Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial

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Abstract

Background

The Glenohumeral internal-rotation deficit (GIRD) is related to the altered eccentric external-rotator (ER), the concentric internal-rotator (IR), muscle strength, and the ER: IR ratio. GIRD has been documented as a risk factor for shoulder injuries. However, few studies have investigated the effect of an exercise training on these parameters in athletes with GIRD. Therefore, the purpose of this study was to evaluate the effects of an 8-week throwing exercise with a TheraBand for retraining the rotator cuff on Electromyography (EMG) activity of selected muscles, rotator cuff muscle strength, the glenohumeral (GH) joint IR range of motion (ROM) and GH joint position sense in asymptomatic male volleyball players with GIRD.

Methods

Sixty male volleyball players with GIRD were randomized into either a training group or a control group. The experimental group underwent an 8-week throwing exercise with a TheraBand including 5 sessions of stretching and 3 sessions of strengthening exercises per week. The control group received an active self-exercise program. EMG (onset time and muscle activation), shoulder range of motion (ROMs), strength and GH joint position sense were all assessed pre and post trainings.

Results

There were statistically significant within-group differences in the EMG activity of the anterior deltoid ( p = 0.005), middle deltoid ( p = 0.007), posterior deltoid ( p = 0.004), infraspinatus ( p = 0.001) and supraspinatus ( p = 0.001) muscles, IR ROM ( p = 0.001), rotator cuff muscle strength ratio ( p = 0.001), and GH joint position sense ( p = 0.033) in the experimental group. A 2 × 2 analysis of variance with a mixed model design and independent and paired t-tests were used for statistical analysis.

Conclusions

Throwing exercise with a TheraBand improved shoulder muscle activation, IR ROM, rotator cuff muscle strength ratio and GH joint position sense in participants with GIRD. These findings may improve the treatment of GIRD in a clinical setting. Although the results are significant, further studies should follow up the long-term effects of the Throwing exercise with a TheraBand on GIRD.

Trial registration

Current Controlled Trials using the UMIN-RCT website with ID number of, UMIN000038416 “Retrospectively registered” at 2019/10/29.

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Most cited references 32

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Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement.

Gregory Cook, Paula Ludewig (2000)

Treatment of patients with impingement symptoms commonly includes exercises intended to restore "normal" movement patterns. Evidence that indicates the existence of abnormal patterns in people with shoulder pain is limited. The purpose of this investigation was to analyze glenohumeral and scapulothoracic kinematics and associated scapulothoracic muscle activity in a group of subjects with symptoms of shoulder impingement relative to a group of subjects without symptoms of shoulder impingement matched for occupational exposure to overhead work. Fifty-two subjects were recruited from a population of construction workers with routine exposure to overhead work. Surface electromyographic data were collected from the upper and lower parts of the trapezius muscle and from the serratus anterior muscle. Electromagnetic sensors simultaneously tracked 3-dimensional motion of the trunk, scapula, and humerus during humeral elevation in the scapular plane in 3 handheld load conditions: (1) no load, (2) 2. 3-kg load, and (3) 4.6-kg load. An analysis of variance model was used to test for group and load effects for 3 phases of motion (31(-60(, 61(-90(, and 91(-120(). Relative to the group without impingement, the group with impingement showed decreased scapular upward rotation at the end of the first of the 3 phases of interest, increased anterior tipping at the end of the third phase of interest, and increased scapular medial rotation under the load conditions. At the same time, upper and lower trapezius muscle electromyographic activity increased in the group with impingement as compared with the group without impingement in the final 2 phases, although the upper trapezius muscle changes were apparent only during the 4.6-kg load condition. The serratus anterior muscle demonstrated decreased activity in the group with impingement across all loads and phases. Scapular tipping (rotation about a medial to lateral axis) and serratus anterior muscle function are important to consider in the rehabilitation of patients with symptoms of shoulder impingement related to occupational exposure to overhead work. [Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement.

