Longitudinal Analysis of the ASES and Constant-Murley Scores, and the Internal Rotation/Shift and Jobe Tests Following Arthroscopic Repair of Supraspinatus Lesions.

It is essential to investigate patients post-surgery using functional surveys like the American Shoulder and Elbow Surgeons Shoulder (ASES) and the Constant-Murley shoulder (CMS) scores, as well as clinical tests, such as the Internal Rotation and Shift (IRO/Shift) and Jobe tests. In this study, 51 out of an initial 87 patients underwent an arthroscopic supraspinatus repair (22 single-row, 16 double-row, 13 debridement). Testing occurred pre-surgery, and 3 and 6 months post-surgery. Both surveys showed significant improvements over time among all 87 patients, but there were no differences between groups (lesion/no lesion) (p > 0.815) or time × group (p > 0.895). The IRO/Shift test showed a stronger ability to distinguish between both groups (positive vs. negative) with respect to the ASES and CMS scores over time, but the Jobe test did not (p > 0.100). Improvements in the CMS scores and the Jobe test were lower following repair compared to the ASES and IRO/Shift test. Most patients returned to adequate levels of functional abilities at 6 months post-surgery. The time required to return to activities of daily living and negative clinical tests was longer for the double-row repair patients compared to the single-row and debridement groups. In conclusion, both the functional surveys and the clinical tests demonstrated improvements following surgery.

Clinical characteristics of sarcoma patients: a population-based data analysis from a German clinical cancer registry.

PURPOSE: Sarcomas are a heterogeneous group of malignant neoplasms with a wide range of histological types and occur in almost any anatomic site and side. This study evaluated the prognostic factors in sarcoma patients based on German clinical cancer registry data. METHODS: The German clinical cancer register of Saxony-Anhalt was used for all data analyses. Sarcoma cases of all clinical or pathological T-stages (T1a-T4c), all N-stages (N0-3) and M-stages (0-1b) corresponding to the Union for International Cancer Control (UICC) stages I to IVB were considered. In our analyses, 787 cases diagnosed between 2005 and 2022 were included. Further, we assessed the association of cancer-related parameters with mortality and hazard ratios (HR) from the Cox proportional hazard models. We included sex, age at diagnosis, histological grade, T-, N- and M-stages, tumor size, tumor localization and tumor side as parameters in our regression models. RESULTS: The majority of sarcoma patients were diagnosed with leiomyosarcoma (12%), liposarcoma (11%), angiosarcoma (5.3%) and myxofibrosarcoma (2.7%). In our univariate regression models, tumors localized in more than one location, head, face and neck region as well as the pelvis and lower extremity were associated with increased mortality risk (more than one location: HR 7.10, 95% CI 2.20-22.9; head, face and neck: HR 1.35, 95% CI 0.89-2.06; pelvis: HR 1.27, 95% CI 0.86-1.89; lower extremity: HR 1.44, 95% CI 1.05-1.96). Higher histological grades, UICC-grades and TNM-stages were related to a higher mortality risk. Differing histological subtypes had significant influence on overall survival and progression-free survival. Patients diagnosed with fibromyxoid sarcoma, rhabdomyosarcoma and angiosarcoma were related to higher mortality risk compared to other histological subtypes (fibromyxoid sarcoma: HR 5.2, 95% CI 0.71-38.1; rhabdomyosarcoma: HR 2.93, 95% CI 1.44-6.00; angiosarcoma: HR 1.07, 95% CI 0.53-2.18). CONCLUSIONS: Histological grade, tumor size, nodal and distant metastasis, tumor localization and histological subtype were determined as prognostic factors in terms of survival.

Effects of Sensorimotor Training on Transversus Abdominis Activation in Chronic Low Back Pain Patients.

