目的:本系统评价的目的是更新有关高架运动中肩关节损伤的危险因素和预防策略的知识,特别强调方法学质量。
方法:所有方法学程序均按照Asker等人先前的系统综述进行。(2018)。文献检索是在PubMed上进行的,谷歌学者,科克伦,和SPORT-讨论数据库。由于偏见评估的风险,仅纳入至少方法学质量可接受的研究.进行了最佳证据综合,以阐明风险因素和预防策略的证据和方向。
结果:共有9项研究纳入数据提取过程。一项研究的方法学质量较高,8项研究的方法学质量可接受。七项队列研究调查了危险因素,两项随机对照研究评估了预防策略。发现了两个不可改变的证据(游戏位置,性别)和三个可改变的因素(肩部旋转力量,肩胛骨运动障碍,肩部预防计划)与肩部损伤风险相关。所有进一步的危险因素与风险有中度和无关联(肩关节旋转ROM,关节位置感觉)或有限(肩/肘疼痛史,年龄,培训经验,训练量,学校年级,游戏级别),和相互矛盾的证据(设置)。
结论:有适度的证据表明有两个不可修改的(游戏位置,性别)和三个可改变的因素(肩部旋转力量,肩胛骨运动障碍,肩部预防计划)与高架运动中的肩部受伤风险有关。
OBJECTIVE: The aim of this systematic
review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on methodological quality.
METHODS: All methodological procedures were performed in line with a previous systematic
review by Asker et al. (2018). The literature search was conducted in the PubMed, Google Scholar, Cochrane, and SPORT-Discuss databases. Due to the risk of bias assessment, only studies with at least an acceptable methodological quality were included. A best-evidence synthesis was performed to clarify the evidence and direction of the risk factors and prevention strategies.
RESULTS: A total of nine studies were included in the data extraction process. One study had a high and eight studies had an acceptable methodological quality. Seven cohort studies investigated risk factors and two randomised controlled trails evaluated prevention strategies. Moderate evidence was found for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) that were associated with the shoulder injury risk. All further risk factors had moderate and no association with risk (shoulder rotational ROM, joint position sense) or limited (history of shoulder/elbow pain, age, training experience, training volume, school grade, playing level), and conflicting evidence (setting).
CONCLUSIONS: There is moderate evidence for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) being associated with the shoulder injury risk in overhead sports.