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The Differences of Functional Performance between Symptomatic and Healthy Overhead Athletes
return to play,overhead athletes,volleyball players,functional performance assessment,screening,
|Publication Year :||2020|
|Abstract:||研究背景: 肩膀傷害在過肩型運動員中是常見造成運動生涯縮減的傷害類型。而就判斷回場的時機而言，目前的研究顯示，由於影響回場的因素之複雜，多數回場的決策建立於專家意見，參考不同專業、角色的判斷與評估，來做出個別化的判斷。這樣的決策機制儘管根據選手狀態做個別化的考量，但在決策上仍可能因為主觀因素造成決策的錯誤。現今在運動場上，若沒有醫療專業的協助，大部分的運動員由於缺乏標準化的回場規劃，可能在回場後仍然存有症狀，並可能導致後續的表現下降或二度傷害。因此，本篇研究希望透過功能性表現測試，分析有症狀之男性業餘排球員與健康業餘排球員在功能性表現上的差異，並提供客觀化的篩檢數據及判斷標準，協助物理治療師或相關專業從功能性表現的層面評估選手訓練或治療上需要加強的層面。研究目的: 一、檢測功能性表現測試分數、一般理學檢查和病人自填功能性問卷各項間是否有顯著的關聯性。二、檢測功能性表現測試分數、一般理學檢查和病人自填功能性問卷在有症狀之肩部受傷過肩型運動員與健康過肩運動員之間是否有顯著差異。三、檢測功能性表現測試分數、一般理學檢查和病人自填功能性問卷是否有分辨受傷過肩運動員與健康過肩運動員之效果。實驗設計: 此研究計畫預計招募有肩部傷害的男性業餘排球員與健康業餘排球員兩組，評估內容包含一般理學檢查、病人自填上肢功能性問卷及功能性表現測試，並比較以上評估項目在兩組受試者之間的差別。主要測量項目: 一般理學檢查(兩側肩部活動度差異、兩側等長收縮肌力比值)、病人自填上肢功能性問卷(KJOC、DASH、DASH sports module)及功能性表現測試(功能性動作評估(FMS)、Y字平衡測試上肢版(YBTUQ)、單手坐姿藥球推擲(USSP)、閉鎖動作鏈上肢穩定測試(CKCUEST)、伏地挺身測試(PU)。結果: 各項測驗彼此對照，發現僅有無至一般相關性(no to fair correlation, r< 0.6)在各個測驗分項之間。比較組間差異，有症狀之男性業餘排球員在內轉肌力比值、病人自填問卷(DASH、KJOC)及數項功能性表現測試(YBTUQ、CKCUEST、PU)中比起健康組受試者表現有顯著較差之結果(p<0.05)。此外，若要辨別兩組差別，使用二元羅吉斯回歸分析，若包含一般理學檢查及功能性表現測試有顯著差異的變數，則發現內轉肌力比值為最可靠之變數。結論: 在業餘男性排球運動員之中，一般理學檢查結果(肩部活動度兩側差異、肌力比值)、功能性表現與病人自覺功能之間並無顯著之關聯性。而內轉肌力、病人自填問卷及功能性表現測試則能在有症狀與無症狀之兩組排球員間看到顯著的差異，並能作為進一步分辨兩組的預測因子。重要性與預期貢獻: 本實驗之結果，可了解有症狀之排球運動員與健康排球運動員在上肢功能測驗中之表現差異。藉此，在上肢型運動員在評估上提供客觀之測量方式及判斷數值，了解選手在不同功能層面的弱點。臨床人員可參考此研究結果作為訓練及評估運動員狀態的依據。|
Background & Purpose: Overhead athletes, especially volleyball players, often suffer from shoulder injuries due to the demand of the repetitive and high-speed overhead arm movements. After injury, returning to play (RTP) on the same sport or even to the same performance become a critical issue. Nevertheless, previous studies had showed that the decision-making in RTP was too complicated to provide a standardized, objective criteria following upper extremity injuries, thus leaded to potential functional impairment afterward. Functional performance assessments (FPAs) provided objective information in differentiating symptomatic athletes from healthy ones. The main purpose of this study was to differentiate symptomatic and healthy overhead athletes via FPAs. Objective: There were 3 objectives for this study: (1) to investigate the correlations among general physical examinations, self-reported outcomes, and FPAs; (2) to investigate the differences in general physical examinations, self-reported outcomes, and FPAs between male volleyball players with and without symptoms; (3) to investigate the discriminant validity of the FPAs as diagnostic tools in differentiating male volleyball players with and without shoulder symptoms. Design: Male, amateur, volleyball players with symptoms over shoulder region were recruited in this study and assigned to the symptomatic group. Active, healthy male volleyball players without shoulder symptoms for at least 1 year were recruited as the healthy group for comparison. General physical examinations, self-reported outcomes, and FPAs were assessed in both groups. Main outcome measures: Shoulder range of motion (ROM) differences, Shoulder isometric strength ratio (dominant/non-dominant), FPAs including closed kinetic chain upper extremity stability test (CKCUEST), Y-balance test – upper quarter (YBTUQ), unilateral seated shot-put test (USSP), Functional Movement Screen (FMS), and push-up test (PU) were main outcomes of the study. Results: Comparing each variable from different category, we found no to fair correlations (r< 0.6). The symptomatic group showed significantly worse results (p< 0.05) in self-reported outcomes, internal rotation strength ratio (StrIR), and some of the results of FPAs (YBTUQ, CKCUEST, and PU). Among all the potential variables, StrIR was the strongest indicator in differentiating symptomatic and healthy male volleyball players. Conclusions: In order to thoroughly screen the profile of the athlete, different perspectives of assessments were needed. Both subjective and objective assessments were found sensitive to differentiate the symptomatic and healthy male volleyball players and were suitable to perform in the volleyball players screening. Significance and Contribution: The result of this study established potential indicators differentiating the symptomatic and healthy volleyball players, these tools can help us rule out/in potential injury factors in particular athletes and find weakness of the athletes which enables further training to be more specific to their deficiency. This information can be applied on functional impairment screening and forming training strategy.
|Appears in Collections:||物理治療學系所|
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