Closed Kinetic Chain Upper Extremity Stability Test Research Articles

Reference values, intrarater reliability, and measurement error for the closed kinetic chain upper extremity stability test and upper quarter y balance test in young adults

Aims: To describe reference values for the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) and Upper Quarter Y Balance Test (UQYBT) in young adults, and to determine whether there were differences in both tests based on gender and age. Intrarater reliability and measurement error were also assessed. Methods: Test-retest design with a sample of 146 young adults. The CKCUEST (number of touches, normalized score, and power) and the UQYBT (normalized reach in the medial, superolateral, and inferolateral direction, and the composite score) were used. Mean and standard deviation were calculated for both tests. A linear and a mixed regression model were applied to determine significant differences in test scores. Reliability was determined using Intraclass Correlation Coefficient (ICC) and error measurement through Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC). Results: Normative values were established and divided by gender and age. Men presented greater scores regarding the number of touches, power score, superolateral and inferolateral reaches. Good intrarater reliability was found for both tests. In the CKCUEST, the SEM and SDC values were 1 and 3 touches. In the UQYBT, the SEM values ranged from 3 to 7 cm, while the SDC ranged from 8 to 19 cm. Conclusion: Normative data were provided and men presented greater scores than women. Good intrarater reliability was found and values of SEM and SDC were established. Clinicians must use both tests in clinical practice since different aspects of the upper quarter are assessed.

The effect of shoulder injury prevention program on glenohumeral range of motion and upper extremity performance in adolescent throwers: A pilot study

Background: The Oslo Sports Trauma Research Center (OSTRC) Shoulder Injury Prevention Program is an exercise program developed to increase the internal rotation (IR) range of motion (ROM), external rotator muscle strength and scapular muscle strength and to improve kinetic chain involvement and thoracic mobility. The purpose of this study is to investigate the effect of this program on glenohumeral ROM and upper extremity functional performance in adolescent throwers. Material and Methods: Ten adolescent throwers (discus, shot put and javelin throwers) were involved in the study. The OSTRC Shoulder Injury Prevention Program was applied three times a week for 8 weeks as a handball warm-up. Glenohumeral IR and external rotation (ER) ROM were evaluated with a goniometer. The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) was used to evaluate the upper extremity functional performance. Results: It was found that there was a statistically significant difference in the dominant side IR ROM and CKCUEST between the pre-test and post-test (p<0.05); however, there was no difference in terms of other parameters (p>0.05). Conclusions: This study shows that the glenohumeral IR ROM and upper extremity functional performance increases after the 8-week OSTRC Shoulder Injury Prevention Program. For these purposes, physiotherapists and trainers can include this program in their training programs.

Reliability and validity of the One Arm Hop Test and Seated Medicine Ball Throw Test in young adults: A cross-sectional study

BackgroundFunctional performance tests are inexpensive, accessible, and easy to apply tools that can be used to help practitioners in daily decision making process. The purpose of this study was to evaluate the reliability and validity of the One Arm Hop Test (OAHT) and Seated Medicine Ball Throw Test (SBMT) in young adults. MethodsCross-sectional study with a sample consisted of 59 young adults. The subjects performed the OAHT and SMBT in two moments separated by seven days and by two examiners. The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) was performed at the second moment. The time in OAHT, distance in SMBT, mean number of touches, normalized score, and power of the CKCUEST were measured. Reliability was determined using Intraclass Correlation Coeficient (ICC) and Bland-Altman Plots. Validity was assessed via Pearson's Correlation Coefficient (r) between these tests and CKCUEST. ResultsWe found good reliability of the OAHT between different raters (dominant limb – ICC = 0.83; non-dominant limb – ICC = 0.80) and moderate reliability between the same rater (dominant limb – ICC = 0.63; non-dominant limb – ICC = 0.62). In the SMBT we found good reliability inter-examiner (ICC = 0.84) and intra-examiner (ICC = 0.77). Low to moderate correlations with the CKCUEST were found (r < 0.70; p < 0.05). ConclusionsThe OAHT and the SMBT show moderate/good reliability intra and inter-examiner, however these tests are poorly correlated with CKCUEST. The SMBT presented higher values of ICC than OAHT. A combination of the SMBT and CKCUEST is recommended in clinical practice.

