Shoulder Flexibility Research Articles

THE INCIDENCE AND RISK FACTORS OF SHOULDER PAIN IN JUNIOR COMPETITIVE SWIMMERS

BackgroundThe relationship between shoulder pain and shoulder flexibility has not been clarified because of different views regarding differences in age or competition level among research-targeted swimmers. Studies to date have...

国内一流水球選手における肩関節の柔軟性および身体特性とスポーツ障害の関連性

The purpose of this study was to investigate relationship between the shoulder pain and the flexibility of the shoulder in Japanese elite male water polo players. We also conducted to find the physical characteristics of the range of shoulder rotation. Subjects were Japanese elite male water polo players that was 30 (study 1) and 40 (study 2). We measured and compared shoulder flexibility by finger vertebral distance (FVD). In study 2, a standard universal goniometer was utilized to measure range of shoulder rotation with the arm in 90 degrees of abduction. There is significant correlation range of motion on the dominant shoulder showed significant decrease in internal rotation and increase external rotation. The results indicate that decrease exists in the shoulder flexibility of elite water polo players with pain. Furthermore, our findings suggest that prevention or rehabilitation of painful water polo player’s dominant shoulder is considered to be existing two reasons that are at risk of developing shoulder pain because of the repetitive nature of swimming combined with throwing.

The architectural and functional specifications of intrinsic muscles of the fore limb of the Egyptian Baladi goats (Capra hircus)

This study provides quantitative anatomical data on the muscle–tendon units of intrinsic muscles of the fore limb of the domesticated goat specifically; muscle mass, volume, fascicle length, tendon mass, tendon volume, and tendon rest length. From these measurements, the physiological cross sectional area (PCSA) and maximum isometric force (Fmax), in addition to tendon stress and tendon strain were calculated for each muscle. A total of 180 muscles (60 from each cadaver; 30 in each limb) were dissected to examine each muscle functional specifications and their role in limb function. The largest muscle mass was revealed to have the largest volume, long fascicle length and the highest capacity for force production. Within the functional groups of muscles, the proportion of muscle mass, muscle volume, PCSA as well as force generation was the greatest for the shoulder flexors followed by shoulder extensors. This is suitable for their role in weight bearing. The muscles working on joints of digits were having long tendons with high cross section area (CSA) and architecture index (AI) and thus were functionally suited to elastic energy storage needed for digital movement. In conclusion, architecture properties are crucial factors for determination of muscle function.

Muscle strength in breast cancer patients receiving different treatment regimes.

BackgroundMuscle dysfunction and sarcopenia have been associated with poor performance status, an increased mortality risk, and greater side effects in oncologic patients. However, little is known about how performance is affected by cancer therapy. We investigated muscle strength in breast cancer patients in different adjuvant treatment settings and also compared it with data from healthy individuals.MethodsBreast cancer patients (N = 255) from two randomized controlled exercise trials, staged 0–III and aged 54.4 ± 9.4 years, were categorized into four groups according to their treatment status. In a cross‐sectional design, muscle function was assessed bilaterally by isokinetic dynamometry (0°, 60°, 180°/s) as maximal voluntary isometric contraction (MVIC) and maximal isokinetic peak torque (MIPT) in shoulder rotators and knee flexors and extensors. Additionally, muscular fatigue index (FI%) and shoulder flexibility were evaluated. Healthy women (N = 26), aged 53.3 ± 9.8 years, were tested using the same method. Analysis of covariance was used to estimate the impact of different cancer treatments on skeletal muscle function with adjustment for various clinical and socio‐demographic factors.ResultsConsistently, lower muscle strength was measured in shoulder and knee strength in patients after chemotherapy. On average, patients had up to 25% lower strength in lower extremities and 12–16% in upper extremities in MVIC and MIPT during cancer treatment compared with healthy women. No substantial difference between patient groups in shoulder strength, but significantly lower shoulder flexibility in patients with radical mastectomy was measured. Chemotherapy‐treated patients had consistently higher FI%. No serious adverse events were reported.ConclusionsBreast cancer patients showed markedly impaired muscle strength and joint dysfunctions before and after anticancer treatment. The significant differences between patients and healthy individuals underline the need of exercise therapy as early as possible in order to prevent or counteract the loss of muscle function after curative surgery as well as the consequences of neo‐/adjuvant chemotherapy.