(1) Background: The aim of this study was to investigate and compare the effect of sensorimotor training on transversus abdominis activation. (2) Methods: Seventy-five patients with chronic low back pain were randomly assigned to one of three groups (whole body vibration training using Galileo®, coordination training using Posturomed®, or physiotherapy (control)). Transversus abdominis activation was measured by using sonography pre- and post-intervention. Second, changes in clinical function tests and their correlation with the sonographic measurements were determined. (3) Results: All three groups showed an improvement in activation of the transversus abdominis post-intervention, with the Galileo® demonstrating the largest improvement. There were no relevant (r > 0.5) correlations between activation of the transversus abdominis muscle and any clinical tests. (4) Conclusions: The present study provides evidence that sensorimotor training on the Galileo® significantly improves the activation of the transversus abdominis muscle.

Effects of Different Forms of Sensorimotor Training on Postural Control and Functional Status in Patients with Chronic Low Back Pain.

The aim of this study was to compare three sensorimotor training forms in patients with chronic low back pain to determine their effects on the reduction of pain-related impairment and changes in posturography. Over two weeks, during the multimodal pain therapy (MMPT) period, six sessions of sensorimotor physiotherapy or training in the Galileo® or Posturomed® (n = 25 per group) were performed. A significant reduction in pain-related impairment after the intervention phase was shown across all groups (time effect: p < 0.001; ηp2 = 0.415). There was no change in postural stability (time effect: p = 0.666; ηp2 = 0.003), but there was a significant improvement in the peripheral vestibular system (time effect: p = 0.014; ηp2 = 0.081). An interaction effect was calculated for the forefoot-hindfoot ratio (p = 0.014; ηp2 = 0.111). Only the Posturomed® group showed an improvement in anterior-posterior weight distribution (heel load: 47% vs. 49%). These findings suggest that these forms of sensorimotor training in the context of MMPT are suitable for reducing pain-related impairment. Posturography demonstrated stimulation of a subsystem, but no improvement in postural stability.

Relationships Between Lower Extremity Power and Fastball Spin Rate and Ball Velocity in Professional Baseball Pitchers.

ABSTRACT: Wong, R, Laudner, K, Amonette, W, Vazquez, J, Evans, D, and Meister, K. Relationships between lower extremity power and fastball spin rate and ball velocity in professional baseball pitchers. J Strength Cond Res 37(4): 823-828, 2023-Lower extremity power has been hypothesized to increase ball spin and velocity during pitching in baseball. Therefore, the purpose of this study was to determine the relationship between lower extremity power and fastball spin rate in professional baseball pitchers. A secondary purpose was to determine the relationship between lower extremity power and ball velocity. Fifty-three asymptomatic professional pitchers participated (24.5 ± 3.6 years; 189.9 ± 6.1 cm; 92.6 ± 10.3 kg). Each athlete performed 3 separate bilateral jump tests on force plates: countermovement jump (CMJ), squat jump (SJ), and drop jump (DJ). The average fastball spin rate and ball velocity for each pitcher was calculated using a 3-dimensional Doppler radar and video system over the course of a competitive season. Standard multiple regression analyses ( p ≤ 0.05) revealed significant relationship between ball spin and summation of variables for the CMJ (peak force, peak power, rate of power development, and jump height) ( R2 = 0.20, F = 3.1, p = 0.03). However, no individual variable was significantly associated ( p > 0.09). There was also a significant amount of variance in ball spin explained by summation of variables for the SJ (peak force, peak power, rate of power development, and jump height) ( R2 = 0.19, F = 2.8, p = 0.04); rate of power development was the only variable that significantly predicted ball spin within this model ( B = 0.27; 95% confidence interval [CI]: 0.003-0.75, p = 0.05). Ball spin was not associated with summation of DJ variables (peak power, rate of power development, jump height, reactive strength index, and total peak power in watts) ( R2 = 0.18, F = 2.0, p = 0.09). For ball velocity, there were no significant relationships for the summation of either the CMJ variables ( R2 = 0.10, p = 0.28) or the SJ variables ( R2 = 0.07, p = 0.44). However, there was a significant amount of variance in ball velocity explained by summation of variables for the DJ ( R2 = 0.30, F = 3.93, p = 0.005). The reactive strength index was the sole unique contribution to this model ( B = 1.18; 95% CI: -10.34 to 2.36, p = 0.002). These findings highlight the relevance of increased lower extremity power on increasing fastball spin rate and ball velocity.

