پژوهش در طب ورزشی و فناوری

تاثیر شش هفته تمرینات اغتشاشی اندام فوقانی بر قدرت اکسنتریک چرخش دهنده خارجی شانه و میزان چرخش بالایی کتف والیبالیست های مستعد آسیب اندام فوقانی

مقالات آماده انتشار

نویسندگان

ابراهیم سلطان آبادی
ملیحه حدادنژاد
مهدی خالقی

دانشگاه خوارزمی

چکیده
ایمبالانس‌های عضلانی در شانه به‌صورت ضعف در عضلات چرخش‌دهنده خارجی نسبت به چرخش‌دهنده‌های داخلی است که ضعف چرخش دهنده های خارجی از ریسک فاکتورهای آسیب شانه والیبالیست‌ها می‌باشند. بدحرکتی کتف می‌تواند به دلیل ایمبالاس عضلات ثبات دهنده کتفی ایجاد شده که با هماهنگی عضلات بهبود می‌یابد. هدف از انجام این تحقیق بررسی تاثیر تمرینات اغتشاشی بر قدرت اکسنتریک چرخش دهنده های خارجی و کینماتیک کتف می باشد.24 مرد والیبالیست با نمره کمتر از 30 در آزمون سیکوئیست در این تحقیق شرکت کردند که به صورت تصادفی به دوگروه 12 نفری تجربی و کنترل تقسیم شدند .قدرت اکسنتریک چرخش دهنده های خارجی با استفاده از دستگاه ایزوکنیتیک با سرعت 120 درجه بر ثانیه اندازه گیری شد. چرخش بالایی کتف نیز با شیب سنج دوگانه در زوایای°45، °90، °135و انتهای دامنه حرکتی آبداکشن شانه اندازه گیری شد. تغییرات میانگین با استفاده از آزمون آنالیز واریانس با اندازه گیری مکرر بررسی شد. در مقایسه دو گروه تجربی و کنترل اختلاف معناداری در قدرت اکسنتریک چرخش دهنده خارجی شانه مشاهده شد(P=0.032). در بررسی چرخش بالایی کتف فقط در زاویه °135 اختلاف معنادار وجود داشت(P=0.048). در زوایای دیگر اختلاف معناداری بین دو گروه مشاهد نشد( زاویه °45 P=0.497، زاویه °90 P=0.254، انتهای دامنه حرکتی P=0.350).نتایج بیانگر تاثیر مثبت تمرینات اغتشاشی بر قدرت اکسنتریک چرخش دهنده های خارجی و چرخش بالایی کتف در حرکت آبداکشن بازو بود ؛ بنابراین می توان به مربیان و بازیکنان والیبال توصیه نمود که برای افزایش عملکرد و پیشگیری از آسیب های شانه این تمرینات را به برنامه های تمرینی خود اضافه کنند.

کلیدواژه‌ها

کینماتیک کتف
شانه
قدرت عضلات چرخش دهنده
چرخش بالایی کتف
بدحرکتی کتف

عنوان مقاله English

The effect of six weeks of upper extremity perturbation training on eccentric strength of shoulder external rotators and scapula upward rotation in volleyball players prone to upper extremity injury

نویسندگان English

Ebrahim Soltanabadi
Maliheh Hadadnezhad
Mahdi Khaleghi
University of Khrazmi
چکیده English

Muscle imbalances in the shoulder are a weakness in the external rotator cuff muscles compared to the internal rotator cuffs, in which the weakness of the external rotator cuff muscles is a risk factor for volleyball players' shoulder injuries. Shoulder dyskinesis can be caused by imbalance of the scapula stabilizing muscles, which improves with muscle coordination the aim of this study was to investigate the effect of perturbation training on eccentric strength of external rotators and scapular kinematics. Twenty-four male volleyball players with a score of less than 30 on CKCUEST test participated in this study, which was randomly divided into two groups of experimental and control. The eccentric strength of the external rotator cuff muscles was measured using an isokinetic at 120 degrees per second. Scapular upward rotation also measured with a dual inclinometer at 45 °, 90 °, 135 ° and the end range of motion of the shoulder abduction. Comparing the experimental and control groups, a significant difference was observed in the shoulder external rotators eccentric strength. There was a significant difference only in 135 ° of scapular upward rotation. In other angles, no significant difference was observed between the two groups. The results showed the positive effect of perturbation training on the eccentric strength of external rotators and scapular upward rotation in arm abduction; therefore, coaches and volleyball players can be advised to add these exercises to their training programs to increase performance and prevent shoulder injuries.

