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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Influence of a Prevention Program on Arm Injury Risk: An RCT in Adolescent Pitchers
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Influence of a Prevention Program on Arm Injury Risk: An RCT in Adolescent Pitchers

机译：预防计划对手臂受伤风险的影响：青少年投手的随机对照试验

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Objectives: High school pitchers are at three times greater risk of an upper extremity (UE) injury compared to position players, with most (69%) injuries occurring during the first month of the season. Therefore, a prevention program for pitchers targeting known risk factors may reduce their injury risk, particularly early in the season. The purpose of this study was to determine the effectiveness of a preseason training program in decreasing the injury rate and altering the pattern of UE injuries in a cohort of high school pitchers. Methods: Healthy high school pitchers (n=196) who were participating in all team activities were block randomized by school to intervention (INV, n=103) or control (CON, n=93) groups. The INV group received a scapular stability, rotator cuff strength, and posterior shoulder flexibility program (3 times/week for 8 consecutive weeks) supervised by an Athletic Trainer. The CON group participated in the teams’ usual preseason training. Training activities for all teams were recorded. All players participated in a 4-week interval-throwing program. Athletic exposures (AEs), injury incidence (participation absence or limitation due to injury) were tracked from the first day of practice until the last day of competition. Incidence rates were calculated per 1,000 AEs and monthly trends for injury were examined for occurrence by group, injury history, and body location. As a secondary analysis, published injury rates from 2009 in the same high schools were compared to their 2012 data. Rate ratios (RR) and 95% confidence intervals (CIs) were used to compare injury rates by group, injury history, body location, and year. Results: Overall, there were 27 UE injuries incurred among the pitchers; 15 in the INT group (10 shoulder & 5 elbow injuries) and 12 in the CON group (10 shoulder & 2 elbow injuries). The injury rate was similar in the INT and CON groups (RR=0.86; 95% CI: 0.43-2.2). The pattern of arm injuries throughout the season was evenly distributed in both groups. In 2012, 67% of CON teams were observed participating in a general “arm care” program as compared to 6% of CON teams in 2009. Previous arm injury did not increase the risk of an UE injury in the INV group (RR=1.0; 95% CI: 0.38-2.8) but did increase the risk of an UE injury almost 4-fold (RR= 3.7,95% CI: 1.3-10.7) in the CON group. The injury incidence rate for pitchers was 12 times higher in 2009 (29.3/1,000 AEs) than in 2012 (3.4/1,000 AEs) (RR=11.6, 95% CI: 7.1-16.1). The risks of shoulder (RR=11.0; 95% CI: 6.6-15.4) and elbow injury (RR=12.6; 95% CI: 8.0-17.3) were higher in 2009 compared to 2012. The pattern of upper extremity injuries was higher in the first quarter of the season compared to 2012 (See Figure 1). Conclusion: The main finding of this study is that INV and CON pitchers had a similar injury rate, however, the overall injury rates were significantly lower in 2012 than in 2009. Thus it appears that a general “arm care” and interval-throwing program may also be effective in reducing the injury rate in high school pitchers, perhaps in the early part of the season as injury rates based on the differences in rates between 2012 and 2009. Pitchers with a previous injury in the INV group were less likely to suffer an injury in 2012 than pitchers’ with a previous injury in the CON group. Thus, a targeted pre-season conditioning program may help reduce the injury risk in pitchers with a history of of previous arm injury. Further studies are warranted to confirm our results.
机译：目标：高中投手的上肢（UE）受伤风险是位置运动员的三倍，大多数（69％）受伤发生在赛季的第一个月。因此，针对投手已知危险因素的预防计划可以降低其受伤风险，尤其是在赛季初期。这项研究的目的是确定季前训练计划在降低高中投手队的受伤率和改变UE受伤模式方面的有效性。方法：将参加所有团队活动的健康高中投手（n = 196）按学校随机分为干预组（INV，n = 103）或对照组（CON，n = 93）。在运动训练员的指导下，INV组接受了肩shoulder骨稳定性，肩袖强度和后肩柔韧性训练（每周3次，连续8周）。 CON小组参加了球队的常规季前训练。记录了所有团队的培训活动。所有球员都参加了为期4周的间隔投掷项目。从练习的第一天到比赛的最后一天，跟踪运动暴露（AEs），受伤发生率（由于受伤而没有参加或受到限制）。每1,000例AE计算出发病率，并按组别，损伤史和身体位置检查损伤的每月趋势。作为辅助分析，将同一所高中2009年的公布伤害率与2012年的数据进行了比较。比率比率（RR）和95％置信区间（CIs）用于按组，受伤历史，身体位置和年份比较受伤率。结果：总体而言，投手中有27起UE受伤; INT组15例（10例肩部和5个肘部受伤），CON组12例（10例肩部和2例肘部受伤）。 INT和CON组的损伤率相似（RR = 0.86; 95％CI：0.43-2.2）。整个季节的手臂受伤情况在两组中平均分布。 2012年，观察到67％的CON团队参加了常规的“手臂护理”计划，而2009年则为6％。CONV团队以前的手臂受伤并没有增加UE受伤的风险（RR = 1.0 ; 95％CI：0.38-2.8），但确实使CON组的UE受伤风险增加了近4倍（RR = 3.7,95％CI：1.3-10.7）。 2009年（29.3 / 1,000 AE）的投手受伤发生率是2012年（3.4 / 1,000 AE）的12倍（RR = 11.6，95％CI：7.1-16.1）。与2012年相比，2009年肩部（RR = 11.0; 95％CI：6.6-15.4）和肘部损伤（RR = 12.6; 95％CI：8.0-17.3）的风险较高。与2012年相比，该季度的第一季度（见图1）。结论：这项研究的主要发现是INV和CON投手的受伤率相近，但是，2012年的总体受伤率明显低于2009年。因此，看来，一般的“手臂护理”和间隔投掷程序也许也可以有效地降低高中投手的受伤率，也许是在赛季初期，因为受伤率是基于2012年至2009年之间的比率差异。INV组中先前受伤的投手受苦的可能性较小2012年的受伤人数比CON组中先前受伤的投手高。因此，有针对性的赛季前训练程序可以帮助减少投手有前臂伤史的受伤风险。有必要进一步研究以确认我们的结果。

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