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Preville-Gendreau A, Naraghi A, Dilkas S, Coros K, Moktassi A, Griffin A, White LM. Spectrum and patterns of shoulder pathology on MRI in symptomatic elite wheelchair basketball athletes. Skeletal Radiol 2024; 53:1359-1368. [PMID: 38267761 DOI: 10.1007/s00256-024-04593-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Wheelchair basketball (WCB) is a popular para-sport adapted for athletes with physical disabilities. Shoulder injuries are commonly reported among WCB athletes. However, the understanding of the specific patterns and characteristics of shoulder injuries in WCB players is currently limited, and there is a lack of comprehensive literature available on this subject. OBJECTIVES To investigate the spectrum of pathologies observed in elite wheelchair basketball (WCB) athletes referred for MRI evaluation of symptomatic injuries of the shoulder. METHODS Retrospective review of consecutive elite WCB athletes referred for MRI evaluation of symptomatic shoulder injury. Demographic, clinical, and functional data including international wheelchair basketball federation (IWBF) classification of each athlete were collected. A total of 28 MRI studies were reviewed. Excluding MRI examinations of the same shoulder, 18 study cases were assessed for pathology of the rotator cuff (RC), labrum, long-head of biceps tendon, glenohumeral and acromioclavicular joints, and osseous lesions of the humerus or glenoid. Correlations between clinical-demographic features and MRI findings were statistically evaluated. RESULTS Supraspinatus tears were observed in 72.2%, infraspinatus tears in 50%, and subscapularis tears in 38.9% shoulders. Articular-sided partial tears frequently involved posterior supraspinatus (88.9%) and anterior infraspinatus (100%). Labral tears were seen in 38.9%, with involvement of the posterosuperior labrum in all tears. Hill-Sachs and osseous Bankart lesions (5.6%), and anterior-inferior labral tears (11.1%), were uncommon findings. Statistically significant correlations were observed of low IWBF point class and non-ambulatory athletes with subscapularis tendinosis (p = 0.015, p = 0.001) and tearing (p = 0.050, p = 0.013), and athletes with limited trunk control with subscapularis tendinosis (p = 0.013). CONCLUSIONS RC tears are common in elite WCB athletes with pattern of RC and labral tearing suggesting internal (superior-posterior) impingement as a contributory pathoetiologic mechanism. Non-ambulatory, low IWBF point class athletes, as well as those with limited trunk control have a statistically significant increase in subscapularis tendon pathology on MRI.
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Affiliation(s)
- Anne Preville-Gendreau
- Joint Department of Medical Imaging, Sinai Health System, Toronto, ON, Canada
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ali Naraghi
- Joint Department of Medical Imaging, Sinai Health System, Toronto, ON, Canada
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Steven Dilkas
- West Park Healthcare Centre, Toronto, ON, Canada
- Canadian Sports Institute Ontario (CSIO), Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kimberly Coros
- Canadian Sports Institute Ontario (CSIO), Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Physical Medicine and Rehabilitation, Hennick/Bridgepoint, Sinai Health System, Toronto, ON, Canada
| | - Aiden Moktassi
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- William Osler Health System, Etobicoke General Hospital, Toronto, ON, Canada
| | - Anthony Griffin
- Orthopedic Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | - Lawrence M White
- Joint Department of Medical Imaging, Sinai Health System, Toronto, ON, Canada.
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Farì G, Quarta F, Longo SC, Masiero L, Ricci V, Coraci D, Caforio L, Megna M, Ranieri M, Varrassi G, Bernetti A. How does classification score affect falls in wheelchair basketball? A video-based cross-sectional study on the Italian national team during the European Para Championships 2023. Phys Ther Sport 2024; 67:77-82. [PMID: 38614046 DOI: 10.1016/j.ptsp.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/30/2024] [Accepted: 03/31/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the mechanism of falls in male elite wheelchair basketball (WB) players and to analyse the falls characteristics considering their classification score which ranges from 1.0 to 4.5 and it is related to their functional capacity and particularly to their volume of action. DESIGN A cross-sectional video analysis was conducted using European para championships 2023official match videos. SETTING Players of the sample team were divided into 2 groups according to their classification point: low-point players (LPP) and high-point players (HPP). Every occurred fall was systematically analysed focusing on falling related characteristics and game circumstances. PARTICIPANTS Twelve WB players of the Italian national team. MAIN OUTCOME Number of falls and mechanism of falls. RESULTS The results showed a higher number of falls for HPP and highlighted a statistically significant differences between LPP and HPP for the fall direction, the playing time and the first anatomical site in contact with the floor. CONCLUSION Results reported significant differences between LPP and HPP in terms of mechanism of fall. Further studies should focus on the development of new preventive training strategies tailored to WB players with different levels of impairments to reduce fall related injuries.