Characteristic of shoulder and hip rotation range of motion in adolescent tennis players.

Adolescent tennis players require sufficient hip and shoulder flexibility to achieve the kinetic chain of a tennis stroke or serve. Hence, the objective of this study is to measure the glenohumeral joint internal and external rotation (IR and ER, respectively) and hip ER range of motion (ROM) and to compare these parameters between experienced and beginner-level adolescent tennis players. Twenty-three adolescent tennis players were divided into experienced (N.=12) and beginner groups (N.=11) on the basis of the adolescent national ranking of the Taiwan Tennis Association. For all participants, the shoulder IR and ER at 90° of abduction were measured, and hip ER which used Partick's Test was also evaluated on the dominant and nondominant sides. The total rotation ROM of the shoulder and the difference in shoulder ER, IR, and total rotation and hip ER between the dominant and nondominant sides were also calculated after measurements. An independent-samples t-test was applied to test the homogeneity of the participants' demographic data and the difference in shoulder IR, ER, and total rotation and hip ER values between the dominant and nondominant sides. Subsequently, a repeated-measured two-way analysis of variance (2 × 2) was used to compare the dominant and nondominant shoulder and hip ROM of the participants between the experienced and beginner groups. The experienced group exhibited a significantly less total rotation ROM than the beginner group. In addition, both groups showed less dominant shoulder IR ROM and more dominant shoulder ER ROM compared with the nondominant side. Compared with the experienced group, the beginner group showed an obvious difference in total shoulder rotation between dominant and nondominant sides. More tightness for the hip ER was observed in the experienced group than in the beginner group, but no difference was observed between the dominant and nondominant sides in both groups. Beginner adolescent tennis players differ more in the degree of total shoulder ROM between the dominant and nondominant sides than experienced players. Beginner and experienced adolescent tennis players also have more shoulder ER and less IR on the dominant side. The results suggest that beginner-level adolescent tennis players should undergo a stretching and strengthening program to reduce the potential risk of injury and possibly enhance performance.

Asociación entre el porcentaje graso y las capacidades físicas básicas de niños de 7 a 11 años en etapa escolar de una institución educativa de Bogotá, D.C.

Introducción. La obesidad es una enfermedad de evolución rápida y constante que genera costos en salud por enfermedades consecuentes, las cuales aparecen en edades cada vez más tempranas. La disminución del rendimiento físico ocasionado por la obesidad se ha descrito en varios estudios, principalmente, asociado a la alteración de capacidad aeróbica como agente causal, pero también a la disminución de la afectación de otras capacidades físicas. Objetivo. Determinar el grado de asociación entre porcentaje graso y capacidades físicas (fuerza, flexibilidad y resistencia) en escolares. Materiales y métodos. Se evaluaron las capacidades físicas de escolares de segundo a quinto grado, entre 7 a 11 años, utilizando FITNESSGRAM®. También se correlacionaron las variables de porcentaje graso y capacidades físicas básicas para determinar la fuerza de asociación entre estas. Resultados. Existe asociación significativa entre porcentaje graso y nivel PACER (p=0.0001), push up (p<0.0001), resistencia abdominal (p=0.0148) y flexibilidad de hombro izquierdo (p=0.03186). Sin embargo, no hubo asociación con la fuerza potencia. Conclusión. El porcentaje graso tiene alta influencia sobre las capacidades físicas en general. Se necesita desarrollar estrategias desde temprana edad para contrarrestar el sobrepeso y la obesidad, así como fomentar la actividad física para minimizar los efectos deletéreos sobre la salud.

Task-based mirror therapy enhances ipsilesional motor functions in stroke: A pilot study

To examine the effect of Mirror therapy (MT) on dexterity, coordination, and muscle strength of the less-affected upper limb in stroke. Pre-test post-test, single group, experimental design. Rehabilitation institute. Post-stroke hemiparetic chronic subjects (N=21). Forty sessions of MT using various tasks in addition to the conventional rehabilitation. Tasks such as lifting a glass, ball-squeezing, and picking-up objects were performed by the less-affected side in front of the mirror-box creating an illusion for the affected side. Minnesota Manual Dexterity Test (MMDT), Purdue Peg Board Test (PPBT), and Manual Muscle Testing (MMT) were used to measure the deficits of the less-affected side. Post-intervention, the less-affected side of the participants exhibited significant improvement on MMDT (p<0.001), PPBT (p<0.001), and MMT (shoulder flexors, wrist extensors and deviators, and finger flexors-extensors; p=0.005-0.046). In post-stroke hemiparesis, MT also led to the improvement in dexterity, coordination, and strength of the less-affected side. In addition to the affected side, the technique may augment the subtle motor deficits of the less-affected side.

