Avaliação da mobilidade do ombro no atleta de crossfit® - estudo observacional transversal
Data
2022-08-26
Autores
Rosa, João Roberto Polydoro 
Orientadores
Astur, Diego da Costa
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O CrossFit® é um programa de treinamento e condicionamento físico que tem despertado interesse e ganhando reconhecimento entre a população que realiza atividades físicas. Os estudos baseados em questionários encontraram o ombro como a região mais comumente acometida no CrossFit®. O arco de movimento anormal do ombro está relacionado com desordens incluindo impacto subacromial, impacto interno e lesões labiais. Objetivos: Avaliar o arco de movimento do ombro de atletas de CrossFit® e realizar uma comparação lado dominante e não dominante. Tipo de estudo: Estudo transversal. Métodos: Foi aplicado um questionário por um avaliador e mobilidade articular foi avaliada por outro avaliador especialista de ombro e cotovelo, antes do início do treinamento, de acordo com as orientações da Sociedade Americana de Cirurgiões de Ombro e Cotovelo (ASES). Todas as medidas foram realizadas com goniômetro graduado e o ombro não dominante foi utilizado para parâmetro para avaliarmos possíveis ganhos e perdas do arco de movimento. O déficit de rotação medial maior do que 10%, em relação ao arco de movimento contralateral e o déficit de rotação medial dividido pelo ganho de rotação lateral maior do que 1, foram calculados para avaliarmos os atletas com o “ombro em risco” descrito por Burkhart et al. Resultados: Foram avaliados 159 atletas de Crossfit®, sendo excluídos 28 atletas devido aos critérios adotados de não inclusão e exclusão, o que nos propiciou uma amostra final de 131 atletas. Dos 131 atletas avaliados, foram constatados 95 atletas do sexo masculino e 36 atletas do sexo feminino, a média de idade foi 33,7 anos, de peso 78 kg, de altura 1,72m, com tempo de prática médio de 41,3 meses (3,44 anos) e com frequência média de 4,95 dias na semana. Em relação à mobilidade do ombro, encontramos uma média de perda de arco de movimento (ADM) do ombro dominante de 8,58 graus. Tomando como exemplo todos os atletas, nós temos que a média do arco de movimento do ombro dominante foi de 135,7 contra 144,3 do Não Dominante (p-valor <0,001). Destaca-se também média de déficit de rotação medial (DRM) do ombro dominante de 11,3 graus e um ganho de rotação lateral (GRL) do ombro dominante de 2,76 graus. Em 62,6% (82 atletas) foi identificado discinesia escapular. Foram identificados situação de Ombro em Risco estatisticamente significante de 61,8% (81 atletas) contra apenas 38,2% sem Ombro em Risco (p<0,001). Foi identificada correlação do déficit de força de rotação lateral em 90 graus de adução e presença de dor no ombro em algum momento, com uma média de déficit de -0,681kg em pacientes sem dor contra 0,526kg em pacientes com dor (p< 0,001).
Conclusão: O ombro dominante dos atletas de CrossFit® adultos, neste estudo, apresentou diferenças significativas de arco de movimento (ADM) e rotação medial quando comparado ao seu ombro não dominante.