A Longitudinal Analysis of the Internal Rotation and Shift (IRO/Shift) Test Following Arthroscopic Repair of Superior Rotator Cuff Lesions.

Although the use of clinical tests to diagnose superior rotator cuff pathology is common, there is paucity in the research regarding the accuracy of such tests following arthroscopic repair. The aim of this study was to determine the accuracy of the IRO/Shift test compared to the Jobe test at 3 months and 6 months post-surgery for superior rotator cuff repair. Arthroscopic repair was conducted on 51 patients who were subsequently seen for clinical evaluation at 3 and 6 months following surgery. At 3 months post-surgery only 27% of the patients had a negative IRO/Shift test and 18% had a negative Jobe test. However, at 6 months 88% of the patients presented with a negative IRO/Shift test and 61% a negative Jobe test. When compared to each other, the IRO/Shift test and the Jobe test had 90% agreement pre-operatively, 71% agreement at 3 months post-surgery, and 67% agreement at 6 months. These results demonstrate that the accuracy of the IRO/Shift test and the Jobe test improved between 3 and 6 months following arthroscopic surgery of the superior rotator cuff, with the IRO/Shift test having better accuracy.

IRO/Shift Test Is Comparable to the Jobe Test for Detection of Supraspinatus Lesions.

To determine how the internal rotation and shift (IRO/shift) test compares to the gold standard of clinical tests (Jobe test) for diagnosing supraspinatus lesions and to confirm these clinical results with surgical findings, 100 symptomatic patients were clinically examined between October 2018 and November 2019. All 100 patients were evaluated using both the IRO/shift test and Jobe test. A total of 48 of these patients received surgical intervention. Based on these data, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for both the IRO/shift test and Jobe test were calculated. The IRO/shift test had a sensitivity of 96% (95% CI: 82-100%), specificity of 50% (95% CI: 27-73%), PPV of 73% (95% CI: 56-86%), NPV of 91% (95% CI: 59-100%), and an accuracy of 77% (95% CI: 63-88%). The Jobe test had a sensitivity of 89% (95% CI: 72-98%), specificity of 60% (95% CI: 36-81%), PPV of 76% (95% CI: 58-89%), NPV of 80% (95% CI: 52-96%), and an accuracy of 77% (95% CI: 54-81%). These results suggest that the IRO/shift test is comparable to the Jobe test, which is often viewed as the gold standard clinical examination for assessing supraspinatus lesions. This study was approved by the Ethics Commission of the Martin Luther University Halle-Wittenberg (reference number: 2018-05).

The internal rotation and shift-test for the detection of superior lesions of the rotator cuff: reliability and clinical performance.

Background: Using reliable and valid clinical tests are essential for proper diagnosis and clinical outcomes among injuries involving the rotator cuff. The addition of a new clinical examination test could improve the clinical diagnosis and informative value of the sensitivity and specificity of pathology. This study of diagnostic accuracy evaluated the use of a new rotator cuff test, called the internal rotation and shift-test (IRO/shift-test), to determine its reliability and clinical performance (sensitivity, specificity, positive (PPV)/negative predictive value (NPV)). Clinical diagnostic outcomes were confirmed with radiological findings (MRI). Methods: 100 patients from a specialized shoulder unit participated (64 male, 36 female, mean age: 55 ± 13.5 years). A single-blinded (no knowledge of prior clinical or technical diagnostics) study design was used with two experienced physicians performing the IRO/shift-test. For clinical performance, all clinical testing was compared with MRI. Results: The intra-rater (ICC = 0.73, 95% CI: 60-82) and inter-rater (ICC = 0.89, 95% CI: 81-94) coefficients for the IRO/shift-test showed good-to-excellent reliability. 75% of the patients showed a positive IRO/shift-test, while 65% had a radiologically diagnosed superior rotator cuff tear. 60% of these patients had both a positive IRO/shift-test and objective rotator cuff tear via MRI. The sensitivity of the IRO/shift-test to detect superior rotator cuff lesions based on MRI diagnosis was calculated at 92% (95% CI: 86-99%), while specificity was 67% (95% CI: 50-84%). Predictive values were also found to be high with 86% PPV (95% CI: 78-94%) and 80% NPV (95% CI: 64-96%). Conclusion: Our results demonstrate that the IRO/shift-test is a reliable and valid tool for assessing superior rotator cuff pathology. With good-to-excellent intrarater and inter-rater reliability and strong sensitivity and specificity this test should be considered a valuable addition to clinicians' cadre of clinical evaluation tools.

