有和没有肩部疼痛病史的青少年网球运动员的运动范围和肌肉僵硬差异
Range of Motion and Muscle Stiffness Differences in Junior Tennis Players with and without a History of Shoulder Pain.
作者信息
Colomar Joshua, Peña Javier, Vicens-Bordas Jordi, Baiget Ernest
机构信息
University of Vic - Central University of Catalonia, Sport, Exercise and Human Movement Research Group (SEaHM), Vic, Spain.
Sport and Physical Activity Studies Centre (CEEAF), University of Vic - Central University of Catalonia, Vic, Spain.
出版信息
Int J Sports Phys Ther. 2025 Jan 1;20(1):71-78. doi: 10.26603/001c.127263. eCollection 2025.
BACKGROUND
Due to its significant unilateral predominance, tennis can provoke functional and morphological asymmetries that develop over time and may result in undesired morphological alterations.
HYPOTHESIS/PURPOSE: The goals of this study were a) to assess glenohumeral range of motion and muscular stiffness in young tennis players with and without a history of shoulder pain and b) to examine interlimb asymmetries in these variables in both groups. It was hypothesized that players with a history of shoulder pain would show a reduced glenohumeral internal rotation (IR) and total arc of motion (TAM) and increased stiffness in internal rotator muscles compared to those without shoulder pain.
STUDY DESIGN
Cross-sectional observational study.
METHODS
Twenty-five participants participated in the study (11 with a history of shoulder pain and 14 without pain). Participants performed stiffness measurements on muscles involved in the main tennis stroke motions alongside range of motion examinations on the dominant (D) and non-dominant (ND) extremities including IR, external shoulder rotation (ER), and TAM. A two-way mixed-design ANOVA analyzed group and limb effects, with effect sizes classified as small, medium, or large. Significant effects were further examined using Bonferroni post hoc tests.
RESULTS
There were significant differences between the shoulder pain and no shoulder pain group in the D IR (-3.1º, 6.43%, p = 0.048; effect size [ES] = 0.58) and D TAM (-6.1º, 3.01%, p = 0.024; ES = 0.66). Moreover, significant differences were found between the D and ND extremities in IR in both groups (-9.2º, 14.94%, p < 0.001; ES = -1.72) and TAM in the shoulder pain group (-5.6º, 2,77%, p = 0.038; ES = 0.61). Stiffness measurements showed no significant differences between groups or extremities.
CONCLUSIONS
Significantly lower values of D IR and TAM and higher IR asymmetries in the shoulder pain group suggest that a deficit in these parameters could be associated with shoulder pain history in junior competitors.
LEVEL OF EVIDENCE
背景
由于网球运动存在显著的单侧优势，它可能引发随着时间推移而出现的功能和形态不对称，进而可能导致不理想的形态改变。
假设/目的：本研究的目标是：a）评估有和没有肩部疼痛病史的年轻网球运动员的盂肱关节活动范围和肌肉僵硬度；b）检查两组在这些变量上的肢体间不对称性。研究假设是，与没有肩部疼痛的运动员相比，有肩部疼痛病史的运动员盂肱关节内旋（IR）和总运动弧（TAM）会减小，内旋肌的僵硬度会增加。
研究设计
横断面观察性研究。
方法
25名参与者参与了本研究（11名有肩部疼痛病史，14名无疼痛）。参与者对主要网球击球动作涉及的肌肉进行僵硬度测量，并对优势（D）和非优势（ND）肢体进行活动范围检查，包括IR、肩外旋（ER）和TAM。采用双向混合设计方差分析来分析组间和肢体效应，效应大小分为小、中或大。使用Bonferroni事后检验进一步检查显著效应。
结果
肩部疼痛组和无肩部疼痛组在优势侧IR（-3.1°，6.43%，p = 0.048；效应大小[ES]=0.58）和优势侧TAM（-6.1°，3.01%，p = 0.024；ES = 0.66）方面存在显著差异。此外，两组在IR方面优势侧和非优势侧之间存在显著差异（-9.2°，14.94%，p < 0.001；ES = -1.72），肩部疼痛组在TAM方面优势侧和非优势侧之间也存在显著差异（-5.6°，2.77%，p = 0.038；ES = 0.61）。僵硬度测量结果显示组间和肢体间无显著差异。
结论
肩部疼痛组优势侧IR和TAM值显著较低，且IR不对称性较高，这表明这些参数的不足可能与青少年运动员的肩部疼痛病史有关。
证据水平
2级。
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