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紧肩:伸展前后有症状和无症状男性上肢运动员的临床、运动学和力量比较。

Tight shoulders: A clinical, kinematic and strength comparison of symptomatic and asymptomatic male overhead athletes before and after stretching.

机构信息

Laboratoire d'Analyse du Mouvement Humain, University of Liège, Liège, Belgium.

Department of Motricity Sciences, University of Liège, Liège, Belgium.

出版信息

Eur J Sport Sci. 2021 May;21(5):781-791. doi: 10.1080/17461391.2020.1785015. Epub 2020 Jul 7.

Abstract

A tightness of the posterior structures of the throwing shoulder has been hypothesised to be associated with injuries and pain because of alterations of the scapular kinematics and muscular imbalances. The aims of this study were to identify the clinical and biomechanical profile of symptomatic and asymptomatic overhead athletes with a tight shoulder and to evaluate the efficiency of a self-applied stretching program. Twenty male overhead athletes were recruited. Half of them reported a painful shoulder at the beginning of the study. For four weeks, the volunteers performed daily stretching exercises. Before and after the stretching program, gleno-humeral mobility, scapular kinematics, rotator muscles strength and pain were evaluated. Before stretching, the main difference between the groups was more impingement syndrome and rotator cuff tendon lesion positive tests in the symptomatic group (< 0.027, effect size = 0.51). After the program, pain reported by the symptomatic volunteers was reduced by approximately 40% and the gleno-humeral internal rotation bilateral difference was significantly reduced by 77.6% ( < 0.009, effect size = 0.84). In the symptomatic group, the scapula at rest was significantly more posteriorly tilted ( = 0.027, effect size = 0.69) after the stretching; a position that has been shown to limit the risk of impingement. The absence of significant differences of the profiles of the symptomatic and asymptomatic overhead athletes before stretching may indicate that the initiation of early prevention programs, including self-applied stretching, should not rely solely on biomechanical and clinical parameters and might be recommended to all players with a tight shoulder.

摘要

投掷肩后部结构紧张被假设与损伤和疼痛有关,因为肩胛运动学的改变和肌肉失衡。本研究的目的是确定有紧肩症状和无症状的上肢运动员的临床和生物力学特征,并评估自我应用伸展计划的效果。招募了 20 名男性上肢运动员。他们中的一半在研究开始时报告肩部疼痛。志愿者们进行了为期四周的日常伸展运动。在伸展计划前后,评估了盂肱关节活动度、肩胛骨运动学、旋转肌力量和疼痛。在伸展前,症状组的撞击综合征和肩袖肌腱病变阳性试验更多,这是两组之间的主要区别(<0.027,效应量=0.51)。在计划后,症状志愿者报告的疼痛减少了约 40%,盂肱关节内旋双侧差异显著减少了 77.6%(<0.009,效应量=0.84)。在症状组中,伸展后肩胛骨休息时明显向后倾斜(=0.027,效应量=0.69),这已被证明可降低撞击的风险。在伸展前,症状和无症状上肢运动员的特征没有显著差异,这可能表明,包括自我应用伸展在内的早期预防计划的启动不应仅依赖于生物力学和临床参数,并且可能建议所有肩部紧张的运动员都参加。

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