Relationships Between Clinically Measured Upper-Extremity Physical Characteristics and Ball Spin Rate in Professional Baseball Pitchers.

ABSTRACT: Wong, R, Laudner, K, Evans, D, Miller, L, Blank, T, and Meister, K. Relationships between clinically measured upper-extremity physical characteristics and ball spin rate in professional baseball pitchers. J Strength Cond Res 35(5): 1331-1337, 2021-During baseball pitching, physical characteristics of the shoulder, elbow, wrist, hand, and fingers have been hypothesized to be critical to creating ball spin. The purpose of this study was to determine if pitchers with greater shoulder, elbow, wrist, and finger range of motion (ROM), arm and hand length, wrist strength, or grip and finger strength would produce greater ball spin than those with less physical characteristics. Ninety, asymptomatic, professional baseball pitchers participated (age = 24.5 ± 3.9 years; height = 189.9 ± 6.1 cm; body mass = 92.6 ± 10.6 kg). Goniometers and a digital level were used to measure shoulder, elbow, wrist, and finger ROM, a tape measure was used to assess arm and hand lengths, and handheld dynamometers were used to measure wrist, grip, and finger strength. Ball spin was measured using a 3-dimensional Doppler radar and video system. Standard multiple regression analyses showed no significant relationships existed between ball spin and any of the upper-extremity ROM or limb length variables (R2 = 0.01-0.03; p = 0.40-0.94). However, there was a significant relationship for the summation of wrist strength (R2 = 0.24, p = 0.03). Both time to wrist extension strength {B = 0.50 (95% confidence interval [CI]: 0.23-0.76), p = 0.001} and radial deviation strength (B = 0.41 [95% CI: 0.15-0.66], p = 0.002) were significant predictors within this model. These results demonstrate that the rate of ball spin during a pitch may be partially altered by increasing wrist extension acceleration and radial deviation strength. However, the subsequent clinical measurements of shoulder, elbow, wrist, and finger ROM, arm and hand length, and grip and finger strength were not associated with ball spin.

Lumbopelvic Control and the Development of Upper Extremity Injury in Professional Baseball Pitchers.

BACKGROUND: The baseball-throwing motion requires a sequential order of motions and forces initiating in the lower limbs and transferring through the trunk and ultimately to the upper extremity. Any disruption in this sequence can increase the forces placed on subsequent segments. No research has examined if baseball pitchers with less lumbopelvic control are more likely to develop upper extremity injury than pitchers with more control. PURPOSE: To determine if baseball pitchers who sustain a chronic upper extremity injury have less lumbopelvic control before their injury compared with a group of pitchers who do not sustain an injury. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 49 asymptomatic, professional baseball pitchers from a single Major League Baseball organization participated. Lumbopelvic control was measured using an iPod-based digital level secured to a Velcro belt around each player's waist to measure anteroposterior (AP) and mediolateral (ML) deviations (degrees) during single-leg balance with movement and static bridge maneuvers. During a competitive season, 22 of these pitchers developed upper extremity injuries, while the remaining 27 sustained no injuries. Separate 2-tailed t-tests were run to determine if there were significant differences in lumbopelvic control between groups (P < .05). RESULTS: There were no significant between-group differences for the stride leg (nondominant) during the bridge test in either the AP (P = .79) or the ML (P = .42) directions, or either direction during the drive leg bridge test (P > .68). However, the injured group had significantly less lumbopelvic control than the noninjured group during stride leg balance in both the AP (P = .03) and the ML (P = .001) directions and for drive leg balance in both the AP (P = .01) and the ML (P = .04) directions. CONCLUSION: These results demonstrate that baseball pitchers with diminished lumbopelvic control, particularly during stride leg and drive leg single-leg balance with movement, had more upper extremity injuries than those with more control. Clinicians should consider evaluating lumbopelvic control in injury prevention protocols and provide appropriate exercises for restoring lumbopelvic control before returning athletes to competition after injury. Specific attention should be given to testing and exercises that mimic a single-limb balance task.