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Affiliation(s)
- Giacomo Farì
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy; Italian Wheelchair Basketball Federation (Federazione Italiana Pallacanestro in Carrozzina, FIPIC, Rome, Italy.
| | - Francesco Quarta
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy
| | - Sara Clelia Longo
- Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Laura Masiero
- Department of Statistical Science, University of Padova, Padova, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Department of Biomedical and Neuromotor Science, Istituto di Ricovero e Cura a Carattere Scientifico Rizzoli Orthopedic Institute, Bologna, Italy
| | - Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Laura Caforio
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, Bari, Italy
| | - Marisa Megna
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, Bari, Italy
| | - Maurizio Ranieri
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, Bari, Italy
| | | | - Andrea Bernetti
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy
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Yuine H, Mutsuzaki H, Yoshii Y, Shimizu Y, Ishida N, Yasuda T, Iwai K, Hotta K, Shiraishi H, Tachibana K. Evaluation of hand functions and distal radioulnar joint instability in elite wheelchair basketball athletes: a cross-sectional pilot study. BMC Sports Sci Med Rehabil 2023; 15:58. [PMID: 37061701 PMCID: PMC10105936 DOI: 10.1186/s13102-023-00658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/24/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Wrist injury affects wheelchair basketball players' performance; however, the relationship between distal radioulnar joint (DRUJ) instability and hand functions is unclear. This cross-sectional pilot study investigated DRUJ instability in elite female wheelchair basketball athletes using force-monitor ultrasonography. METHODS Nine elite female wheelchair basketball athletes (18 wrists) were included in the study. A triangular fibrocartilage complex (TFCC) injury was confirmed using magnetic resonance imaging (MRI). Hand functions were evaluated based on the range of motion (ROM) of wrist palmar flexion, dorsiflexion, radial deviation, and ulnar deviation; grip strength; arm circumference; forearm circumference; and DRUJ instability or pain using the ballottement test. The Mann-Whitney U test was used to compare parameters between the TFCC-injured and intact wrists. Radioulnar displacement was measured using force-monitor ultrasonography and pressure data, and the displacement-to-force ratio was used as an indicator of DRUJ instability. The correlation between the DRUJ displacement-to-force ratio and each hand function assessment was evaluated using Pearson correlation coefficient for the TFCC-injured and intact wrists. A generalized linear mixed model (GLMM) was used to estimate the relationship between hand functions and DRUJ instability. RESULTS TFCC injuries in seven wrists were confirmed using MRI findings (38.9%). The ulnar deviation ROM values of the TFCC-injured wrist (n = 7) and intact (n = 11) groups were 38.6 ± 8.0° and 48.6 ± 7.8°, respectively. The ulnar deviation ROM was significantly smaller in the TFCC-injured wrists (p = 0.02, r = - 0.54). In the TFCC-injured wrists, no correlation was observed between the displacement-to-force ratio and the hand function assessment. In contrast, the displacement-to-force ratio negatively correlated with grip strength, arm circumference, and forearm circumference in the intact wrists (Pearson correlation coefficient r = - 0.78, - 0.61, and - 0.74, respectively). The GLMM showed that the displacement-to-force ratio significantly affected grip strength, arm circumference, and forearm circumference in the intact group. CONCLUSIONS In intact wrists, correlations were observed between hand functions such as upper arm/forearm strength and DRUJ stability evaluated using ultrasound. Maintaining and strengthening grip strength, forearm circumference, and arm circumference are associated with DRUJ stability and may be related to TFCC injury prevention in wheelchair basketball athletes. TRIAL REGISTRATION The protocol was registered with the UMIN Clinical Trials Registry (UMIN000043343) [Date of first registration: 16/02/2021].
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Affiliation(s)
- Hiroshi Yuine
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan.
| | - Hirotaka Mutsuzaki
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
| | - Yuichi Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, 300-0395, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Natsuki Ishida
- Geriatric Health Services Facility Nadeshiko, Tsukuba, Ibaraki, 300-4245, Japan
| | - Taku Yasuda
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
| | - Koichi Iwai
- Center for Humanities and Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
| | - Kazushi Hotta
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan
| | - Hideki Shiraishi
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan
| | - Kaori Tachibana
- Department of Physical Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
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