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运动中胸椎运动处方的临床推理框架:一项系统评价与叙述性综合分析

Clinical reasoning framework for thoracic spine exercise prescription in sport: a systematic review and narrative synthesis.

作者信息

Heneghan Nicola R, Lokhaug Svein M, Tyros Isaak, Longvastøl Sigurd, Rushton Alison

机构信息

Centre of Precision Rehabiliation for Spinal Pain (CPR Spine), School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, West Midlands, UK.

Helsefag, Norwegian Institute of Sport Medicine, Oslo, Norway.

出版信息

BMJ Open Sport Exerc Med. 2020 Mar 29;6(1):e000713. doi: 10.1136/bmjsem-2019-000713. eCollection 2020.

Abstract

BACKGROUND

The thoracic spine is critical for athletic kinetic chain functioning yet widely overlooked in terms of specific evidenced-based exercise prescription. Thoracic mobility, motor control and strength are required to optimise performance in sport and minimise excessive load/stress on other components of the kinetic chain.

OBJECTIVE

To identify and evaluate mobility, motor control, work capacity and strength thoracic exercises for use in athletes.

DESIGN

Systematic review involving expert reviewers at key stages: searches and screening (n=1), eligibility, evaluation, data extraction and evaluation (n=3). Key databases and social media sources were searched to 16 August 2019. Eligible exercises were thoracic exercises to promote mobility, motor control, work capacity and strength. A narrative synthesis enabled an outcome-based classification of exercises, with level of evidence of individual sources informing overall level of evidence for each outcome (Oxford Centre for Evidence-based Medicine).

RESULTS

From 2348 sources (social media, database searches and other sources), 38 exercises were included. Sources included images, video clips and written descriptions of exercises. Exercises targeting all planes of motion were evaluated and classified according to outcome. Exercises comprised functional and non-functional exercises for mobility (n=9), work capacity (n=15), motor control (n=7) and strength (n=7). Overall level of evidence for each outcome was level 5.

CONCLUSION

This synthesis and evaluation of exercises has captured the scope of thoracic exercises used in 'practice'. Evaluation against an expert-derived outcome-based classification provides practitioners with a framework to facilitate exercise prescription. Evaluation of validity and effectiveness of exercises on outcomes is now required.

摘要

背景

胸椎对于运动员的运动动力链功能至关重要,但在基于具体循证的运动处方方面却被广泛忽视。胸椎的灵活性、运动控制能力和力量对于优化运动表现以及将动力链其他部分的过度负荷/压力降至最低是必需的。

目的

识别和评估用于运动员的胸椎灵活性、运动控制、工作能力和力量训练动作。

设计

系统性综述,在关键阶段由专家评审员参与:检索和筛选(n = 1)、资格审查、评估、数据提取和评估(n = 3)。检索关键数据库和社交媒体来源直至2019年8月16日。符合条件的训练动作是促进胸椎灵活性、运动控制、工作能力和力量的训练动作。叙述性综合分析实现了基于结果的训练动作分类,各个来源的证据水平为每个结果的总体证据水平提供参考(牛津循证医学中心)。

结果

从2348个来源(社交媒体、数据库检索和其他来源)中,纳入了38个训练动作。来源包括训练动作的图像、视频片段和文字描述。针对所有运动平面的训练动作根据结果进行了评估和分类。训练动作包括用于灵活性(n = 9)、工作能力(n = 15)、运动控制(n = 7)和力量(n = 7)的功能性和非功能性训练动作。每个结果的总体证据水平为5级。

结论

这种训练动作的综合分析和评估涵盖了“实践”中使用的胸椎训练动作范围。根据基于专家得出的基于结果的分类进行评估,为从业者提供了一个便于制定运动处方的框架。现在需要对训练动作在结果方面的有效性和效果进行评估。

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