scholarly journals Hypermobility of ulnar nerve does not affect throwing performance (122)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0026
Author(s):  
Masahito Yoshida ◽  
Tetsuya Takenaga ◽  
Satoshi Takeuchi ◽  
Keishi Takaba ◽  
Atsushi Tsuchiya ◽  
...  

Objectives: Ulnar nerve neuropathy around the elbow is a common pathology in throwing athletes, and occurs due to many factors including valgus elbow, and ulnar nerve hypermobility. For patients with ulnar nerve neuropathy, anterior transposition of the ulnar nerve is common procedures. Meanwhile, Ulnar nerve hypermobility has been reported to be present in 2% to 47% of asymptomatic individuals. However, no studies have investigated the rate of ulnar nerve hypermobility in throwing athletes, and the relationship between ulnar nerve mobility, and clinical symptom and throwing performance. This study was designed to classify the sonographic assessment for the mobility of the ulnar nerve compared to physical evaluation, and to determine whether ulnar nerve hypermobility is associated with clinical symptoms and throwing performance in baseball players. We investigated ulnar nerve hypermobility using ultrasound to evaluate the relationship between the ulnar nerve hypermobility and clinical sign including throwing performance in college baseball players. Methods: 138 elbows in 69 college baseball players were examined. Each participant was queried regarding symptoms attributable to the ulnar nerve. In addition, structural measurements consisting of the tinel test and elbow flexion compression testing were examined. Sonographic examiners were, unaware of reported symptoms, independently performed a standardized examination of both elbows to assess ulnar nerve hypermobility. For sonographic assessment, the ultrasound probe was located at the medial condyle of the humerus to visualize the ulnar nerve in short-axis view in the extended elbow position. During extension to flexion of the elbow, the mobility of ulnar nerves was assessed, and categorized as stable, or hypermobile, which was further subclassified as subluxation, or dislocation (Figure 1A, 1B, 1C). Pared t-test was used to compare the mobility of the ulnar nerve between throwing and non-throwing sides. Fisher’s exact test was used to assess the relationship between physical exams and the mobility of the ulnar nerve. Values of p<0.05 were considered statistically significant. Results: Ulnar nerve hypermobility was identified in 54 (78.3%) of the 69 elbows in throwing side. Meanwhile, hypermobility was 53 (76.8%) in non-throwing side without significant difference, compared to non-throwing side. Elbows with nerve hypermobility did not experience a higher prevalence of subjective symptoms (snapping, pain, and tingling) than did elbows with stable nerves. Provocative physical examination testing for ulnar nerve irritability, however, showed consistent trends toward heightened irritability in hypermobile nerves (p = 0.04 to 0.16). Demographic data and anatomic measurements were similar between the subjects with stable nerves and those with hypermobile nerves. Additionally, all participants did not show decrease of throwing performance. Conclusions: Ulnar nerve hypermobility occurs in over half of the baseball players in throwing and non-throwing sides. Utilizing a standardized sonographic examination, a diagnosis of ulnar nerve hypermobility can be established with substantial interobserver reliability. In baseball players, ulnar nerve hypermobility does not appear to be associated with an increased symptomatology attributable to the ulnar nerve and throwing performance. Anterior transplantation of ulnar nerve may not be needed for baseball players with ulnar nerve neuropathy.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dandan Li ◽  
Fengyan Zhang ◽  
Lu Wang ◽  
Yifan Zhang ◽  
Tingting Yang ◽  
...  

