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机械性痛觉过敏而非肩部前伸姿势与排球运动员肩部疼痛相关:一项横断面研究。

Mechanical Hyperalgesia but Not Forward Shoulder Posture Is Associated with Shoulder Pain in Volleyball Players: A Cross-Sectional Study.

作者信息

Pecos-Martín Daniel, Patiño-Núñez Sergio, Quintero-Pérez Jessica, Cruz-Riesco Gema, Quevedo-Socas Cintia, Gallego-Izquierdo Tomás, Beltran-Alacreu Hector, Fernández-Carnero Josué

机构信息

Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain.

Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidad de A Coruña, Campus de Oza s/n, 15006 A Coruña, Spain.

出版信息

J Clin Med. 2022 Mar 8;11(6):1472. doi: 10.3390/jcm11061472.

Abstract

Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with and without shoulder pain. Furthermore, this study observed if there is an association between shoulder posture and upper limb mechanical hyperalgesia in volleyball players with and without shoulder pain. Methods: a cross-sectional study was conducted in the Physiotherapy and Pain Research Center in Alcalá de Henares (Spain). A total of 56 volleyball players met the inclusion criteria and agreed to enter the study. Subjects were divided into two groups: shoulder pain group (SPG) and control group (without pain). The following measurements of the dominant sides of the players were collected: FSA, PMI, and pressure pain threshold (PPT) in serratus anterior, lower trapezius, infraspinatus, teres minor, upper trapezius, levator scapulae, pectoralis major, radial nerve, cubital nerve, and median nerve. Results: The Spearman’s Rho revealed no significant correlations were found between FSA and PMI. Moreover, Spearman’s Rho test revealed in the SPG a negative moderate correlation between FSA and Infraspinatus-PPT (Rho = −0.43; p = 0.02); FSA and levator scapulae-PPT (Rho = −0.55; p < 0.01); FSA and pectoralis major-PPT (Rho = −0.41; p = 0.02); PMI and cubital nerve-PPT (Rho = −0.44; p = 0.01). Conclusions: No association was found between the forward shoulder angle and the pectoralis minor index in volleyball players with and without shoulder pain. There is a moderate negative association between shoulder forward angle and muscle mechanical hyperalgesia in volleyball players with shoulder pain, but no such associations were found in volleyball players without shoulder pain. Treatment of the infraspinatus, levator scapulae, pectoralis major, and pectoralis minor muscles could improve shoulder pain and ulnar nerve mechanosensitivity.

摘要

肩部前冲、肩胛运动学改变以及肌肉活动失衡通常与肩部疼痛相关。本研究旨在观察有或无肩部疼痛的排球运动员的前肩角度(FSA)与胸小肌长度指数(PMI)之间是否存在关联。此外,本研究还观察了有或无肩部疼痛的排球运动员的肩部姿势与上肢机械性痛觉过敏之间是否存在关联。方法:在西班牙阿尔卡拉德埃纳雷斯的物理治疗与疼痛研究中心进行了一项横断面研究。共有56名排球运动员符合纳入标准并同意参与研究。受试者被分为两组:肩部疼痛组(SPG)和对照组(无疼痛)。收集了运动员优势侧的以下测量数据:FSA、PMI以及前锯肌、下斜方肌、冈下肌、小圆肌、上斜方肌、肩胛提肌、胸大肌、桡神经、尺神经和正中神经的压痛阈值(PPT)。结果:Spearman秩相关分析显示FSA与PMI之间无显著相关性。此外,Spearman秩相关检验显示在SPG中,FSA与冈下肌-PPT之间存在中度负相关(Rho = -0.43;p = 0.02);FSA与肩胛提肌-PPT之间存在中度负相关(Rho = -0.55;p < 0.01);FSA与胸大肌-PPT之间存在中度负相关(Rho = -0.41;p = 0.02);PMI与尺神经-PPT之间存在中度负相关(Rho = -0.44;p = 0.01)。结论:有或无肩部疼痛的排球运动员的前肩角度与胸小肌指数之间未发现关联。有肩部疼痛的排球运动员的肩部前伸角度与肌肉机械性痛觉过敏之间存在中度负相关,但无肩部疼痛的排球运动员未发现此类关联。治疗冈下肌、肩胛提肌、胸大肌和胸小肌可能会改善肩部疼痛和尺神经机械敏感性。

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