The Effect of a High Pitch Volume on Musculoskeletal Adaptations in High School Baseball Pitchers

Background: Shoulder range of motion and strength adaptations occur at an early age in baseball pitchers. Purpose/Hypothesis: The purpose of this study was to examine the effect of pitch volume on in-season and year-to-year range of motion (ROM) and strength adaptations in high school baseball pitchers. The hypothesis was that a high pitch volume will not affect range of motion asymmetries but will impair supraspinatus strength. Study Design: Cohort study; Level of evidence, 2. Methods: Pre- and postseason ROM and strength measures were performed on pitchers from 3 high schools for 4 consecutive seasons, for a total of 95 player-seasons (mean ± SD participant age, 16 ± 1 years). Preseason measures were repeated the next year on players returning to the teams, for a total of 71 consecutive player-seasons. ROM tests included internal-external rotation and posterior shoulder flexibility. Strength tests (hand-held dynamometer) included internal-external rotation, supraspinatus, and scapular retraction. Pitchers were categorized by pitch count for the season (high, >400; moderate, 180-400; low, <180). ROM and strength changes in the dominant versus nondominant arm were assessed by analysis of variance. Results: Dominant versus nondominant ROM differences did not change from pre- to postseason (P = .36-.99) or from one year to the next (P = .46-.86), with no effect of pitch volume (P = .23-.87). Supraspinatus strength decreased in the dominant arm during the season, with 13% loss in high-volume pitchers (P < .001) and insignificant losses in moderate- (6%) and low-volume pitchers (2%). Strength in other tests was unaffected by pitch volume. Consistent with physical development, strength increased bilaterally from one year to the next (supraspinatus, 12%; external rotation, 15%; internal rotation, 14%; scapular retraction, 23%; P < .001). Supraspinatus strength gain in the dominant arm was affected by prior pitch volume (P = .02): 24% in low-volume pitchers (P < .01), with no significant change in moderate-volume (0%; P = .99) or high-volume (5%; P = .99) pitchers. Conclusion: Dominant versus nondominant ROM differences did not progress during the season, or from one year to the next, and were unaffected by pitch volume. A high pitch volume was associated with in-season supraspinatus weakness and diminished strength gains from one year to the next. In conclusion, a high pitch volume appeared to have a catabolic effect on supraspinatus strength.

Effectiveness of a Preseason Prevention Program on Arm Injury Risk Factors: An Randomized Control Trial in Adolescent Pitchers

Deficits in posterior shoulder flexibility and strength have been identified as risk factors for pitching injuries. This study assessed the effectiveness of a preseason prevention program to resolve these deficits in adolescent pitchers. Pitchers(n=143 age=15.7±1.2;height=165.0±43.8cm; weight=72.2±12.6kg) participating in team activities were block randomized by school to intervention(INV n=88) or control(CON n=76). INV received an ATC supervised program(3x/week for 8-weeks). The CON had their usual training. All pitchers participated in a 4-week interval-throwing program immediate to the start of practice. Pre-post supine bilateral ER, IR, and HA ROM and strength were assessed using a digital inclinometer with the scapula stabilized at 90° of abduction. Muscle testing was used for strength assessments via held dynamometer with arm at the side and in supine 90°/90° then normalized to body weight(BW). Injuries were recorded over the subsequent baseball season. Two trials were averaged to calculate deficits(non-dominant–dominant) and pre-post change to determine if the program to ameliorate baseline deficits. A one-way ANOVA compared change scores between groups and a 2-way ANOVA(group by injury) compared change scores influence on injury(α=0.05). The INV group displayed a greater reduction in IR deficit(INV=7.3°±11;CON=1.8°±9;F(1,106)=5.1,P=0.01) P=0.05) and HA deficit(INV=3.3°±13; CON= -2.4°±11;F(1,106)=6.7,P=0.01) compared to the CON group. The INV group also maintained their dominant ER-0:IR-90 ratio(INT=-1.6 ±5%BW;CON= -3.5 ±5%BW; F(1,106)=2.1,P=0.09) compared to the CON group. There were 19 arm injuries over the subsequent season(INV=11 ;CON=8 arm injuries). Control group pitchers with an injury did not decrease their HA deficit (Uninjured=3.0°±10;Injured=-9.5°±14;F(1,106)=3.3,P=0.03) or their IR deficit went on to suffer an injury(Uninjured=-1.7°±8;Injured 8.5°±13;F(1,106)=3.8,P=0.02). There were no other differences between or among groups(P>0.05). Adolescent pitchers displayed clinically meaningful improvements in posterior shoulder flexibility (HA and IR) and maintenance of their ER:IR ratio during an Athletic Trainer supervised preseason program. The improvements were associated with decreased injury risk over the course of the subsequent season.