Shoulder Strength and Closed Kinetic Chain Upper Extremity Stability Test Performance in Division III Collegiate Baseball and Softball Players.

BackgroundShoulder strength measured with a handheld dynamometer (HHD) and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) are clinical tools that have been used to measure athlete’s performance and track their progress.PurposeThe specific aims of this study were to describe baseball (BB) and softball (SB) players isometric strength measures and their performance on the CKCUEST; examine the relationships between strength and the CKCUEST; compare isometric strength measures of the throwing and non-throwing arms; and compare the strength and the CKCUEST measures between BB and SB players.Study DesignObservational cohort study.MethodsParticipants included 50 DIII BB and 24 DIII SB players. Shoulder strength for the internal and external rotators were measured using a HHD and the CKCUEST was performed. The CKCUEST score and power were calculated. Descriptive statistics and paired t-tests were used to compare throwing and non-throwing shoulder strength. Independent t-test was used to compare BB and SB players shoulder strength and the CKCUEST measures.ResultsThe BB players demonstrated significant strength differences between the throwing and non-throwing shoulders and the internal rotators were significantly stronger than the external rotators (p < 0.05), while the strength ratio of the internal and external rotators was not different between arms (p=0.87). The SB players demonstrated no significant strength differences between the throwing and non-throwing shoulders for the internal and external rotators or the strength ratio of the rotators (p > 0.05). There were no significant differences between the strength of the internal and external rotators of the non-throwing shoulder (p=0.075) or the throwing shoulder (p=0.096). The BB players throwing and non-throwing shoulders produced significantly more internal and external force than the SB players (p < 0.001), however, the internal/external rotators strength ratio were similar (p=0.32, p=0.30). The CKCUEST power had inverse and significant correlations (p=0.006, p=0.003) with SB players internal and external rotators, respectively. The CKCUEST power was significantly different between BB and SB players (p < 0.001).ConclusionThis study presented shoulder rotator strength and CKCUEST reference values for DIII BB and SB players. BB players demonstrated more strength but overall, less symmetry compared to SB players. CKCUEST power may be considered for the evaluation of athletes.Level of EvidenceLevel III

A Comparison of Resting Scapular Posture and the Davies Closed Kinetic Chain Upper Extremity Stability Test.

BACKGROUNDIn orthopaedic practice, it is well established that weak scapular stabilizers and an unstable scapula is related to shoulder dysfunction. Faulty scapular position has been linked to decreased scapular stability and is thought to be a result of weak or unbalanced timing in the recruitment of scapulothoracic dynamic stabilizing muscles. Kibler has described a four-type classification of scapulothoracic dysfunction. Functional performance testing is used to objectively measure activities that simulate various desired activities. The reliability of assessing the four static scapular positions may be important in diagnosing shoulder dysfunction. An understanding of the scapular position and its relationship to functional performance testing is needed.PURPOSEThe purpose of this study was to determine if a static scapular test, the Kibler scapula classification, in healthy participants affects the ability to perform a closed chain functional test that involves the use of the scapula and the upper extremity, the Davies Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). A secondary analysis was performed to evaluate the reliability of a student physical therapist and an experienced physical therapist to identify scapular type by observation.STUDY DESIGNMulticenter, single session descriptive cohortMETHODSSixty-one healthy participants (33 males, 28 females; mean age 24.19±2.61) completed testing across two locations in one testing session. Blood pressure and heart rate as well as height and weight were measured for each participant. Participants were classified by visual observation of Kibler scapular classification. The average number of CKUEST touches, a normalized score, and a power score were calculated for each participant. Three trials were performed and participants were required to take a 45-second rest break between each CKCUEST trial.RESULTSOne way analysis of variance (ANOVA) showed statistically significant differences in Type I and Type IV Kibler scapula classification for the CKCUEST power score, however when an ANCOVA controlled for body mass index, there was no statistically significant difference. A strong correlation r=.94 was observed between student and experienced physical therapist in evaluating all four types of Kibler scapular classification.CONCLUSIONSVisually observed Kibler scapular position does not affect the ability to perform the Davies CKCUEST in healthy young adults. The ability to identify Kibler scapular position was reliable between student and experienced physical therapists. Additional studies are required to identify the usefulness of the Kibler scapular position classification.LEVEL OF EVIDENCE2b: Individual Cohort Study

