A review of the design of educational programs for upper extremity work injury prevention

Work ◽  
1998 ◽  
Vol 11 (1) ◽  
pp. 35-42
Author(s):  
Paula C. Bohr ◽  
Sarah A. LaSalle
2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988887 ◽  
Author(s):  
Toufic R. Jildeh ◽  
Kelechi R. Okoroha ◽  
Joseph S. Tramer ◽  
Jorge Chahla ◽  
Benedict U. Nwachukwu ◽  
...  

Background: As the incidence of overuse injuries to the medial elbow in overhead athletes continues to rise, recent evidence suggests a link between these injuries and alterations in biomechanics produced by athlete fatigue. Previous studies have evaluated the effect of fatigue on elbow injuries using a wide array of fatigue protocols/athletic tasks, and, as a consequence, the results have been heterogeneous. Purpose: To determine whether there is a uniform alteration in neuromuscular function or biomechanics as the overhead athlete fatigues. Furthermore, this study sought to determine whether player fatigue should be accounted for in ulnar collateral ligament (UCL) injury prevention programs. Study Design: Systematic review. Methods: A systematic review of the literature using PubMed and MEDLINE databases was performed. Keywords included fatigue, upper extremity, baseball, pitcher, throwing, and muscle activity. Inclusion criteria consisted of original research articles in the English language involving healthy athletes, use of fatigue protocols, and the evaluation of at least 1 upper limb biomechanical variable. Results: A total of 35 studies involving 644 athletes (90 females, 554 males; mean age, 20.2 years) met the inclusion criteria. General fatigue protocols were used in 2 investigations, peripheral protocols were used in all 35 studies, and 5 different athletic tasks were studied (simulated baseball game, overhead throwing, high-effort swimming, simulated tennis game, and overhead serving). There was a uniform decrease in muscle force production and proprioception in athletes after completing a fatigue protocol. However, there was no consistency among studies when evaluating other important upper limb biomechanical factors. The fatigue protocols did not consistently produce statistically significant changes in elbow torque, pitching biomechanics, or ball velocity. Conclusion: A uniform decrease in muscle force production and proprioception was found after fatigue protocols; however, a majority of fatigue protocols published in the current literature are inconsistently measured and produce heterogeneous results. Therefore, currently, no recommendations can be made for changes in UCL injury prevention training programs to account for potential effects of fatigue. The effect of muscle force production and proprioception on upper extremity injuries should be evaluated in future studies.


2021 ◽  
Author(s):  
Rachel Lau ◽  
Swarup Mukherjee

Abstract Background Youth athletes in single hand overhead sport are at risk of upper extremity overuse injuries due to musculoskeletal immaturity, repetitive actions and stress overload. While several upper extremity injury prevention programs have been developed, the effectiveness of upper extremity injury prevention programs on performance outcome measures in overhead youth athletes has not been investigated. This study critically evaluated the effectiveness of existing upper extremity injury prevention programs on performance outcome measures in overhead youth athletes and identified and categorized the training components of these programs.Methods A systematic search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), SPORTDiscus (via EBSCOhost), ScienceDirect, and Web of Science. The inclusion criteria were youth athletes with full participation in throwing or striking sports; the intervention utilized training programs or exercises; control group performed usual training or sham exercises; reported at least one performance outcome measure; and utilized either randomized controlled trials, cluster-randomized controlled trials, or non-randomized controlled trials. Studies had to be published in the English language and within the last two decades. Methodological quality was assessed based on the PEDro Scale. Results Five studies, with a total of 456 youth athletes (age range 10.2-17.1 years) were included. The average PEDro score was 6.6. The effectiveness of the injury prevention programs on the identified performance outcome measures of strength, mobility, and sport-specific measures (ball speed and serve accuracy) were 30.4%, 28.6%, and 22.2%, respectively. The training components targeted were categorized as strength, mobility, and plyometrics. Strength was the most common training component and the most widely investigated performance outcome measure among existing upper extremity injury prevention programs. ConclusionCurrent injury prevention programs have a modest effect on sport performance outcome measures. Future upper extremity injury prevention programs should include training components of strength, mobility and plyometrics in their design given their moderate effects on strength, mobility, and sport-specific outcome measures. Standardized protocols are required for injury prevention program characteristics, and measurement and reporting of performance outcomes measures.


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