Johnson Caleb D, Nijst Branco K J F, Eagle Shawn R, Kessels Marijn W M, Lovalekar Mita T, Krajewski Kellen T, Flanagan Shawn D, Nindl Bradley C, Connaboy Christopher
Neuromuscular Research Laboratory, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
Orthop J Sports Med. 2019 Mar 13;7(3):2325967119831272. doi: 10.1177/2325967119831272. eCollection 2019 Mar.
Musculoskeletal injuries at the shoulder are highly prevalent and place a large burden on United States Special Forces personnel. Literature is lacking regarding the risk factors for these types of injuries.
PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the association of shoulder strength and kinematic characteristics, which have shown retrospective associations with shoulder conditions/injuries, with prospectively collected shoulder injuries. We hypothesized that lower strength and abnormal kinematics would be predictive of future shoulder injury.
Case-control study; Level of evidence, 3.
A total of 140 male Special Forces operators underwent a musculoskeletal evaluation of the shoulder that included a scapular kinematic assessment during a humeral elevation task and isokinetic strength testing of the scapular protractors/retractors, external/internal rotators, and elevators of the shoulder. From strength assessments, ipsilateral strength ratios and bilateral strength asymmetries were also calculated. Musculoskeletal injuries of the shoulder were collected prospectively by use of medical chart reviews at 365 days following the evaluation. Separate generalized estimating equations (GEEs) and simple logistic regressions were used to analyze the association between baseline predictors and development of shoulder injury.
Results of the GEEs showed no significant prediction of shoulder injury by shoulder strength (odds ratio [OR], 1.00-1.03), ipsilateral strength ratios (OR, 0.43-2.12), or scapular kinematics (OR, 0.99-1.01). Logistic regression indicated that none of the bilateral asymmetries were significantly predictive of shoulder injury (OR, 1.00-1.04).
The results indicate that shoulder strength and kinematic characteristics are not risk factors for shoulder injury in the Special Forces population. These findings are in opposition to the general findings of previous research using a retrospective analysis.
肩部肌肉骨骼损伤非常普遍，给美国特种部队人员带来了沉重负担。关于这类损伤的危险因素的文献尚缺。
目的/假设：本研究的目的是评估肩部力量和运动学特征与前瞻性收集的肩部损伤之间的关联，肩部力量和运动学特征已显示出与肩部疾病/损伤存在回顾性关联。我们假设力量较低和运动学异常可预测未来的肩部损伤。
病例对照研究；证据等级，3级。
总共140名男性特种部队操作员接受了肩部肌肉骨骼评估，包括在肱骨抬高任务期间进行肩胛运动学评估以及对肩胛前伸肌/后缩肌、肩部外旋/内旋肌和上举肌进行等速力量测试。从力量评估中，还计算了同侧力量比和双侧力量不对称性。在评估后的365天，通过查阅病历前瞻性收集肩部肌肉骨骼损伤情况。分别使用广义估计方程（GEEs）和简单逻辑回归分析基线预测因素与肩部损伤发生之间的关联。
GEEs结果显示，肩部力量（优势比[OR]，1.00 - 1.03）、同侧力量比（OR，0.43 - 2.12）或肩胛运动学（OR，0.99 - 1.01）对肩部损伤均无显著预测作用。逻辑回归表明，双侧不对称性均未对肩部损伤有显著预测作用（OR，1.00 - 1.04）。
结果表明，肩部力量和运动学特征不是特种部队人群肩部损伤的危险因素。这些发现与先前使用回顾性分析的研究的一般结果相反。