Abstract Objective Numerous studies have identified impaired decision making (DM) under both ambiguity and risk in adult patients with schizophrenia. However, the assessment of DM in patients with adolescent-onset schizophrenia (AOS) has been challenging as a result of the instability and heterogeneity of manifestations. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT), which are frequently used to evaluate DM respectively under ambiguity and risk, are sensitive to adolescents and neuropsychiatric patients. Our research intended to examine the performance of DM in a relatively large sample of patients with AOS using the above-mentioned two tasks. We also aimed to take a closer look at the relationship between DM and symptom severity of schizophrenia. Methods We compared the performance of DM in 71 patients with AOS and 53 well-matched healthy controls using IGT for DM under ambiguity and GDT for DM under risk through net scores, total scores and feedback ration. Neuropsychological tests were conducted in all participants. Clinical symptoms were evaluated by using Positive and Negative Syndrome Scale (PANSS) in 71 patients with AOS. Pearson’s correlation revealed the relationship among total score of DM and clinical and neuropsychological data. Results Compared to healthy controls, patients with AOS failed to show learning effect and had a significant difference on the 5th block in IGT and conducted more disadvantageous choices as well as exhibited worse negative feedback rate in GDT. Apart from DM impairment under risk, diminished DM abilities under ambiguity were found related to poor executive function in AOS in the present study. Conclusions Our findings unveiled the abnormal pattern of DM in AOS, mainly reflected under the risky condition, extending the knowledge on the performance of DM under ambiguity and risk in AOS. Inefficient DM under risk may account for the lagging impulse control and the combined effects of developmental disease. In addition, our study demonstrated that the performance on IGT was related to executive function in AOS.


2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0016
Author(s):  
Brandon J. Erickson ◽  
Peter Nissen Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo

Background: Isolated ulnar nerve decompression/transposition is an uncommon surgery amongst professional baseball players. Purpose: To determine the rate of return to sport (RTS) and performance upon RTS in professional baseball players following isolated ulnar nerve decompression/transposition, including those who required an ulnar nerve transposition/decompression following ulnar collateral ligament reconstruction (UCLR), and to determine if outcomes differ between players with isolated ulnar nerve decompression/transposition and matched controls. Hypothesis: There is a high rate of RTS in professional baseball players undergoing isolated ulnar nerve decompression/transposition with no significant difference in RTS rate or performance (specifically related to the primary outcome performance variables of earned run average (ERA), WHIP ((walks +hits)/innings pitched), wins above replacement (WAR), and on base + slugging percentage (OPS)) between cases and controls. Methods: All professional baseball players who underwent isolated ulnar nerve decompression/transposition between 2010-2016 were included. Demographic and performance data (pre and post surgery) for each player was recorded. Performance metrics were then compared between cases and a group of matched controls. Results: Overall 52 players, 83% pitchers (14 who underwent prior UCLR) were included. Most surgeries (92%) were anterior subcutaneous transpositions. Overall, 62% of players were able to successfully RTS and 56% returned to the same or a higher level. There was no significant difference between cases and controls in the majority of performance metrics pre-operative or post-operatively, specifically ERA, WHIP, WAR, and OPS. When players who had a UCLR prior to their ulnar nerve transposition/decompression were compared to controls with a history of a UCLR but who did not go on to have an ulnar nerve transposition/decompression, the only performance difference of all the recorded metrics was cases allowed more walks per 9 innings (4.4 vs. 2.8; p=0.011). Conclusion: Anterior subcutaneous transposition is the most common surgery in professional baseball players to address ulnar nerve compression. Players have a 62% rate of RTS. Upon RTS, players performance compared to matched controls remains the same in the majority of performance metrics including ERA, WHIP, WAR, and OPS. Post-operatively, pitchers with a UCLR prior to ulnar nerve transposition/decompression performed the same as matched controls with prior UCLR.


2013 ◽  
Vol 22 (3) ◽  
pp. 216-223 ◽  
Author(s):  
Stephen John Thomas ◽  
Charles Buz Swanik ◽  
Thomas W. Kaminski ◽  
Jill S. Higginson ◽  
Kathleen A. Swanik ◽  
...  

