ABSTRACT
BACKGROUND: Due to the repetitive overhead activity involved in playing tennis and the physical demands of the game, shoulder joint injury is common. There is limited research available describing sport specific risk factors for injury in tennis, however, changes in shoulder rotational range of motion (ROM) have been associated with injury in other overhead 'throwing' type sports. PURPOSE: This study had two purposes: i) to identify reference values for passive glenohumeral joint rotational ROM in elite tennis players, and, ii) to investigate differences in ROM between various age groups of players. STUDY DESIGN: Cross-sectional analysis. METHODS: Data was collected at national performance camps held at a National Tennis Centre between September 2012 and July 2015. One hundred and eighty-four tennis players aged between 11 and 24 years took part. All had a top eight national ranking within their respective age group. Participants were divided into three age groups; under 14 years, 14-15 years, and 16 years and over. The main outcome measures were dominant and non-dominant internal and external rotation as well as total glenohumeral joint passive ROM. RESULTS: Reduced internal, and greater external rotation passive ROM were identified on the dominant side (p < 0.05), however, no side-to-side differences in total rotation ROM were found (p > 0.05). A glenohumeral joint internal rotation deficit (GIRD) was prevalent on the dominant side, which increased in magnitude with rising player age. Differences in dominant side internal and external rotation ROM were identified between age groups with the 14-15-year olds having less internal and greater external rotation than the under 14-year olds and the over 16-year old athletes (p < 0.05). The total range of motion values were not found to differ between age groups (p > 0.05). CONCLUSIONS: This study provides reference values for glenohumeral joint rotational ROM in elite tennis players and demonstrates age specific differences. Future studies should investigate links between changes in ROM and injury risk. LEVEL OF EVIDENCE: 3.
ABSTRACT
It has been suggested that the positive position of the O'Brien test (shoulder flexion, horizontal adduction, and internal rotation) tensions the bicipital labral complex relative to the negative position (shoulder flexion, horizontal adduction, and external rotation). This study measured active and passive tension in the long head of biceps in the 2 positions of the O'Brien test to validate the proposed anatomic basis of the test. Active tension was measured using surface electromyography of the long head of biceps in 12 healthy young adults. Passive tension was measured using a load cell attached to the intracapsular tendon of the long head of biceps in 5 cadaver specimens. Active and passive tension were higher in the negative position, thus refuting the proposed anatomic basis of the test. Although there may be an alternative basis for the test, the failure to support the proposed anatomic basis may partly explain the variable likelihood ratios obtained in clinical accuracy studies of the O'Brien test. The results of this study reinforce the need for anatomic validation during the development of clinical testing procedures.
Subject(s)
Electromyography , Ligaments, Articular/injuries , Physical Examination , Shoulder Injuries , Adult , Female , Humans , Ligaments, Articular/physiopathology , Male , Muscle, Skeletal/physiopathology , Predictive Value of Tests , Shoulder Joint/physiopathology , Stress, MechanicalABSTRACT
INTRODUCTION: Telecommunications and information technology provide clinical care at distance by means of telemedicine. Hospitals and other health care facilities use medical telemetry devices for monitoring patients' vital signs. These portable devices are used for measuring patient vital signs such as ECG, blood pressure, heart rate, respiration, capnography (CO2) and other important parameters and then transmit these information to a remote location using a nearby receiver. APPLICATION OF TELEMETRY: Eliminating the need for wired connection with the patient, monitors allow, otherwise bedridden patients to be mobile, which shortens the recovery time. Wireless technology is also useful in the emergency care units, because emergency physicians need not leave their patients while consulting a handheld wireless device. This equipment also enables a paramedic to communicate with emergency physicians for early assessment, well before patients' arrive in hospital. TELEMEDICINE: Certain types of medical telemetry devices may be used in home conditions. Telemetry can provide monitoring and home health care services at distance, using advanced telecommunications and information technology in patients with reasonably stable, but a severe, chronic, difficult condition and caring home environment. This information can enable health-care providers to effectively manage treatment without need for acute emergency treatment and hospitalization. CONCLUSION: Hospitals worldwide are under constant pressure to decrease healthcare cost and to improve treatment outcome. Telemedicine and home health care may be one of the solutions for the problem.