Yoga reduces perceived stress and exhaustion levels in healthy elderly individuals

This study investigated whether a 7-week yoga intervention could improve physical function, perceived stress, and mental/emotional wellness in elderly participants. Methods8 participants (66.5 ± 0.3 years) attended 2 60-min Hatha yoga sessions/week for 7 weeks, and performed pre- and post-intervention assessments. Balance was assessed using a 5-test battery. Flexibility was measured by sit-and-reach and shoulder flexibility tests. Functional mobility tests included 8-ft up-and-go, 5 chair stands, and 4-m walk. Participants completed SF-12, exhaustion level, and Perceived Stress Scale (PSS) questionnaires. ResultsSF-12 Mental Component Summary scores, exhaustion levels, and PSS scores improved post-intervention. No differences were found for physical function measures. ConclusionsYoga participation can improve mental/emotional wellness, exhaustion levels, and stress levels in elderly individuals, even without measurable improvements in physical function. Clinicians and health practitioners who work with the elderly should consider yoga as a potential therapeutic modality for improving important aspects of quality of life in this population.

Effects of Long Term Periodization Training in Korean Male Elite Golfers

[Purpose] The purpose of this study was to develop the periodization training for elite golfers and investigate the effect of the program for elite golfers. [Methods] Eighteen male participants were divided into training group (TG: n=8) and control group (CG: N=10). The periodization consists of flexibility and strength training and conducted for 20weeks. To examine the effects of training program, physical fitness (isometric muscle strength, flexibility, isotonic maximum strength, muscle power, muscle endurance, isokinetic trunk muscle strength) and driver performance (launch angle, club head speed, ball speed, and carry distance of the driver shot) were measured after 20 weeks of training. [Results] Back muscle strength, shoulder flexibility, isotonic maximum strength, muscle power, club-head speed, ball speed, carry distance showed significant interaction. [Conclusion] These results suggest that periodization training for 20-weeks turned out to be an effective in improving physical fitness and driver performance in Korean elite golfers. Therefore, not only during the preparation period but also the competition period, scientific physical training should be maintained in order to improve the physical function and driver performance.

Impact of a workplace exercise program on neck and shoulder segments in office workers

Work-related musculoskeletal disorders are a common problem among office workers. The purpose of this study is to evaluate the impact of a workplace exercise program on neck and shoulder pain and flexibility in office workers. The workstation assessment was performed using Rapid Office Strain Assessment. Workers were assessed for pain pre- and post-implementation of the workplace exercise program using the Nordic Questionnaire for Musculoskeletal Symptoms, and for flexibility. The program lasted 3 months and entailed twice weekly sessions. The sample consisted of an intervention group (n = 30) and a control group (n = 8). The results suggest improvements in pain reduction and increased flexibility. The workers had less musculoskeletal pain at the end of the evaluation. The increase in flexibility between the evaluations was significant in the intervention group, though there were slight improvements there too.

A common neural element receiving rhythmic arm and leg activity as assessed by reflex modulation in arm muscles.

