Functional Strength Ratio in Athletes with and Without Glenohumeral Internal Rotation Deficit (GIRD)

Objectives: Eccentric external rotator (ER) and concentric internal rotator (IR) strength is expressed as a functional strength ratio (ER:IR) for shoulder. The difference in functional strength ratio has been well documented in athletes, but no one compared the functional ratio in athletes with glenohumeral internal rotation deficit (GIRD). The aim of this study was to investigate the effects of GIRD on functional ER:IR strength ratio of the adolescent athletes. Methods: Fifty-three adolescent athletes (12-18 years) from basketball and volleyball teams participated in the study. All the athletes were filled a questionnaire to obtain demographic information and information about their sporting activity. To determine the GIRD, the range of glenohumeral internal rotation motion was measured with the use of a digital inclinometer. An isokinetic dynamometer was used for the assessment of eccentric and concentric muscle strength of the dominant and non-dominant shoulders. Student-t test was used to assess the difference on ER:IR strength ratio between groups. Results: After the clinical examination of all shoulders the athletes were divided into 2 different groups, which were shoulders with glenohumeral internal rotation deficit (Group 1, n=34) and shoulders without GIRD (Group 2, n=22). There was a significant difference among groups on functional ER: IR strength ratio (t=-2.172, p=0.034). The ratio was lower in shoulders with GIRD. Conclusion: GIRD has an adverse effect on functional shoulder ratio, which is one of the causes of shoulder injuries in adolescent athletes. Therefore, GIRD should be treated to prevent future injuries.

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The Effect of Glenohumeral Internal-Rotation Deficit on Functional Rotator-Strength Ratio in Adolescent Overhead Athletes

Journal of Sport Rehabilitation ◽

10.1123/jsr.2014-0260 ◽

2016 ◽

Vol 25 (1) ◽

pp. 52-57 ◽

Cited By ~ 8

Author(s):

Hande Guney ◽

Gulcan Harput ◽

Filiz Colakoglu ◽

Gul Baltaci

Keyword(s):

Adverse Effect ◽

Internal Rotation ◽

Outcome Measures ◽

Cross Sectional Study ◽

Shoulder Injuries ◽

Cross Sectional ◽

Overhead Athletes ◽

Glenohumeral Internal Rotation Deficit ◽

Significant Difference ◽

The Difference

Context:Glenohumeral (GH) internal-rotation deficit (GIRD) and lower eccentric external-rotator (ER) to concentric internal-rotator (IR) strength (ER:IR) ratio have been documented as risk factors for shoulder injuries, but there is no information on whether GIRD has an adverse effect on ER:IR ratio in adolescent overhead athletes.Objectives:The aim of this study was to investigate the effects of GIRD on functional ER:IR ratio of the adolescent overhead athletes.Design:Cross-sectional study.Setting:University research laboratory.Participants:52 adolescent overhead athletes.Main Outcome Measures:To determine GIRD, the range of GH IR and ER motion was measured with a digital inclinometer. An isokinetic dynamometer was used to assess eccentric and concentric IR and ER muscle strength of the dominant and nondominant shoulders. One-way ANCOVA where sport type was set as a covariate was used to analyze the difference between athletes with and without GIRD.Results:After standardized examinations of all shoulders, the athletes were divided into 2 groups, shoulders with (n = 27) and without GIRD (n = 25). There was a significant difference between groups in functional ER:IR ratio (P < .001). Athletes with GIRD had lower ER:IR ratio (0.56) than athletes without GIRD (0.83).Conclusions:As GIRD has an adverse effect on functional ratio of the shoulder-rotator muscles, interventions for adolescent overhead athletes should include improving GH-rotation range of motion.

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Measurement of Glenohumeral Internal Rotation in Asymptomatic Tennis Players and Swimmers

The American Journal of Sports Medicine ◽

10.1177/0363546508329544 ◽

2009 ◽

Vol 37 (5) ◽

pp. 1017-1023 ◽

Cited By ~ 41

Author(s):

Renato Rangel Torres ◽

João Luiz Ellera Gomes

Keyword(s):

