SHOULDER PAIN IN COMPETITIVE TEENAGE SWIMMERS AND IT'S PREVENTION: A RETROSPECTIVE EPIDEMIOLOGICAL CROSS SECTIONAL STUDY OF PREVALENCE.

BACKGROUND: The term "swimmer's shoulder" was first introduced in 1974 by Kennedy and Hawkins to describe a common condition among competitive swimmers characterized by pain and dysfunction of the shoulder complex. Currently, the term does not define a specific clinical diagnosis and its etiology is considered to be multifactorial. In the literature shoulder pain prevalence varies according to the adopted definitions (from 3% to 91%); however, in the Italian environment there is no prevalence study regarding swimmer shoulder. Prevention by means of dry land activities may assist in delimiting shoulder pain in swimmers. PURPOSES: The purpose of this study was to investigate the prevalence of swimmer's shoulder over the prior 12 months among teenage athletes and the preventive activities carried out across different sport's teams. A second purpose was to determine whether the extent of the condition is affected by dry land preventive activity. And finally, to compare different preventive activities related to the prevalence of swimmer's shoulder. STUDY DESIGN: Retrospective epidemiological cross-sectional study of prevalence. METHODS: Athletes from four levels of training: Esordienti A, Ragazzi, Juniores and Cadetti (according to Italian Swimming Federation F.I.N.'s partition age) belonging to eight Italian swimming teams and their respective coaches were involved in this study. Two types of questionnaires were created and completed by both the athletes and their coaches during May 2015. The collected data were analyzed by means of descriptive and inferential statistics. RESULTS: Shoulder pain prevalence over the previous 12 months from the completion of the survey was 51%. In six out of eight of the societies a specific shoulder dry land warm-up was carried out before water training, whereas among seven out of eight societies also utilized weekly sessions of performance (physical) training. Statistically significant differences were noticed between shoulder pain and gender, weekly frequency and duration of dry land warm-up and duration of physical training. CONCLUSION: The results of the current study indicate that shoulder pain is prevalent in youth swimmers (51%) and appears to be affected by dry land preventive activities. A weekly frequency of dry land warm-up more than five times appeared to protect swimmers from pain (p=0.044); whereas, a dry land warm-up duration greater than 10 minutes seems to cause shoulder pain (p=0.043). A single physical training duration lower than 45 minutes seems to be associated with pain (p=0.035). LEVELS OF EVIDENCE: 3a.

ACUTE EFFECTS OF DRY NEEDLING ON POSTERIOR SHOULDER TIGHTNESS. A CASE REPORT.

BACKGROUND AND PURPOSE: Posterior shoulder tightness has been associated with numerous shoulder disorders. Methods to increase posterior shoulder mobility may be beneficial. The purpose of this case report is to report the outcomes of a subject with posterior shoulder tightness treated with dry needling as a primary intervention strategy. CASE DESCRIPTION: The subject was a 46-year-old man who was referred to physical therapy with primary symptoms of shoulder pain and loss of motion consistent with subacromial impingement syndrome. Clinical findings upon examination revealed glenohumeral internal rotation and horizontal adduction losses of motion and reproduction of pain symptoms upon palpation of the infraspinatus, teres minor, and posterior deltoid. A single treatment of trigger point dry needling was used to decrease pain and improve range of motion. OUTCOMES: Following the intervention, clinically meaningful improvements were seen in pain and shoulder range of motion. DISCUSSION: This case report describes the use of trigger point dry needling in the treatment of a subject with posterior shoulder tightness. The immediate improvement seen in this subject following the dry needling to the infraspinatus, teres minor, and posterior deltoid muscles suggests that muscles may be a significant source of pain and range of motion limitation in this condition. LEVEL OF EVIDENCE: Level 4.

[Foot and ankle ability measure: cross-cultural translation and validation of the Italian version of the ADL module (FAAM-I/ADL)]. / Foot and ankle ability measure: traduzione e validazione della versione Italiana del modula ADL (FAAM-I/ADL).

BACKGROUND: Valid and reliable outcome measures are fundamental for evaluating and comparing the effects of rehabilitation. Among the different tools used for the assessment of musculoskeletal disorders of the lower limb, the Foot and Ankle Ability Measure (FAAM) has been shown to have good psychometric properties. However, it has not yet been translated into Italian. The module regarding the performance of daily living activities (FAAM/ADL), in particular, can be applied also in an occupational setting. OBJECTIVE: To obtain an Italian version of the FAAM, and to validate the FAAM-I/ADL. METHODS: The cultural adaptation was performed according to international guidelines for forward/backward translation. The activities of daily living (ADL) module of the FAAM-I (FAAM-I/ADL) was validated with classical test theory methods in a convenience sample of 57 patients. Different parameters were calculated: internal consistency (Cronbach's α and item-to-total correlation); criterion validity, through Pearson's correlation (r) with the Lower Extremity Functional Scale (LEFS); test-retest reliability (ICC2,1); Standard Error of Measurement (SEM); and Minimal Detectable Change (MDC95). RESULTS: The statistical analysis showed good internal consistency (Cronbach's α=.96, item-to-total correlation ranged between .51 and .85), high criterion validity (r=.66, p<0.01) and excellent test-retest reliability (ICC2, 1=.98, CI95%=.97-.99). The SEM was 2.7 points, with a MDC95 of 7.5 points. CONCLUSIONS: FAAM-I/ADL shows good psychometric properties, together with speed and ease of administration and scoring. Its use will facilitate the comparison of Italian data with international studies, ensuring greater uniformity of assessment.

The Functional Dexterity Test: test-retest reliability analysis and up-to date reference norms.

STUDY DESIGN: Clinical measurement. INTRODUCTION: Among the available tests for fine finger dexterity, the Functional Dexterity Test (FDT) has been indicated as a valid instrument to measure outcome in different conditions. PURPOSE OF THE STUDY: To analyze test-retest reliability, to study the influence of gender, age and hand dominance on the FDT score, and to collect reference norms for adult and elderly age-groups. METHODS: Test-retest reliability was calculated with the Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM) in a subgroup of 324 healthy volunteers. An enlarged sample of 698 subjects, tested at least once, was used to present stratified data for age group, sex, and hand dominance, and ANOVA was used to investigate statistically significant differences between groups. RESULTS: The FDT showed excellent reliability (ICC > 0.90; SEM: <2 s for net times; <3 s for total scores). Age, gender and hand dominance significantly influenced FDT scores (p < 0.05), but no interaction between variables was found. CONCLUSIONS: FDT is confirmed as reliable, and up-to-date reference norms over a broad range of ages of the Italian adult population have been provided. LEVEL OF EVIDENCE: NA.