Poploski Kathleen M, Picha Kelsey J, Winters Joshua D, Royer Scott D, Heebner Nicholas R, Lambert Brad, Lephart Scott M, Abt John P
Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Interdisciplinary Sciences, A.T. Still University, Mesa, AZ, USA.
Int J Sports Phys Ther. 2020 Dec;15(6):1129-1140. doi: 10.26603/ijspt20201129.
The specialized roles of many military personnel require specific skills and high physical demands, placing unique stresses on the shoulders and increasing risk of injury. As normal dominant/nondominant shoulder asymmetries have been established in military personnel, bilateral strength comparisons must be understood in context of daily physical demands to monitor patients' progress or readiness to return to duty.
This study aims to assess bilateral differences in strength and explosive force in United States Marines with a history of dominant or nondominant shoulder pathology.
Cross-Sectional.
A total of 52 full-duty, male US Marines with a shoulder injury within the prior year participated. Bilateral isokinetic shoulder internal (IR) and external (ER) rotation strength, and peak force (Peak Force) and average rate of force production (Avg Rate) during an explosive push-up were collected. Dominant versus nondominant side data were independently examined within each group (DOM: dominant injury, NOND: nondominant injury). Comparison between DOM and NOND, as well as previously published CON (no history of shoulder injury) was also completed.
NOND (n = 26) demonstrated significantly less IR ( < 0.001) and ER ( = 0.003) strength and Peak Force ( = 0.001) and Avg Rate ( = 0.047) on the injured side, while DOM (n = 26) demonstrated no bilateral differences in strength or push-up performance. Comparison between the three groups showed that NOND demonstrated significantly less ER strength than CON ( = 0.022).
Military personnel demonstrate asymmetric strength patterns likely due to increased demand of the dominant shoulder. US Marines with a history of injury to the nondominant shoulder performed differently than those with a dominant side injury, presenting with both strength and push-up asymmetries. They also demonstrated significant ER strength deficits compared to CON. Common clinical practice and previous literature often compare injured and uninjured limbs or injured individuals to healthy controls, but further distinction of dominant or nondominant side may provide more accurate information needed to develop targeted treatment strategies.
Recognizing unique occupational demands and how patients may present differently with dominant versus nondominant side shoulder injuries are important considerations for ensuring accurate assessment and effective individualized rehabilitation.
许多军事人员的特殊职责需要特定技能和较高的体能要求，这给肩部带来独特压力，增加受伤风险。由于军事人员中已存在正常的优势/非优势肩不对称情况，在日常体能需求背景下理解双侧力量比较，对于监测患者恢复进度或重返岗位的准备情况至关重要。
本研究旨在评估有优势或非优势肩部病变史的美国海军陆战队队员双侧力量和爆发力的差异。
横断面研究。
共有52名去年内肩部受伤的现役男性美国海军陆战队队员参与。收集双侧肩等速内旋（IR）和外旋（ER）力量，以及爆发性俯卧撑过程中的峰值力（Peak Force）和平均力量产生速率（Avg Rate）。在每组（DOM：优势侧受伤，NOND：非优势侧受伤）内独立检查优势侧与非优势侧数据。还完成了DOM组与NOND组以及与先前发表的CON组（无肩部受伤史）之间的比较。
NOND组（n = 26）受伤侧的IR力量（<0.001）、ER力量（= 0.003）、峰值力（= 0.001）和平均力量产生速率（= 0.047）明显较低，而DOM组（n = 26）在力量或俯卧撑表现上未显示出双侧差异。三组之间的比较表明，NOND组的ER力量明显低于CON组（= 0.022）。
军事人员表现出不对称的力量模式，可能是由于优势肩需求增加所致。有非优势肩受伤史的美国海军陆战队队员与有优势侧受伤的队员表现不同，存在力量和俯卧撑不对称情况。与CON组相比，他们还表现出明显的ER力量缺陷。常见临床实践和先前文献常将受伤和未受伤肢体或受伤个体与健康对照进行比较，但进一步区分优势侧或非优势侧可能提供制定针对性治疗策略所需的更准确信息。
认识到独特的职业需求以及患者优势侧与非优势侧肩部受伤表现的差异，对于确保准确评估和有效的个体化康复至关重要。
3级。
