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[牙合变化是否会影响职业女排运动员盂肱关节内旋不足(GIRD)的康复?一项初步研究]

[Do Changes in Dental Occlusion Influence the Rehabilitation of a Glenohumeral Internal Rotation Deficit (GIRD) in Professional Female Volleyball Players? A Pilot Study].

作者信息

Baum Sarah, van Kampen Heleen, Ballenberger Nikolaus, von Piekartz Harry

机构信息

Hochschule Osnabrück, Faculty of Physical Therapy and Rehabilitation Science, Osnabrück.

出版信息

Sportverletz Sportschaden. 2019 Aug;33(3):160-171. doi: 10.1055/a-0753-2796. Epub 2019 Feb 21.

Abstract

INTRODUCTION

There have been controversial discussions in research regarding the mutual relationship between changes in dental occlusion and postural reorganisation. Particularly in professional sports, the application of dental splints has been studied increasingly. However, there is a lack of data regarding the effects of a dental splint on the motor function of the shoulder joint, although overhead athletes often have to deal with long-lasting shoulder problems and their consequences. This study aimed to investigate the influence of a change in dental occlusion by means of a dental splint on the rehabilitation of a glenohumeral internal rotation deficit (GIRD) among volleyball players.

METHOD

In this study, 22 professional female volleyball players with GIRD and a tROM larger than five degrees were included. Participants were randomised to a splint group (n = 11) and a non-splint group (n = 11). Range of motion and the isometric strength of the dominant shoulder were measured. Shoulder pain and function were investigated by the SPADI assessment, and the functional status of the temporomandibular joints was assessed through the DC/TMD classification. Over a period of eight weeks, both groups received an individual training program. The splint group completed the training program with a dental splint (1-2 mm thick), the non-splint group without a splint.

RESULTS

Range of motion: There are no significant differences between the two groups in the range of motion (internal rotation U = 33 000, p = 0.36; external rotation U = 39 500, p = 0.66; GIRD U = 41 000, p = 0.78; tROM U = 41 000, p = 0.78). At the end of the study, none of the volleyball players in the splint or non-splint group had a GIRD > 20 degrees or a tROM difference > 5 degrees. Shoulder strength: No differences were detected between the two groups in force (internal rotation U = 36 000, p = 0.50; external rotation U = 44 000, p = 0.97; elbow flexion U = 28 000, p = 0.18). Only the force of the shoulder quadrant changed significantly (U = 20 500, p = 0.04). Shoulder pain and function (SPADI): No significant differences were found for the SPADI assessment (U = 31 000; p = 0.28). Functional status of the temporomandibular joint (DC/TMD): The DC/TMD assessments also did not change significantly.

CONCLUSION

Regarding the secondary hypothesis, a significant change in Q strength was detected. All other parameters (ROM: internal rotation, external rotation, GIRD, tROM; strength: internal rotation, external rotation, elbow flexion; shoulder pain and function: SPADI; TMJ: depression, palpation of masseter muscle and temporalis muscle, TMJ) revealed no significant changes between the two groups. In sum, it can be stated that the use of a dental splint does not significantly influence the rehabilitation of GIRD in volleyball players.

摘要

引言

关于牙合变化与姿势重组之间的相互关系,研究中存在争议性的讨论。特别是在职业体育中,牙托的应用研究越来越多。然而,尽管上肢运动员经常面临长期的肩部问题及其后果,但关于牙托对肩关节运动功能影响的数据却很缺乏。本研究旨在探讨通过牙托改变牙合对排球运动员盂肱关节内旋不足(GIRD)康复的影响。

方法

本研究纳入了22名患有GIRD且总旋转活动度(tROM)大于5度的职业女排运动员。参与者被随机分为牙托组(n = 11)和无牙托组(n = 11)。测量优势肩的活动度和等长力量。通过SPADI评估调查肩部疼痛和功能,并通过DC/TMD分类评估颞下颌关节的功能状态。在八周的时间里,两组都接受了个性化的训练计划。牙托组佩戴牙托(1 - 2毫米厚)完成训练计划,无牙托组不佩戴牙托。

结果

活动度:两组在活动度方面无显著差异(内旋U = 33000,p = 0.36;外旋U = 39500,p = 0.66;GIRD U = 41000,p = 0.78;tROM U = 41000,p = 0.78)。研究结束时,牙托组或无牙托组的排球运动员均无GIRD>20度或tROM差异>5度。肩部力量:两组在力量方面未检测到差异(内旋U = 36000,p = 0.50;外旋U = 44000,p = 0.97;肘屈曲U = 28000,p = 0.18)。仅肩部象限的力量有显著变化(U = 20500,p = 0.04)。肩部疼痛和功能(SPADI):SPADI评估未发现显著差异(U = 31000;p = 0.28)。颞下颌关节的功能状态(DC/TMD):DC/TMD评估也未显著改变。

结论

关于次要假设,检测到Q力量有显著变化。所有其他参数(活动度:内旋、外旋、GIRD、tROM;力量:内旋、外旋、肘屈曲;肩部疼痛和功能:SPADI;颞下颌关节:凹陷、咬肌和颞肌触诊、颞下颌关节)两组之间均未显示出显著变化。总之,可以说使用牙托对排球运动员GIRD的康复没有显著影响。

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