Internal Rotation ◽

External Rotation ◽

Control Group ◽

Level Of Evidence ◽

Cross Sectional ◽

Tennis Players ◽

Glenohumeral Internal Rotation Deficit ◽

Significant Difference ◽

Overhead Sports ◽

The Difference

Background Glenohumeral internal rotation deficit, often diagnosed in players of overhead sports, has been associated with the development of secondary shoulder lesions. Hypothesis Asymptomatic players of different overhead sports will exhibit variable degrees of glenohumeral internal rotation deficit. Study Design Cross-sectional study; Level of evidence, 3. Methods Fifty-four asymptomatic male volunteers (108 shoulders) divided into 3 groups (tennis players, swimmers, control group) underwent measurements of glenohumeral internal and external rotation using clinical examination with scapular stabilization. Measurements of dominant and nondominant shoulders were compared within and between groups. Glenohumeral internal rotation deficit (GIRD) was defined as the difference in internal rotation between the nondominant and dominant shoulders. Results In tennis players, mean GIRD was 23.9° ± 8.4° (P < .001); in swimmers, 12° ± 6.8° (P < .001); and in the control group, 4.9° ± 7.4° (P = .035). Dominant shoulders showed significant difference between all groups, and the difference in internal rotation of the dominant shoulder between the group of tennis players in comparison with the control group (27.6°, P < .001) was greater than the difference in internal rotation of the dominant shoulder found in the group of swimmers compared with the control group (17.9°, P < .001). Between tennis players and swimmers, the difference in internal rotation of the dominant shoulder was 9.7° (P = .002). Conclusion Dominant limbs showed less glenohumeral internal rotation than the nondominant limbs in all groups, with the deficit in the group of tennis players about twice the deficit found for swimmers. Mean difference between limbs in the control group was less than 5°, which is within normal parameters according to most studies. There were statistically significant differences between all groups when dominant shoulders were compared with each other, differences that were not compensated by external rotation gain. Tennis players had the least range of motion, followed by swimmers.

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A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

The Journal of Laryngology & Otology ◽

10.1017/s0022215121000293 ◽

2021 ◽

pp. 1-5

Author(s):

A H A Baazil ◽

J G G Dobbe ◽

E van Spronsen ◽

F A Ebbens ◽

F G Dikkers ◽

...

Keyword(s):

Computed Tomography ◽

Middle Ear ◽

Three Dimensional ◽

Endoscopic Approach ◽

Microscopic Approach ◽

Significant Difference ◽

Computed Tomography Scans ◽

The Difference ◽

Group 2 ◽

Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

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The Biomechanics of Shoulder Movement with Implications for Shoulder Injury in Table Tennis: A Minireview

Applied Bionics and Biomechanics ◽

10.1155/2021/9988857 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Liang Li ◽

Feng Ren ◽

Julien S. Baker

Keyword(s):

Internal Rotation ◽

Clinical Treatment ◽

Table Tennis ◽

Shoulder Injuries ◽

Shoulder Injury ◽

Tennis Players ◽

Future Studies ◽

Glenohumeral Internal Rotation Deficit ◽

Shoulder Movement ◽

Injury Mechanisms

A high proportion of shoulder injuries in table tennis players are common, which is both a diagnostic and therapeutic challenge. An understanding of the interaction between biomechanical function of the shoulder and mechanisms of shoulder injuries in table tennis players is necessary to prevent injury and to conduct clinical treatment of the shoulder as soon as possible. The purpose of this minireview was to select the available evidence on the biomechanical characteristics of shoulder movement and potential relationships with various shoulder injuries that are common in table tennis players. Five studies revealed interesting biomechanical characteristics of shoulder movement patterns in table tennis players: large internal rotation torque, an increased torsion-rotation movement, and a greater angular velocity of internal rotation were found. Two studies were noted that were related to specific shoulder injury: glenohumeral internal rotation deficit (GIRD) and impingement syndrome. Unfortunately, it is difficult to draw conclusions on the mechanisms of shoulder injury in table tennis players due to the little evidence available that has investigated shoulder injury mechanisms based on biomechanical characteristics. Future studies should focus on the potential relationship between the biomechanical characteristics of the shoulder and injury prevalence to provide valuable reference data for clinical treatment.

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The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

International Surgery Journal ◽

10.18203/2349-2902.isj20205423 ◽

2020 ◽

Vol 8 (1) ◽

pp. 24

Author(s):

Ali G. Mohammed Redha ◽

Adil A. Jaber ◽

Aqeel M. Nasser

Keyword(s):

Hernia Repair ◽

Mesh Fixation ◽

Good Alternative ◽

P Value ◽

Absorbable Sutures ◽

Significant Difference ◽

The Difference ◽

Group 2 ◽

One Year ◽

Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.

