A Field-expedient Arm Care Screening Tool Can Identify Musculoskeletal Risk Factors in Baseball Players.

BACKGROUND: Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time prevent high school baseball coaches from performing movement screens on their players. HYPOTHESIS: The arm care screen (ACS) will be highly sensitive to detecting musculoskeletal risk factors. STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 150 baseball players were independently scored on the ACS electronically by reviewing a video recording of each player's screening performance. Discriminability of the ACS was determined with a 2 × 2 contingency table dichotomizing musculoskeletal risk factors as present or absent based on a predetermined cutoff value and those who passed or failed the corresponding ACS subtest. RESULTS: High sensitivity was observed on the reciprocal shoulder mobility (0.89; 95% CI 0.81-0.94), 90/90 total body rotation (0.86; 95% CI 0.79-0.92), and lower body diagonal reach (0.85; 95% CI 0.78-0.91) tests of the ACS suggesting sufficient ability to identify musculoskeletal impairments and risk factors. CONCLUSION: The ACS is a simplistic screening tool that the coach can administer to discriminate between youth, high school, and college-level baseball players who possess musculoskeletal risk factors. The ACS subtests demonstrated high sensitivity for correctly identifying musculoskeletal risk factors common in baseball players and can be useful as a screening tool for baseball coaches developing arm care exercise programs. CLINICAL RELEVANCE: A field-expedient screen could provide coaches the ability to identify musculoskeletal risk factors that need to be addressed to minimize injury risk factors in a time-efficient manner.

The Intra- and Inter-rater Reliability of an Arm Care Screening Tool in High School Baseball Coaches.

BACKGROUND: Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time intensive testing procedures prevent high school coaches from accurately performing frequent movement screens on their players. PURPOSE: To establish the intra-rater and inter-rater reliability of a novel arm care screening tool based on the concepts of the Functional Movement Screen (FMS™) and Selective Functional Movement Assessment (SFMA™) in high school coaches. STUDY DESIGN: Methodological intra- and inter-rater reliability study. METHODS: Thirty-one male high school baseball players (15.9 years ± 1.06) were independently scored on the Arm Care Screen (ACS) by three examiners (two coaches, one physical therapist) in real-time and again seven days later by reviewing video recordings of each players' initial screening performance. Results from each examiner were compared within and between raters using Cohen's kappa and percent absolute agreement. RESULTS: Substantial to excellent intra-rater and inter-rater reliability were established among all raters for each component of the ACS. The mean Cohen's kappa coefficient for intra-rater reliability was 0.76 (95% confidence interval, 0.54-0.95) and percent absolute agreement ranged from 0.82-0.94 among all raters. Inter-rater reliability demonstrated a mean Cohen's kappa value of 0.89 (95% confidence interval, 0.77-0.99) while percent absolute agreement between raters ranged from 0.81-1.00. Intra- and inter-rater reliability did not differ between raters with various movement screening experience (p>0.05). CONCLUSIONS: High school baseball coaches with limited experience screening movement can reliably score all three components of the ACS in less than three minutes with minimal training. LEVEL OF EVIDENCE: Level 3, Reliability study.

Current Concepts in Arm Care Exercise Programs and Injury Risk Reduction in Adolescent Baseball Players: A Clinical Review.

CONTEXT: Awareness of important injury risk factors associated with excessive pitching volume has been highlighted in the literature, but injury rates remain high. Shoulder pain in baseball players is associated with various changes in musculoskeletal movements, which presents as measurable impairments throughout the kinetic chain. Baseball coaches and rehabilitation professionals have utilized exercise programs targeting strength and flexibility of the throwing arm to prevent injuries. The purpose of this review is to summarize the current evidence regarding the effectiveness of arm care exercise programs in reducing upper extremity injury rates in adolescent baseball players. EVIDENCE ACQUISITION: A search of electronic databases, including CINAHL with full text, MEDLINE, and SPORTDiscus was conducted to retrieve available articles in English from the years 2010 through 2020. The search terms injury prevention, exercise, and adolescent baseball were used. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: Improving shoulder internal rotation range of motion by stretching the posterior shoulder muscles daily was associated with a 36% risk reduction of shoulder and elbow injuries. Group-based arm care exercise programs that target multiple musculoskeletal impairments demonstrated an approximately 50% reduced risk of elbow injury. CONCLUSION: For adolescent baseball players, arm care injury prevention programs focusing on important musculoskeletal impairments are effective at reducing injury incidence rates. Multimodal injury prevention programs that improve multiple musculoskeletal impairments are more comprehensive and may result in better injury reduction than programs focusing on a singular impairment.

