Biomechanical upper-extremity performance tests and isokinetic shoulder strength in collision and contact athletes

Digital twin-driven dynamic monitoring system of the upper limb force

Digital twin represents the core technology to realize the dynamic monitoring of complex industrial systems. However, the human body, as the most complex system in the physical world, digital twin is rarely applied in it. In this study, we successfully demonstrated a digital twin in the human biomedical application by proposing a dynamic monitoring system of the upper limb force. In this system, the real upper limb drives the motion of the virtual one in real-time and dynamically updates the force. Meanwhile, the virtual upper limb feeds back the monitoring-results of the force to the controller of the real upper limb via immersive virtual reality interaction. Experimental results of the typical motions of the upper limb revealed that the proposed system functioned interactively in real-time in a non-invasive manner, while ensuring the accurate solving of the muscle force. In conclusion, our digital twin-driven system is of great importance for rehabilitation medicine, biomechanical scientific research and physical training, promoting the application of the digital twin in the human biomedical field.

The supine moving apprehension test-Reliability and validity among healthy individuals and patients with anterior shoulder instability

Background

Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads.

Methods

Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability. Patients completed the supine moving apprehension test and the Western Ontario Shoulder Instability index before and 6 months after surgical stabilization of their shoulder. The presence of anterior apprehension was also documented post-operatively.

Results

The supine moving apprehension test demonstrated good test-retest reliability (intraclass correlation coefficient = 0.74-0.84). Patients performed 18-30 repetitions less than healthy individuals during the supine moving apprehension test (P < 0.01). A strong correlation was found between supine moving apprehension test scores and Western Ontario Shoulder Instability post-operatively (r = -0.74, P ≤ 0.01). Supine moving apprehension test scores significantly improved among patients following surgery (P < 0.01). Patients with a negative apprehension test post-operatively performed the supine moving apprehension test significantly better than patients with a positive apprehension test (P < 0.01).

Conclusions

The supine moving apprehension test is reliable and valid among patients with anterior shoulder dislocation and may serve to assess patients' ability to control shoulder anterior instability loads.

Upper Limb Strength and Performance Deficits after Glenohumeral Joint Stabilization Surgery in Contact and Collision Athletes

PURPOSE

The primary aim was to identify and quantify differences in interlimb asymmetry magnitudes across a battery of upper extremity strength and performance tests at 4 and 6 months after glenohumeral joint stabilization surgery shoulder stabilization in contact and collision athletes compared with an un-injured group. A secondary aim was to investigate if identified asymmetry magnitudes changed from 4 to 6 months after glenohumeral joint stabilization surgery. The third aim was to explore associations within the different performance and strength variables.

METHODS

Fifty-six male contact and collision sport athletes who had had undergone unilateral glenohumeral joint stabilization were tested at 4 and 6 months after surgery. An un-injured control group ( n = 39 for upper extremity performance tests, n = 47 for isokinetic dynamometry) were tested on a single occasion. Three upper extremity force platform-based performance tests and angle-specific concentric internal and external isokinetic shoulder rotational strength were assessed, and interlimb asymmetries were compared between the two groups.

RESULTS

At 4 months after surgery, the glenohumeral joint stabilization group demonstrated significantly higher absolute interlimb asymmetry values than the un-injured group for almost all the performance test variables. In the ballistic upper-body performance tests, the glenohumeral joint stabilization group achieved only half the body elevation reached by the un-injured (counter-movement push-up jump height ( η2 = 0.50) and press-jump jump height ( η2 = 0.39)). At 6 months after surgery, absolute interlimb asymmetries reduced for the performance test variables, but some asymmetry persisted. The glenohumeral joint stabilization group had significantly greater absolute interlimb asymmetries for five out the eight isokinetic variables.

CONCLUSIONS

Contact and collision athletes who may be cleared to return to sport at 4 to 6 months after glenohumeral joint stabilization surgery shoulder stabilization continue to demonstrate upper limb strength and performance deficits when compared with their un-injured limb and their un-injured counterparts.

Validation of a Portable Wireless Force Platform System To Measure Ground Reaction Forces During Various Tasks

Background

Force platforms are widely used in biomechanics to measure ground reaction forces (GRF) during various human movements. However, traditional force plates are not easily used outside a research lab. To overcome this issue, researchers and manufacturers are developing low-cost portable force platforms that can be used in a variety of settings, including outdoors.

Purpose

To validate the kinetic data obtained from a pair of portable K-Deltas force platforms compared to gold standard platforms fixed in the lab and to examine the measurement reliability between this pair of portable force platforms.

