Objective To characterise whether preseason screening of shoulder range of motion (ROM) is associated with the risk of shoulder and elbow injuries in overhead athletes. Design Systematic review and meta-analysis. Data sources Six electronic databases up to 22 September 2018. Eligibility criteria Inclusion criteria were (1) overhead athletes from Olympic or college sports, (2) preseason measures of shoulder ROM, (3) tracked in-season injuries at the shoulder and elbow, and (4) prospective cohort design. Exclusion criteria were (1) included contact injuries, (2) lower extremity, spine and hand injuries, and (3) full report not published in English. Results Fifteen studies were identified, and they included 3314 overhead athletes (baseball (74.6%), softball (3.1%), handball (16.1%), tennis (2.0%), volleyball (2.0%) and swimming (2.2%)). Female athletes are unrepresented (12% of the overall sample). Study quality ranged from 11 to 18 points on a modified Downs and Black checklist (maximum score 21, better quality). In one study, swimmers with low (<93°) or high (>100°) shoulder external rotation were at higher risk of injuries. Using data pooled from three studies of professional baseball pitchers, we showed in the meta-analysis that shoulder external rotation insufficiency (throwing arm <5° greater than the non-throwing arm) was associated with injury (odds ratio=1.90, 95% confidence interval 1.24 to 2.92, p<0.01). Conclusion Preseason screening of shoulder external rotation ROM may identify professional baseball pitchers and swimmers at risk of injury. Shoulder ROM screening may not be effective to identify handball, softball, volleyball and tennis players at risk of injuries. The results of this systematic review and meta-analysis should be interpreted with caution due to the limited number of studies and their high degree of heterogeneity. PROSPERO registration number CRD42017072895.

中文翻译：

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过顶运动员的季前肩运动范围筛查和季前肩肘损伤风险：系统评价和荟萃分析

目的 确定肩部活动范围 (ROM) 的季前筛查是否与过顶运动员肩部和肘部受伤的风险相关。设计系统回顾和荟萃分析。数据来源 截至 2018 年 9 月 22 日的六个电子数据库。 资格标准 纳入标准是 (1) 来自奥运会或大学体育项目的高架运动员，(2) 肩部 ROM 的季前测量，(3) 肩部和肘部的赛季中追踪损伤， (4) 前瞻性队列设计。排除标准为 (1) 包括接触性损伤，(2) 下肢、脊柱和手部损伤，以及 (3) 未以英文发表的完整报告。结果 确定了 15 项研究，包括 3314 名头顶运动员（棒球（74.6%）、垒球（3.1%）、手球（16.1%）、网球（2.0%）、排球（2.0%）和游泳（2.2%））。女运动员没有代表（占总样本的 12%）。修改后的 Downs 和 Black 检查表的研究质量从 11 分到 18 分不等（最高得分 21，质量更好）。在一项研究中，肩外旋低（<93°）或高（>100°）的游泳者受伤的风险更高。使用来自职业棒球投手的三项研究的汇总数据，我们在荟萃分析中显示肩部外旋不足（投掷臂比非投掷臂大 < 5°）与受伤相关（优势比 = 1.90，95% 置信度区间 1.24 到 2.92，p<0.01）。结论 肩外旋 ROM 的季前筛查可以识别职业棒球投手和游泳运动员有受伤风险。肩部 ROM 筛查可能无法有效识别手球、垒球、有受伤风险的排球和网球运动员。由于研究数量有限及其高度异质性，应谨慎解释本系统评价和荟萃分析的结果。PROSPERO 注册号 CRD42017072895。