adduction, and flexion-extension; elbow pronation-supination and flexion-extension; and wrist ulnar-radial deviation and flexion-extension. We calculated acuity for each joint and the entire upper extremity using 3-dimensional variable error.

RESULTS

Fatigue occurred after an average of 62 +/- 28 throws and increased 3-dimensional variable error scores (ie, decreased acuity) of the entire upper extremity and all joints in both positions (P < .05) except for the wrist in arm cock. Fatigue increased errors (ranging from 0.6 degrees to 2.3 degrees ) at arm cock for scapulothoracic internal-external rotation, upward rotation, and posterior tilt; glenohumeral internal-external rotation and flexion-extension; elbow flexion-extension; and wrist ulnar-radial deviation and at ball release for scapulothoracic internal-external rotation and upward rotation, glenohumeral horizontal abduction-adduction, elbow pronation-supination, and wrist ulnar-radial deviation and flexion-extension (P < .05).

CONCLUSIONS

Functional fatigue affects the acuity of the entire upper extremity, each individual joint, and multiple joint motions in overhead throwers. Clinicians should consider the deleterious effects of upper extremity fatigue when designing injury prevention and rehabilitation programs and should incorporate multijoint and multiplanar endurance exercises. Compromised neuromuscular control of the scapulohumeral relationship may hold pathologic implications for this population as well.

摘要

背景

在运动表现过程中,感觉运动系统控制着上肢稳定性与灵活性之间的平衡。研究表明,疲劳会妨碍感觉运动系统功能;然而,很少有研究者对功能性疲劳或多关节、多平面测量进行研究。

目的

探讨功能性疲劳对过顶投掷运动员上肢位置再现的影响。

设计

单节段重复测量设计。

地点

大学肌肉骨骼实验室。

患者或其他参与者

16名健康的大学棒球运动员(年龄=21.0±1.6岁,身高=175.8±10.2厘米,体重=82.8±4.3千克)。

干预措施

受试者单膝跪地以最大速度投出棒球(每5秒一次),每投20次后对上肢用力程度进行评分。当受试者报告伯格量表得分超过14分时停止投掷,并立即开始进行测试后测量。

主要观察指标

我们测量了两个位置的主动多关节再现情况:手臂预摆和球出手。因变量为10个关节运动的绝对误差和可变误差:肩胛胸壁关节的内旋-外旋、上旋和后倾;盂肱关节的内旋-外旋、水平外展-内收和屈伸;肘关节的旋前-旋后和屈伸;以及腕关节的尺侧-桡侧偏斜和屈伸。我们使用三维可变误差计算每个关节以及整个上肢的敏锐度。

结果

平均投出62±28次后出现疲劳,除手臂预摆时的腕关节外,两个位置的整个上肢和所有关节的三维可变误差得分均增加(即敏锐度降低)(P<.05)。疲劳使手臂预摆时肩胛胸壁关节内旋-外旋、上旋和后倾、盂肱关节内旋-外旋和屈伸、肘关节屈伸以及腕关节尺侧-桡侧偏斜的误差增加(范围为0.6度至2.3度);球出手时,肩胛胸壁关节内旋-外旋和上旋、盂肱关节水平外展-内收、肘关节旋前-旋后以及腕关节尺侧-桡侧偏斜和屈伸的误差增加(P<.05)。

结论

功能性疲劳会影响过顶投掷运动员整个上肢、各个关节以及多个关节运动的敏锐度。临床医生在设计损伤预防和康复计划时应考虑上肢疲劳的有害影响,并应纳入多关节和多平面耐力训练。肩胛肱骨关节关系的神经肌肉控制受损可能对该人群也具有病理学意义。

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