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Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.811 ◽

2018 ◽

pp. 1

Author(s):

Baris Buke ◽

Hatice Akkaya ◽

Cigdem Karakukcu

Keyword(s):

Cesarean Section ◽

Inflammatory Reaction ◽

Operation Time ◽

Blood Samples ◽

Inflammatory Reactions ◽

Tnf Α ◽

Significant Difference ◽

The Difference ◽

Group 2 ◽

Group 1

Objectives: There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels. To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique.Study Desıgn: The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups.Results: There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001).Conclusions: The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.

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Physiotherapy following cardiac surgery: Program comparison

SHS Web of Conferences ◽

10.1051/shsconf/20184002012 ◽

2018 ◽

Vol 40 ◽

pp. 02012

Author(s):

D. Pulmane ◽

A. Vetra ◽

R. Lacis ◽

D. Driba

Keyword(s):

Cardiac Surgery ◽

Artery Bypass ◽

Bypass Graft ◽

Forced Expiratory Volume ◽

Replacement Surgery ◽

Respiratory Parameters ◽

Significant Difference ◽

Before And After ◽

The Difference ◽

Group 2

The objective is to examine and compare the usability of two physiotherapy programmes, analyzing respiratory function in patients before and after cardiac surgery in hospital during seven postoperative days (POD). Quantitative randomized prospective study of 157 patients before and after the valve replacement surgery, coronary artery bypass graft and combined surgeries, who moved independently. Participants were randomized into two groups (1 and 2) with different physiotherapy programmes. The routine physiotherapy of breath-enhancing techniques, micro-circulation improvement were used for the first group, for the second group - modified physiotherapy – the improvement of inspiration muscles, mm. quadriceps. gluteus max strength. Anthropometric measurements were defined for both groups on the day before surgery and during spirography - dynamic indicators - forced vital capacity (FVC), forced expiratory volume in the 2nd second (FEV1), Tiffeneau index (FEV1 / VC (%)), peak expiratory flow (PEF), operation parameters. By comparing the postoperative respiratory parameters between the two groups and using independent samples t test, it was found out that the difference in FVC between groups is 1.71 [95% CI: −8.25 to 4.8] and it is not statistically significant (t (155) = −0.52; p = 0.60). Based on the Leuven test results FVC the distribution variance is not statistically notably different for group 1 and group 2 (F = 0.27, p=0.60). Using routine and modified physiotherapy and comparing postoperative dynamic respiratory performance of the two groups, there was no statistically significant difference, proving that the two models are equally effective.

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Shoulder-Rotator Strength, Range of Motion, and Acromiohumeral Distance in Asymptomatic Adolescent Volleyball Attackers

Journal of Athletic Training ◽

10.4085/1062-6050-51.12.04 ◽

2016 ◽

Vol 51 (9) ◽

pp. 733-738 ◽

Cited By ~ 7

Author(s):

Gulcan Harput ◽

Hande Guney ◽

Ugur Toprak ◽

Tunca Kaya ◽

Fatma Filiz Colakoglu ◽

...

Keyword(s):

Range Of Motion ◽

High Performance ◽

Glenohumeral Joint ◽

External Rotation ◽

Cross Sectional Study ◽

Shoulder Injuries ◽

Adolescent Athletes ◽

Cross Sectional ◽

Acromiohumeral Distance ◽

External Rotator

Context: Sport-specific adaptations at the glenohumeral joint could occur in adolescent athletes because they start participating in high-performance sports in early childhood. Objective: To investigate shoulder-rotator strength, internal-rotation (IR) and external-rotation (ER) range of motion (ROM), and acromiohumeral distance (AHD) in asymptomatic adolescent volleyball attackers to determine if they have risk factors for injury. Design: Cross-sectional study. Setting: University laboratory. Participants: Thirty-nine adolescent high school-aged volleyball attackers (22 boys, 17 girls; age = 16.0 ± 1.4 years, height = 179.2 ± 9.0 cm, mass = 67.1 ± 10.9 kg, body mass index = 20.7 ± 2.6 kg/m2). Main Outcome Measure(s): Shoulder IR and ER ROM, total-rotation ROM, glenohumeral IR deficit, AHD, and concentric and eccentric strength of the shoulder internal and external rotators were tested bilaterally. Results: External-rotation ROM was greater (t38 = 4.92, P < .001), but IR ROM (t38 = −8.61, P < .001) and total ROM (t38 = −3.55, P = .01) were less in the dominant shoulder, and 15 athletes had a glenohumeral IR deficit (IR ROM loss > 18°). We observed greater concentric internal-rotator (t38 = 2.89, P = .006) and eccentric external-rotator (t38 = 2.65, P = .01) strength in the dominant than in the nondominant shoulder. The AHD was less in the dominant shoulder (t38 = −3.60, P < .001). Conclusions: Adolescent volleyball attackers demonstrated decreased IR ROM, total ROM, and AHD and increased ER ROM in their dominant shoulder. Therefore, routine screening of adolescent athletes and designing training programs for hazardous adaptive changes could be important in preventing shoulder injuries.