Methods

Force-time curves from known masses, countermovement vertical jumps, and balance tests were used to assess validity of K-Deltas using a pair of Bertec force plates as a gold standard and between the K-Deltas pair of plates. Bland-Altman plots were used to evaluate the differences between K-Deltas and Bertec force plates. For the assessment of countermovement vertical jumps, impulse, peak rate of force development and peak force were calculated for both instruments and checked for agreement between instruments. Three young adults (2 male, 1 female, 25.4±0.83 years) participated in the study.

Results

The percentage of Bland-Altman plot point within the limits of agreement was 94.59 % for the comparison between K-Deltas and Bertec and 94.83% between the pair of K-Deltas.

Conclusion

The results show that the portable force platforms could be utilized successfully for assessing pertinent parameters in clinical and sports biomechanics. The findings suggest that portable force platforms can be used as an alternative to traditional laboratory equipment for field assessment, providing significant improvements compared to the past.

Level of Evidence

Level 3.

Evaluating the Asymmetry of Muscle Activation and Strength in Paralympic Powerlifting Athletes

BACKGROUND

Strength training is a complex task, as it requires a combination of many variables. In paralympic powerlifting (PP) asymmetries for the evaluation of activation, and static force indicators have been increasingly studied.

OBJECTIVE

To investigate the asymmetries in the strength and muscle activation indicators, before and after a training session of PP athletes.

METHODOLOGY

Twelve elite athletes from the PP participated in the study, and asymmetry was evaluated through surface electromyography (sEMG) and static strength indicators. Evaluations were made before and after a protocol of five series of five repetitions (5 × 5), with 80% of 1-Maximum Repetition (1RM).

RESULTS

In the pectoral muscles, there were differences in the non-dominant limbs between the before and after in the sEMG. There were differences in the pectoralis muscle in the non-dominant limb between moments before (110.75 ± 59.52%) and after (130.53 ± 98.48%, p < 0.001), and there was no difference in triceps activation. In the Maximum Isometric Strength (MIF), there was a difference in the non-dominant limb between before (710.36 ± 129.36) and after (620.27 ± 69.73; p < 0.030). There was a difference before in the dominant (626.89 ± 120.16; 95% CI 550.55-703.24) and non-dominant (710.36 ± 129.36; p = 0.011) limbs. There was no difference in time to MIF.

CONCLUSION

PP athletes showed small levels of asymmetry before and after training, and adaptation to training tends to promote fewer asymmetries.

Progressing On-Court Rehabilitation After Injury: The Control-Chaos Continuum Adapted to Basketball

BACKGROUND: Sport-specific training is an integral component of returning to sport following injury. Frameworks designed to guide sport-specific rehabilitation need to integrate and adapt to the specific context of elite sport. The control-chaos continuum (CCC) is a flexible framework originally designed for on-pitch rehabilitation in elite football (soccer). The concepts underpinning the CCC transfer to other elite sport rehabilitation environments. CLINICAL QUESTION: How can practitioners and clinicians transfer the CCC to elite basketball, to support planning and return to sport? On-court rehabilitation is a critical sport-specific rehabilitation component of return to sport, yet there are no frameworks to guide practitioners when planning and delivering on-court rehabilitation. KEY RESULTS: Based on our experience working in the National Basketball Association, we report how the CCC framework can apply to elite basketball. We focus on the design and delivery of progressive training in the presence of injury in this basketball-specific edition of the CCC. Given the challenges when quantifying "load" in basketball, we encourage practitioners and clinicians to consider the qualitative aspects of performance such as skill, sport-specific movement, contact, and decision making. CLINICAL APPLICATION: The 5-phase framework describes training progression from high control, a return to on-court running, to high chaos, a return to "live" unrestricted basketball. The model can be adapted to both short- and long-term injuries based on injury and progression criteria. Strength and power "diagnostics" can be strategically implemented to enhance decision making throughout the return to sport continuum. J Orthop Sports Phys Ther 2023;53(9):1-12. Epub: 9 August 2023. doi:10.2519/jospt.2023.11981.

Development of a rugby shoulder function (RSF) questionnaire: An online Delphi study

OBJECTIVE

Develop a questionnaire to monitor symptoms of player perceived shoulder function/dysfunction.

DESIGN

3-Stage Online Delphi Study.

METHODS

Participants: surgeons, sports and exercise medics, academic researchers, strength and conditioning coaches, therapists and athletes split by level of expertise/experience. Stage-1: experts (n = 12) rated constructs/items from the steering group and made changes/proposed additional constructs/items. Stage-2: experts rated/amended new constructs/items from stage-1. Stage-3: experienced professionals (n = 25) rated/ranked constructs/items from stage 2. Consensus thresholds were defined per stage (≥50% agreement/4-5 rating on 1-5 Likert scale (stages 1-2), ≥68% agreement, and items ranked for perceived importance (stage-3)).

