Mason Barry S, Vegter Riemer J K, Paulson Thomas A W, Morrissey Dylan, van der Scheer Jan W, Goosey-Tolfrey Victoria L
Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough University, UK(1).
Faculty of Medical Sciences, University of Groningen, The Netherlands.
Gait Posture. 2018 Sep;65:151-156. doi: 10.1016/j.gaitpost.2018.07.170. Epub 2018 Jul 20.
Shoulder pain is the most common complaint for wheelchair athletes. Scapular orientation and dyskinesia are thought to be associated with shoulder pathology, yet no previous studies have examined the bilateral scapula kinematics of wheelchair athletes during propulsion.
To examine bilateral scapular kinematics of highly trained wheelchair rugby (WR) players and any associations with self-reported shoulder pain during everyday wheelchair propulsion.
Ten WR players (5 with shoulder pain, 5 without) performed 2 × 3-minute bouts of exercise in their everyday wheelchair on a wheelchair ergometer at two sub-maximal speeds (3 and 6 km h). During the final minute, 3D kinematic data were collected at 100 Hz to describe scapulothoracic motion relative to each propulsion cycle. Instantaneous asymmetries in scapular orientation between dominant and non-dominant sides were also reported. Differences in scapular kinematics and propulsion asymmetries were compared across shoulders symptomatic and asymptomatic of pain.
An internally rotated, upwardly rotated and anteriorly tilted scapula was common during wheelchair propulsion and asymmetries ≤14° did exist, yet minimal changes were observed across speeds. Participants with bilateral shoulder pain displayed a less upwardly rotated scapula during propulsion, however large inter-individual variability in scapular kinematics was noted.
Scapular asymmetries are exhibited by wheelchair athletes during wheelchair propulsion, yet these were not exacerbated by increased speed and had limited associations to shoulder pain. This suggests that propulsion kinematics of highly trained athletes may not be the primary cause of pain experienced by this population.
肩痛是轮椅运动员最常见的主诉。肩胛方位和运动障碍被认为与肩部病变有关，但此前尚无研究考察轮椅运动员在推进过程中的双侧肩胛骨运动学。
考察高水平轮椅橄榄球（WR）运动员的双侧肩胛骨运动学，以及与日常轮椅推进过程中自我报告的肩痛之间的任何关联。
10名WR运动员（5名有肩痛，5名无肩痛）在轮椅测力计上以两种次最大速度（3和6公里/小时）在其日常轮椅上进行2×3分钟的运动。在最后一分钟，以100赫兹的频率收集三维运动学数据，以描述相对于每个推进周期的肩胛胸廓运动。还报告了优势侧和非优势侧肩胛骨方位的瞬时不对称情况。比较了有疼痛症状和无疼痛症状的肩部之间肩胛骨运动学和推进不对称性的差异。
在轮椅推进过程中，肩胛骨内旋、上旋和前倾很常见，不对称性≤14°确实存在，但不同速度下观察到的变化很小。双侧肩痛的参与者在推进过程中肩胛骨上旋较少，然而，肩胛骨运动学存在较大的个体间差异。
轮椅运动员在轮椅推进过程中表现出肩胛骨不对称，但这些不对称并未因速度增加而加剧，与肩痛的关联有限。这表明，高水平运动员的推进运动学可能不是该人群疼痛的主要原因。