Context:Subacromial impingement is a common injury in baseball players and has been linked to a reduction in the subacromial space. In addition, it has been suggested that decreases in scapular upward rotation will lead to decreases in the subacromial space and ultimately impingement syndrome.Objective:The objective of this study was to evaluate the relationship between acromiohumeral distance and scapular upward rotation in healthy college baseball players.Design:Posttest-only study design.Setting:Controlled laboratory setting.Participants:24 healthy college baseball players.Intervention:Participants were measured for all dependent variables at preseason.Main Outcome Measures:Acromiohumeral distance at rest and 90° of abduction was measured with a diagnostic ultrasound unit. Scapular upward rotation at rest and 90° of abduction was measured with a digital inclinometer.Results:Dominant-arm acromiohumeral distance at rest and 90° of abduction (P = .694, P = .840) was not significantly different than in the nondominant arm. In addition, there was not a significant correlation between acromiohumeral distance and scapular upward rotation at rest and 90° of abduction for either the dominant or the nondominant arm.Conclusions:These results indicate that the acromiohumeral distance is not adapting in the dominant arm in healthy throwing athletes. In addition, a relationship was not identified between acromiohumeral distance and scapular upward rotation, which was previously suggested. These results may suggest that changes that are typically seen in an injured population may be occurring due to the injury and are not preexisting. In addition, scapular upward rotation may not be the only contributing factor to acromiohumeral distance.


2009 ◽  
Vol 41 ◽  
pp. 307-308
Author(s):  
David J. Szymanski ◽  
Jessica M. Szymanski ◽  
Kelly A. Brooks ◽  
Michael T. Braswell ◽  
Andrew T. Britt ◽  
...  

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 367
Author(s):  
Dian Hudiyawati ◽  
Ajie Maulana Prakoso

Introduction: Psychological problems in patients with heart failure are the result of a combination of the influence of behavior and interactions with physiological responses, which if not handled properly will contribute to worsening clinical symptoms and have a higher risk of rehospitalization. The objective of the study was to evaluate the effects of cognitive behavior therapy (CBT) on psychological symptoms among CHF patients.Methods: This was a quasi-experimental, pretest-posttest control study that applying a CBT to overcome depression, anxiety, and stress. Thirty eligible respondents were recruited and were randomly divided into a case group and waiting list group. Psychological symptoms of respondents were measured using Depression, Anxiety and Stress Scale – 21 questionnaires (DASS-21). Chi-square was used to compare demographic data between groups and T-test analysis was used to describe changes in mean scores between and within groups. Both groups had similar characteristics and psychological symptoms level at baseline.Results: The mean score of depression, anxiety and stress showed a significant difference within the group after the intervention (p<0.05).Conclusion: A recent study found that CBT was effective to reduce psychological symptoms among CHF patients. Based on the study results it can be highlighted that it is important for nurses to provide brief CBT to hospitalized patients in an effort to reduce short term psychological symptoms.


2016 ◽  
Vol 45 (1) ◽  
pp. 144-149 ◽  
Author(s):  
Casey J. Meyer ◽  
J. Craig Garrison ◽  
John E. Conway

Background: Previous work has suggested that an increase in the amount of developmentally acquired, dominant arm humeral retrotorsion (D HRT) in the thrower’s shoulder may be a potentially protective mechanism. Although the relationship between HRT and shoulder injuries has been reported, the relationship between HRT and ulnar collateral ligament (UCL) tears in baseball players is not known. Purpose: To determine whether D HRT and nondominant arm HRT (ND HRT) measurements in baseball players with a UCL tear differ statistically from a matched healthy cohort. Study Design: Case-control study; Level of evidence, 3. Methods: D HRT and ND HRT were measured in 112 male competitive high school and collegiate baseball players seen over an 18-month period from 2013 to 2015. A total of 56 participants with a clinical and magnetic resonance imaging–confirmed diagnosis of a throwing-arm UCL tear (UCLInj group) were compared with 56 healthy baseball players with no history of an elbow injury who were matched for age, experience, and position (NUCLInj group). The mean ages in the UCLInj and NUCLInj groups were 17.9 ± 2.2 and 17.6 ± 2.8 years, respectively. Using a previously validated ultrasound method, D HRT and ND HRT were measured in the supine position, and the HRT side-to-side difference (D HRT – ND HRT) was calculated. A 1-way multivariate analysis of variance was used to determine the mean statistical differences between groups ( P < .05). Results: Baseball players with a UCL tear displayed significantly more humeral torsion (ie, less retrotorsion) in their nondominant arm compared with healthy baseball players (UCLInj = 33.27° ± 10.27°, NUCLInj = 27.82° ± 10.88°; P = .007). Baseball players with a UCL tear did not display any differences in D HRT compared with healthy baseball players (UCLInj = 18.67° ± 9.41°, NUCLInj = 17.09° ± 9.92°; P = .391). Significant side-to-side differences in HRT existed between groups (UCLInj = −14.60° ± 6.72°, NUCLInj = −10.72° ± 6.88°; P = .003). Conclusion: There was a significant increase in mean nondominant arm humeral torsion (ie, less retrotorsion) in the UCL tear group, but there was no significant difference in the mean D HRT between the injured and uninjured groups. A greater HRT side-to-side difference was displayed in the UCL tear group. The extent to which a thrower has developmentally acquired both D HRT and ND HRT may affect elbow UCL tear risk. Furthermore, it is possible that the extent of genetically predisposed ND HRT may influence the throwing-related increase in D HRT.