USE OF AN UPPER EXTREMITY FUNCTIONAL TESTING ALGORITHM TO DETERMINE RETURN TO PLAY READINESS IN COLLEGIATE FOOTBALL PLAYERS: A CASE SERIES.

Return to play decision making for upper extremity injuries is challenging due to a lack of evidence-based protocols and testing. Current guidelines utilize tests and measures with minimal evidence on re-injury risks and prediction. The purpose of this case series is to highlight a functional testing algorithm for upper extremities injuries and the outcomes for the patients that followed it. Case series. Six subjects (18 - 21 years old) who underwent shoulder capsulolabral repair secondary to recurrent instability and/or unyielding pain are included. All subjects underwent a criterion-based rehabilitation program before being assessed with the authors' upper extremity functional testing algorithm. The upper extremity functional testing algorithm consists of measures of active range of motion (AROM), passive range of motion (PROM), peak isometric force, a fatigue testing battery, and the closed kinetic chain upper extremity stability test (CKCUEST) to assess readiness for return to sport. All athletes achieved > 90% symmetry on at least two out of three tests during a fatigue testing protocol and at least 25 touches on the CKCUEST. All of the athletes returned to unrestricted football the season following surgical intervention. None of the athletes sustained an additional glenohumeral subluxation, dislocation, or upper extremity injury requiring surgical intervention for the remainder of their athletic careers (six years). The presented cases help to illustrate the effectiveness of the upper extremity functional testing algorithm to assess return to sport readiness for male collegiate football athletes. The algorithm included testing of AROM/PROM and strength that is typically used, but also included the CKCUEST and fatigue testing to further challenge and assess the upper extremity prior to returning to sports. 4.

Biomechanical analysis of the closed kinetic chain upper extremity stability test in healthy young adults

ObjectivesTo compare kinematic and ground reaction force (GRF) patterns between the dominant and non-dominant limbs in males and females conducting the closed kinetic chain upper extremity stability test (CKCUEST). DesignDescriptive. SettingBiomechanics laboratory. ParticipantsSixteen male and sixteen female healthy and physically active young adults. Main outcome measuresHand contact and flight times, peak and average vertical (vGRF) and medial-lateral (mlGRF) ground reaction forces, medial-lateral (ML) distance and ML velocity per repetition, three-dimensional (3D) distance and 3D velocity per repetition, and average number of touches per trial during the CKCUEST. ResultsOnly peak and average mlGRF were statistically different between limbs. Males and females were statistically different across every measured variable. ML and 3D velocities were the only variables strongly correlated to the number of touches achieved. ConclusionsBoth sexes were symmetrical between limbs in all but mlGRF; however, there were distinct differences in both kinematics and GRF patterns between sexes that may be attributed to differences in the testing position between males and females.

