Preventing overuse shoulder injuries among throwing athletes: a cluster-randomised controlled trial in 660 elite handball players
Preventing overuse shoulder injuries among throwing athletes: a cluster-randomised controlled trial in 660 elite handball players
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DOI：
10.1136/bjsports-2016-096226
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发表时间：
2017-07-01
影响因子：
18.4
通讯作者：
Myklebust, Grethe
中科院分区：
文献类型：
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作者：
Andersson, Stig Haugsboe;Bahr, Roald;Myklebust, Grethe
背景 肩部问题在优秀手球运动员中非常普遍。盂肱旋转减少、外旋无力和肩胛骨运动障碍已被确定为危险因素。 目的 评估旨在减少精英手球中肩部问题发生率的运动计划的效果。 方法 对 45 支精英手球队（女队 22 支，男队 23 队，660 名球员）进行整群随机分组（干预组 22 支球队，331 名球员，对照组 23 支球队，329 名球员） 并随后进行 1 个赛季（7 个月）。奥斯陆运动创伤研究中心（OSTRC）肩部损伤预防计划是一项旨在增加盂肱内旋、外旋力量和肩胛肌力量，以及改善动力链和胸椎活动度的锻炼计划，作为手球热身的一部分，由教练和队长每周进行 3 次。每月测量主要结果指标，即肩部问题和实质性肩部问题的患病率。 结果 干预组在季节期间肩部问题的平均患病率为 17%（95% CI 16% 至 19%），对照组为 23%（95% CI 21% 至 26%）（平均差异 6%）。干预组中严重肩部问题的平均患病率为 5%（95% CI 4% 至 6%），对照组为 8%（95% CI 7% 至 9%）（平均差异 3%）。使用广义估计方程模型，与对照组相比，干预组出现肩部问题的风险降低了 28%（OR 0.72，95% CI 0.52 至 0.98，p=0.038），重大肩部问题的风险降低了 22%（OR 0.78，95% CI 0.53 至 1.16，p=0.23）。结论 OSTRC 肩部伤害预防计划降低了精英人群肩部问题的患病率 手球应该作为热身的一部分。
Background Shoulder problems are highly prevalent among elite handball players. Reduced glenohumeral rotation, external rotation weakness and scapula dyskinesis have been identified as risk factors.Aim Evaluate the effect of an exercise programme designed to reduce the prevalence of shoulder problems in elite handball.Methods 45 elite handball teams (22 female teams, 23 male teams, 660 players) were cluster randomised (22 teams, 331 players in the intervention group, 23 teams, 329 players in the control group) and followed for 1 competitive season (7 months). The Oslo Sports Trauma Research Center (OSTRC) Shoulder Injury Prevention Programme, an exercise programme to increase glenohumeral internal rotation, external rotation strength and scapular muscle strength, as well as improve kinetic chain and thoracic mobility, was delivered by coaches and captains 3 times per week as a part of the handball warm-up. The main outcome measures, prevalence of shoulder problems and substantial shoulder problems, were measured monthly.Results The average prevalence of shoulder problems during the season was 17% (95% CI 16% to 19%) in the intervention group and 23% (95% CI 21% to 26%) in the control group (mean difference 6%). The average prevalence of substantial shoulder problems was 5% (95% CI 4% to 6%) in the intervention group and 8% (95% CI 7% to 9%) in the control group (mean difference 3%). Using generalised estimating equation models, a 28% lower risk of shoulder problems (OR 0.72, 95% CI 0.52 to 0.98, p=0.038) and 22% lower risk of substantial shoulder problems (OR 0.78, 95% CI 0.53 to 1.16, p=0.23) were observed in the intervention group compared with the control group.Conclusions The OSTRC Shoulder Injury Prevention Programme reduced the prevalence of shoulder problems in elite handball and should be included as a part of the warm-up.