The Effect of Exertion on Joint Kinematics and Kinetics During Running Using a Waveform Analysis Approach

2015 ◽  
Vol 31 (4) ◽  
pp. 250-257 ◽  
Author(s):  
Lauren C. Benson ◽  
Kristian M. O’Connor
Keyword(s):  
Internal Rotation ◽  
Repeated Measures ◽  
External Rotation ◽  
Statistical Significance ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Principal Component ◽  
Waveform Analysis ◽  
Joint Mechanics ◽  
Before And After

About half of all runners sustain a running-related injury every year. Exertion may contribute to risk of injury by altering joint mechanics. The purpose of this study was to examine the effects of exertion on runners’ joint mechanics using principal component analysis (PCA). Three-dimensional motion analysis of the lower extremity was performed on 16 healthy female runners before and after their typical training run. PCA was used to determine exertion-related changes in joint mechanics at the ankle, knee, and hip. Statistical significance for repeated-measures MANOVA of the retained principal components at each joint and plane of motion was at P < .05. Exercise effects were identified at the ankle (greater rate of eversion [PC2: P = .027], and decreased plantar flexion moment [overall: P = .044] and external rotation moment [PC3: P = .003]), knee (increased adduction [overall: P = .044] and internal rotation [PC3: P = .034], and decreased abduction moment [overall: P = .045]), and hip (increased internal rotation [PC1: P = .013] and range of mid- to late-stance rotation [PC2: P = .009], and decreased internal rotation moment [PC1: P = .001]). The observed changes in running mechanics reflect a gait profile that is often linked to running injury. The effects of more strenuous activity may result in mechanics that present an even greater risk for injury.

scholarly journals Validity and reliability of smartphone applications for measurement of hip rotation, compared with three‐dimensional motion analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Phob Ganokroj ◽  
Nuchanun Sompornpanich ◽  
Pichitpol Kerdsomnuek ◽  
Bavornrat Vanadurongwan ◽  
Pisit Lertwanich
Keyword(s):  
Internal Rotation ◽  
Motion Analysis ◽  
Supine Position ◽  
External Rotation ◽  
Three Dimensional ◽  
Angle Measurement ◽  
Smartphone Applications ◽  
Rater Reliability ◽  
Link Type ◽  
Hip Rotation

Abstract Background Measurement of hip rotation is a crucial clinical parameter for the identification of hip problems and the monitoring of symptoms. The objective of this study was to determine whether the use of two smartphone applications is valid and reliable for the measurement of hip rotation. Methods An experimental, cross-sectional study was undertaken to assess passive hip internal and external rotation in three positions by two examiners. The hip rotational angles were measured by a smartphone clinometer application in the sitting and prone positions, and by a smartphone compass application in the supine position; their results were compared with those of the standard, three-dimensional, motion analysis system. The validities and inter-rater and intra-rater reliabilities of the smartphone applications were evaluated. Results The study involved 24 participants. The validities were good to excellent for the internal rotation angles in all positions (ICC 0.81–0.94), good for the external rotation angles in the prone position (ICC 0.79), and fair for the sitting and supine positions (ICC 0.70–0.73). The measurement of the hip internal rotation in the supine position had the highest ICC value of 0.94 (0.91, 0.96). The two smartphone applications showed good-to-excellent intra-rater reliability, but good-to-excellent inter-rater reliability for only three of the six positions (two other positions had fair reliability, while one position demonstrated poor reliability). Conclusions The two smartphone applications have good-to-excellent validity and intra-rater reliability, but only fair-to-good inter-rater reliability for the measurement of the hip rotational angle. The most valid hip rotational position in this study was the supine IR angle measurement, while the lowest validity was the ER angle measurement in the sitting position. The smartphone application is one of the practical measurements in hip rotational angles. Trial registration Number 20181022003 at the Thai Clinical Trials Registry (http://www.clinicaltrials.in.th) which was retrospectively registered at 2018-10-18 15:30:29.

scholarly journals Cytotoxicity of three-dimensional paper-based models from a three-dimensional paper-based printer

