Dystonic Golfer's cramp: Pilot study of propranolol and looking at the hole.

INTRODUCTION: There is limited data in the scientific literature using quantitative methods to assess response of golfer's cramp to intervention. The objective of this pilot study was to use quantitative measures to study the effect of propranolol and looking at the hole when putting. METHODS: 14 golfers completed 50 10' putts (10 each x 5 conditions): two-handed looking at the ball, right hand only looking at the ball, two-handed looking at the hole, then following a single 10 mg oral dose of propranolol two-handed and right hand only putts looking at the ball. Quantitative measurements of putter movement and surface EMG to assess wrist muscle co-contraction were measured. RESULTS: Based on video review of the putting, five golfers with dystonic golfer's cramp and nine with non-dystonic yips were compared. Those with dystonic golfer's cramp had more putts with the yips and yips with co-contraction when two-handed putting looking at the ball, no increase when putting right hand only, less smoothness of putter movement, and all of these improved following propranolol and when looking at the hole. The non-dystonic group had an increase in yipped putts and yipped putts with co-contraction putting right hand only and no improvement with either intervention. CONCLUSION: Yipped putts with co-contraction, right hand only putting, and smoothness of putter movement differed between dystonic golfer's cramp and non-dystonic yips. Propranolol and looking at the hole only improved dystonic golfer's cramp putting. This is the first pilot study of oral medication treatment for this task-specific dystonia.

The Yips: Methods to Identify Golfers with a Dystonic Etiology/Golfer's Cramp.

PURPOSE: To determine whether quantitative methods could separate golfers with a possible dystonic cause of the "yips" from those that appear to be nondystonic. METHODS: Twenty-seven golfers completed 10 two-handed and 10 right hand-only putts. Surface EMG assessed forearm muscle co-contraction and motion detectors monitored wrist and putter movements. Based on a videotape review, golfers were grouped into those with yips of dystonic etiology, those with the yips nondystonic, and those with no yips. RESULTS: On video review of two-handed putting, five golfers had yips that appeared to be dystonic, nine had yips that did not appear to be dystonic, and 13 had no yips. During two-handed putting co-occurrence of a yipped putt and wrist flexor/extensor and/or pronator/supinator co-contraction was significantly more frequent in those with dystonic yips. The dystonic group had no increase in the number of yipped putts or yips with co-contraction when putting right hand only, whereas the nondystonic group had significantly more yipped putts and more yipped putts with co-contraction with right hand only. CONCLUSIONS: Quantitative methods were identified that appear to identify golfers with a dystonic etiology for the yips. It is not just the frequency of yips nor just specific motion patterns alone, rather it is also a combination of yips with co-occurring co-contraction when putting with two hands, and then right hand only, that distinguished this possible etiology. Despite being a small study, identifying a dystonic pattern, even in a nonpressure indoor setting, may aid in assessment and possible monitoring of treatment.

Are the yips a task-specific dystonia or "golfer's cramp"?

This study compared golfers with and without the yips using joint movement and surface electromyographic detectors. Fifty golfers (25 with and 25 without complaints of the yips) were studied while putting. All putts were videotaped. Surface electromyography assessed arm cocontraction. A CyberGlove II (Immersion Technologies, Palo Alto, CA) assessed right-arm angular movements. Primary analysis was done by subjective complaint of the yips, whereas secondary analysis was done by video evidence of an involuntary movement. When grouped by subjective complaints, there were no differences in any movement parameter. When grouped by video evidence of an involuntary movement, yips cases had more (P < 0.001) angular movement in wrist pronation/supination and a trend (P = 0.08) for wrist flexor/extensor cocontraction (yips: 7 of 17, 41.2%; no yips: 6 of 33, 18.2%). Golfers with video evidence of an involuntary movement while putting have excessive rotation of the right wrist in a pronation/supination motion and, as previously reported, a trend for wrist flexor/extensor cocontraction.

Aerobic physical activity effects on psychological well-being in low-income Hispanic children.

Psychological well-being has been generally associated with vigorous aerobic activity and structured aerobic activity in adolescents and children. Low-income children are at greater risk than the general population for experiencing high environmental stress and increased mental health problems. This study investigated the effects of a structured physical fitness program on psychological well-being in low-income Hispanic children. A total of 66, 33 girls, 33 boys, in Grade 4 were randomly assigned to either an Aerobic intensity (n = 34) or a Control intensity physical activity program (n = 32) for 6 wk. Psychological well-being was defined as scores on trait anxiety, depression, and self-esteem, measured, respectively, by the Trait Anxiety Inventory, Beck Depression Inventory, and Rosenberg Self-esteem scale. Analysis showed the children in the Aerobic intensity program significantly (p < .05) improved their cardiovascular fitness as measured by the PWC170 test. After the program was over, the children in this Aerobic group reported significantly (p < .05) less depression. The main effect for self-esteem reflected the Aerobic group's greater self-reported self-esteem. No differences were found on trait anxiety. The effects on depression and self-esteem may only be attributed to the cardiovascular improvement given the higher intensity physical activity program because causation was not assessed here.

A Physiological Profile of Four Wheelchair Marathon Racers.

In brief A profile of four wheelchair marathon racers (WMRs) is presented including an athletic history, dietary habits, maximal oxygen uptake, and average race pace oxygen uptake (Vo2) values. These values were compared with those of able-bodied marathon runners matched for age and race time. The WMRs had lower Vo2 max, maximal heart rates, and higher respiratory exchange ratios, and they used a higher percentage of their Vo2 max and maximal heart rate at race pace. The authors suggest that a high degree of training is required to perform the grueling marathon.