Shoulder structures and strength in competitive preadolescent swimmers: A longitudinal ultrasonographic study.

BACKGROUND: Repetitive shoulder movements during competitive training may cause changes in the strength of periarticular shoulder structures in preadolescent swimmers. OBJECTIVE: To prospectively determine the effects of training on shoulder periarticular structures and muscle strength in preadolescent swimmers. DESIGN: Prospective cohort study. SETTING: Community-based natatorium. PARTICIPANTS: Twenty-four preadolescent swimmers aged 10-12 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measurements were repeated in three periods as preseason, midseason, and postseason. Ultrasonographic measurements (supraspinatus tendon thickness, humeral head cartilage thickness, deltoid muscle thickness, and acromiohumeral distance) were performed using a portable device and a linear probe. Shoulder (flexion, extension, abduction, internal and external rotation) and back (serratus anterior, lower, and middle trapezius) isometric muscle strength were measured with a handheld dynamometer. RESULTS: Supraspinatus tendon thickness and acromiohumeral distance were similar in all periods (all p > .05); however, deltoid muscle and humeral head cartilage thicknesses increased throughout the season (p = .002, p = .008, respectively). Likewise, whereas shoulder muscle strength increased (all p < .05), back muscle strength was similar in all periods (all p > .05). CONCLUSIONS: In preadolescent swimmers, acromiohumeral distance and supraspinatus tendon thickness seem to not change; but humeral head cartilage and deltoid muscle thicknesses as well as shoulder muscle strength increase throughout the season.

Comparison of Biopsychosocial Characteristics of Children with Juvenile Idiopathic Arthritis According to Common Disease Subtypes.

OBJECTIVE: In this study, we assessed the functional and biopsychosocial characteristics of juvenile idiopathic arthritis (JIA) patients according to disease subtypes. MATERIALS AND METHODS: Child Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Disease Activity Score-71 (JADAS-71), and Juvenile Arthritis Biopsychosocial Questionnaire (JAB-Q) scales were administered to 304 JIA patients, and the subscale of JAB-Q was administered to their families. RESULTS: The median age of JIA patients at diagnosis was 7.9 (5.5-13) years (female/male = 1.3). Most patients were under treatment (68.7%) and had inactive disease (69.3%). While there was no significant difference between JADAS-71 scores according to the JIA subtypes, total CHAQ scores in polyarticular JIA patients were higher than in systemic JIA patients (P = .005). Enthesitis-related arthritis (ERA) patients had higher JAB-Q fatigue total scores compared to systemic JJIA patients (P = .001). Juvenile Arthritis Biopsychosocial Questionnaire-child psychosocial status scores were higher in polyarticular JIA patients than oligoarticular and systemic JIA patients (P = .004 and P = .003, respectively), and they had higher JAB-Q child form total scores than systemic JIA patients (P = .006). In addition, systemic JIA patients' parents had higher JAB-Q family total scores compared to oligoarticular JIA patients' parents (P = .03). CONCLUSION: Our results suggest that polyarticular JIA patients had higher CHAQ, JAB-Q psychosocial status, and child form total scores, and the JAB-Q fatigue score was higher in ERA patients. Also, JAB-Q-parent scores were higher in systemic JIA patients' parents. Biopsychosocial characteristics should be evaluated in both JIA patients and their parents.

Countermovement push-up test to assess the upper extremity force-time characteristics in swimmers during a macrocycle.

