Yuine Hiroshi, Mutsuzaki Hirotaka, Yoshii Yuichi, Shimizu Yukiyo, Ishida Natsuki, Yasuda Taku, Iwai Koichi, Hotta Kazushi, Shiraishi Hideki, Tachibana Kaori
Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan.
Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan.
BMC Sports Sci Med Rehabil. 2023 Apr 15;15(1):58. doi: 10.1186/s13102-023-00658-8.
Wrist injury affects wheelchair basketball players' performance; however, the relationship between distal radioulnar joint (DRUJ) instability and hand functions is unclear. This cross-sectional pilot study investigated DRUJ instability in elite female wheelchair basketball athletes using force-monitor ultrasonography.
Nine elite female wheelchair basketball athletes (18 wrists) were included in the study. A triangular fibrocartilage complex (TFCC) injury was confirmed using magnetic resonance imaging (MRI). Hand functions were evaluated based on the range of motion (ROM) of wrist palmar flexion, dorsiflexion, radial deviation, and ulnar deviation; grip strength; arm circumference; forearm circumference; and DRUJ instability or pain using the ballottement test. The Mann-Whitney U test was used to compare parameters between the TFCC-injured and intact wrists. Radioulnar displacement was measured using force-monitor ultrasonography and pressure data, and the displacement-to-force ratio was used as an indicator of DRUJ instability. The correlation between the DRUJ displacement-to-force ratio and each hand function assessment was evaluated using Pearson correlation coefficient for the TFCC-injured and intact wrists. A generalized linear mixed model (GLMM) was used to estimate the relationship between hand functions and DRUJ instability.
TFCC injuries in seven wrists were confirmed using MRI findings (38.9%). The ulnar deviation ROM values of the TFCC-injured wrist (n = 7) and intact (n = 11) groups were 38.6 ± 8.0° and 48.6 ± 7.8°, respectively. The ulnar deviation ROM was significantly smaller in the TFCC-injured wrists (p = 0.02, r = - 0.54). In the TFCC-injured wrists, no correlation was observed between the displacement-to-force ratio and the hand function assessment. In contrast, the displacement-to-force ratio negatively correlated with grip strength, arm circumference, and forearm circumference in the intact wrists (Pearson correlation coefficient r = - 0.78, - 0.61, and - 0.74, respectively). The GLMM showed that the displacement-to-force ratio significantly affected grip strength, arm circumference, and forearm circumference in the intact group.
In intact wrists, correlations were observed between hand functions such as upper arm/forearm strength and DRUJ stability evaluated using ultrasound. Maintaining and strengthening grip strength, forearm circumference, and arm circumference are associated with DRUJ stability and may be related to TFCC injury prevention in wheelchair basketball athletes.
The protocol was registered with the UMIN Clinical Trials Registry (UMIN000043343) [Date of first registration: 16/02/2021].
手腕损伤会影响轮椅篮球运动员的表现；然而，远侧桡尺关节（DRUJ）不稳定与手部功能之间的关系尚不清楚。这项横断面试点研究使用测力超声检查了精英女性轮椅篮球运动员的DRUJ不稳定情况。
本研究纳入了9名精英女性轮椅篮球运动员（18只手腕）。使用磁共振成像（MRI）确认三角纤维软骨复合体（TFCC）损伤。基于腕关节掌屈、背屈、桡偏和尺偏的活动范围（ROM）、握力、上臂围、前臂围以及使用冲击试验评估DRUJ不稳定或疼痛情况来评估手部功能。采用曼-惠特尼U检验比较TFCC损伤手腕和未损伤手腕之间的参数。使用测力超声和压力数据测量桡尺位移，并将位移-力比用作DRUJ不稳定的指标。使用皮尔逊相关系数评估TFCC损伤手腕和未损伤手腕的DRUJ位移-力比与每项手部功能评估之间的相关性。使用广义线性混合模型（GLMM）估计手部功能与DRUJ不稳定之间的关系。
根据MRI结果确认7只手腕存在TFCC损伤（38.9%）。TFCC损伤手腕组（n = 7）和未损伤手腕组（n = 11）的尺偏ROM值分别为38.6±8.0°和48.6±7.8°。TFCC损伤手腕的尺偏ROM明显更小（p = 0.02，r = -0.54）。在TFCC损伤的手腕中，未观察到位移-力比与手部功能评估之间存在相关性。相比之下，在未损伤的手腕中，位移-力比与握力、上臂围和前臂围呈负相关（皮尔逊相关系数r分别为-0.78、-0.61和-0.74）。GLMM显示，在未损伤组中，位移-力比对握力、上臂围和前臂围有显著影响。
在未损伤的手腕中，观察到上臂/前臂力量等手部功能与使用超声评估的DRUJ稳定性之间存在相关性。维持和增强握力、前臂围和上臂围与DRUJ稳定性相关，可能与预防轮椅篮球运动员的TFCC损伤有关。
该方案已在UMIN临床试验注册中心注册（UMIN000043343）[首次注册日期：2021年2月16日]。