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Effect of Passive Ultrasonic Irrigation over Organic Tissue of Simulated Internal Root Resorption

International Journal of Dentistry ◽

10.1155/2021/3130813 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Amjad Abu Hasna ◽

Jaiane Bandoli Monteiro ◽

Ricardo Toledo Abreu ◽

Wanessa Camillo ◽

Amanda Guedes Nogueira Matuda ◽

...

Keyword(s):

Root Resorption ◽

Acrylic Resin ◽

Tissue Mass ◽

Passive Ultrasonic Irrigation ◽

Significant Difference ◽

Before And After ◽

Ultrasonic Irrigation ◽

The Difference ◽

Group 2 ◽

Organic Tissue

This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) on dissolving the organic tissue inside simulated internal root resorption (IRR) using sodium hypochlorite (NaOCl) or chlorhexidine (CHX). A total of 40 human lower premolars were collected based on dimensional and morphological similarities. The roots were embedded in cylinders (3 cm diameter; 2.5 cm height) of self-cured acrylic resin, and then an IRR was simulated. The specimens were divided into 4 groups (n = 10) according to irrigation protocols: group 1: CHX + PUI; group 2: CHX; group 3: NaOCl + PUI; group 4: NaOCl. The total irrigation time was 150 s at a flow rate of 5 mL/min. A tissue mass of porcine palatine mucosa was used to simulate the organic tissue, it was weighed before and after the irrigation using an analytic balance, and the difference between both readings was calculated and transferred to percentage values. Data were submitted to statistical analysis using two-way ANOVA (factors: irrigant type and with/without PUI) and Tukey’s test for multiple comparisons among the experimental groups (α = 0.05). There was a significant difference in both factors (irrigant: p = 0.04 ; PUI: p ≤ 0.001 ). The groups that used PUI were more effective in dissolving the organic tissue of the IRR simulation than the groups without PUI. PUI is more effective than the syringe and needle irrigation in organic tissue dissolution.

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Comparing the early function and complications between fluoroscopic guidance and blindly insertion of permanent hemodialysis catheter

Journal of Emergency Practice and Trauma ◽

10.15171/jept.2018.10 ◽

2018 ◽

Vol 5 (1) ◽

pp. 19-22

Author(s):

Nasser Malekpour Alamdari ◽

Samad Shams Vahdati ◽

Barmak Gholizadeh ◽

Shima Nayebian

Keyword(s):

Vascular Injury ◽

Fluoroscopic Guidance ◽

Hemodialysis Catheter ◽

Early Function ◽

Catheter Exchange ◽

Significant Difference ◽

Electrolyte Homeostasis ◽

The Difference ◽

Group 5 ◽

Group 2

Objective: Chronic kidney disease (CKD) is a complicated kidney defect causing permanent failure in renal function in progressive stages. Hemodialysis is the most accepted treatment to maintain body’s fluid/electrolyte homeostasis at the terminal stages of the disease. Permanent hemodialysis catheter (permicath) may be inserted blindly or by fluoroscopic guidance. This study aimed to compare the early function and complications between fluoroscopic guidance and blindly insertion of permanent hemodialysis catheter. Methods: This prospective randomized clinical trial was undertaken in the emergency department of Modarres hospital in Tehran, Iran during 2014 and 2015. Patients who needed catheter due to renal failure entered the study. Patients who needed emergency dialysis and those who could not wait for permicath were excluded. Patients were randomly assigned into 2 groups, under fluoroscopic guidance and blindly catheter insertion. Data were collected using a questionnaire and a checklist related to function (after 24 hours and 1 month), a need to exchange the catheter and the early adverse effects such as pneumothorax, hemothorax, and vascular injury. Results: A total of 101 patients were enrolled in this trial. Early dysfunction (blind group= 5), a need for catheter exchange (blind group= 2), pneumothorax (blind group=2), vascular injury (blind group=1) were recorded but the difference between the two groups was not statistically significant (P>0.05). Conclusion: We did not observe a significant difference between the placement of permicath by fluoroscopic or blind method. However, more studies with larger groups are recommended.

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