Effect Of Scapular Dyskinesis On Scapular Functionality And Back Endurance In Elite Women Handball Players

PURPOSE: In professional handball players, accurate scapulohumeral rhythm is crucial for the prevention of overhead shoulder injuries. Additionally low back strength and endurance transfer power to scapular and upper part of body via posterior fascia chain. The aim of this study was to investigate the difference between handball players with scapular dyskinesis and without scapular dyskinesis regarding to functionality and back endurance. METHODS: Forty-one elite female handball players were included in the study. Sixteen women (mean age: 22.5±6.4yrs BMI: 22.5±2.7kg/m2) who has scapular dyskinesis according to lateral scapular slide test (LSST) as Group 1, 25 women (mean age: 22.5±6.4yrs, BMI:21.8±2.0kg/m2) who has no scapular dyskinesia according to LSST as Group 2 divided into groups. Davies Test and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) were used for the measurement of scapular functionality and Sorensen Test for the measurement of back extensor endurance. Mann-Whitney U test was used to compare the mean values between the groups. RESULTS: There were no statistically significant differences in CKCUEST and Davies tests between both groups (p> 0.05). There was statistically significant difference in favor of Group 2 according to Sorensen test between both groups (p = 0.026). CONCLUSION: Endurance of the trunk extensor muscles seems to have influence in scapular dyskinesis in elite female handball players. Besides, functionality of upper extremity in scapular dyskinesis needs to future studies for handball players.

Profile of upper extremity strength and function in division 1 collegiate athletes

ObjectivesTo profile shoulder strength and functional test scores in collegiate athletes across various sports. DesignCross-sectional. SettingPre-participation physical screens for varsity athletes at a Division I university. Participants476 healthy Division 1 collegiate athletes (270 males; 27 varsity sports). Main outcome measuresTwo trials of each 1. Isometric peak force (PF) using hand-held dynamometry for shoulder internal rotation (IR), external rotation (ER), and forward elevation (FE) in kg; 2. Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), quantified by number of touches. ResultsPF values (mean(SD), dominant/non-dominant) for females were: IR = 8.7(2.6)/8.7(6.2); ER = 8.2(2.5)/7.9(2.5); FE = 8.0(2.5)/8.0(2.7); CKCUEST scores were 21.8(3.9). PF values for males were: IR = 12.0(3.8)/11.9(3.6); ER = 10.7(3.4)/10.7(3.5); FE = 10.7(3.5)/10.4 (3.5); CKCUEST scores were 26.0(4.1) touches. ConclusionsNormative values should be used as an athlete’s baseline for the CKCUEST. This may help target athletes who are at a higher risk of upper extremity injury and help with goals or return to sport readiness during the rehabilitation process.

Test-Retest Reliability of the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) in a Modified Test Position in Division I Collegiate Basketball Players

The closed kinetic chain upper extremity stability test (CKCUEST) as originally described may not be appropriate for assessing athletes interchangeably considering body size variations. A modified test position may be warranted to normalize the CKCUEST to body size, in order to reflect an accurate representation of upper limb function. To determine test-retest reliability of the CKCUEST in a modified test position in Division I collegiate basketball players. Test-retest reliability. 15 subjects (8 male, 7 female) were recruited from Division I basketball teams. Subjects began in a push-up position with their hands located directly under their shoulders. Subjects performed one 15 second trial of the modified CKCUEST initially and a second trial one week later. Hand-written data was transferred to a spreadsheet for analysis using Minitab Statistical Software for comparison. Test-retest reliability was 0.88 for men's basketball, 0.79 for women's basketball, and 0.90 when both teams were combined. Test mean for men's basketball were 29.5 ± 4.78, and retest mean were 31.88 ± 4.99. Test mean for women's basketball were 24.86 ± 5.52, and retest mean were 26.71 ± 5.41. Test mean for both teams combined were 27.33 ± 5.5, and retest mean were 29.47 ± 5.67. The CKCUEST in a modified test position is a reliable assessment tool. Results support previous findings and may contribute to injury prevention and return to sport decision-making. 3b.

The Self-Assessment Corner for Shoulder Strength: Reliability, Validity, and Correlations With Upper Extremity Physical Performance Tests.