NEMESIS ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 15 ◽  
Author(s):  
Marcin Kozakiewicz ◽  
Piotr Szymor ◽  
Raphael Olszewski
Keyword(s):  
Operating Room ◽  
Dermal Fibroblast ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Dermal Fibroblasts ◽  
Tissue Adhesive ◽  
Biological Behaviour ◽  
Sterilization Method ◽  
Significant Difference ◽  
Before And After

Objective: Our study aimed to determine the possibility of using models created with a low-cost, paper based 3D printer in an operating room. Therefore influence of different methods of sterilization on models was tested and cytotoxicity of generated models was determined. Material and methods: 30 cuboids divided into three groups were used for verification of shape stability after sterilization. Each group was sterilized either with: Ethylene oxide in temperature 55˚C, Hydrogen peroxide gas plasma in temperature 60˚C or Gamma irradiation at 21˚C, 25kGy. Each cuboid was measured using calliper three times before and three times after sterilization. Results were analysed statistically in Statgraphics Plus. Statistical significance was determined as p< 0.05. Sixty cylinders divided into six groups were used for cytotoxicity tests. Three of those groups were covered before sterilization with 2-octyl-cyanoacrylate. Each group was sterilized with one of the previously described methods. Cytotoxicity was tested by Nanostructural and Molecular Biophysics Laboratory in Technopark Lodz using normal adult human dermal fibroblasts. Survival of cells was tested using spectrophotometry with XTT and was defined as ratio of absorbency of tested probe to absorbency of control probe. Calcein/Ethidium dyeing test was performed according to LIVE/DEAD Viability/Cytotoxicity Kit protocol. Observation was done under Olympus GX71 fluorescence microscope. Results: There was no statistically significant difference for established statistical significance p=0.05 in cuboids dimensions before and after sterilization regardless of sterilization method. In XTT analysis all samples showed higher cytotoxicity against normal, human, adult dermal fibroblast culture when compared to positive control. ANOVA statistical analysis confirmed that 2-octyl cyanoacrylate coating of paper model improved biological behaviour of the material. It decreased cytotoxicity of the model independently of sterilization method. In calcein/ethidium dyeing test due to the high fluorescence of the background caused by cylinders of analysed substance it was impossible to perform the exact analysis of the number of marked cells. Conclusions: Acquired results allow to conclude that Mcor Technology Matrix 300 3D paper-based models can be used in operating room only if covered with cyanoacrylate tissue adhesive. Nemesis relevance: We found no statistically significant difference in cuboids dimensions before and after sterilization regardless of sterilization method. Three-dimensional paper-based models present with high cytotoxicity without coating.

Late Rearfoot Eversion and Lower-limb Internal Rotation Caused by Changes in the Interaction between Forefoot and Support Surface

2009 ◽  
Vol 99 (6) ◽  
pp. 503-511 ◽  
Author(s):  
Thales R. Souza ◽  
Rafael Z. Pinto ◽  
Renato G. Trede ◽  
Renata N. Kirkwood ◽  
Antônio E. Pertence ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Internal Rotation ◽  
Lower Limb ◽  
Repeated Measures ◽  
Three Dimensional ◽  
Support Surface ◽  
Kinetic Chain ◽  
Mechanical Factors ◽  
Lateral Wedges ◽  
Rearfoot Eversion

Background: The influence of distal mechanical factors that change the interaction between the forefoot and the support surface on lower-limb kinematics is not well established. This study investigated the effects of the use of lateral wedges under the forefoot on the kinematics of the lower extremity during the stance phase of walking. Methods: Sixteen healthy young adults participated in this repeated-measures study. They walked wearing flat sandals and laterally wedged sandals, which were medially inclined only in the forefoot. One wedged sandal had a forefoot lateral wedge of 5° and the other wedged sandal had a forefoot lateral wedge of 10°. Kinematic variables of the lower extremity, theoretically considered clinically relevant for injury development, were measured with a three-dimensional motion analysis system. The variables were evaluated for three subphases of stance: loading response, midstance, and late stance. Results: The 5° laterally wedged sandal increased rearfoot eversion during midstance and the 10° laterally wedged sandal increased rearfoot eversion during mid- and late stances, in comparison to the use of flat sandals. The 10° laterally wedged sandal produced greater internal rotation of the shank relative to the pelvis and of the hip joint, during the midstance, also compared to the use of flat sandals. Conclusions: Lateral wedges under the forefoot increase rearfoot eversion during mid-and late stances and may cause proximal kinematic changes throughout the lower-extremity kinetic chain. Distal mechanical factors should be clinically addressed when a patient presents late excessive rearfoot eversion during walking. (J Am Podiatr Med Assoc 99(6): 503–511, 2009)

