Passive and Dynamic Shoulder Rotation Range in Uninjured and Previously Injured Overhead Throwing Athletes and the Effect of Shoulder Taping

PM&R(2012)

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摘要
Objectives To investigate: (1) the passive and dynamic shoulder internal (IR) and external (ER) rotation range of motion (ROM) of 2 groups of asymptomatic overhead throwing athletes: one group who had never experienced shoulder symptoms and another who had shoulder symptoms >12 months ago, (2) the effect of taping on the passive and dynamic IR-ER ROM in both these groups. Design A within-subject repeated measures analysis of variance design to determine the differences in passive and dynamic shoulder rotation range and the effect of shoulder taping on the rotation range in a group of uninjured and previously injured overhead throwing athletes. Setting Academic institution sports medicine setting. Participants Twenty-six overhead throwing collegiate athletes: 17 with no history of shoulder injury and 9 with previous shoulder injury. Methods Passive shoulder ROM was measured with a goniometer with the subject in the supine position. To measure dynamic ROM, the subjects sat on a chair and threw a handball into a net. An 8-camera Vicon Motion Capture system recorded markers placed on the upper limb and trunk. Dynamic ROM was calculated with inverse kinematics by using OpenSim. Main Outcome Measurement Shoulder IR-ER ROM. Results Dynamic IR-ER ROM was significantly greater than passive IR-ER ROM (P < .0001). There was no difference in passive IR-ER ROM between the uninjured and previously injured overhead throwing athletes. However, there was a significant difference in the total dynamic IR-ER ROM, whereby the overhead throwing athletes who had never experienced shoulder symptoms had less IR-ER ROM than the previously injured group (173.9° versus 196.9°, respectively; P = .049). Taping the shoulder increased the passive ROM in both groups of subjects (P < .001), increased the dynamic IR-ER ROM in the uninjured subjects, but decreased the dynamic IR-ER ROM in the previously injured subjects, although this was not statistically significant (P = .07). Conclusions Passive IR-ER ROM is a poor indication of dynamic shoulder function. Athletes who have had a previous shoulder injury demonstrate a greater dynamic IR-ER ROM than athletes who have never had a shoulder injury. Shoulder taping decreased the dynamic range of the previously injured athlete, so that it was nearer the dynamic range of the uninjured athlete. Shoulder taping might provide increased protection for the injured athlete by decreasing the dynamic IR-ER ROM and by facilitating better shoulder and scapular muscle control. Further studies are necessary to demonstrate whether this finding is clinically significant.
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