2015 ◽  
Vol 8 (5) ◽  
pp. 81 ◽  
Author(s):  
Soroush Amani ◽  
Parastoo Yarmohammadi

<p><strong>BACKGROUND &amp; AIM:</strong><strong><em> </em></strong>High prevalence of acute otitis media (AOM) in children represents a combination of the factors developing eustachian tube dysfunction and higher susceptibility to upper respiratory tract infections in children. This disease is relatively prevalent in Iran and much cost is spent annually to treat it. This study investigated the effect of household parental smoking on development of AOM in children under 12 years.<strong></strong></p> <p><strong>METHODS:</strong> In this case-control study all patients under the age of 12 years with AOM referring an ENT clinic in Shahrekord, southwest Iran between April 2014 and August 2014 were enrolled by convenience sampling. This study included two groups. Group 1 (G1) was exposed to parental smoking at home and group 2 (G2) was not. For the patients, a questionnaire of demographic data such as age and gender, the disease symptoms, parents' education level, history of respiratory diseases, allergy, surgery (adenoidectomy, tonsillectomy, and tympanostomy), and household smoking was filled out by a specialist through interview.</p> <p><strong>RESULTS:</strong> In this study, 250 children 1-12 years with AOM, 145 in G1 and 105 in G2, were investigated.<strong> </strong>Clinical symptoms including fever (p=0.001) and hearing loss (p=0.014) were significantly more frequent in the children of G1 than G2, and otalgia, discharge, and tinnitus were similarly frequent in the two groups (p&gt;0.05). Also, eardrum inflammation was more frequent in G1 than G2, with no significant difference (p&gt;0.05). AOM was reported 70.3% in G1, which was higher than 26.7% reported in G2 (p=0.001). Also, asthma, recurrent ear pain, enlargement of the tonsils, and respiratory problems were more frequent in G1 than G2 (p&lt;0.05). <strong></strong></p> <p><strong>CONCLUSIONS:</strong> Parental smoking was a risk factor for AOM and respiratory problems and therefore the parents are recommended to avoid smoking near children to reduce the likelihood of AOM development and exacerbation in children.<strong></strong></p>


Author(s):  
Hasanpour M. ◽  
Norouzi V. ◽  
Orouji P.

<p class="abstract"><strong>Background:</strong> VO<sub>2</sub>/VCO<sub>2</sub> ratio and blood lactate are different indices of adequacy of oxygen delivery to oxygen needs. The aim of this study was to investigate the relationship between serum lactate and VO<sub>2</sub>/VCO<sub>2</sub> in patients undergoing CABG in Ardabil city.</p><p class="abstract"><strong>Methods:</strong> This descriptive-analytical study was performed on 30 patients who underwent CABG at Ardabil city hospital during 2017. Demographic data of patients including age and sex were collected. Standard monitoring included electrocardiogram, invasive arterial pressure, pulse oximetry, end tidal carbon dioxide, temperature and urine output was done. The CAB was carried out through a CPB pump at the time of grafting. Blood lactate and VO<sub>2</sub>/VCO<sub>2</sub> were measured in 3 groups of patients based on number of grafts, EF and serum Creatinine. Collected data analyzed by statistical methods in SPSS version 19.  </p><p class="abstract"><strong>Results:</strong> Most of patients were male (86.7%). The mean age of patients was 58.1 years. The blood lactate and VO<sub>2</sub>/VCO<sub>2</sub> values increased after surgery. There was no statistically significant difference in two groups based on number of grafts and serum Cr but it was statistically significant based on E/F. There was a significant correlation between Blood lactate and VO<sub>2</sub>/VCO<sub>2</sub> ratio in patients.</p><p class="abstract"><strong>Conclusions:</strong> The results showed that blood lactate as an indicator for patients status during CABG surgery can be replaced with VO<sub>2</sub>/VCO<sub>2</sub>.</p>