کلیدواژه‌ها English

Scapular Kinematics
Shoulder
Rotator Cuff Muscle Strength
Scapular Upward Rotation
Scapular Dyskinesis
1. Myklebust G, Hasslan L, Bahr R, Steffen K. High prevalence of shoulder pain among elite Norwegian female handball players. Scand J Med Sci Sport. 2013;23(3):288–94. (DOI: 10.1111/j.1600-0838.2011.01398.x)
2. Jan J, Benkalfate T, Rochcongar P. The impact of recurrent dislocation on shoulder rotator muscle balance (a prospective study of 102 male patients). Annals of physical and rehabilitation medicine. 2012 Sep 1;55(6):404-14. (DOI: 10.1016/j.rehab.2012.05.004)
3. Challoumas D, Stavrou A, Dimitrakakis G. The volleyball athlete’s shoulder: biomechanical adaptations and injury associations. Sports Biomechanics. 2017. (DOI: 10.1080/14763141.2016.1222629)
4. Jurkojć J, Michnik R, Czapla K. Mathematical modelling as a tool to assessment of loads in volleyball player’s shoulder joint during spike. J Sports Sci. 2017;35(12):1179–86. (DOI: 10.1080/02640414.2016.1214284)

5. Reeser JC, Joy EA, Porucznik CA, Berg RL, Colliver EB, Willick SE. Risk factors for volleyball-related shoulder pain and dysfunction. Pm&r. 2010;2(1):27–36. (DOI: 10.1016/j.pmrj.2009.11.010)
6. Dick R, Sauers EL, Agel J, Keuter G, Marshall SW, McCarty K, McFarland E. Descriptive epidemiology of collegiate men's baseball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. Journal of athletic training. 2007 Apr;42(2):183. (PMCID: PMC1941283)
7. Challoumas D, Artemiou A, Dimitrakakis G. Dominant vs. non-dominant shoulder morphology in volleyball players and associations with shoulder pain and spike speed. J Sports Sci. 2017;35(1):65–73. (DOI: 10.1080/02640414.2016.1155730)
8. Vincent HK, Zdziarski LA, Vincent KR. Review of Lacrosse-Related Musculoskeletal Injuries in High School and Collegiate Players. Sports Health. 2015;7(5):448–51. (DOI: 10.1177/1941738114552990)
9. Grabara M. Comparison of posture among adolescent male volleyball players and non-athletes. Biol Sport. 2015;32(1):79. (PMCID: PMC4314608)
10. James LP, Kelly VG, Beckman EM. Injury risk management plan for volleyball athletes. Sports Med. 2014;44(9):1185–95. (DOI: 10.1007/s40279-014-0203-9)
11. Saeterbakken AH, Andersen V, Behm DG, Krohn-Hansen EK, Smaamo M, Fimland MS. Resistance-training exercises with different stability requirements: time course of task specificity. Eur J Appl Physiol. 2016;116(11–12):2247–56. (DOI: 10.1007/s00421-016-3470-3)
12. Burne G, Tack C. Overhead Perturbation Training. Strength Cond J. 2017;39(3):87–93. (DOI: 10.1519/SSC.0000000000000280)
13. Lephart, S. M., & Henry, T. J. (1996). The role of proprioception in the management and rehabilitation of athletic injuries. The American Journal of Sports Medicine, 24(1), 130–137. (DOI: 10.1177/036354659702500126)
14. Ellenbecker, T. S., & Cools, A. (2010). Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: An evidence-based review. British Journal of Sports Medicine, 44(5), 319–327. (DOI: 10.1136/bjsm.2009.058875)
15. Kibler, W. B., Sciascia, A., & Wilkes, T. (2012). Scapular dyskinesis and its relation to shoulder injury. Journal of the American Academy of Orthopaedic Surgeons, 20(6), 364–372. (DOI: 10.5435/JAAOS-20-06-364)
16. Wilk KE, Arrigo CA, Hooks TR, Andrews JR. Rehabilitation of the Overhead Throwing Athlete: There Is More to It Than Just External Rotation/Internal Rotation Strengthening. Vol. 8, PM and R. 2016. p. S78–90. (DOI: 10.1016/j.pmrj.2015.12.005)
17. Myers JB, Lephart SM. The Role of the Sensorimotor System in the Athletic Shoulder. J Athl Train. 2000;35(3):351–63. (PMID: 16558648)
18. Roush JR, Kitamura J, Waits MC. Reference Values for the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) for Collegiate Baseball Players. N Am J Sports Phys Ther. 2007;2(3):159–63. (PMID: 21522211)
19. Niederbracht Y, Shim AL, Sloniger MA, Paternostro-Bayles M, Short TH. Effects of a shoulder injury prevention strength training program on eccentric external rotator muscle strength and glenohumeral joint imbalance in female overhead activity athletes. The Journal of Strength & Conditioning Research. 2008 Jan 1;22(1):140-5. (DOI: 10.1519/JSC.0b013e31815f5634)