Neural interactions between regulatory systems for rhythmic arm and leg movements are an intriguing issue in locomotor neuroscience. Amplitudes of early latency cutaneous reflexes (ELCRs) in stationary arm muscles are modulated during rhythmic leg or arm cycling but not during limb positioning or voluntary contraction. This suggests that interneurons mediating ELCRs to arm muscles integrate outputs from neural systems controlling rhythmic limb movements. Alternatively, outputs could be integrated at the motoneuron and/or supraspinal levels. We examined whether a separate effect on the ELCR pathways and cortico-motoneuronal excitability during arm and leg cycling is integrated by neural elements common to the lumbo-sacral and cervical spinal cord. The subjects performed bilateral leg cycling (LEG), contralateral arm cycling (ARM), and simultaneous contralateral arm and bilateral leg cycling (A&L), while ELCRs in the wrist flexor and shoulder flexor muscles were evoked by superficial radial (SR) nerve stimulation. ELCR amplitudes were facilitated by cycling tasks and were larger during A&L than during ARM and LEG. A low stimulus intensity during ARM or LEG generated a larger ELCR during A&L than the sum of ELCRs during ARM and LEG. We confirmed this nonlinear increase in single motor unit firing probability following SR nerve stimulation during A&L. Furthermore, motor-evoked potentials following transcranial magnetic and electrical stimulation did not show nonlinear potentiation during A&L. These findings suggest the existence of a common neural element of the ELCR reflex pathway that is active only during rhythmic arm and leg movement and receives convergent input from contralateral arms and legs.

Effectiveness of a Preseason Prevention Program on Arm Injury Risk Factors

Objectives:Deficits in posterior shoulder flexibility and strength have been identified as modifiable risk factors for pitching injuries. There are no studies showing the effect of a prevention program on arm injuries and associated risk factors such as strength and ROM. The purpose of this study was to assess the effectiveness of a preseason prevention program to resolve these deficits in adolescent pitchers.Methods:Baseball pitchers (n=143 age=15.7±1.2; height=165.0±43.8cm; weight=72.2±12.6kg) participating in all team activities were block randomized by school to intervention (INV n=88) or control (CON n=76) groups. The INV group received an Athletic Trainer supervised posterior shoulder flexibility and strengthening program (3x/week for 8-weeks). The CON group participated in their usual training. All pitchers participated in a 4-week interval-throwing program immediate to the start of practice. Bilateral shoulder ROM and strength were assessed pre-post program using a digital inclinometer (DI) to measure supine external rotation(ER), internal rotation (IR), and horizontal adduction (HA) ROM with the scapula stabilized at 90 degrees of abduction. Standard manual muscle testing was used for strength assessments using a hand held dynamometer with arm at the side(ER-0) and in supine 90 degrees/90 degrees (ER-90, IR-90) then normalized to body weight (BW). Injuries were recorded over the subsequent baseball season. Two trials were averaged and used to calculate deficits (non-dominant-dominant) and pre-post change scores to examine the ability of the program to ameliorate baseline deficits associated with injury risk. A one-way ANOVA was used to compare change scores between groups and a 2-way ANOVA (group by injury) to examine the change scores influence on injury (α=0.05).Results:The INV group displayed a greater reduction in IR deficit(INV=7.3 degrees ±11;CON=1.8 degrees ±9;F(1,106)=5.1,P=0.01) P=0.05) and HA deficit(INV=3.3 degrees ±13; CON= -2.4 degrees ±11;F(1,106)=6.7,P=0.01) compared to the CON group. The INV group also maintained their dominant ER-0: IR-90 ratio (INT=-1.6 ±5%BW; CON= -3.5 ±5%BW; F (1,106) =2.1, P=0.09) compared to the CON group. There were 19 arm injuries over the subsequent season (INV=11; CON=8 arm injuries). Control group pitchers who went on to suffer an injury did not decrease their HA deficit (Uninjured=3.0 degrees ±10;Injured=-9.5 degrees ±14;F(1,106)=3.3,P=0.03) or their IR deficit went on to suffer an injury(Uninjured=-1.7 degrees ±8;Injured 8.5 degrees ±13;F(1,106)=3.8,P=0.02). There were no other differences between or among groups (P>0.05).Conclusion:Adolescent pitchers displayed clinically meaningful improvements in posterior shoulder flexibility (HA and IR) and maintenance of their ER: IR ratio during an Athletic Trainer supervised preseason program. The improvements in HA and IR deficits were associated with decreased injury risk over the course of the subsequent high school season. Thus, a targeted pre-season program appears to be effective in improving HA deficit and impacting injury risk. Further studies are warranted to confirm our results.

Impact of 10-weeks of yoga practice on flexibility and balance of college athletes.