scholarly journals A Kinematic Analysis of Fundamental Movement Skills

2016 ◽  
Vol 25 (3-4) ◽  
pp. 261-275 ◽  
Author(s):  
Cain C. T. Clark ◽  
Claire M. Barnes ◽  
Mark Holton ◽  
Huw D. Summers ◽  
Gareth Stratton
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Three Dimensional ◽  
Rotation Velocity ◽  
Building Blocks ◽  
Mass Range ◽  
Centre Of Mass ◽  
Movement Skills ◽  
Fundamental Movement Skills ◽  
The Relationship

Abstract Fundamental movement skills are considered the basic building blocks for movement and provide the foundation for specialized and sport-specific movement skills required for participation in a variety of physical activities. However, kinematic analyses of fundamental movement has not been performed. The aims of this study were to, (1) characterise the relationship between facets of fundamental movement and, (2) characterise the relationship between overall integrated acceleration and three-dimensional kinematic variables whilst performing fundamental movement skills. Eleven participants (10±0.8y, 1.41±0.07m, 33.4±8.6kg, body mass index; 16.4±3.1 kg·m2) took part in this study, had anthropometric variables recorded and performed a series of fundamental movement tasks, whilst wearing a tri-axial accelerometer and were recorded using a three-dimensional motion capture system. Maximum shoulder external rotation (°) and maximum shoulder internal rotation velocity (°.s−1) (r=0.86, p<0.001), mediolateral centre of mass range (cm) and centre of mass coefficient of variation (%) (r=0.83, p<0.001), maximum stride angle (°) in the jog and walk (r=0.74, p=0.01) and maximum sprint stride angle and maximum shoulder internal rotation velocity (°.s−1) (r=0.67, p<0.02) were significantly correlated. Maximum sprint stride angle (hip: r=0.96, p<0.001, ankle: r=0.97, p<0.001) and maximum internal rotation velocity (ankle: r=0.6, p=0.05) were significantly correlated to overall integrated acceleration. Overall integrated acceleration was comparable between participants (CV: 10.5), whereas three-dimensional variables varied by up to 65%. Although overall integrated acceleration was comparable between participants, three-dimensional variables were much more varied. Indicating that although overall activity may be correspondent, the characteristics of a child’s movement may be highly varied.

Infraspinatus Cross-Sectional Area and Shoulder Range of Motion Change Following Live-Game Baseball Pitching

2019 ◽  
Vol 28 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Brett S. Pexa ◽  
Eric D. Ryan ◽  
Elizabeth E. Hibberd ◽  
Elizabeth Teel ◽  
Terri Jo Rucinski ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Athletic Training ◽  
Repeated Measures ◽  
External Rotation ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Shoulder Range Of Motion ◽  
Posterior Shoulder ◽  
Before And After