20. Struyf F, Roussel N, Struyf F, Nijs J, Mottram S, Roussel NA, et al. Clinical assessment of the scapula : A review of the literature Clinical assessment of the scapula : a review of the literature. Br J Sport Med. 2012;(July). (DOI: 10.1136/bjsports-2012-091059)
21. Wilson GJ, Murphy AJ, Giorgi A. Weight and Plyometric Training: Effects on Eccentric and Concentric Force Production. Can J Appl Physiol [Internet]. 1996;21(4):301–15.( DOI: 10.1139/h96-026)
22. Newton RU, Rogers RA, Volek JS, Häkkinen K, Kraemer WJ. Four weeks of optimal load ballistic resistance training at the end of season attenuates declining jump performance of women volleyball players. J Strength Cond Res. 2006;20(4):955–61. (DOI: 10.1519/R-5050502x.1)
23. Malatesta D, Cattaneo F, Dugnani S, Maffiuletti NA. Effects of electromyostimulation training and volleyball practice on jumping ability. J Strength Cond Res. 2003;17(3):573–9. (DOI: 10.1519/1533-4287(2003)0172.0.co;2)
24. Cardinale M, Lim J. Electromyography activity of vastus lateralis muscle during whole-body vibrations of different frequencies. J Strength Cond Res. 2003;17(3):621–4. (DOI: 10.1519/1533-4287(2003)0172.0.co;2)
25. Han H, An K, Ryu K, Lee J. The Effects of Scapular Stabilization Exercise on the Muscular Functions and Pain Release of Shoulder Joints in Youth Baseball Players. The Korean Journal of Sports Medicine. 2015 Dec 1;33(2):110-9. (DOI:10.5763/kjsm.2015.33.2.110)
26. Berckmans K, Maenhout AG, Matthijs L, Pieters L, Castelein B, Cools AM. The isokinetic rotator cuff strength ratios in overhead athletes: Assessment and exercise effect. Vol. 27, Physical Therapy in Sport. 2017. p. 65–75. (DOI: 10.1016/j.ptsp.2017.03.001)
27. Ellenbecker TS, Davies GJ, Rowinski MJ. Concentric versus eccentric isokinetic strengthening of the rotator cuff: Objective data versus functional test. Am J Sports Med. 1988;16(1):64–9. (DOI: 10.1177/036354658801600112)
28. Mont MA, Cohen DB, Campbell KR, Gravare K, Mathur SK. Isokinetic Concentric Versus Eccentric Training of Shoulder Rotators with Functional Evaluation of Performance Enhancement in Elite Tennis Players. Am J Sports Med. 1994;22(4):513–7. (DOI: 10.1177/036354659402200413)
29. de Villarreal ESS, Requena B, Newton RU. Does plyometric training improve strength performance? A meta-analysis. Vol. 13, Journal of Science and Medicine in Sport. 2010. p. 513–22. (DOI: 10.1016/j.jsams.2009.08.005)
30. Ellenbecker TS, Davies GJ. The Application of Isokinetics in Testing and Rehabilitation of the Shoulder Complex. J Athl Train. 2000;35(3):338–50. (PMCID: PMC1323396)
31. Guido Jr JA, Stemm J. Reactive neuromuscular training: a multi-level approach to rehabilitation of the unstable shoulder. North American journal of sports physical therapy: NAJSPT. 2007 May;2(2):97. (PMCID: PMC2953291)

33. Pascoal AG, Van Der Helm FFCT, Pezarat Correia P, Carita I. Effects of different arm external loads on the scapulo-humeral rhythm. Clin Biomech. 2000;15(SUPPL. 1). (DOI: 10.1016/s0268-0033(00)00055-3)
34. Turgut E, Duzgun I, Baltaci G. Effects of Scapular Stabilization Exercise Training on Scapular Kinematics, Disability, and Pain in Subacromial Impingement: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2017;98(10):1915-1923.e3. (DOI: 10.1016/j.apmr.2017.05.023)
35. Wang CH, McClure P, Pratt NE, Nobilini R. Stretching and strengthening exercises: Their effect on three- dimensional scapular kinematics. Arch Phys Med Rehabil. 1999;80(8):923–9. (DOI: 10.1016/s0003-9993(99)90084-9)
36. DiVeta J, Walker ML, Skibinski B. Relationship between performance of selected scapular muscles and scapular abduction in standing subjects. Physical therapy. 1990 Aug 1;70(8):470-6. (DOI: 10.1093/ptj/70.8.470)
پژوهش در طب ورزشی و فناوری

مقالات آماده انتشار، پذیرفته شده
انتشار آنلاین از 01 آبان 1398