Background:With clearer evidence of its benefits, coaches, and athletes may better see that yoga has a role in optimizing performance.Aims:To determine the impact of yoga on male college athletes (N = 26).Methods:Over a 10-week period, a yoga group (YG) of athletes (n = 14) took part in biweekly yoga sessions; while a nonyoga group (NYG) of athletes (n = 12) took part in no additional yoga activity. Performance measures were obtained immediately before and after this period. Measurements of flexibility and balance, included: Sit-reach (SR), shoulder flexibility (SF), and stork stand (SS); dynamic measurements consisted of joint angles (JA) measured during the performance of three distinct yoga positions (downward dog [DD]; right foot lunge [RFL]; chair [C]).Results:Significant gains were observed in the YG for flexibility (SR, P = 0.01; SF, P = 0.03), and balance (SS, P = 0.05). No significant differences were observed in the NYG for flexibility and balance. Significantly, greater JA were observed in the YG for: RFL (dorsiflexion, l-ankle; P = 0.04), DD (extension, r-knee, P = 0.04; r-hip; P = 0.01; flexion, r-shoulder; P = 0.01) and C (flexion, r-knee; P = 0.01). Significant JA differences were observed in the NYG for: DD (flexion, r-knee, P = 0.01: r-hip, P = 0.05; r-shoulder, P = 0.03) and C (flexion r-knee, P = 0.01; extension, r-shoulder; P = 0.05). A between group comparison revealed the significant differences for: RFL (l-ankle; P = 0.01), DD (r-knee, P = 0.01; r-hip; P = 0.01), and C (r-shoulder, P = 0.02).Conclusions:Results suggest that a regular yoga practice may increase the flexibility and balance as well as whole body measures of male college athletes and therefore, may enhance athletic performances that require these characteristics.

Handgrip strength deficits best explain limitations in performing bimanual activities after stroke.

[Purpose] To evaluate the relationships between residual strength deficits (RSD) of the upper limb muscles and the performance in bimanual activities and to determine which muscular group would best explain the performance in bimanual activities of chronic stroke individuals. [Subjects and Methods] Strength measures of handgrip, wrist extensor, elbow flexor/extensor, and shoulder flexor muscles of 107 subjects were obtained and expressed as RSD. The performance in bimanual activities was assessed by the ABILHAND questionnaire. [Results] The correlations between the RSD of handgrip and wrist extensor muscles with the ABILHAND scores were negative and moderate, whereas those with the elbow flexor/extensor and shoulder flexor muscles were negative and low. Regression analysis showed that the RSD of handgrip and wrist extensor muscles explained 38% of the variance in the ABILHAND scores. Handgrip RSD alone explained 33% of the variance. [Conclusion] The RSD of the upper limb muscles were negatively associated with the performance in bimanual activities and the RSD of handgrip muscles were the most relevant variable. It is possible that stroke subjects would benefit from interventions aiming at improving handgrip strength, when the goal is to increase the performance in bimanual activities.

Block-Periodized Training Improves Physiological and Tactically Relevant Performance in Naval Special Warfare Operators.

Human performance training and prevention strategies are necessary to promote physical readiness and mitigate musculoskeletal injuries of the Naval Special Warfare (NSW) Operator. The purpose of this study was to measure the effectiveness of 2 training programs when performed during a training evolution of Operators. A total of 85 Operators (experimental: n = 46, age: 29.4 ± 5.5 years, height: 176.7 ± 6.4 cm, mass: 86.7 ± 11.6 kg; control: n = 39, age: 29.0 ± 6.0 years, height: 177.1 ± 6.3 cm, mass: 85.7 ± 12.5 kg) participated in a trial to measure the effectiveness of these programs to improve physical, physiological, and performance characteristics. Operators in the experimental group performed a 12-week block-periodized program, whereas those in the control group performed a nonlinear periodized program. Pretesting/posttesting was performed to assess body composition, aerobic capacity/lactate threshold, muscular strength, flexibility, landing biomechanics, postural stability, and tactically relevant performance. The experimental group demonstrated a significant loss in body fat, fat mass, and body mass compared with the control group, whereas aerobic capacity increased for the both groups. The experimental group demonstrated a significant increase in posterior shoulder flexibility and ankle dorsiflexion, whereas the control group had a significant reduction in shoulder, knee, and ankle flexibility. The experimental group also improved landing strategies and balance. Both groups improved upper and lower muscular power and upper-body muscular endurance, whereas only the experimental group demonstrated significant improvements in agility and total body muscular strength. Implementation of a population-specific training program provides structured and progressive training effectively and promotes physical readiness concurrently with tactical training without overload.