The effects of restricted glenohumeral horizontal adduction motion on shoulder and elbow forces in collegiate baseball pitchers.

BACKGROUND: Decreased glenohumeral (GH) horizontal adduction range of motion (ROM) among baseball pitchers has been associated with the development of various shoulder and elbow pathologies. No research has examined how this tightness may affect the forces placed on the shoulder and elbow during the pitching motion. METHODS: Fifty-five asymptomatic National Collegiate Athletic Association Division I baseball pitchers participated. Twenty-five participants had -10° or less horizontal adduction ROM in their throwing shoulder. The remaining 30 participants had greater than -10° of horizontal adduction. A digital inclinometer was used to measure GH horizontal adduction, internal rotation, and external rotation ROM while in 90° of shoulder abduction. Forces produced in the throwing shoulder and elbow were assessed with a 3-dimension, high-speed video capture system and based on the sum of angular momenta of the kinetic chain segments around the center of gravity. Separate 2-tailed t tests were run to determine significant differences between groups (P < .05). RESULTS: Both groups presented with significant bilateral differences in their total arcs of motion (P < .04). This suggests that the loss of horizontal adduction in these groups was at least partially due to soft tissue tightness. There were no significant between-group differences for shoulder external rotation torque or shoulder and elbow distraction (P > .10). The restricted ROM group had significantly more shoulder abduction torque (P = .04), shoulder horizontal abduction torque (P = .004), elbow flexion torque (P = .002), and elbow valgus torque (P = .02) compared with the control group. CONCLUSIONS: These results demonstrate that collegiate pitchers with -10° or less of horizontal adduction ROM in their throwing shoulder create significantly more shoulder abduction and horizontal abduction torque, as well as more elbow flexion and valgus torque, during the pitching motion than those with more ROM.

Effects of Viscosupplementation on Quality of Knee Joint Arthrokinematic Motion Analyzed by Vibroarthrography.

OBJECTIVE: To evaluate the influence of viscosupplementation on osteoarthritic knee arthrokinematics analyzed by VAG. It is considered that intra-articular hyaluronic acid injection may improve the function of synovial joints by recovery of friction-reducing properties of articular environment. DESIGN: Thirty-five patients with knee osteoarthritis (grade II according to the Kellgren-Lawrence system) and 50 asymptomatic subjects were enrolled in the study. Patients were analyzed at 3 time points: 1 day before and 2 weeks and 4 weeks after single injection of 1.5% cross-linked hyaluronate. Control subjects were tested once. The vibroarthrographic signals were collected during knee flexion/extension motion using an accelerator and described by variation of mean square (VMS), mean range (R5), and power spectral density for frequency of 50 to 250 Hz (P1), and 250 to 450 Hz (P2). RESULTS: Patients before viscosupplementation were characterized by about 2-fold higher values of vibroarthrographic parameters than controls. Two weeks after the procedure, the values of R5, P1, and P2 significantly decreased, in comparison to pre-injection. At 4 weeks post-injection, we noted a significant increase in R5, P1, and P2 values, when compared to 2 weeks post-injection. Finally, at 4 weeks post-injection, the level of VMS, R5, and P2 parameters did not differ from values obtained at pre-injection. CONCLUSIONS: We showed that viscosupplementation may be effective in providing arthrokinematics improvement, but with a relatively short period of duration. This phenomenon is observed as decreased vibroacoustic emission, which reflects a more smooth movement in the joint.

