The validity of the sphygmomanometer for shoulder strength assessment in amateur rugby union players.

OBJECTIVES: To determine the concurrent validity of a sphygmomanometer for assessing shoulder strength in the I, Y and T positions during the athletic shoulder test (ASH test). Force platforms were used as the gold standard measurement tool for this purpose. DESIGN: Shoulder strength was assessed using force platforms and a sphygmomanometer, both placed on the floor and the participant positioned prone. One rater assessed strength, taking three measurements in each of the I, Y and T positions, using the sphygmomanometer and force platforms. Concurrent validity was calculated using the force platforms as the gold standard device. SETTING: Data was collected within the treatment room of an amateur rugby club. PARTICIPANTS: Twenty male amateur rugby players (25.15 years old ± 3.27 years) were recruited for this study. MAIN OUTCOME MEASURES: Peak force across the shoulder girdle was assessed using the force platforms and sphygmomanometer which provided values in Newtons (N) and millimetres of mercury (mmHg) respectively. RESULTS: Results showed high concurrent validity (Pearsons r = 0.76-0.81) between the sphygmomanometer and the force platform. Coefficient of determination (r2 = 0.59-0.67) showed the sphygmomanometer to have a valid predictive model in the I, Y and T positions. CONCLUSIONS: The sphygmomanometer is suitable for monitoring force transfer across the shoulder during the ASH test, and is able to quantify peak force in mmHg. The sphygmomanometer enables coaches and clinicians to accurately quantify force production across the shoulder girdle in order to screen and monitor players at a low cost.

Return-to-Play Practices Following Hamstring Injury: A Worldwide Survey of 131 Premier League Football Teams.

PURPOSE: Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. METHODS: We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. RESULTS: One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. CONCLUSIONS: General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.

The Athletic Shoulder (ASH) test: reliability of a novel upper body isometric strength test in elite rugby players.

OBJECTIVES: Lower limb isometric tests are used to assess strength and strength asymmetries and monitor reductions in muscle force that may contribute to loss of performance and increase injury risk. Isometric tests in the upper body may be appropriate to monitor neuromuscular performance of the shoulder joint in sports involving contact and overhead actions. The aim of this study was to determine the reliability of a novel upper body isometric strength test. METHODS: Eighteen elite rugby players (age 22.4±4.6 years; body mass 95.5±13.4 kg) were tested on consecutive days. Maximal isometric contractions using both limbs against a force platform were assessed at three angles of abduction (180°, 'I'; 135°, 'Y' and 90°, 'T'), in a prone lying position. To evaluate interday reliability, intraclass coefficients (ICC) were calculated for mean net peak force (NPF) and highest NPF achieved in any trial (peak NPF). Intratrial variability was assessed using coefficient of variation (CV), and the standard error of measurement (SEM) was used to calculate minimal detectable change (MDC). RESULTS: Interday reliability for NPF was excellent in all test positions (ICC 0.94-0.98). The test demonstrated high absolute reliability values (SEM 4.8-10.8) and interday measurement error was below 10% in all test positions (CV 5.0-9.9%) except for the non-dominant arm I-position (CV 11.3%). Minimum detectable change was between 13.2 and 25.9 N. CONCLUSION: The Athletic Shoulder test demonstrated excellent reliability for each test position supporting its use as a reliable tool to quantify the ability to produce and transfer force across the shoulder girdle.