2019 ◽  
Vol 47 (5) ◽  
pp. 1124-1129 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo

Background: Isolated ulnar nerve decompression/transposition is an uncommon surgical procedure among professional baseball players. Purpose/Hypothesis: To determine performance and rate of return to sport (RTS) among professional baseball players after isolated ulnar nerve decompression/transposition, including those who required decompression/transposition after ulnar collateral ligament reconstruction (UCLR), and to compare outcomes between cases and matched controls. The authors hypothesized a high rate of RTS among professional baseball players undergoing isolated ulnar nerve decompression/transposition with no difference in RTS rate or performance between cases and controls as related to earned run average, WHIP ([walks + hits]/innings pitched), wins above replacement, and on base + slugging percentage. Study Design: Cohort study; Level of evidence, 3. Methods: Utilizing the injury database of Major League Baseball, we identified all professional baseball players who underwent isolated ulnar nerve decompression/transposition between 2010 and 2016. De-identified demographic and performance data (before and after surgery) for each player were recorded from Major League Baseball records. Performance metrics were then compared between cases and matched controls. Results: The study included 52 players; 83% were pitchers; and 14 underwent prior UCLR. Most surgical procedures (92%) were anterior subcutaneous transpositions. Overall, 62% of players were able to successfully RTS, and 56% returned to the same or higher level. There was no significant difference between cases and controls in the majority of pre- and postoperative performance metrics—specifically, earned run average, WHIP, wins above replacement, and on base + slugging percentage. When players who had UCLR before ulnar nerve decompression/transposition were compared with controls with a history of UCLR but no subsequent ulnar nerve decompression/transposition, the only performance difference of all the recorded metrics was that cases allowed more walks per 9 innings (4.4 vs 2.8, P = .011). Conclusion: Anterior subcutaneous transposition is the most common surgical procedure among professional baseball players to address ulnar neuropathy at the elbow. Players have a 62% rate of RTS, which is lower than expected for this nonreconstruction or repair procedure. For players who successfully RTS, performance metrics versus matched controls remained the same except for allowing significantly more walks per 9 innings. Postoperatively, pitchers with UCLR before ulnar nerve decompression/transposition who had a successful RTS performed the same as matched controls with prior UCLR without subsequent ulnar nerve decompression/transposition.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mahsa Nikzad ◽  
Hamid Reza Banafshe ◽  
Mansooreh Momen-Heravi ◽  
Hamed Haddad Kashani ◽  
Maryam Shiehmorteza

Abstract Introduction Community acquired pneumonia (CAP) is a prevalent low respiratory infection. Diagnosis is based on clinical symptoms, radiologic evidence and culture. Biomarkers such as IL6, CRP and procalcitonin are helpful in diagnosis. Procalcitonin is a soluble biomarker in serum that increase in systemic inflammation and bacterial infections. People with normal procalcitonin have low risk to infect pneumonia. Patient with CAP have more oxidative stress than normal people. Studies show that receiving vitamin C can reduce incidence of pneumonia. The present study was designed to evaluate the effect of vitamin C supplement on procalcitonin biomarker in patient with CAP. Methods Patients with CAP who passed inclusion and exclusion criteria after obtaining informed consent, were assigned randomly in two groups of drug and placebo. The drug group received vitamin C (1000 mg/d) daily and medications that physician prescribed for treating CAP for 10 days and placebo group received placebo and medications that physician prescribed. The serum level of procalcitonin was measured at the beginning of the study and after 10 days of intervention. Results 35 patients finished the study. Serum level of procalcitonin on the first and tenth day did not show any significant difference between drug and placebo groups. Conclusions To clarify the relationship between the effects of vitamin C on procalcitonin in CAP, a larger sample size is required.


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