Rotator cuff weakness and rotation ratio imbalances are possible risk factors for shoulder injury among overhead athletes. In consensus statements, organizations have highlighted the importance of a screening examination to identify athletes at risk of injury. The screening should be portable and designed to be feasible in many different environments and contexts. To evaluate the reliability and validity of the Self-Assessment Corner (SAC) for self-assessing shoulder isometric rotational strength and examining whether performance on 2 physical performance tests was correlated with isometric shoulder rotational strength using the SAC in handball players. Cross-sectional study. Sport setting. A first sample of 42 participants (18 men, 24 women) was recruited to determine the reliability and validity of the SAC. In a second sample of 34 handball players (18 men, 16 women), we examined correlations between physical performance tests and the SAC. The SAC was used to measure isometric rotational strength with the upper extremity at 90° of abduction in the frontal plane and 90° of external rotation and the elbow flexed to 90° with neutral rotation of the forearm. The SAC findings were compared with those from manual testing. Results from the seated medicine ball throw (SMBT) and closed kinetic chain upper extremity stability test (CKCUEST) were used to establish relationships with the SAC. We calculated intraclass correlation coefficients to determine relative reliability and used standard error of measurement and minimal detectable change to quantify absolute reliability. Relationships among the different strength-testing procedures and with the physical performance tests were determined using the Pearson product moment correlation coefficient (r) or Spearman rank correlation coefficient (rs). We observed good to excellent reliability (intraclass correlation coefficient [2,k] range = 0.89 to 0.92). The standard error of measurement varied from 3.45 to 3.48 N. The minimal detectable change with 95% confidence intervals ranged from 8.06 to 8.13 N. Strong correlations were present among strength procedures (r = 0.824, rs range = 0.754-0.816). We observed moderate to strong correlations between the CKCUEST findings and rotational strength (r range = 0.570-0.767). Moderate correlations were found between rotational strength and SMBT (r range = 0.573-0.626). The SAC is a clinically applicable and standardized protocol for self-assessing rotational strength in young healthy adults without pathologic conditions. Performance on the SMBT and CKCUEST may be valuable as a screening tool to further assess shoulder strength.

A randomised observational study of individualised variations in the start position of the closed-kinetic chain upper extremity stability test

ObjectivesTo assess the reliability, precision and differences between scores produced using the standard 36″ start position and 3 modified start positions of the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), towards normalisation to the individual. DesignRCT of 4 conditions. SettingClinical. ParticipantsThirty-four asymptomatic individuals. Main outcome measuresUsing an RCT method, variations in CKCUEST starting hand position were tested using hand spacing at standard 36″, 50% height, bi-acromial distance, and bi-acromial distance with reach to 36″. The average number of touches over 3 × 15 s maximal efforts were used to assess the intra-variation reliability, minimum detectable change (MDC) and differences to the standard 36″ start position. ResultsThe most reliable variation was the 50% height (ICC: 0.93) and with the smallest MDC (14%). 36″ results were second-most reliable (ICC: 0.90), with a low MDC (19%). Significant differences were found between bi-acromial and 50% height to the 36″ standard setup. ConclusionsA setup position where the hand separation is 50% of the individual’s height offers excellent repeated measures reliability and the smallest MDC, suggesting it is the most sensitive to change and is a recommendation to clinicians. Conversion calculations between start variations are presented.