Context: Following a baseball pitching bout, changes can occur to glenohumeral range of motion that could be linked to injury. These effects are in part due to the posterior shoulder’s eccentric muscle activity, which can disrupt muscle contractile elements and lead to changes in muscle cross-sectional area (CSA), as measured by ultrasound. Objective: To assess changes in muscle CSA, and range of motion immediately before and after pitching, and days 1 to 5 following pitching. Design: Repeated measures. Setting: Satellite athletic training room. Patients: Ten elite college baseball pitchers participating in the fall season (age: 18.8 [1.2] y, height: 189.2 [7.3] cm, mass: 93.1 [15.3] kg, 8 starters, 2 long relievers). Intervention: A pitching bout of at least 25 pitches (63.82 [17.42] pitches). Main Outcome Measures: Dominant and nondominant infraspinatus CSA, as measured by ultrasound, and glenohumeral range of motion including internal rotation (IRROM), external rotation (ERROM), and total rotation range of motion (TROM) before pitching, after pitching, and days 1 to 5 following the pitching bout. Results: Dominant limb CSA significantly increased day 1 after pitching, and returned to baseline on day 2 (P < .001). Dominant and nondominant TROM did not change until day 5 (4.4°, P < .001) and day 3 (4.5°, P < .001), respectively, where they increased. Dominant IRROM was significantly decreased for 3 days (day 1: 1.9°, P < .001; day 2: 3.1°, P < .001; day 3: 0.3°, P < .001) following pitching and returned to baseline on day 4, with no such changes in the nondominant limb. Dominant external rotation significantly increased immediately post pitching (4.4°, P < .001) but returned to baseline by day 1. Conclusions: The results of the study demonstrate that infraspinatus CSA does not recover until 2 days following pitching, and IRROM does not recover until 4 days following pitching. Baseball pitching elicits damage to the posterior shoulder muscle architecture, resulting in changes to physical characteristics that last up to 4 days following pitching.

Three-Dimensional Scapular Kinematics during the Throwing Motion

2008 ◽  
Vol 24 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Kristin E. Meyer ◽  
Erin E. Saether ◽  
Emily K. Soiney ◽  
Meegan S. Shebeck ◽  
Keith L. Paddock ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Angular Position ◽  
Three Dimensional ◽  
Low Velocity ◽  
Dynamic Activity ◽  
Motion Data ◽  
Asymptomatic Subjects ◽  
Scapular Motion

Proper scapular motion is crucial for normal shoulder mechanics. Scapular motion affects glenohumeral joint function during throwing, yet little is known about this dynamic activity. Asymptomatic subjects (10 male and 10 female), ages 21 to 45, were analyzed. Electromagnetic surface sensors on the sternum, acromion, and humerus were used to collect 3-D motion data during three trials of low-velocity throwing. Scapular angular position data were described for five predetermined events throughout the throw corresponding with classic descriptions of throwing phases, and trial-to-trial reliability was determined. ANOVA compared scapular angles across events. Subjects demonstrated good to excellent reliability between trials of the throw (ICC 0.74–0.98). The scapula demonstrated a pattern of external rotation, upward rotation (peak of approx. 40°), and posterior tilting during the initial phases of the throw, progressing into internal rotation after maximum humeral horizontal abduction. During the arm acceleration phase, the scapula moved toward greater internal rotation and began anteriorly tilting. At maximum humeral internal rotation, the scapula ended in internal rotation (55°), upward rotation (20°), and anterior tilting (3°).

scholarly journals A novel metric reveals previously unrecognized distortion in dimensionality reduction of scRNA-Seq data

2019 ◽  
Author(s):  
Shamus M. Cooley ◽  
Timothy Hamilton ◽  
J. Christian J. Ray ◽  
Eric J. Deeds
Keyword(s):  
Dimensionality Reduction ◽  
Single Cells ◽  
High Dimensional Data ◽  
Three Dimensional ◽  
Principal Component ◽  
Cell Types ◽  
High Dimensional ◽  
Before And After ◽  
Downstream Analysis ◽  
High Level

AbstractHigh-dimensional data are becoming increasingly common in nearly all areas of science. Developing approaches to analyze these data and understand their meaning is a pressing issue. This is particularly true for the rapidly growing field of single-cell RNA-Seq (scRNA-Seq), a technique that simultaneously measures the expression of tens of thousands of genes in thousands to millions of single cells. The emerging consensus for analysis workflows reduces the dimensionality of the dataset before performing downstream analysis, such as assignment of cell types. One problem with this approach is that dimensionality reduction can introduce substantial distortion into the data; consider the familiar example of trying to represent the three-dimensional earth as a two-dimensional map. It is currently unclear if such distortion affects analysis of scRNA-Seq data sets. Here, we introduce a straightforward approach to quantifying this distortion by comparing the local neighborhoods of points before and after dimensionality reduction. We found that popular techniques like t-SNE and UMAP introduce substantial distortion even for relatively simple geometries such as simulated hyperspheres. For scRNA-Seq data, we found the distortion in local neighborhoods was often greater than 95% in the representations typically used for downstream analysis. This high level of distortion can readily introduce important errors into cell type identification, pseudotime ordering, and other analyses that rely on local relationships. We found that principal component analysis can generate accurate embeddings of the data, but only when using dimensionalities that are much higher than typically used in scRNA-Seq analysis. We suggest approaches to take these findings into account and call for a new generation of dimensional reduction algorithms that can accurately embed high dimensional data in its true latent dimension.

