Bullock Garrett S, Thigpen Charles A, Zhao Hannah, Devaney Laurie, Kline Daniel, Noonan Thomas J, Kissenberth Michael J, Shanley Ellen
Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA; Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
ATI Physical Therapy, Greenville, SC, USA.
J Shoulder Elbow Surg. 2025 Feb;34(2):421-429. doi: 10.1016/j.jse.2024.08.026. Epub 2024 Oct 11.
The authors observed an association between cervical spine mobility and arm injury risk in baseball players; however, there is a need to assess the generalizability of cervical measurement data. Assessing the downstream associations of cervical dysfunction on shoulder and elbow injuries can inform clinical interventions to help reduce future arm injuries. The purpose of this study was to assess the generalizability of neck range of motion measures as arm injury prognostic factors in professional baseball pitchers.
A prospective cohort of professional baseball pitchers in one Major League Baseball Organization was studied. Pitchers underwent preseason neck range of motion including cervical flexion, extension, rotation, lateral flexion, and the flexion-rotation test, and were followed for the season. The outcome was the occurrence of a shoulder or elbow injury. A Cox proportional hazards analysis was performed and reported as hazard ratios with 95% confidence intervals (95% CIs).
A total of 88 pitchers were included (age: 24.2 [2.4] years; left-handed: 21 [23%]; fastball velocity: 92.3 [1.8]), with 15,942 athlete exposure days collected over the season. Pitcher neck range of motion was assessed (flexion: 64° [10°]; extension: 69° [11°]; difference in lateral flexion: -1° [7°]; difference in neck rotation: -2° [9°]; difference in cervical flexion-rotation test: -1° [7°]). A total of 20 arm injuries (shoulder: 9 [10%]; elbow: 11 [13%]; combined rate: 1.3 [95% CI: 0.7, 1.7] per 1000 exposure days) were suffered by pitchers during the season. For every degree increase in the difference in dominant (rotating to dominant shoulder) vs. nondominant (rotating to nondominant shoulder) neck rotation, there was a 4-fold increase in arm injury hazard (hazard ratio: 4.0 [95% CI: 1.1, 13.9], P = .031). No other neck measurements demonstrated prognostic value.
A deficit in dominant vs. nondominant neck rotation was prognostic for a pitching arm injury. However, the cervical rotation test did not have prognostic value in this sample. Further research is required to assess the generalizability and scalability of neck range of motion assessment in relation to baseball shoulder and elbow injuries across different competition levels.
作者观察到棒球运动员颈椎活动度与手臂受伤风险之间存在关联；然而，有必要评估颈椎测量数据的普遍性。评估颈椎功能障碍对肩部和肘部损伤的下游关联可以为临床干预提供信息，以帮助减少未来的手臂损伤。本研究的目的是评估颈部活动度测量作为职业棒球投手手臂损伤预后因素的普遍性。
对一个美国职业棒球大联盟组织中的职业棒球投手进行了一项前瞻性队列研究。投手在季前赛时接受了颈部活动度检查，包括颈椎前屈、后伸、旋转、侧屈以及前屈旋转试验，并在整个赛季进行随访。观察结果为肩部或肘部损伤的发生情况。进行了Cox比例风险分析，并以风险比及95%置信区间（95%CI）的形式报告。
共纳入88名投手（年龄：24.2[2.4]岁；左撇子：21名[23%]；快球速度：92.3[1.8]），整个赛季共收集到15942个运动员暴露日。评估了投手的颈部活动度（前屈：64°[10°]；后伸：69°[11°]；侧屈差异：-1°[7°]；颈部旋转差异：-2°[9°]；颈椎前屈旋转试验差异：-1°[7°]）。赛季期间，投手共遭受20次手臂损伤（肩部：9次[10%]；肘部：11次[13%]；合并发生率：每1000个暴露日1.3次[95%CI：0.7，1.7]）。优势侧（向优势肩旋转）与非优势侧（向非优势肩旋转）颈部旋转差异每增加1度，手臂受伤风险增加4倍（风险比：4.0[95%CI：1.1，13.9]，P = ；031）。其他颈部测量指标均未显示出预后价值。
优势侧与非优势侧颈部旋转不足是投手手臂损伤的预后因素。然而，在本样本中，颈椎旋转试验没有预后价值。需要进一步研究以评估颈部活动度评估在不同比赛水平上与棒球肩部和肘部损伤相关的普遍性和可扩展性。