Intrarater reliability and agreement of a modified Closed Kinetic Chain Upper Extremity Stability Test

ObjectivesTo assess the reliability of a modified procedure for Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). DesignIntra- and intersession reliability and agreement; SettingClinical. ParticipantsTwenty-seven asymptomatic athletes. Main outcome measuresThe modifications (m-CKCUEST) in CKCUEST procedure consisted in hand spacing at one half arm-span, and to complete the three regular-series of 15 s exertion by performing a fourth 1-min series during which the number of touches was counted every 15 s. The intra- and intersession reliability and agreement were assessed for the numbers of touches in order to produce two outcome measures: m-CKCUEST score and muscular endurance index. ResultsThe most reliable m-CKCUEST score was obtained when averaging the numbers of touches of the second and third sets (Intraclass Coefficient of Correlation(3,k); ICC = 0.92). Good reliability was found for muscular endurance index computed when dividing the one-half number of touches counted during the last 30 s of 1-min set, by the m-CKCUEST score calculated above (ICC = 0.86). ConclusionsThe m-CKCUEST allowed the production of two reliable outcome measures, which assessed the upper limb stability and the muscular endurance. Such outcomes may be used in a follow-up to assess performance or rehabilitation level.

Inactive individuals with chronic neck pain have changes in range of motion and functional performance of the shoulder

To correlate the range of movement and functional performance of the shoulder with pain measures in inactive individuals with and without neck pain. In addition, comparisons were made between the groups. The sample comprised two groups of inactive adults, aged 18-45years: chronic neck pain (n=30) and healthy subjects (n=30). All participants had no clinical dysfunction in the shoulder joint. Aspects related to neck pain were evaluated with the Numerical Rating Scale, Neck Disability Index, and the Catastrophic Thoughts about Pain Scale. Range of motion and shoulder functionality was evaluated by means of goniometry and the Closed Kinetic Chain Upper Extremity Stability (CKCUES) test, respectively. Individuals with neck pain presented reduction in CKCUES test (absolute score, mean difference [MD]=-1.50, 95% confidence interval [CI] [-2.87, -0.12]) and in abduction (MD=-7.36°, 95% CI [-13.84, -0.89]) and lateral rotation (MD=-8.61°, CI [-15.94, -1.28]) range of motion. Moreover, weak, significant, and negative association (p<0.05, r=-0.262 to -0.384) was observed between the CKCUES test and pain intensity at rest and during active cervical movements, as well as catastrophizing. A weak, significant, and negative association (p<0.05, r=-0.256 to -0.389) was also observed between the lateral rotation range of motion and catastrophizing, as well as pain intensity both at rest and during active movements. The greater the neck pain intensity and catastrophizing, the lower the functional performance and lateral rotation range of motion of the shoulder.

THE MUSCULOSKELETAL READINESS SCREENING TOOL- ATHLETE CONCERN FOR INJURY &amp; PRIOR INJURY ASSOCIATED WITH FUTURE INJURY

The Musculoskeletal Readiness Screening Tool (MRST) was developed in an effort to consistently predict injury among military personnel. Current injury prediction tools have not consistently predicted injury in this population. The MRST is comprised of the weight bearing forward lunge, modified deep squat, closed kinetic chain upper extremity stability test (CKCUEST), forward step down with eyes closed, stationary tuck jump, unilateral wall sit hold, and subjective, individual perceived level of risk for injury. The Feagin hop and self-reported history of injury were also included in this study protocol. The Feagin hop was a functional test used consistently by the orthopedic department located at the testing site as well as used in a recent study aimed at defining a return to duty screen; self-reported history of injury has been identified as a potential predictor of injury. To examine whether MRST scores, as a composite as individual components, were predictive of a United States Military Academy Preparatory School (USMAPS) student athlete sustaining a future musculoskeletal injury. Prospective Cohort Study. MRST scores were collected for 141 student athletes (mean age 18.63 ± 1.31) at USMAPS. The injury surveillance period was nine months. Students participated in regularly occurring military specific training and various sports. Mean scores were compared between injured and uninjured groups; binary logistic regression model was also completed. Seventy students sustained an injury. The top activities resulting in injury included football (36%) and basketball (11%) with injuries predominantly located in the lower extremity including the knee (24%), hip (15%), and ankle (14%). Composite MRST scores were not statistically different between injured (12.58 ± 2.16) and uninjured (13 ± 2.27) groups. There was an association between those with a personal concern for future injury and actual injury (p = .04). There was an association between those reporting a prior injury in the preceding 12 months and those incurring an injury at USMAPS (p = .04). The MRST composite scores were not predictive of injury in this population. Previous injury and personal concern for injury were significant injury predictors. 2a.

Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) in DIII Collegiate Baseball and Softball Players

PURPOSE: The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) has been used as an alternative to the push up test to examine upper extremity stability and function. However, no studies have investigated its use in division III collegiate baseball (BB) and softball (SB) players. The purpose of this study was to describe the normative values, power and normalized scores for the CKCUEST for this population. METHODS: Seventy four division III collegiate athletes (SB n=24; BB n=50) between 18-21 years old signed an approved informed consent. Participants assumed a push-up (male) or a modified push-up (female) position and were instructed to alternately touch two pieces of tape placed on the ground 36 inches apart as many times as possible for 15 seconds. After one submaximal warm-up, the average number of lines touched (CKCUEST value) from three trials was calculated. Power and a normalized score were calculated based on the CKCUEST value and the participant’s weight or height, respectively. Additionally, shoulder strength was measured bilaterally for internal and external rotation using a handheld dynamometer in the standard testing position. RESULTS: There was a significant difference (p<.001) between the power of BB (71.35±14.4) and SB (55.37±11.6) players. However, there was no significant difference between the two groups in in the CKCUEST value or the normalized score. There were small and nonsignificant correlations between the CKCUEST and shoulder internal (IR) or external rotation (ER) strength. CONCLUSIONS: This study reported the normative values for the CKCUEST for division III SB and BB players with representation from all positions. The significant differences in power between BB and SB players may be linked to sex, training regimens and/or the physical requirements of each sport. The small correlation of shoulder IR and ER strength and the CKCUEST value may be related to the rotator cuffs primary stabilization function; which may not influence the CKCUEST value as much as the strength of the prime movers of the shoulder during the motion prescribed by the test. Strength of the pectoralis major and deltoid may better correlate with the values of the CKCUEST for this population and should be considered in future research.

Upper-Extremity Functional Performance Tests: Reference Values for Overhead Athletes.

This study aimed to provide an age, gender and sport-based normative database for three functional shoulder tests: Y Balance Test - Upper Quarter (YBT-UQ), Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), and Seated Medicine Ball Throw (SMBT). A second aim was to discuss gender, age and sports differences. Finally, correlation between tests was evaluated. Overhead athletes (106 male, 100 female) between 18 and 50 years old and from three different sports (volleyball, tennis, handball) performed all functional tests. A linear mixed or regression model was applied to determine significant differences in test scores between gender, age and sports. Pearson correlation coefficients were analyzed to determine the relationship between tests. Normative values were established and divided by gender, sports and age. Results showed significant gender and age differences for all tests. For YBT-UQ, also significant side and sports differences were recorded. CKCUEST is moderately correlated with SMBT and YBT-UQ. Weak correlation was found between SMBT and YBT-UQ. In conclusion, this study provides normative data for YBT-UQ, CKCUEST and SMBT, which is clinically relevant for functionally screening overhead athletes and benchmark their performance to others from the same gender, age and sports. A combination of included tests is recommended.

Investigation of the Effectiveness of a Preseason Strength and Conditioning “Prehab” Program for Collegiate Athletes: A Pilot Study