scholarly journals Changes in Fatigue, Multiplanar Knee Laxity, and Landing Biomechanics During Intermittent Exercise

2015 ◽  
Vol 50 (5) ◽  
pp. 486-497 ◽  
Author(s):  
Sandra J. Shultz ◽  
Randy J. Schmitz ◽  
John R. Cone ◽  
Robert A. Henson ◽  
Melissa M. Montgomery ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Hierarchical Linear Modeling ◽  
Intermittent Exercise ◽  
External Rotation ◽  
Knee Laxity ◽  
Knee Valgus ◽  
Linear Modeling ◽  
Warm Up ◽  
Landing Biomechanics ◽  
Before And After

Context Knee laxity increases during exercise. However, no one, to our knowledge, has examined whether these increases contribute to higher-risk landing biomechanics during prolonged, fatiguing exercise. Objectives To examine associations between changes in fatigue (measured as sprint time [SPTIME]), multiplanar knee laxity (anterior-posterior [APLAX], varus-valgus [VVLAX] knee laxity, and internal-external rotation [IERLAX]) knee laxity and landing biomechanics during prolonged, intermittent exercise. Design Descriptive laboratory study. Setting Laboratory and gymnasium. Patients or Other Participants A total of 30 male (age = 20.3 ± 2.0 years, height = 1.79 ± 0.05 m, mass = 75.2 ± 7.2 kg) and 29 female (age = 20.5 ± 2.3 years, height = 1.67 ± 0.08 m, mass = 61.8 ± 9.0 kg) competitive athletes. Intervention(s) A 90-minute intermittent exercise protocol (IEP) designed to simulate the physiologic and biomechanical demands of a soccer match. Main Outcome Measure(s) We measured SPTIME, APLAX, and landing biomechanics before and after warm-up, every 15 minutes during the IEP, and every 15 minutes for 1 hour after the IEP. We measured VVLAX and IERLAX before and after the warm-up, at 45 and 90 minutes during the IEP, and at 30 minutes after the IEP. We used hierarchical linear modeling to examine associations between exercise-related changes in SPTIME and knee laxity with exercise-related changes in landing biomechanics while controlling for initial (before warm-up) knee laxity. Results We found that SPTIME had a more global effect on landing biomechanics in women than in men, resulting in a more upright landing and a reduction in landing forces and out-of-plane motions about the knee. As APLAX increased with exercise, women increased their knee internal-rotation motion (P = .02), and men increased their hip-flexion motion and energy-absorption (P = .006) and knee-extensor loads (P = .04). As VVLAX and IERLAX increased, women went through greater knee-valgus motion and dorsiflexion and absorbed more energy at the knee (P ≤ .05), whereas men were positioned in greater hip external and knee internal rotation and knee valgus throughout the landing (P = .03). The observed fatigue- and laxity-related changes in landing biomechanics during exercise often depended on initial knee laxity. Conclusions Both exercise-related changes in fatigue and knee laxity were associated with higher-risk landing biomechanics during prolonged exercise. These relationships were more pronounced in participants with greater initial knee laxity.

scholarly journals Effect of Glenohumeral Internal Rotation Deficit on Shoulder in Baseball Pitchers during Fastball Pitching

2020 ◽  
Vol 17 (21) ◽  
pp. 8211
Author(s):  
Hwai-Ting Lin ◽  
Yu-Chuan Lin ◽  
You-Li Chou ◽  
Hung-Chien Wu ◽  
Rong-Tyai Wang ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Motion Analysis ◽  
External Rotation ◽  
Three Dimensional ◽  
Limited Information ◽  
Shoulder Injury ◽  
Acceleration Phase ◽  
Glenohumeral Internal Rotation Deficit ◽  
Baseball Pitchers ◽  
Analysis System