Vibroarthrographic analysis of patellofemoral joint arthrokinematics during squats with increasing external loads.

BACKGROUND: The patellofemoral joint (PFJ) provides extremely low kinetic friction, which results in optimal arthrokinematic motion quality. Previous research showed that these friction-reducing properties may be diminished due to the increase in articular contact forces. However, this phenomenon has not been analyzed in vivo during functional daily-living activities. The aim of this study was the vibroarthrographic assessment of changes in PFJ arthrokinematics during squats with variated loads. METHODS: 114 knees from 57 asymptomatic subjects (23 females and 34 males) whose ages ranged from 19 to 26 years were enrolled in this study. Participants were asked to perform 3 trials: 4 repetitions of bodyweight squats (L0), 4 repetitions of 10 kg barbell back loaded squats (L10), 4 repetitions of 20 kg barbell back loaded squats (L20). During the unloaded and loaded (L10, L20) squats, vibroarthrographic signals were collected using an accelerometer placed on the patella and were described by the following parameters: variation of mean square (VMS), mean range (R4), and power spectral density for frequency of 50-250 Hz (P1) and 250-450 Hz (P2). RESULTS: Obtained results showed that the lowest values were noted in the unloaded condition and that the increased applied loads had a significant concomitant increase in all the aforementioned parameters bilaterally (p < 0.05). CONCLUSION: This phenomenon indicates that the application of increasing knee loads during squats corresponds to higher intensity of vibroacoustic emission, which might be related to higher contact stress and kinetic friction as well as diminished arthrokinematic motion quality.

POSTERIOR SHOULDER TIGHTNESS AND SUBACROMIAL IMPINGEMENT CHARACTERISTICS IN BASEBALL PITCHERS: A BLINDED, MATCHED CONTROL STUDY.

BACKGROUND: Baseball pitchers frequently develop varying levels of posterior shoulder tightness (PST) and often present with characteristics associated with subacromial impingement. PURPOSE: To determine if a group of baseball pitchers with excessive PST (bilateral internal rotation ROM difference >18 ° and bilateral total arc of motion difference >5 °) have differences in subacromial joint space, forward scapular posture, or glenohumeral elevation range of motion (ROM) when compared to a control group. STUDY DESIGN: Descriptive, cross-sectional study. METHODS: Thirty-five asymptomatic professional baseball pitchers with excessive PST were matched with 35 pitchers with acceptable levels of PST. The investigators measured subacromial space using diagnostic ultrasound, glenohumeral elevation ROM using a digital goniometer, and scapular posture using a double square, and were blinded to the group of each participant. Separate t-tests were used to determine significant differences between groups (p < 0.05). RESULTS: The excessive PST group presented with significantly less subacromial space (p = .0007) and glenohumeral elevation ROM (p = .03) compared to the acceptable level PST group. The excessive PST group also had significantly more forward scapular posture than the control group (p = .03). CONCLUSION: The baseball pitchers with excessive PST had less subacromial space and glenohumeral elevation ROM, as well as more forward scapular posture in their throwing arms compared to pitchers with acceptable levels of PST. LEVEL OF EVIDENCE: 3.

The Effects of Circuit Strength Training on the Development of Physical Fitness and Performance-Related Variables in Handball Players.

The purpose of this study was to determine the effects of 12 weeks of circuit training on physical fitness in handball players. Subjects were randomly divided into a circuit strength training group (CT, n = 10) and a control group (CG, n = 9). Training sessions and matches were performed together, but during the 12-week intervention, the experimental group replaced part of the regular regimen with circuit strength training. Measures assessed in both groups before and after the intervention included: the agility T-half Test, the Yo-Yo intermittent recovery test, squat and counter-movement jumps, 15 m and 30 m sprints, and strength tests for the bench press, pull over, and the half squat. The upper limb bench press and pull-over tests along with the lower limb back half squat were performed using a 1-repetition maximum protocol. Based on the intraclass correlation coefficient and excluding the agility T-test (ICC = 0.72), we found excellent relative reliability for all variables (intraclass correlation coefficient range: 0.85-0.96, SEM range: 0.03-3.00). For absolute reliability or coefficients of variation, 71% (5/7) of the variables were excellent (CV < 5%). The circuit strength training group showed significant interaction effects and relevant effect sizes for the 12-week training period (8/9, 89%), and the mean effect size for the CT was markedly higher (d = 1.3, range: 0.41 - 2.76) than in the CG (d = - 1.0, range: -0.73 - 0.29). The largest improvements were in the Yo-Yo test (d = 2.76) and the squat jump (d = 2.05). These results show that a 12-week circuit strength training program is an effective method to increase handball-related performance characteristics.

