Physical contributors to glenohumeral internal rotation deficit in high school baseball players  

作　　者：Elizabeth E. Hibberd Casey E. Shutt Sakiko Oyama J. Troy Blackburn Joseph B. Myers 

机构地区：[1]Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487-0311, USA [2]U.S. Army-Baylor University, San Antonio, TX 78234-6100, USA [3]Department of Health and Kinesiology, University of Texas at San Antonio, San Antonio, TX 78249, USA [4]Department of Exercise and Sport Science, Neuromuscular Research Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA [5]Department of Exercise and Sport Science, Sports Medicine Research Laboratories, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA

出　　处：《Journal of Sport and Health Science》2015年第3期299-306,共8页运动与健康科学（英文）

摘　　要：Background： Glenohumeral internal rotation deficit （GIRD） is a risk factor for shoulder and elbow injury in baseball players. Although this evidence forms a basis for recommending stretching, clinical measures of internal rotation range of motion （ROM） do not differentiate if GIRD is due to muscular, capsuloligamentous, or osseous factors. Understanding the contributions of these structures to GIRD is important for the development of targeted interventions. We hypothesize that the osseous component will have the greatest relative contribution to GIRD, followed by muscle stiffness and posterior capsule thickness. Methods： Internal rotation ROM, muscle stiffness （teres minor, infraspinatus, and posterior deltoid）, posterior capsule thickness, and humeral retrotorsion were evaluated on 156 baseball players. A side-to-side difference was calculated for each variable. Variables were entered into a multivariable linear regression to determine the significant predictors of GIRD. Results： The regression model was statistically significant （R2 = 0.134, F（1, 156） = 24.0, p 〈 0.01） with only humeral retrotorsion difference remaining as a significant predictor （β = -0.243, t156 = -4.9, p 〈 0.01）. A greater humeral retrotorsion side-to-side difference was associated with more GIRD. Conclusion： Humeral retrotorsion accounted for 13.3% of the variance in GIRD. The stiffness of the superficial shoulder muscles and capsular thickness, as measured in this study, were not predictors of GIRD. Factors not assessed in this study, such as deeper muscle stiffness, capsule/ ligament laxity, and neuromuscular regulation of muscle stiffness may also contribute to GIRD. Since it is the largest contributor to GIRD, causes of changes in humeral retrotorsion need to be identified. The osseous component only accounted for 13.3% of the variance in GIRD, indicating a large contribution from soft tissues factors that were not addressed in this study. These factors need to be identified to develop evidence-based背景对棒球运动员而言,盂肱关节内旋能力降低(GIRD)是导致肩部和肘部损伤的一个危险因素。尽管这为推荐拉伸提供证据基础,但内旋活动范围(ROM)临床测试无法区分GIRD是由于肌肉韧带还是骨成分因素导致。因此正确理解导致GIRD的原因,对采取针对性干预措施有重要意义。本研究假设骨成分是导致其内旋能力降低的主要因素,其次是肌肉僵硬和后囊膜厚度。方法以156位棒球运动员为对象,评估其内旋ROM,肌肉僵硬(小圆肌、冈下肌与三角肌后束)程度,后囊膜厚度和肱骨后移程度。每个变量都计算了左右侧的差异。将变量输入多元线性回归分析以确定GIRD的重要预测因素。结果:该回归模型只在肱骨后移作为重要预测因素(β=-0 243,t_(156)=-4 9,p<0 01)时存在显著性差异(R^2=0 134,F(1,1 56)=24 0,p<0 01)。不同侧肱骨后移的变化与GIRD有关。结论:肱骨后移在导致GIRD的原因中占13 3%。而浅表肌肉和囊膜僵硬不能作为GIRD的预测因素。在本研究中未评估的因素,如更深层肌肉的僵硬程度、囊膜GIRD或韧带松弛以及神经肌肉调节能力迟缓也可能导致GIRD。肱骨后移是导致GIRD的最大的因素,需要确认其原因。骨成分在GIRD中仅占13 3%,揭示了在这项研究中并未解决软组织因素对该问题的影响。需要进一步确认这些因素,以便完善其评估证据及干预方案,从而降低棒球运动员的受伤风险度。

关 键 词：BASEBALL GIRD Humeral retrotorsion Muscle stiffness Posterior capsule thickness 

分 类 号：TS952.38[轻工技术与工程] Q441[生物学—生理学]