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Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy

Yuming Huang, Zhibin Lan, Weihong Xu (2019)

Background To investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s). Methods In total, 42 patients with complete radiographic measurements following ACHDF in the Spine Surgery Department of the First Affiliated Hospital of Fujian Medical University from August 2014 to January 2017 were retrospectively analysed. Radiographic measurements included C2–7 lordosis, T1 s, C2–7 sagittal vertical axis (SVA), cervical tilting and cranial tilting. The neck disability index (NDI) was used to evaluate the HRQOL. Spearman’s correlation coefficients were calculated between pairs of cervical sagittal parameters and NDI scores. Results Preoperative NDI scores were correlated with preoperative T1 s (r = 0.413); follow-up NDI scores were correlated with follow-up T1 s (r = 0.534). The regression analysis indicated that a preoperative T1 s value of 42.36° corresponded to a preoperative NDI score of 25 (r2 = 0.171, P < 0.001). A follow-up T1 s value of 48.61° corresponded to a follow-up NDI score of 25 (r2 = 0.421, P < 0.01). The differences in C2–7 SVA and cranial tilting before and after the operation were statistically significant (P < 0.05). Conclusion This study showed that the sagittal balance of the cervical vertebrae changed significantly after ACHDF, showing a forward trend. The sagittal parameters after ACHDF were related to clinical prognosis. An excessive T1 s can be considered a risk factor. The T1 s could provide a reference value to determine the correction of the sagittal balance of the cervical spine.

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Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review.

Ann Cools, T Ellenbecker (2010)

Rehabilitation of the patient with glenohumeral impingement requires a complete understanding of the structures involved and the underlying mechanism creating the impingement response. A detailed clinical examination and comprehensive treatment programme including specific interventions to address pain, scapular dysfunction and rotator cuff weakness are recommended. The inclusion of objective testing to quantify range of motion and both muscular strength and balance in addition to the manual orthopaedic clinical tests allows clinicians to design evidence-based rehabilitation programmes as well as measure progression and patient improvement.

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Author and article information

Contributors

Amir Letafatkar:

ORCID: http://orcid.org/0000-0002-5612-8340

letafatkaramir@yahoo.com

Julien S. Baker: jsbaker@hkbu.edu.hk

Journal

Journal ID (nlm-ta): BMC Musculoskelet Disord

Journal ID (iso-abbrev): BMC Musculoskelet Disord

Title: BMC Musculoskeletal Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2474

Publication date (Electronic): 13 June 2020

Publication date PMC-release: 13 June 2020

Publication date Collection: 2020

Volume: 21

Electronic Location Identifier: 376

Affiliations

[1 ]GRID grid.412265.6, ISNI 0000 0004 0406 5813, Faculty of Physical Education and Sport sciences, Department of Biomechanics and Sport injuries, , Kharazmi University, ; Tehran, Islamic Republic of Iran

[2 ]GRID grid.412265.6, ISNI 0000 0004 0406 5813, Department of Biomechanics and Sport injuries, , Kharazmi University, ; Tehran, Islamic Republic of Iran

[3 ]GRID grid.412265.6, ISNI 0000 0004 0406 5813, Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport sciences, , Kharazmi University, ; Mirdamad Blvd., Hesari St, Tehran, Iran

[4 ]GRID grid.221309.b, ISNI 0000 0004 1764 5980, Centre for Health and Exercise Science Research, , Hong Kong Baptist University, ; Kowloon Tong, Hong Kong

Author information

Amir Letafatkar http://orcid.org/0000-0002-5612-8340

Article

Publisher ID: 3414

DOI: 10.1186/s12891-020-03414-y

PMC ID: 7293786

PubMed ID: 32534582

SO-VID: 13469d70-3ce0-47e8-9702-6940c3a047b5

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 31 October 2019

Date accepted : 9 June 2020

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: glenohumeral internal-rotation deficit,injury prevention,volleyball player

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: glenohumeral internal-rotation deficit, injury prevention, volleyball player

Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial

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Most cited references 32

Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement.

Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy

Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review.

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