Acute Effects of Pectoralis Minor Self-Mobilization on Shoulder Motion and Posture: A Blinded and Randomized Placebo-Controlled Study in Asymptomatic Individuals.

CONTEXT: Tightness of the pectoralis minor is a common characteristic that has been associated with aberrant posture and shoulder pathology. Determining conservative treatment techniques for maintaining and lengthening this muscle is critical. Although some gross stretching techniques have been proven effective, there are currently no empirical data regarding the effectiveness of self-myofascial release for treating tightness of this muscle. OBJECTIVE: To determine the acute effectiveness of a self-myofascial release with movement technique of the pectoralis minor for improving shoulder motion and posture among asymptomatic individuals. DESIGN: Randomized controlled trial. SETTING: Orthopedic rehabilitation clinic. PARTICIPANTS: A total of 21 physically active, college-aged individuals without shoulder pain volunteered to participate in this study. MAIN OUTCOME MEASURES: Glenohumeral internal rotation, external rotation, and flexion range of motion (ROM), pectoralis minor length, and forward scapular posture were measured in all participants. The intervention group received one application of a self-soft-tissue mobilization of the pectoralis minor with movement. The placebo group completed the same motions as the intervention group, but with minimal pressure applied to the xiphoid process. Separate analyses of covariance were used to determine differences between groups (P < .05). RESULTS: Separate analyses of covariance showed that the self-mobilization group had significantly more flexion ROM, pectoralis minor length, and less forward scapular posture posttest than the placebo group. However, the difference in forward scapular posture may not be clinically significant. No differences were found between groups for external or internal rotation ROM. CONCLUSIONS: The results of this study indicate that an acute self-myofascial release with movement is effective for improving glenohumeral flexion ROM and pectoralis minor length, and may assist with forward scapular posture. Clinicians should consider this self-mobilization in the prevention and rehabilitation of pathologies associated with shortness of the pectoralis minor.

Comparison of a Combined Strength and Handball-Specific Training vs. Isolated Strength Training in Handball Players Studying Physical Education.

OBJECTIVES: The purpose of this study was to compare the effect of combined resistance training including handball-specific drill (CRT) with resistance training excluding handball-specific drill training (NSDT). MATERIALS AND METHODS: Twenty-two male handball players who studied physical education were randomly assigned to two groups: CRT (combined resistance training with sport-specific drill; n = 12) and NSDT (resistance training without any sport-specific drill training; n = 10). Over a 10-week period during the competitive season, the players performed a specific training program twice per week, which replaced their normal team handball training. The CRT regimen consisted of a combined (associated) resistance training and handball-specific drill, whereas the NSDT program consisted of a resistance training without handball-specific drill (dissociated). Pre- and post-test measures included squat jump and countermovement jumps, bench press, back half squats, throwing velocity during a 3-step jump throw, and a jump shot, repeated-sprint ability (six 2 × 15-m shuttle sprints) (RSA), medicine ball throw and anthropometric measurements. RESULTS: In both groups, significant intervention effects (d ≥ 1.0) were seen for all sprint (3/3), throwing (3/3) and jump (2/2) measures. Regarding maximal strength parameters, an effect size lower than 0.5 was only detected in the NSDT group for half back squats (d = 0.48). The largest effects were observed in the NSDT group for squat jump (d = 6.20) and medicine ball throw (d = 6.07). Interaction effects (group × time) were found for 50 % (5/10) of parameters. The greatest difference between groups regarding performance development over time was detected for jump shot (interaction effect: η²â€Š= 0.748). In contrast, there was no difference in performance development in both groups over time for RSAbest (interaction effect: η²â€Š= 0.025). CONCLUSIONS: The current findings suggest that during the competitive season, 10 weeks of CRT with only two training sessions per week improved numerous measures of athletic performance in handball students of physical education. Such conditioning should be highly recommended as part of the annual training program of handball players.

