Amaç: Tenis, voleybol, beyzbol, basketbol gibi farklı hareket mekaniğine sahip sporlar, omuz eklemindeki statik ve dinamik yapıları önemli ölçüde zorlar. Bu çalışmada, basketbol ve voleybolcularda tekrarlayan omuz elevasyonu sonrası aksiller sinir ve deltoid kasta oluşabilecek elektrofizyolojik değişiklikler ve bunların kuvvete yansımasının incelenmesi amaçlanmıştır. Tek bir kökten (C5) inerve olan rhomboid kası dışında tüm kaslar birbirine komşu birkaç kökten inerve olmaktadır. Kök basısını bertaraf etmek için C5 ten inerve olan rhomboid kasa da iğne elektromiyografi (EMG) yapılmıştır. Gereç ve Yöntemler: Toplam 35 sporcu [8'i (%22,9) kadın, 27'si (%77,1) erkek, 13'ü (%37,1) voleybol, 22'si (%62,9) basketbol] ve 35 sedanter [21'i (%60) kadın, 14'ü (%40) erkek] çalışmaya dâhil edildi. Tüm katılımcıların omuz abdüksiyon ve addüksiyon kuvveti izokinetik olarak ölçüldü. Deltoid ve rhomboid kasların kantitatif EMG analizi ve aksiller sinire bilateral motor sinir iletimi ölçümleri sadece sporcularda yapıldı. Bulgular: Sporcular, tüm hareketlerde kontrol grubuna göre daha yüksek pik tork değerleri gösterdi (p <0,05). Tüm deneklerde, abdüksiyon pik torku addüksiyona göre daha düşük bulundu. Basketbolcularda ve voleybolcularda aksiller sinir lezyonu ile uyumlu olabilecek elektronörografi bulgusuna rastlanmadı. 7 (%20) sporcuda (2 kadın voleybol, 5 erkek basketbol) sağ rhomboid ve deltoid kaslarda nörojenik tutulum saptandı. 2 sporcuda (1 bayan voleybol, 1 erkek basketbol) sağ dorsal skapular sinirin kronik parsiyel aksonal lezyonu rapor edildi. Nörojenik tutulumu olan ve olmayan sporcuların pik tork değerleri arasındaki fark istatistiksel olarak anlamlı değildi. Sonuç: Bu çalışmada, baş üstü aktivite yapan sporcularda aksiller sinirin yanı sıra skapula dorsal sinirin de tuzaklanabileceğini görmüş olduk. Spesifik risk faktörlerinin belirlenmesi, sporcuların ve antrenörlerin antrenman programlarını düzenlemelerine ve bu yaralanmaları azaltmalarına yardımcı olacaktır.
Anahtar Kelimeler: Aksiller sinir; basketbol; izokinetik kuvvet; kantitatif elektromiyografi; voleybol
Objective: Sports such as tennis, volleyball, baseball, and basketball with different movement mechanics force the static and dynamic structures in the shoulder joint to a substantial extent. In this study, it is aimed to examine what are the electrophysiological changes that may occur in the axillary nerve and deltoid muscle after repetitive shoulder elevation in basketball and volleyball players and how they are reflected on the strength. Except for the rhomboid muscle, which is innervated by a single root (C5), all muscles are innervated by several adjacent roots. In order to eliminate root compression, needle electromyography (EMG) was performed on the rhomboid muscle innervated from C5. Material and Methods: A total of 35 athletes [8 (22.9%) were female, 27 (77.1%) male, 13 (37.1%) volleyball, and 22 (62.9%) were basketball players], and 35 sedentary participants [21 (60%) were female, 14 (40%) male] were included in the study. Shoulder abduction and adduction of all participants was measured isokinetically. Quantitative EMG analysis of the deltoid and rhomboid muscles, and measurements of bilateral motor-sensory nerve transmission to the axillary nerve, were performed only athletes. Results: Athletes showed higher peak torque values in all movements compared to the control group (p<0.05). In all subjects, the peak torque of abduction was lower than that of adduction. There were no electroneurographic findings compatible with axillary nerve lesion in basketball and volleyball players. Neurogenic involvement was detected in the right rhomboid and deltoid muscles in 7 (20%) athletes (2 female volleyball, 5 male basketball). Chronic partial axonal lesion of the right dorsal scapular nerve was reported in 2 athletes (1 female volleyball, 1 male basketball). There was no statistically significant difference between the peak torque values of the athletes with and without neurogenic involvement. Conclusion: In this study, we have seen that the scapula dorsal nerve can also be trapped in addition to the axillary nerve in athletes doing overhead activities. Identifying specific risk factors will help athletes and coaches adjust their training programs and reduce these injuries.
Keywords: Axillary nerve; basketball; isokinetic power; quantitative electromyography; volleyball
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