Dowling Brittany, Brusalis Christopher M, Streepy John T, Hodakowski Alexander, Pauley Patrick J, Heidloff Dave, Garrigues Grant E, Verma Nikhil N, Fleisig Glenn S
Midwest Orthopaedics at RUSH.
Rush University Medical Center.
Int J Sports Phys Ther. 2024 Feb 1;19(2):176-188. doi: 10.26603/001c.92016. eCollection 2024.
In the rehabilitation of injured baseball pitchers, there is lack of consensus on how to guide a player back to pitching. It is unknown how different contemporary interval throwing programs (ITPs) progress in the amount of throwing workload.
To 1) evaluate three prominent ITPs commonly employed in baseball pitcher rehabilitation and assess whether these ITPs produce training loads that increase in a controlled, graduated manner and 2) devise an ITP that produced training loads which increased steadily over time.
Cross-sectional study.
Three publicly available ITPs from prominent sports medicine institutions were analyzed. Elbow varus torque per throw was calculated from a 2 order polynomial regression based upon a relationship between recorded torque measurements and throwing distance measured from a database of 111,196 throws. The relative rate of workload increase was measured as an acute:chronic workload ratio (ACWR). For each ITP, throw counts, daily/acute/chronic workloads, and ACWR were calculated and plotted over time. Finally, an original ITP was devised based upon a computational model that gradually increases ACWR over time and finished with an optimal chronic workload.
Each ITP exhibited a unique progression of throwing distances, quantities, and days to create different workload profiles. The three ITPs had throwing schedules ranging from 136 days to 187 days, ACWR spiked above or fell below a literature-defined "safe" range (i.e. 0.7 - 1.3) 19, 21, and 23 times. A novel ITP, predicated on a 146-day schedule and with a final chronic workload of 14.2, was designed to have no spikes outside of the safe range.
Existing ITPs widely utilized for rehabilitation of baseball pitchers exhibit significantly inconsistent variation in the rate of throwing load progression. Computational modeling may facilitate more incremental workload progression in ITPs, thereby reducing injury during rehabilitation and more efficiently condition a pitcher for return to competition.
3b.
在受伤棒球投手的康复过程中，对于如何指导运动员恢复投球缺乏共识。目前尚不清楚不同的当代间歇投球计划（ITP）在投球工作量方面是如何进展的。
1）评估棒球投手康复中常用的三种主要ITP，并评估这些ITP是否能产生以可控、渐进方式增加的训练负荷；2）设计一种能产生随时间稳步增加的训练负荷的ITP。
横断面研究。
分析了来自著名运动医学机构的三种公开的ITP。根据111196次投球数据库中记录的扭矩测量值与投球距离之间的关系，通过二阶多项式回归计算每次投球的肘内翻扭矩。工作量增加的相对速率以急性：慢性工作量比（ACWR）来衡量。对于每个ITP，计算投球次数、每日/急性/慢性工作量和ACWR，并随时间绘制图表。最后，基于一个随着时间逐渐增加ACWR并以最佳慢性工作量结束的计算模型，设计了一个原始的ITP。
每个ITP在投球距离、数量和天数方面都呈现出独特的进展情况，以创建不同的工作量概况。这三种ITP的投球计划从136天到187天不等，ACWR分别有19次、21次和23次超过或低于文献定义的“安全”范围（即0.7 - 1.3）。设计了一种新的ITP，基于146天的计划，最终慢性工作量为14.2，旨在使安全范围之外没有峰值。
广泛用于棒球投手康复的现有ITP在投球负荷进展速率方面表现出明显不一致的变化。计算建模可能有助于ITP中更渐进的工作量进展，从而减少康复期间的损伤，并更有效地使投手适应重返比赛。
3b。