RESULTS

Stage-1, all four constructs (a. Activities of daily living, b. Range of motion, c. Strength and conditioning, d. Sports specific training and competition) and 26/42 original items achieved consensus. Twelve items were combined into five items. Four new items were also proposed. Stage-2, the combined items and three of the four new items achieved consensus. Stage-3 the four constructs and 22 items all achieved consensus.

CONCLUSIONS

Following a 3-stage online Delphi process, involving expert and experienced clinicians, practitioners and athletes, a new four construct, 22 item RSF questionnaire has been developed which can be used with rugby players, to monitor perceived shoulder performance and symptoms.

ISOKINETIC MUSCLE STRENGTH CHARACTERISTICS OF LOWER LIMB JOINTS IN LONG JUMPERS

ABSTRACT Introduction: Joint strength of the lower limbs plays a decisive role in the competitive ability of long jumpers. Special strength training based on science and targeted at the strength of the lower limb joints is an essential topic for long jumpers. Objective: To analyze isokinetic muscle strength characteristics of lower limb joints in long jumpers. Methods: Voluntary jumpers were submitted to isokinetic concentric contraction tests of the lower limbs and hip joints. We also analyzed the effect of strength training on lower limb joint injury. Results: The knee muscles of the athletes have reduced eccentric contractility. The ankle of the athlete has the most vulnerable joint to injuries in the sport. Conclusion: The explosive force and eccentric contractility of long jumpers’ lower limb extensor muscles have the most significant impact on joint thrust and extension speed. Athletes need muscle strength training to develop isokinetic muscle strength. This can effectively prevent injury to lower extremity joint movements. The research findings of this paper can provide a specific theoretical basis for formulating scientific training for long jumpers. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Angle-Specific Isokinetic Shoulder Rotational Strength Can be Reliably Assessed in Collision and Contact Athletes

An increased understanding of rotational strength as a potential prognostic factor for injury in contact and collision athletes may be important in planning return to sport. The aim of this study was to (1) determine the test-retest reliability of clinically relevant, angle-specific rotational and peak torque measurements in a cohort of uninjured collision and contact athletes; (2) develop a normal descriptive profile of angle-specific rotational torque measurements in the same cohort; and (3) examine the effects of direction and joint angle on shoulder rotational strength interlimb asymmetries. Twenty-three collision and contact athletes were recruited for the interday reliability substudy and 47 athletes were recruited for the remaining substudies. We used intraclass correlation coefficients with 95% confidence intervals to quantify interday reliability of all variables. We used a 2-way repeated-measures analysis of variance to analyze differences in absolute interlimb asymmetries. Interday reliability for the isokinetic strength variables was good to excellent (0.78-0.90) on the dominant side and moderate to good (0.63-0.86) on the nondominant side. Maximum angle-specific torque (as well as peak torque) can be measured reliably in internally and externally rotated positions. A normal profile of clinically relevant, angle-specific shoulder rotational torque measurements for collision and contact athletes has been established which provides a reference when assessing shoulder strength in this population.

The validity of using one force platform to quantify whole-body forces, velocities, and power during a plyometric push-up

Background

Previous studies have typically measured velocity and power parameters during the push-up, either using one or two force platforms. The purpose of the study was to compare the force, velocity, and power parameters between the one-force-platform method and the two-force-platform method during plyometric push-ups.

Methods

Thirty-four physically active young adults participated in the study to perform the plyometric push-up. For the two-force-platform calculation method, the forces applied to the feet and hands were both measured. For the one-force-platform calculation method, the forces applied to the feet were assumed to be constant, while the forces applied to hands were measured by one force platform. Whole-body linear velocities were calculated based on the impulse and momentum theorem. Whole-body power was calculated as the product of the whole-body forces and velocities.

Results

The one-force-platform method overestimated the whole-body velocities and power compared with the two-force-platform method (1.39 ± 0.37 m/s vs. 0.90 ± 0.23 m/s, Cohen’s d = 1.59, p < 0.05; 1.63 ± 0.47 W/body weight vs. 1.03 ± 0.29 W/body weight, Cohen’s d = 1.49, p < 0.05). These differences were caused by the decreased forces applied to the feet compared to the initial value throughout most of the push-up phase. Large to perfect correlations (r = 0.55 – 0.99) were found for most variables between the two-force-platform and one-force-platform methods. Previous findings of push-up velocities and power using the two-force-platform and one-force-platform methods should be compared with caution. While the two-force-platform method is recommended, linear regression equations may be used to predict velocities and power parameters obtained from one force platform.

Conclusions

For those professionals who need to accurately quantify kinetic variables during the plyometric push-up, the two-force-platform method should be considered.