The Effectiveness of the Transtheoretical Model to Improve Physical Activity in Healthy Adults: A Systematic Review.

BACKGROUND: Despite the known risks of physical inactivity, only 50% of adults meet the recommended guidelines for physical activity (PA). Therefore, numerous interventions have been designed to increase PA across a lifespan. The purpose of this systematic review was to determine the effectiveness of interventions based on the transtheoretical model to improve PA in healthy adults. METHODS: Electronic databases (CINAHL, MEDLINE, Psychology & Behavioral Sciences Collection, PsycINFO, Sociological Collection, and SPORTDiscus) were systematically searched from January 2001 to May 2020. RESULTS: A total of 11 randomized pretest-posttest studies were included in this review. Ten studies utilized a subjective measurement of PA, and 3 studies included an objective measure. Five studies demonstrated significant improvements in PA for the transtheoretical model-based intervention groups compared with control/comparison groups; however, 6 studies demonstrated no differences between groups. CONCLUSION: The findings suggest that there is inconsistent evidence to support the use of interventions based on the transtheoretical model to improve PA in adult populations. Interventions were more successful when materials were delivered via in-person counseling and when study participants were in the precontemplation or contemplation phases at baseline.

Reliability of Clinical Assessment Methods to Measure Scapular Upward Rotation: A Critically Appraised Topic.

Clinical Scenario: Assessing movement of the scapula is an important component in the evaluation and treatment of the shoulder complex. Currently, gold-standard methods to quantify scapular movement include invasive technique, radiation, and 3D motion systems. This critically appraised topic focuses on several clinical assessment methods of quantifying scapular upward rotation with respect to their reliability and clinical utility. Clinical Question: Is there evidence for noninvasive methods that reliably assess clinical measures of scapular upward rotation in subjects with or without shoulder pathologies? Summary of Key Findings: Four studies were selected to be critically appraised. The quality appraisal of diagnostic reliability checklist was used to score the articles on methodology and consistency. Three of the 4 studies demonstrated support for the clinical question. Clinical Bottom Line: There is moderate evidence to support reliable clinical methods for measuring scapular upward rotation in subjects with or without shoulder pathology. Strength of Recommendation: There is moderate evidence to suggest there are reliable clinical measures to quantify scapular upward rotation in patients with or without shoulder pathology.

Reliability of 5 Novel Reaction Time and Cognitive Load Protocols.

CONTEXT: Reaction time (RT) is crucial to athletic performance. Therefore, when returning athletes to play following injury, it is important to evaluate RT characteristics ensuring a safe return. The Dynavision D2® system may be utilized as an assessment and rehabilitation aid in the determination of RT under various levels of cognitive load. Previous research has demonstrated good reliability of simple protocols when assessed following a 24- to 48-hour test-retest window. Expanding reliable test-retest intervals may further refine novel RT protocols for use as a diagnostic and rehabilitation tool. OBJECTIVE: To investigate the test-retest reliability of a battery of 5 novel RT protocols at different time intervals. DESIGN: Repeated measures/reliability. SETTING: Interdisciplinary sports medicine research laboratory. PARTICIPANTS: Thirty healthy individuals. METHODS: Participants completed a battery of protocols increasing in difficulty in terms of reaction speed requirement and cognitive load. Prior to testing, participants were provided 3 familiarization trials. All protocols required participants to hit as many lights as quickly as possible in 60 seconds. After completing the initial testing session (session 1), participants waited 1 hour before completing the second session (session 2). Approximately 2 weeks later (average 14 [4] d), the participants completed the same battery of tasks for the third session (session 3). MAIN OUTCOME MEASURES: The intraclass correlation coefficient, standard error of measurement, minimal detectable change, and repeated-measures analysis of variance were calculated for RT. RESULTS: The intraclass correlation coefficient values for each of the 5 protocols illustrated good to excellent reliability between sessions 1, 2, and 3 (.75-.90). There were no significant differences across time points (F < 0.105, P > .05). CONCLUSIONS: The 1-hour and 14-day test-retest intervals are reliable for clinical assessment, expanding the time frames previously reported in the literature of when assessments can be completed reliably. This study provides novel protocols that challenge cognition in unique ways.