Mountain River Physical Therapy, Chatham, VA.
Michael W. Krzyzewski Human Performance Laboratory, Duke University, Durham, NC.
J Athl Train. 2018 Dec;53(12):1190-1199. doi: 10.4085/1062-6050-439-17. Epub 2018 Dec 7.
Arm injuries in baseball players are a common problem. The identification of modifiable risk factors, including range of motion (ROM), is essential for injury prevention. The purpose of this review was to assess the methodologic quality and level of evidence in the literature and to investigate the relationship between shoulder ROM and the risk of arm injuries in baseball players.
Relevant studies in PubMed, CINAHL, Embase, and SPORTDiscus published from inception to August 1, 2017.
Only studies that encompassed healthy baseball cohorts who were assessed for shoulder ROM and prospectively evaluated for injuries throughout a baseball season or seasons were included.
Six articles met the search criteria. Only 3 studies were included in the meta-analysis due to disparate participant groups.
The modified Downs and Black scale (0-15 points) was used to analyze methodologic quality. Study quality ranged from 11 to 14. Four studies received high-quality (≥12) and 2 studies received moderate-quality (≥10) scores. The overall pooled analysis demonstrated that absolute and internal-rotation deficits (-5.93 [95% confidence interval {CI} = -9.43, -2.43], P < .001 and 4.28 [0.71, 7.86], P = .02, respectively) and absolute total ROM (TROM; -6.19 [95% CI = -10.28, -2.10]; P = .003) were predictors of injury, and these data exhibited homogeneity (absolute IR P value = .77, I = 0%; IR deficit P value = .41, I = 0%; absolute TROM P value = .78, I = 0%). No significance was observed for absolute external rotation (-2.86 [95% CI = -6.56, 0.83], P = .13), which had data with high heterogeneity ( P = .003; I = 83%). A deficit in horizontal adduction was a predictor of injury (-8.32 [95% CI = -12.08, -4.56]; P < .001); these data were homogeneous but yielded a moderate heterogenic effect ( P = .16; I = 50%).
High-quality evidence demonstrated that deficits in throwing-arm TROM and IR were associated with upper extremity injury in baseball players. Heterogeneity across studies for horizontal adduction suggested that this may be a modifiable risk factor for injury, but it requires further research.
棒球运动员的手臂受伤是一个常见的问题。识别可改变的风险因素，包括活动范围（ROM），对于预防受伤至关重要。本综述的目的是评估文献中方法学质量和证据水平，并研究棒球运动员肩部 ROM 与手臂受伤风险之间的关系。
PubMed、CINAHL、Embase 和 SPORTDiscus 从成立到 2017 年 8 月 1 日发布的相关研究。
仅包括评估过肩部 ROM 并在整个棒球赛季或多个赛季中前瞻性评估受伤情况的健康棒球队列的研究。
符合搜索标准的 6 篇文章。由于参与者群体不同，只有 3 项研究纳入荟萃分析。
使用改良的 Downs 和 Black 量表（0-15 分）分析方法学质量。研究质量从 11 分到 14 分不等。4 项研究获得高质量（≥12），2 项研究获得中等质量（≥10）评分。总体汇总分析表明，绝对和内旋不足（-5.93[95%置信区间{CI}=-9.43，-2.43]，P<0.001和 4.28[0.71，7.86]，P=0.02）和绝对总 ROM（TROM；-6.19[95%CI=-10.28，-2.10]；P=0.003）是受伤的预测因素，这些数据表现出同质性（绝对 IR P 值=0.77，I=0%；IR 不足 P 值=0.41，I=0%；绝对 TROM P 值=0.78，I=0%）。绝对外旋无显著意义（-2.86[95%CI=-6.56，0.83]，P=0.13），其数据具有高度异质性（P=0.003；I=83%）。水平内收不足是受伤的预测因素（-8.32[95%CI=-12.08，-4.56]；P<0.001）；这些数据是同质的，但具有中度异质效应（P=0.16；I=50%）。
高质量证据表明，投球臂 TROM 和 IR 不足与棒球运动员上肢受伤有关。研究之间水平内收的异质性表明，这可能是受伤的可改变风险因素，但需要进一步研究。
