Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA.
Br J Sports Med. 2020 Sep;54(17):1019-1027. doi: 10.1136/bjsports-2019-100698. Epub 2020 Jan 14.
To characterise whether preseason screening of shoulder range of motion (ROM) is associated with the risk of shoulder and elbow injuries in overhead athletes.
Systematic review and meta-analysis.
Six electronic databases up to 22 September 2018.
Inclusion criteria were (1) overhead athletes from Olympic or college sports, (2) preseason measures of shoulder ROM, (3) tracked in-season injuries at the shoulder and elbow, and (4) prospective cohort design. Exclusion criteria were (1) included contact injuries, (2) lower extremity, spine and hand injuries, and (3) full report not published in English.
Fifteen studies were identified, and they included 3314 overhead athletes (baseball (74.6%), softball (3.1%), handball (16.1%), tennis (2.0%), volleyball (2.0%) and swimming (2.2%)). Female athletes are unrepresented (12% of the overall sample). Study quality ranged from 11 to 18 points on a modified Downs and Black checklist (maximum score 21, better quality). In one study, swimmers with low (<93°) or high (>100°) shoulder external rotation were at higher risk of injuries. Using data pooled from three studies of professional baseball pitchers, we showed in the meta-analysis that shoulder external rotation insufficiency (throwing arm <5° greater than the non-throwing arm) was associated with injury (odds ratio=1.90, 95% confidence interval 1.24 to 2.92, p<0.01).
Preseason screening of shoulder external rotation ROM may identify professional baseball pitchers and swimmers at risk of injury. Shoulder ROM screening may not be effective to identify handball, softball, volleyball and tennis players at risk of injuries. The results of this systematic review and meta-analysis should be interpreted with caution due to the limited number of studies and their high degree of heterogeneity.
CRD42017072895.
描述在肩部活动范围（ROM）的术前筛查是否与过顶运动员的肩部和肘部受伤风险相关。
系统评价和荟萃分析。
截至 2018 年 9 月 22 日的 6 个电子数据库。
（1）来自奥林匹克运动或大学运动的过顶运动员，（2）术前肩部 ROM 测量，（3）在肩部和肘部追踪到的赛季内损伤，（4）前瞻性队列设计。排除标准：（1）包括接触性损伤，（2）下肢、脊柱和手部损伤，（3）未以英文发表的完整报告。
确定了 15 项研究，共纳入 3314 名过顶运动员（棒球（74.6%）、垒球（3.1%）、手球（16.1%）、网球（2.0%）、排球（2.0%）和游泳（2.2%））。女性运动员的代表性不足（总体样本的 12%）。研究质量在改良的 Downs 和 Black 清单上从 11 分到 18 分不等（最高得分为 21 分，质量更好）。在一项研究中，肩外旋角度小（<93°）或大（>100°）的游泳运动员受伤风险更高。使用来自三项职业棒球投手研究的数据进行荟萃分析，我们表明在术前筛查中，肩外旋不足（投掷臂比非投掷臂小 5°以上）与受伤相关（比值比=1.90，95%置信区间 1.24 至 2.92，p<0.01）。
肩部外旋 ROM 的术前筛查可能识别出受伤风险较高的职业棒球投手和游泳运动员。肩部 ROM 筛查可能无法有效识别手球、垒球、排球和网球运动员的受伤风险。由于研究数量有限且存在高度异质性，因此应谨慎解释本系统评价和荟萃分析的结果。
PROSPERO 注册号：CRD42017072895。