Background: CrossFit® is a physical training and conditioning program that has aroused interest and gained recognition among the population that performs physical activities. Questionnaire-based studies have found the shoulder to be the most affected area in CrossFit®. Abnormal shoulder range of motion is related to disorders including subacromial impingement, internal impingement, and labral tears. Objective: To evaluate the shoulder range of motion on CrossFit® athletes and compare the dominant and non-dominant sides. Study Design: Cross-sectional study. Methodology: A questionnaire was applied by an evaluator, joint mobility was assessed by another evaluator specializing in shoulder and elbow surgery before the start of training, according to the guidelines of the American Society of Shoulder and Elbow Surgeons (ASES). All measurements were performed with a graduated goniometer and the non-dominant shoulder was used as a parameter to evaluate possible gains and losses in the range of motion. The medial rotation deficit greater than 10%, to the contralateral range of motion and the medial rotation deficit divided by the lateral rotation gain greater than 1, were calculated to evaluate athletes with the “shoulder at risk” described by Burkhart et al. Results: A total of 159 Crossfit® athletes were evaluated, 28 athletes were excluded due to the adopted non-inclusion and exclusion criteria, which provided us with a final sample of 131 athletes. Of the 131 athletes evaluated, it consisted of 95 male athletes and 36 female athletes, the average age was 33.7 years, weight 78 kg, height 1.72 m, with an average practice time of 41.3 months (3.44 years) and an average frequency of 4.95 days a week. Regarding shoulder mobility, we found an average loss of range of motion (ROM) of the dominant shoulder of 8.58 degrees. Taking all athletes as an example, the average in the range of motion of the dominant shoulder was 135.7 against 144.3 of the non-Dominant (p<0.001). Also noteworthy is an average medial rotation deficit (MRD) of the dominant shoulder of 11.3 degrees and a gain of lateral rotation (GRL) of the dominant shoulder of 2.76 degrees. In 62,6% (82 athletes), scapular dyskinesia was identified. A statistically significant Shoulder at Risk situation was identified in 61.8% (81 athletes) against only 38.2% without Shoulder at Risk (p-value <0.001). A correlation of lateral rotation strength deficit at 90 degrees of adduction and presence of shoulder pain at some point, with an average deficit of -0.681kg in patients who were in pain versus 0.526kg in patients who were out of pain (p<0.001). Conclusion: The dominant shoulder of adult CrossFit athletes, in this study, showed significant differences in range of motion (ROM) and medial rotation when compared to their non-dominant shoulder.
Background: CrossFit® is a physical training and conditioning program that has aroused interest and gained recognition among the population that performs physical activities. Questionnaire-based studies have found the shoulder to be the most affected area in CrossFit®. Abnormal shoulder range of motion is related to disorders including subacromial impingement, internal impingement, and labral tears. Objective: To evaluate the shoulder range of motion on CrossFit® athletes and compare the dominant and non-dominant sides. Study Design: Cross-sectional study. Methodology: A questionnaire was applied by an evaluator, joint mobility was assessed by another evaluator specializing in shoulder and elbow surgery before the start of training, according to the guidelines of the American Society of Shoulder and Elbow Surgeons (ASES). All measurements were performed with a graduated goniometer and the non-dominant shoulder was used as a parameter to evaluate possible gains and losses in the range of motion. The medial rotation deficit greater than 10%, to the contralateral range of motion and the medial rotation deficit divided by the lateral rotation gain greater than 1, were calculated to evaluate athletes with the “shoulder at risk” described by Burkhart et al. Results: A total of 159 Crossfit® athletes were evaluated, 28 athletes were excluded due to the adopted non-inclusion and exclusion criteria, which provided us with a final sample of 131 athletes. Of the 131 athletes evaluated, it consisted of 95 male athletes and 36 female athletes, the average age was 33.7 years, weight 78 kg, height 1.72 m, with an average practice time of 41.3 months (3.44 years) and an average frequency of 4.95 days a week. Regarding shoulder mobility, we found an average loss of range of motion (ROM) of the dominant shoulder of 8.58 degrees. Taking all athletes as an example, the average in the range of motion of the dominant shoulder was 135.7 against 144.3 of the non-Dominant (p<0.001). Also noteworthy is an average medial rotation deficit (MRD) of the dominant shoulder of 11.3 degrees and a gain of lateral rotation (GRL) of the dominant shoulder of 2.76 degrees. In 62,6% (82 athletes), scapular dyskinesia was identified. A statistically significant Shoulder at Risk situation was identified in 61.8% (81 athletes) against only 38.2% without Shoulder at Risk (p-value <0.001). A correlation of lateral rotation strength deficit at 90 degrees of adduction and presence of shoulder pain at some point, with an average deficit of -0.681kg in patients who were in pain versus 0.526kg in patients who were out of pain (p<0.001). Conclusion: The dominant shoulder of adult CrossFit athletes, in this study, showed significant differences in range of motion (ROM) and medial rotation when compared to their non-dominant shoulder.