Linderman Shannon E, Scarborough Donna Moxley, Oh Luke S
Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
PM R. 2021 Jan;13(1):73-80. doi: 10.1002/pmrj.12365. Epub 2020 May 5.
Despite high injury incidence rates in gymnastics, there is a paucity of data characterizing upper extremity injury causation and biomechanical risk factors. This study investigated contact forces across multiple joints in both upper extremities during a round-off back handspring (ROBHS), a fundamental gymnastics tumbling maneuver.
(1) To characterize the three-dimensional (3-D) biomechanics of the sequential, asynchronous contact of each upper extremity with the ground during a ROBHS using 3-D motion capture, and (2) to evaluate potential correlations to upper extremity injury risk.
Observational cross-sectional study.
Controlled laboratory environment.
Fourteen competitive female gymnasts aged 10-21 years (mean age: 16.6 ± 3.1 years) (1) participating on a competitive gymnastics team; (2) capable of successfully completing a ROBHS; and (3) free of reported injury at enrollment.
Not applicable.
Variables evaluated include joint angle, torque, compression force, ground reaction force (GRF), time to peak GRF, and limb loading rates. Variables were analyzed at the wrist, elbow, and shoulder of both limbs at ground contact. The hypothesis that these dependent variables would differ by ROBHS upper extremity contact order was formulated retrospectively after data collection.
The first contact limb experienced significantly greater extension torque at the elbow (first: 48.89 ± 18.01 Nm, second: 22.49 ± 9.19 Nm; P = .014; CI 95% [14.83, 37.97]) and faster time to peak GRF (P < .001, CI 95% [-1.79, -0.99]). The second limb of contact experienced significantly greater abduction torque at the shoulder (P = .007; CI 95% [-21.58,-8.08]) and anterior-posterior GRF at contact (P = .007; CI 95% [-1.06,-0.26]).
The biomechanical differences between contact limbs during the ROBHS may lead to different injury risk. Recognition of the stresses at the elbow and shoulder for both limbs also provides new insight for rehabilitation clinicians to consider when guiding patients to return to gymnastics activity after injury.
尽管体操运动中的损伤发生率很高，但关于上肢损伤成因和生物力学风险因素的数据却很少。本研究调查了基本体操翻滚动作踺子后手翻（ROBHS）过程中双上肢多个关节的接触力。
（1）使用三维运动捕捉技术，描述ROBHS过程中双上肢依次、异步与地面接触的三维生物力学特征；（2）评估与上肢损伤风险的潜在相关性。
观察性横断面研究。
受控实验室环境。
14名年龄在10 - 21岁之间的竞技女子体操运动员（平均年龄：16.6 ± 3.1岁），（1）参加竞技体操队；（2）能够成功完成ROBHS；（3）入组时无损伤报告。
不适用。
评估的变量包括关节角度、扭矩、压缩力、地面反作用力（GRF）、GRF峰值时间和肢体负荷率。在地面接触时，对双上肢的腕关节、肘关节和肩关节处的变量进行分析。这些因变量会因ROBHS上肢接触顺序不同而有所差异的假设是在数据收集后进行回顾性设定的。
先接触的肢体在肘关节处经历的伸展扭矩显著更大（先接触：48.89 ± 18.01 Nm，后接触：22.49 ± 9.19 Nm；P = 0.014；95%置信区间[14.83, 37.97]），且GRF峰值时间更快（P < 0.001，95%置信区间[-1.79, -0.99]）。后接触的肢体在肩关节处经历的外展扭矩显著更大（P = 0.007；95%置信区间[-21.58, -8.08]），且接触时的前后GRF更大（P = 0.007；95%置信区间[-1.06, -0.26]）。
ROBHS过程中接触肢体之间的生物力学差异可能导致不同的损伤风险。认识到双上肢肘关节和肩关节处的应力，也为康复临床医生在指导受伤患者恢复体操活动时提供了新的思考方向。
