Reinold Michael M, Dowling Brittany, Fleisig Glenn S, Macrina Leonard C, Wilk Kevin E, Streepy John T, Andrews James R
Chicago White Sox.
Champion PT and Performance.
Int J Sports Phys Ther. 2024 Mar 1;19(3):326-336. doi: 10.26603/001c.94146. eCollection 2024.
Interval throwing programs (ITP) have been used for decades to enable baseball pitchers to return to competition after injury or surgery by gradually applying load to the throwing arm. Past programs have been based on personal experience; however, advances in our understanding of the biomechanics and workloads of throwing allow for a more modern data-based program to be developed.
HYPOTHESIS/PURPOSE: To 1) develop a updated ITP for rehabilitation of modern baseball pitchers based upon biomechanical and throwing workload data, and 2) compare the updated program with a past program to determine differences in chronic workload and acute:chronic workload ratios (ACWR).
Cross-sectional study.
Workloads (i.e. daily, acute, chronic, and ACWR) for the original ITP were built from the prescribed throwing schedule. Elbow varus torque per throw was calculated based upon a relationship between elbow varus torque and throwing distance. Throw counts, daily/chronic/acute workloads, and ACWR were calculated and plotted over time. A new ITP was built to model current pitcher's throwing schedules and gradually increased ACWR over time.
The original ITP had a throwing schedule of 136 days, final chronic workload 15.0, and the ACWR above or below the "safe" range (i.e. 0.7 - 1.3) for 18% of the program with a peak of 1.61. The updated ITP was built to consist of a 217-day schedule, final chronic workload of 10.8, and deviated from the safe range for 9% of the program, with a peak of 1.33.
The newly created ITP is more familiar to modern baseball pitchers while exhibiting a more gradual buildup of chronic workload than traditional ITP programs. This ITP may be used to return baseball pitchers back to competition as safely and efficiently as possible, and potentially with less risk of setbacks or reinjury. The ITP may be used following common injuries or surgeries to the throwing shoulder and elbow, such as Tommy John surgery, while also serving as a basis for future development of shorter duration ITPs.
2c.
数十年来，间歇投球计划（ITP）一直被用于帮助棒球投手在受伤或手术后通过逐步增加对投球手臂的负荷来恢复比赛。过去的计划是基于个人经验制定的；然而，随着我们对投掷生物力学和工作量的理解不断进步，现在可以开发出一个更现代的基于数据的计划。
假设/目的：1）基于生物力学和投掷工作量数据，为现代棒球投手的康复制定一个更新的ITP；2）将更新后的计划与过去的计划进行比较，以确定慢性工作量和急性：慢性工作量比率（ACWR）的差异。
横断面研究。
根据规定的投球时间表确定原始ITP的工作量（即每日、急性、慢性和ACWR）。根据肘内翻扭矩与投球距离的关系计算每次投球的肘内翻扭矩。计算投球次数、每日/慢性/急性工作量和ACWR，并随时间绘制图表。构建一个新的ITP来模拟当前投手的投球时间表，并随着时间的推移逐渐增加ACWR。
原始ITP的投球时间表为136天，最终慢性工作量为15.0，在该计划的18%时间内ACWR高于或低于“安全”范围（即0.7 - 1.3），峰值为1.61。更新后的ITP构建为217天的时间表，最终慢性工作量为10.8，在该计划的9%时间内偏离安全范围，峰值为1.33。
新创建的ITP对现代棒球投手来说更熟悉，同时与传统ITP计划相比，其慢性工作量的增加更为渐进。这个ITP可用于尽可能安全有效地让棒球投手恢复比赛，并且潜在地减少挫折或再次受伤的风险。该ITP可用于投掷肩和肘部常见损伤或手术后，如汤米·约翰手术，同时也可作为未来开发更短持续时间ITP的基础。
2c。