Previous studies have reported that pitchers with glenohumeral internal rotation deficit (GIRD) may increase the risk of shoulder injury. However, limited information is available regarding the specific effects of GIRD in baseball pitching. The purpose of this study was to investigate whether baseball pitchers with GIRD change their pitching mechanism. Fifteen baseball pitchers with GIRD and 15 pitchers without GIRD were recruited from university or senior high-school teams. A three-dimensional motion analysis system (Eagle System, Motion Analysis Corporation, Santa Rosa, CA, USA) was used to capture the pitching motion while performing fastball pitches. The kinematics and kinetics of the throwing shoulder and trunk were analyzed based on motion captured data. The Mann–Whitney U test was used to test the differences of the analyzed parameters between two groups. At the instant of ball release, the GIRD group showed lower shoulder external rotation and trunk rotation, and larger shoulder horizontal adduction. In addition, the GIRD group exhibited a significantly larger shoulder inferior force in the cocking and acceleration phase, and a significantly larger internal rotation torque in the acceleration phase. The present results suggested that pitchers with GIRD need stretch training to enlarge joint range of motion, and to improve trunk strength and flexibility to alleviate potential problems associated with pitching in GIRD pitchers.

scholarly journals Acute effect of posterior deltoid static stretching on Glenohumeral Internal Rotation Deficit in elite swimmers after competition. A randomized trial

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
M Solana-Tramunt ◽  
R Lopez-Vidriero ◽  
E Lopez-Vidriero
Keyword(s):  
Internal Rotation ◽  
Repeated Measures ◽  
Sagittal Plane ◽  
External Rotation ◽  
National Level ◽  
Control Group ◽  
Overhead Athletes ◽  
Repeated Measures Design ◽  
Glenohumeral Internal Rotation Deficit ◽  
Experimental Group

Objectives: The aim of this study was to determine whether a static stretch of posterior deltoid could reduce the glenohumeral internal rotation deficit (GIRD) and the total arc of movement deficit (TAMD) in professional swimmers after competition. Methods: Participants: A total of 74 professional swimmers aged from 16-33 years volunteered to participated in the study. Their competition experience were more than 2 years at national level. All the subjects were informed in written and verbal form and signed their informed consent before being assessed. Design and procedures: A randomized repeated measures design was used to assess the glenohumeral rotation in 3 moments: prior to the race, just after finishing their trial and after performing a static passive stretch of posterior deltoid muscles of 90-sec. In randomized order the computer selected 20 subjects as a control group (CG) who didn’t perform the stretching. The experimental group (EG) included 54 swimmers. The glenohumeral internal and external rotation (IR and ER) were recorded by a video camera (IPhone 6 S, version 10.1), in sagittal plane, with the center of the screen at shoulder high. Subjects were laying on supine position over a massage table, with the glenohumeral joint at 90° of abduction, the elbow at 90° of flexion, and the researcher controlling the scapula movements by pushing the shoulder over coracoid apophasis. The App Thechnique (Ubersense ©) was used to measure the glenohumeral rotation degrees between the vertical line (controlled by a plumb) and the forearm segment. Results: The multifactorial ANOVA showed that there were significant differences on GIRD and TAMD between the experimental and the control group performing the stretching F(2,70)=49.150, P=0.000, η2p=0.992. The experimental group reduced the GIRD a16.2% and the TAMD a 6.7%. The dominant IR mean values changed significantly from 66.3±12.5 to 79.2±10.4 degrees for EG ( P=0.00) and non-significantly for CG, from 74.6±12.7 to 77.6±13.9 degrees ( P=0.11). The dominant TAM means changed significantly in EG from 173.2±16.8 to 192.0±17.0 degrees ( P=0.00) and non- significantly for CG 181.5±21.7 to 188.2±23.3 degrees ( P=0.12). Conclusion: To apply a static passive stretching on posterior deltoid during 90-sec reduced GIRD and the TAMD in professional swimmers after competition, which suggest a reduced risk of shoulder injury in these overhead athletes.

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