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体操护腕/护具:它们对你有帮助还是有伤害?

Wrist Guards/Supports in Gymnastics: Are They Helping or Hurting You?

机构信息

Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts, USA.

The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.

出版信息

Am J Sports Med. 2023 Nov;51(13):3426-3433. doi: 10.1177/03635465231199683. Epub 2023 Oct 4.

Abstract

BACKGROUND

The prevalence of wrist pain among gymnasts ranges from 46% to 79%. To alleviate wrist pain, gymnasts wear wrist guards/supports (WG/S).

PURPOSE

To investigate the effect of WG/S on the wrist joint through joint moment, angles, total joint range of motion (ROM) arc, and ground-reaction force (GRF).

STUDY DESIGN

Controlled laboratory study.

METHODS

A cross-sectional study design was used to investigate 23 female gymnasts (mean ± SD: age, 12.3 ± 1.5 years; height, 143.4 ± 7.6 cm; mass, 37.7 ± 6.6 kg; body mass index, 18.6 ± 2.9) who performed back handsprings (analyzed by first half [phase 1] and second half [phase 2]) with the following 3 conditions: no WG/S, Skids/Ultimate Wrist Supports (S/UWS), and Tiger Paws (TP). Wrist joint moments, angles, total ROM arc, and GRF were examined by the 3 conditions using analysis of variance with Bonferroni correction and effect size (Cohen ).

RESULTS

For mean wrist flexion moment, both S/UWS and TP showed significantly higher values than the no-WG/S condition in landing phase 1 (S/UWS: = .001, = 1.30; TP: = .019, = 0.87). In angle comparisons in landing phase 1, no WG/S showed greater mean wrist extension angles compared with S/UWS ( = .046; = 0.80), but no significant differences with TP ( = .096; = 0.65). Also, in landing phase 1, total ROM arc of the right wrist was greater in the no-WG/S condition compared with S/UWS ( = .018; = 0.88), but there were no differences with TP ( = .400; = 0.52).

CONCLUSION

These data show an increased wrist flexion moment using S/UWS and TP compared with the no-WG/S condition in landing phase 1 of back handsprings. Also, increased wrist extension angles and total arc ROM of the right wrist were found in the no-WG/S condition compared with S/UWS, but not with TP in landing phase 1. S/UWS may be helpful to reduce wrist joint angles, specifically wrist extension in landing phase 1, but both S/UWS and TP caused higher wrist flexion joint moment in landing phase 1. There were no differences found in GFG among the three variables.

CLINICAL RELEVANCE

In the first half of the back handspring, wrist guards can limit wrist extension joint angles and total arc ROM; however, an increased wrist flexion moment was found when wrist guards were worn, which may potentially lead to an increased risk of injury. Injury history, especially overuse signs/symptoms, and previous surgery on the wrist joint need to be well considered before the application or use of wrist guards. Also, the amount of time/exposure wearing wrist guards should be carefully controlled in young female gymnasts.

摘要

背景

体操运动员手腕疼痛的患病率为 46%至 79%。为了缓解手腕疼痛,体操运动员会佩戴腕部保护器/支撑物(WG/S)。

目的

通过关节力矩、角度、总关节活动范围(ROM)弧和地面反作用力(GRF)来研究 WG/S 对腕关节的影响。

研究设计

对照实验室研究。

方法

采用横断面研究设计,调查了 23 名女性体操运动员(平均±标准差:年龄 12.3±1.5 岁;身高 143.4±7.6cm;体重 37.7±6.6kg;体重指数 18.6±2.9),她们在做后手翻时采用以下 3 种情况:不戴 WG/S、Skids/Ultimate Wrist Supports(S/UWS)和 Tiger Paws(TP)。通过分析方差并使用 Bonferroni 校正和效应量(Cohen ),在落地阶段 1(分析第 1 半)和第 2 半(分析第 2 半)中,对 3 种情况的腕关节力矩、角度、总 ROM 弧和 GRF 进行了检查。

结果

在落地阶段 1 的平均腕关节屈曲力矩方面,S/UWS 和 TP 与不戴 WG/S 时相比,均表现出明显更高的值(S/UWS: =.001, = 1.30;TP: =.019, = 0.87)。在落地阶段 1 的角度比较中,不戴 WG/S 时,平均腕关节伸展角度与 S/UWS 相比更大( =.046; = 0.80),但与 TP 相比无显著差异( =.096; = 0.65)。此外,在落地阶段 1 时,右腕的总 ROM 弧在不戴 WG/S 时比 S/UWS 更大( =.018; = 0.88),但与 TP 相比无差异( =.400; = 0.52)。

结论

这些数据表明,在做后手翻时,与不戴 WG/S 相比,S/UWS 和 TP 可使腕关节在落地阶段 1 时的屈曲力矩增加。另外,与 S/UWS 相比,在落地阶段 1 时,右腕的伸展角度和总 ROM 弧增加,但与 TP 相比无差异。在这 3 种变量中,均未发现 GRF 的差异。

临床意义

在手翻的前半部分,腕部保护器可以限制腕关节伸展角度和总 ROM;然而,当佩戴腕部保护器时,发现腕关节屈曲力矩增加,这可能会增加受伤的风险。在应用或使用腕部保护器之前,需要充分考虑受伤史,尤其是过度使用的迹象/症状和以前的腕关节手术。此外,应仔细控制年轻女性体操运动员佩戴腕部保护器的时间/暴露时间。

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