Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players
Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players
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DOI：
10.1136/bjsports-2016-096927
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发表时间：
2017-02-01
影响因子：
18.4
通讯作者：
Myklebust, G.
中科院分区：
文献类型：
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作者：
Moller, M.;Nielsen, R. O.;Myklebust, G.
背景 青少年手球运动缺乏对伤害模式的了解，这是预防伤害的重要一步。目的 调查与轻微增加或减少相比，手球负荷的增加是否与肩部受伤率增加相关，以及这种关联是否受到肩胛骨控制、等距肩部力量或盂肱运动范围 (ROM) 的影响。方法 679 名运动员（14-18 岁）使用短信、电话和体检系统提供了 31 周内关于肩部损伤和手球负荷（训练和比赛时间）的每周报告。某一周的手球负荷被分类为（1）相对于前 4 周每周平均手球负荷量的 60%。在基线和赛季中期对肩部等长旋转和外展力量、ROM 和肩胛骨控制进行评估。 结果 与参考组相比，手球负荷增加 > 60% 与更高的肩部损伤率相关（HR 1.91；95% CI 1.00 至 3.70，p=0.05）。手球负荷增加 20% 至 60% 的影响在外旋力量减弱（HR 4.0；95% CI 1.1 至 15.2，p=0.04）或肩胛运动障碍（HR 4.8；95% CI 1.3 至 18.3，p=0.02）的球员中加剧。外旋力量的降低加剧了增加超过 60% 的影响（HR 4.2；95% CI 1.4 至 12.8，p=0.01）。 结论 每周手球负荷的大幅增加会增加精英青少年手球运动员的肩部受伤率；特别是在外旋力量减弱或肩胛骨运动障碍的情况下。
Background Knowledge of injury patterns, an essential step towards injury prevention, is lacking in youth handball. Aim To investigate if an increase in handball load is associated with increased shoulder injury rates compared with a minor increase or decrease, and if an association is influenced by scapular control, isometric shoulder strength or glenohumeral range of motion (ROM).Methods 679 players (14-18 years) provided weekly reports on shoulder injury and handball load (training and competition hours) over 31 weeks using the SMS, phone and medical examination system. Handball load in a given week was categorised into (1) 60% relative to the weekly average amount of handball load the preceding 4 weeks. Assessment of shoulder isometric rotational and abduction strength, ROM and scapular control was performed at baseline and midseason.Results An increase in handball load by >60% was associated with greater shoulder injury rate (HR 1.91; 95% CI 1.00 to 3.70, p=0.05) compared with the reference group. The effect of an increase in handball load between 20% and 60% was exacerbated among players with reduced external rotational strength (HR 4.0; 95% CI 1.1 to 15.2, p=0.04) or scapular dyskinesis (HR 4.8; 95% CI 1.3 to 18.3, p=0.02). Reduced external rotational strength exacerbated the effect of an increase above 60% (HR 4.2; 95% CI 1.4 to 12.8, p=0.01).Conclusions A large increase in weekly handball load increases the shoulder injury rate in elite youth handball players; particularly, in the presence of reduced external rotational strength or scapular dyskinesis.