Relationship Between HbA1c and Complex Regional Pain Syndrome in Stroke Patients With Type 2 Diabetes Mellitus.

ObjectiveTo investigate the relationship between glycosylated hemoglobin A (HbA1c) and complex regional pain syndrome (CRPS) in stroke patients with type 2 diabetes mellitus (T2DM).MethodsA retrospective chart review was performed of stroke patients from January 2012 to December 2013. We reviewed 331 patients and included 200 in the analysis. We divided them into CRPS and non-CRPS groups and compared them by age, gender, stroke lesion, cause of stroke, duration of T2DM, HbA1c (%), National Institutes of Health Stroke Scale score, affected shoulder flexor muscle strength, Fugl-Meyer Assessment score, motricity index, Functional Independence Measure, Korean version of Modified Barthel Index, blood glucose level on admission day, duration from stroke onset to HbA1c check, and duration from stroke onset to three-phase bone scan for CRPS diagnosis. Thereafter, we classified the patients into five groups by HbA1c level (group 1, 5.0%–5.9%; group 2, 6.0%–6.9%; group 3, 7.0%–7.9%; group 4, 8.0%–8.9%; and group 5, 9.0%–9.9%) and we investigated the difference in CRPS prevalence between the two groups.ResultsOf the 200 patients, 108 were in the CRPS group and 92 were in the non-CRPS group. There were significant differences in HbA1c (p<0.05) between the two groups but no significant differences in any other factors. Across the five HbA1c groups, there were significant differences in CRPS prevalence (p<0.01); specifically, it increased as HbA1c increased.ConclusionThis study suggests that higher HbA1c relates to higher CRPS prevalence and thus that uncontrolled blood glucose can affect CRPS occurrence in stroke patients with diabetes.

Reliability and validity of the sequential weight-shifting test: a new functional approach to the assessment of the sitting balance of older adults.

[Purpose] The evaluation of sitting balance is important for the prevention of falls in older adults, especially those who have a disability involving the lower extremities. However, no studies have been designed to assess a patient’s dynamic sitting balance using a sequential protocol. The objective of this study was to investigate the psychometric properties of the sequential weight-shifting (SWS) test. [Subjects and Methods] Twenty-three older adults who were physically dependent with regard to ambulation were recruited by convenience sampling. In study 1, 10 participants performed the SWS test and repeated the procedure 1 week later. In study 2, 23 participants were assessed using the SWS test, forward and lateral reach tests in a sitting position, tests of shoulder flexor and hand grip strength, an eye-hand coordination test, mobility tests, and pulmonary function tests. The test-retest reliability of the SWS test and its correlations with the different physical dimensions were examined. [Results] The intraclass correlation coefficient (3,1) of the SWS test was 0.67. The results of the SWS test correlated significantly with forward reach in the sitting position, arm muscle strength, eye-hand coordination, mobility, and pulmonary function (all p<0.05). [Conclusion] The SWS test demonstrated satisfactory psychometric properties and can be considered a useful functional approach for the measurement of sitting balance.

The Averaged EMGs Recorded from the Arm Muscles During Bimanual “Rowing” Movements

The main purpose was to analyze quantitatively the the average surface EMGs of the muscles that function around the elbow and shoulder joints of both arms in bimanual “rowing” movements, which were produced under identical elastic loads applied to the levers (“oars”). The muscles of PM group (“pulling” muscles: elbow flexors, shoulder extensors) generated noticeable velocity-dependent dynamic EMG components during the pulling and returning phases of movement and supported a steady-state activity during the hold phase. The muscles of RM group (“returning” muscles: elbow extensors, shoulder flexors) co-contracted with PM group during the movement phases and decreased activity during the hold phase. The dynamic components of the EMGs strongly depended on the velocity factor in both muscle groups, whereas the side and load factors and combinations of various factors acted only in PM group. Various subjects demonstrated diverse patterns of activity redistribution among muscles. We assume that central commands to the same muscles in two arms may be essentially different during execution of similar movement programs. Extent of the diversity in the EMG patterns of such muscles may reflect the subject's skilling in motor performance; on the other hand, the diversity can be connected with redistribution of activity between synergic muscles, thus providing a mechanism directed against development of the muscle fatigue.