Warner Martin B, Wilson David, Heller Markus O, Wood Dan, Worsley Peter, Mottram Sarah, Webborn Nick, Veeger DirkJan, Batt Mark
Faculty of Health Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK.
Faculty of Health Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK.
Clin Biomech (Bristol). 2018 Mar;53:7-13. doi: 10.1016/j.clinbiomech.2018.01.022. Epub 2018 Jan 31.
Participating in wheelchair tennis increases the demands placed on the shoulder and could increase the risk of developing shoulder pain and injury that might be associated with differences in scapular kinematics. The aim of the study was to examine the presence of shoulder pain and scapular kinematics in professional wheelchair tennis players.
Scapular kinematics were obtained in 11 professional wheelchair tennis players, 16 people with shoulder impingement and 16 people without shoulder impingement during humeral elevation and lowering. Clinical examination of the wheelchair tennis players was undertaken using the Wheelchair Users Shoulder Disability Index (WUSPI) and clinical signs of shoulder impingement.
The WUSPI questionnaire (mean = 28 SD 13.8) demonstrated wheelchair tennis participants experienced little shoulder pain and clinical examination revealed negative impingement tests. Wheelchair tennis players had greater scapular posterior tilt during humeral elevation (3.9° SE 1.71; P = 0.048) and lowering (4.3° SE 1.8; P = 0.04) on the dominant compared to non-dominant side. The dominant scapulae of wheelchair tennis players were significantly (P = 0.014) more upwardly rotated (21° SD 6.7) than the scapulae of people with shoulder impingement (14.1° SD 7.0) during scapular plane humeral elevation.
This first study of scapular kinematics in professional wheelchair tennis athletes demonstrated bilateral asymmetries and differences to able-bodied participants with shoulder impingement. Understanding the role of sport participation on shoulder function in wheelchair users would assist in the development of preventative and treatment exercise programmes for wheelchair users at risk of shoulder injury and pain.
参与轮椅网球运动增加了肩部所承受的负荷，并可能增加肩部疼痛和受伤的风险，这可能与肩胛骨运动学差异有关。本研究的目的是调查职业轮椅网球运动员肩部疼痛和肩胛骨运动学情况。
在11名职业轮椅网球运动员、16名肩部撞击综合征患者和16名无肩部撞击综合征的人进行肱骨上举和下降动作时，获取其肩胛骨运动学数据。使用轮椅使用者肩部残疾指数（WUSPI）对轮椅网球运动员进行临床检查，并检查肩部撞击的临床体征。
WUSPI问卷（平均值=28，标准差13.8）显示，轮椅网球参与者肩部疼痛较轻，临床检查显示撞击试验为阴性。与非优势侧相比，轮椅网球运动员在优势侧肱骨上举（3.9°，标准误1.71；P=0.048）和下降（4.3°，标准误1.8；P=0.04）时肩胛骨后倾更大。在肩胛骨平面肱骨上举过程中，轮椅网球运动员优势侧肩胛骨的向上旋转角度（21°，标准差6.7）明显大于肩部撞击综合征患者（14.1°，标准差7.0）（P=0.014）。
这项对职业轮椅网球运动员肩胛骨运动学的首次研究表明，其存在双侧不对称性，且与有肩部撞击的健全参与者存在差异。了解运动参与对轮椅使用者肩部功能的作用，将有助于为有肩部受伤和疼痛风险的轮椅使用者制定预防和治疗性锻炼方案。