Although it is known that swimming training can improve upper extremity performance, the force-time characteristics of the upper extremity during different training periods are not well understood. The objective of this study was to measure changes in the force-time characteristics of the upper extremity of young swimmers during different training periods within a season. Seventeen young swimmers, comprising 5 males (age: 15.4 ± 0.54 years); 12 females (16.4 ± 2.6 years) participated in this study. They were tested at four experimental test time points: baseline (E1), post-general preparation (E2), post-specific preparation (E3), and taper season (E4). The countermovement push-up test was performed using a force plate to measure force time parameters. Differences in force, time, velocity and impulse parameters were evaluated between the different periods. The study found that vertical take off velocity significantly increased across the assessed periods (F = 11.79; p = .001; η2 = .424), with significant increases from E1 to E2 (p < .001) and from E3 to E4 (p = .016). Flight Time also significantly increased across the assessed periods (F = 11.79; p = .001; η2 = .424), with significant increases from E1 to E2 (p < .001), from E1 to E4(p = .001), and from E3 to E4 (p = .005). The Force Impulse significantly increased throughout the assessed periods (F = 5.84; p = .012; η2 = .267), with significant increases from E1 to E2, (p = .006), from E1 to E3 (p = .016), and from E1 to E4 (p = .003). As this study shows, periods of increased training intensity can affect athletic progression, even though training aims to improve strength, speed, and performance. While some practical aspects such as strength, flight time, and impulse parameters may change during a macrocycle, the countermovement push-up test can provide trainers with an alternative and convenient way to monitor anaerobic force, speed, and performance, as well as measure explosive force-time performance in the upper body.

A Modified Version of the Forgotten Joint Score-12 in Lower Limb Amputees: Validity and Reliability Study.

Adaptation to prosthesis is important for occupation, quality of life, and participation in social life, so it needs to be evaluated. The aim of this study was to determine the validity and reliability of the Forgotten Joint Score-12 (FJS-12) in lower limb amputees. The FJS-12 was applied to 80 amputees. Criterion-referenced validity was assessed using the activity restriction subparameter of Trinity Amputation and Prosthesis Experience Scale (TAPES). The internal consistency of the FJS-12 was high (Cronbach's α = .943). A statistically significant very good negative correlation was determined between the FJS-12 and the activity restriction subparameter of TAPES (r = -.641; p < .001). The results of this study showed that FJS-12 is a valid and reliable measurement tool that can be used to assess the adaptation to prosthesis in amputees. Evaluation of prosthesis awareness in daily living activities of amputees is important in terms of establishing occupational therapy and rehabilitation programs.

A new biopsychosocial and clinical questionnaire to assess juvenile idiopathic arthritis: JAB-Q.

OBJECTIVE: To create a new multidimensional questionnaire for the assessment of juvenile idiopathic arthritis (JIA) patients in standard clinical practice and study the validity and reliability of this questionnaire. METHODS: The Juvenile Arthritis Biopsychosocial and Clinical Questionnaire (JAB-Q) was created using the Delphi technique and consensus conference following an initial literature search. The questionnaire has three parts including a clinician form, child form and parent form. This is a patient/parent-centered outcome tool, which helps us to evaluate the biopsychosocial aspects of the patient, including disease activity, posture, functional and psychosocial status, fatigue, and performance in school. From January 2015 to January 2018, 6-18 years old children with JIA were enrolled in the study. The previously validated questionnaires were also applied to each participant to validate the JAB-Q: Juvenile Idiopathic Disease Arthritis Score (JADAS) and Childhood Health Assessment Questionnaire (CHAQ), and the Family Impact Questionnaire (FIS). The same questionnaire was re-administered after one week to assess the test-retest reliability in randomly selected 50 children and their parents. RESULTS: A group of experts were invited to the Delphi survey. After the Delphi tours, the final form of the questionnaire containing three parts as clinician form, child form and parent form was created. This tool was applied to 310 JIA patients and their parents. The children and parents easily handled the JAB-Q and filled the forms in around 10-15 min. The validity of the clinician, child and parents' forms were assessed by the JADAS, CHAQ, and FIS, respectively. The validity of these three scales were determined as moderate. In addition, the test-retest reliability of the clinician, child and parents' forms were considerably high. CONCLUSION: JAB-Q is a valid and reliable multidimensional biopsychosocial outcome tool that can be used routinely in clinical practice of pediatric rheumatology. The main advantage of this tool is incorporation of patients' and parents' perspectives separately while providing a practical and standard setting for the clinician's evaluation. However, further validation of this tool in an independent cohort is needed to improve its applicability.