Isometric evaluation of rotator cuff muscles in volleyball athletes.

AIM: The aim of the present study was to evaluate, in a group of semi-professional volleyball players, the function of the rotator cuff muscles with a new specific device. METHODS: We have studied 30 asymptomatic volleyball players, 15 females and 15 males, all right handed central or lateral spikers, with some specific functional tests. Every subject was evaluated by some common clinical tests to detect shoulder range of motion (ROM) and rotator cuff muscles strength in both sides. Athletes were also submitted to an isometric bilateral shoulder strength test, with a specific upper limb dynamometer (Dynatorq), in three different positions: 1) arm 0° abducted; 2) arm 90° abducted and 90° external rotation, to try to reproduce the spike gesture; 3) arm behind the thorax, as a simulation of clinical lift-off test. All clinical and instrumental data were collected in male and female groups and, in each group, comparisons between dominant and non dominant shoulders. RESULTS: Our data show in all athletes an initial postero-superior impingement with significant weakness of the subscapularis muscle in the dominant shoulder. CONCLUSION: In all overhead athletes, and in particular in volleyball spikers, a pre-clinical diagnosis of lack of strength of the subscapularis muscle in the dominant side, before the occurrence of pain or discomfort signs, could be an important diagnostic aspect to avoid or delay the back-retraction of the joint capsule of the shoulder.

Effect of Cromoglycate on Gas Changes, During Bronchial Challenge by UNCDW in Children with Asthma.

Eighteen asthmatic children were challenged with ultrasonically nebulized cold distilled water (UNCDW). Blood gas composition was monitored transcutaneously (tcpO(2) and tcpCO(2)) during and after the challenge. Assuming as basal the response to this UNCDW test, nine children (Group A) were then chosen at random to inhale cromoglycate by aerosol delivery for 8 days. Nine children (Group B), acting as a control, inhaled saline for 8 days. At the end of this therapy, each child repeated the UNCDW test. Statistical analysis with t-test for paired data was used to compare the results of each child to both tests. Mean basal tcpO(2) and tcpCO(2) were all within the expected normal range. In all children, both mean tcpO(2) and tcpCO(2) were reduced during and after UNCDW inhalation. Mean tcpCO(2) values during the challenge were significantly (p < 0.001) lower than the corresponding steady state 2 rain after the UNCDW challenge, with a mean drop of -7% (2.1 S.D.). Mean tcpO(2) values remained significantly decreased (p < 0.001) from the fifth mitt of the UNCDW challenge to the end of the observation period, with a mean drop of -20% (15.5 S.D.). After treatment with cromoglycate (Group A), the mean tcpCO(2) values during UNCDW did not change significantly from those ofsteady state conditions: -0.8% (0.5 S.D.); whereas mean tcpO(2) values decreased by -4% (4.9 S.D.). The control children treated with saline (Group B) showed mean tcpCO(2) and tcpO(2) values which were significantly different (p < 0.001) from those of the steady state conditions: mean drop of tcpCO(2), -6% (4.2 S.D.); mean drop of tcpO(2), -20% (4.7 S.D.). In conclusion, it emerges that: UNCDW induces nonspecific broncho-constriction in asthmatic children with a typical drop of tcpCO(2) and tcpO(2); the treatment with cromoglycate normalizes the time course of tcpCO(2) (hyper-reactivity) and reduces dramatically the drop of tcpO(2) time course (hyper-responsivity) during and after the UNCDW test.