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      Handball-specific loading acutely reduces the acromiohumeral distance in experienced handball players and in non-handball experienced athletes

      systematic-review

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          Abstract

          Context

          When playing handball, the preservation of the subacromial space, which can be quantified by the acromiohumeral distance (AHD), plays a crucial role for shoulder health of handball players. Acute effects of handball-specific loading on the subacromial space with consideration of individual adaptions resulting from long-term handball-specific loading experience have yet to be determined in order to prevent injuries such as e. g. an impingement of the supraspinatus tendon.

          Objective

          To (1) assess the acute effects of handball-specific loading on the AHD in healthy experienced handball players (HB) and non-handball experienced athletes (CG) and (2) to assess the AHD behavior in relation to individual intrinsic factors to identify possible risk factors and the effect of handball-specific experience associated adaptations.

          Participants

          20 HB (10m; 10f) and 20 CG (10m; 10f); 24 ± 5 years.

          Intervention

          Handball-specific loading protocol.

          Main outcome measures

          The AHD was measured by ultrasonography at 0° and 60° abduction pre and post intervention. Isometric shoulder strength was measured with hand-held dynamometry. Shoulder range of motion (ROM) was measured with goniometry.

          Results

          Handball-specific loading led to significantly reduced AHD in the dominant shoulder in the 60° abducted position in both groups (HB: −1.7 ± 2.0 mm; p = 0.001, d = 0.69; CG: −1.1 ± 2.0 mm; p = 0.024, d = 0.37) and in the non-dominant shoulder in 0° (−0.7 ± 1.5 mm; p = 0.038, d = 0.35) and 60° abducted position (−1.3 ± 1.8 mm; p = 0.004, d = 0.69) in HB only. Handball-specific loading enhanced AHD reduction when elevating the shoulder from 0° to 60° in both groups and arms. Larger shoulder abduction strength affected the maintenance of the AHD positively. HB demonstrated less shoulder strength compared to CG, while ROM did not differ.

          Conclusions

          Handball-specific loading can affect the ability to preserve the subacromial space which might put handball players at risk for shoulder injuries. Poor shoulder strength can aggravate this mechanism. Therefore, implementation of strengthening exercises of the external rotator and abductor muscles in the training schedule may improve shoulder health of handball players.

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          Most cited references44

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          Correlation Coefficients

          Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from -1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.
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            Psychophysical bases of perceived exertion

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              Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review.

              To examine the current evidence regarding the reliability and validity of hand-held dynamometry for assessment of muscle strength in the clinical setting. A search was conducted of the following databases: Cochrane, MEDLINE, PubMed, PEDro, OTseeker, Index to Chiropractic Literature (ICL), and MANTIS, from inception until January 29, 2010. The MeSH subject heading "muscle strength dynamometer" was searched, in isolation and in combination with the text word phrases "hand-held dynamometer" and "isokinetic." Four hundred fifty-four different studies met this search and were reviewed for possible inclusion. Two independent reviewers assessed the quality of the included manuscripts. The PEDro data collection system was used in conjunction with the Cochrane Diagnostic Test Accuracy Description. A third reviewer was used when there was disagreement between the primary reviewers. Seventeen manuscripts met the inclusion criteria for this review, with a total of 19 studies (2 of the manuscripts involved 2 separate studies) that compared hand-held dynamometry with an identified reference standard (isokinetic muscle strength testing). The results demonstrated minimal differences between hand-held dynamometry and isokinetic testing. Considering hand-held dynamometry's ease of use, portability, cost, and compact size, compared with isokinetic devices this instrument can be regarded as a reliable and valid instrument for muscle strength assessment in a clinical setting. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Front Sports Act Living
                Front Sports Act Living
                Front. Sports Act. Living
                Frontiers in Sports and Active Living
                Frontiers Media S.A.
                2624-9367
                16 September 2022
                2022
                : 4
                : 997401
                Affiliations
                Institute of Sport Science, Humboldt University of Berlin , Berlin, Germany
                Author notes

                Edited by: Carmen Ferragut, University of Alcalá, Spain

                Reviewed by: Eduard Kurz, University Hospital in Halle, Germany; Roland Van Den Tillaar, Nord University, Norway; Thomas Muehlbauer, University of Duisburg-Essen, Germany

                *Correspondence: Carolin Rentz carolin.rentz@ 123456student.hu-berlin.de

                This article was submitted to Elite Sports and Performance Enhancement, a section of the journal Frontiers in Sports and Active Living

                Article
                10.3389/fspor.2022.997401
                9524289
                b2de6eb0-d603-4df6-8b09-403a97b6f4ac
                Copyright © 2022 Rentz and Legerlotz.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 July 2022
                : 30 August 2022
                Page count
                Figures: 4, Tables: 2, Equations: 0, References: 46, Pages: 12, Words: 7385
                Funding
                Funded by: FAZIT Stiftung, doi 10.13039/501100003099;
                Categories
                Sports and Active Living
                Systematic Review

                shoulder,handball,ultrasonography,acromiohumeral distance,impingement syndrome

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