Objective: To investigate the effectiveness of a preseason strength and conditioning “Prehab” program on decreasing non-contact injuries and improving outcome measures of strength, agility, and balance in collegiate men’s and women’s basketball players, men’s and women’s soccer players, and women’s volleyball players. Methods: Forty-five National Collegiate Athletic Association Division I athletes participated. Participants performed a 10- week Prehab program consisting of five progressive levels advancing every two weeks. Exercises included lumbopelvic stabilization, scapular stabilization, plyometric training, and sport specific exercises. Test measures were taken before and after the Prehab intervention. Outcome measures included vertical jump height, number of push-ups, front/lateral plank time, single limb stance time, back extensor endurance time, thoracic spine rotation range of motion, number of single leg squats, Cross Hop test, Single Leg Crossover test, and closed kinetic chain upper extremity stability test (CKCUEST), as well as the number of non-contact injuries.Results: After completion of the Prehab program, participants showed significant improvement in vertical jump height, number of push-ups, front/lateral plank time, single limb stance time on the right, back extensor endurance time, thoracic spine rotation to the left, Single Leg Crossover test, and CKCUEST. Additionally, all other outcome measures showed a trend toward improvement. Participants experienced a total of 42 inseason repetitive stress injuries in the intervention year and 38 in the year after the intervention. Conclusion: Participation in the “Prehab” program led to a reduced number of in-season non-contact injuries and significant improvements in 9 of the 11 outcomes measures of strength, agility, and balance in collegiate athletes. The lack of significance in some of the outcome measures may be due to the small sample size. A repeat of this study using a randomized-control design with a larger sample size may yield more significant results.

Range of Motion Changes in Female Elite Swimmers Throughout a Competitive Season

Upper extremity injuries are the most common injury in swimming athletes specifically in the collegiate setting. Females in particular, are more likely to suffer these injuries when comparing to male collegiate swimmers. “Swimmer Shoulder”, a generic term for overuse shoulder injuries in the swimming population occurs with high rate and intensity of training. Significant factors that have been found to contribute to this pathology are deficits in internal rotation, lack of stability, and increased demands on the shoulder. The aim for this clinical outcomes project was to evaluate changes in range of motion (ROM) total arc of the shoulder, and patient-perceived function in female elite swimmers throughout a competitive season. Shoulder total arc ROM was measured passively with the student-athlete supine. A digital inclinometer was used to make it simpler for the clinician to assess ROM on their own. The Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score (KJOC) was used to measure self-perceived upper extremity function in sport. It consisted of a set of demographic and participation questions followed by 10 visual analogue scale questions about upper extremity function during sport. Upper extremity stability was also measured using the closed-kinetic chain upper extremity stability test (CKCUE). Results showed shoulder ROM (total arc) restrictions occurred during times of increased training intensity and volume. When patients had smaller total arc measurements, the student-athletes reported lower KJOC scores for sport related function. There was an increase in ROM at a time where intensity, and distance of training were decreased. Overall upper extremity stability gradually improved over the course of a competitive season.

A Four-Week Upper-Extremity Exercise Program on a Balance Device Improves Power and Stability in Collegiate Golfers

Relatively little research has been conducted examining the physical characteristics that are important to a golfer’s performance. The investigators studied whether a series of upper-extremity exercises on a balance device would significantly improve upper- extremity stability and power in collegiate golfers. A total of 23 collegiate golfers (ages: 20.4 ± 1.4 years, height: 67.7 in ± 6.6 in, weight: 171.8 lb. ± 87.6 lb.) participated in the study. A two group non-equivalent pre-test/post-test design was selected for this study. Testing included shoulder flexion, hyper-extension (shoulder flexibility), and a Closed-Kinetic Chain Upper-Extremity Stability test (Upper-Extremity stability and power). Testing was conducted before and after a 4-week upper-extremity exercise conducted on a balance device. An independent t-test was selected to analyze differences if any between the experimental and control group. The experimental group revealed a significant improvement in upper-extremity power (p=0.01) and stability (p=0.01). The shoulder flexibility for the experimental group demonstrated no significance (p=0.058) in the left shoulder hyperextension but showed significant value (p=0.033) in the right shoulder hyperextension. The control group demonstrated a significant (p=0.044) decrease in shoulder flexion in the right shoulder. The results demonstrate that specific upper-extremity exercises on a balance device do improve upper-extremity power, upper-extremity stability, and over-head shoulder flexibility within 4 weeks.