Playing Level and Position Differences in Body Characteristics and Physical Fitness Performance Among Male Team Handball Players.

The primary aim of the study was to examine the anthropometric characteristics, as well as the physical performance of professional handball players classified by playing position and competition level. Twenty male players (age: 20.4 ± 0.88 years) from the first handball league and 18 male players (age: 21.3 ± 1.61 years) from the second handball league were categorized as backs (8/8), pivots (5/4), and wings (7/6). The following variables were measured in both groups: peak power; vertical squat jump (SJ), and countermovement jump (CMJ); sprint times over 15 and 30 m; handball throwing velocity during the jump shot (JS); and 3 steps shot (T3 step); upper and lower limb muscle volumes; Yo-Yo Intermittent Recovery Test. Anthropometric data revealed significantly (p = 0.003, η p 2 = 0.248) less muscle volume for second league players (3.13 ± 0.29 l) than for first league (3.71 ± 0.82 l). The cross-sectional area for the first league players was also larger (p = 0.010, η p 2 = 0.192). Regarding performance parameters, we found significant (p < 0.05 and η p 2 > 0.20) league differences in five of 15 (33%) performance parameters: running throw ( η p 2 = 0.285), SJ power ( η p 2 = 0.670), SJ velocity ( η p 2 = 0.900), peak upper limb power ( η p 2 = 0.231) and Yo-Yo-IR 1 ( η p 2 = 0.348). The second league players showed higher SJ velocity than the first league players ( η p 2 = 0.900). In contrast, we detected a greater difference in SJ power ( η p 2 = 0.670) but in favor of the first league players. Pivots were the players with the highest throwing velocity and wings were the fastest (15, 30 m sprint), strongest (countermovement jump), and most enduring (Yo-Yo-IR 1) athletes. Backs showed consistently the lowest level throwing velocity and sprint performance (exception: second league). The anthropometric differences between playing levels and playing positions may indicate the advantageous characteristics that the respective position demands, whereas the playing position differences in physical fitness characteristics may indicate training specificity issues that must be addressed cautiously.

Differences in Player Position Running Velocity at Lactate Thresholds Among Male Professional German Soccer Players.

This study investigated the differences in running velocities at specific lactate thresholds among male German soccer players. One hundred fifty-two professional (3rd league: n = 78; 4th league: n = 74) male soccer players (mean ± SD; age: 24.7 ± 4.37 years, body mass: 80.8 ± 7.33 kg, body height: 1.83 ± 0.06 m) volunteered for the investigation. Players were categorized as goalkeepers, central defenders, central midfielders, wings and forward. Players completed a treadmill test, at incremental speeds, to determine running velocity at different blood lactate concentrations (v2 = 2 mmol/l; v4 = 4 mmol/l; and v6 = 6 mmol/l). In addition, the largest difference between positions for running velocity was found at the lactate threshold v2 (p = 0.005). The running data revealed that only goalkeepers had significantly lower velocities at the lactate thresholds compared to outfield players. The central midfielders showed the highest average performance level at the lactate thresholds (v2: 12.5 ± 1.20 km/h; v4: 15.2 ± 1.14 km/h; and v6: 16.6 ± 1.14 km/h). In conclusion, this study provides soccer and position-specific reference data for the running performance of male professional German soccer players to evaluate the endurance performance in a standardized way. In this context, future research should extend the database for the first and second leagues. Further research assessing running performance during competition matches over the entire season is required to validate the endurance test performance data.