Investigação do controle sensório-motor e da relação funcional de torque de rotação do ombro em arremessadores com e sem sintomas de impacto

Abstract

Repetitive throwing movement causes adaptations to athletes shoulders and predisposes them to the development of impingement symptoms. The objective of this study was to investigate if there are alterations in sensorimotor control and in the functional torque ratio of shoulder rotation in overhead athletes with impingement symptoms and to distinguish these from alterations due to sporting practice. To this end, three groups of subjects were evaluated: athletes with impingement symptoms, asymptomatic athletes and a control group of nonathletes. The participants were evaluated with a Biodex System 3 isokinetic dynamometer in a seated position with the shoulder at 90º of adduction and 90º of elbow flexion. Sensorimotor control was evaluated using an isometric torque steadiness evaluation. The isometric peak torque and submaximal torque steadiness at 35% peak torque were tested during medial rotation and lateral rotation of the shoulder. For each submaximal repetition, the standard deviation, coefficient of variation and time to stability were calculated. Only the standard deviation during medial rotation was greater in asymptomatic athletes than in control group. The isokinetic evaluation was carried out at the velocities 90°/s e 180°/s and 240°/ in concentric and eccentric modes. Peak torque-to-body weight and the functional torque ratios LREcc/MRCon and MREcc/LRCon were compared between groups. Asymptomatic athletes presented greater peak torque-to-body weight for concentric medial rotation at 180°/s and a lower LREcc/MRCon ratio at 90°/s and 180°/s than CG. The velocity 240°/s was excluded from the analyses because many participants were unable to reach the predetermined velocity in the eccentric tests, principally during lateral rotations. This difficulty was attributed to the low peak torque of lateral rotation that could be generated in this position. Overall, the results demonstrated that overhead sports training leads to adaptations in maximal torque and in the torque steadiness of medial rotation in healthy athletes, which may be related to throwing performance. Nevertheless, it is not possible to conclude that such alterations predispose these athletes to injury, since athletes with impingement symptoms group was not significantly different from the other groups in any of the evaluations.