Clinical evaluation of shoulder ROM in volleyball and handball players in youth categories

Aims. The aim of this study was to clarify whether volleyball and handball players, as representatives of the so-called overhead athletes, already have an increased ROM and specific local hypermobility in the shoulder joints in the junior categories. These changes are described by goniometric measurements and hypermobility tests according to Sachse and Beighton. The results are examined with respect to gender and sport specialization. Methods. Ninety-five subjects without previous shoulder joint injury aged 16 to 19 years, including 73 volleyball and handball players, were tested. The cohort included 33 men, 40 women, 34 handball players and 39 volleyball players. The control group consisted of 22 participants, including 11 men and 11 women. The majority (90.5%) of the study participants were right-hand dominant. Only 9.5% of the participants were left-handed. Measurements were taken with a goniometer with digital display and hypermobility tests according to Sachse and Beighton. Results. In a selected group of volleyball and handball players, the ROM of the shoulder joints of the dominant arm was significantly greater in three ways: into extension, horizontal adduction and external rotation. On the other hand, the ROM of their shoulder joints in internal rotation is smaller and the research group has significant hypermobility in the glenohumeral (scapulohumeral) joint compared to the control group. Our study showed that females compared to males playing volleyball and handball have a significantly higher degree of internal rotation of both dominant and non-dominant arms. No significant differences were found when comparing volleyball and handball players. The difference in ROM between the dominant and non-dominant arms of volleyball and handball players was shown in extension and external rotation.

Progression of long head of the biceps brachii tendon abnormality on magnetic resonance imaging after rotator cuff repair

Objectives To correlate the deterioration of preserved long head of biceps tendon (LHB) after rotator cuff repair with preoperative and postoperative MRI factors. Methods Total of 209 shoulder joints (F:M = 145:64; mean age 57.4 years) which underwent rotator cuff repair and at least two postoperative MRI scans over 10 months after surgery were included. LHB integrity was graded with a five point severity scale. LHB deterioration was defined by increased composite score of integrity and extent score between the preoperative and second postoperative MRI. For preoperative and postoperative MRI factors, size and location of superior cuff -supraspinatus and infraspinatus- and subscapularis tears, fatty degeneration of rotator cuff, preoperative LHB status, subluxation of LHB, superior labral tear, acromion type, repaired rotator cuff status, postoperative capsulitis and acromioplasty state were assessed. Logistic regression was used to evaluate the association between LHB deterioration and aforementioned factors. Same analysis was conducted for 62 shoulder joints with a long-term follow-up MRI. Results Of the 209 shoulders, 49.3% (n = 103) showed LHB deterioration on short-term follow-up MRI. In long-term follow-up subgroup, 32 LHBs were further deteriorated. In multivariate analysis, fatty degeneration of superior cuff showed significant association with LHB deterioration in both short-term (p = .04, p = .007) and long-term subgroups (p = .004, p = .005) among preoperative and postoperative factors, respectively. Conclusions Degree of fatty degeneration in superior cuff is associated with LHB deterioration on postoperative MRI. Advances in knowledge Our results support that tenotomy or tenodesis of LHB should be considered during rotator cuff repair, especially in patients with advanced fatty degeneration of rotator cuff.

ANALYSIS OF TRAINING PROGRAMS OF THE PERFORMANCE SWIMMERS WITHIN THE BASIC MACROCYCLE OF THE ANNUAL TRAINING CYCLE

Throughout this research, it has been pursued the process of studying and creating training programs of the performance swimmers during the basic macrocycle of the annual training cycle, where the emphasis was placed on the development of certain characteristics, which had led the swimmers to the greatest results at the most important competitions. The planning consisted of a periodization of the preparation stages and sub-stages known as macrocycles, mesocycles and microcycles. Within the training of the swimmers during the macrocycle, different training methods were used: force, power, mobility, endurance, speed, technique exercises, starts and turns, rhythm training, training for the competition tactic, psychological training. All the training methods listed above should be included in the content of all stages of preparation, with a different emphasis, depending on the training period. During the general resistance period of the macrocycle, the emphasis was put on improving the overall aerobic capacity, strength, mobility, strokes technique, starts and turns, and on improving the resistance to psychological stress. The trainings during this period were mainly composed of technical exercises, swimming with emphasis on arms and legs at a basic resistance intensity. The exercises on mobility were performed daily, focusing on the ankle, back and shoulder joints. Within the specific resistance period maximum values were reached. During the mentioned period, a large part of the resistance training was performed with the basic stroke, about 55-65%. Regarding training on the ground, the emphasis was placed on rapid repetitions in order to develop muscle strength, and the exercises on mobility were continued. During the competition period the most important competitions were scheduled, the focus of the training, being passed from the resistance to the sprint for all the swimmers, except the stayers. The narrowing period or the final period was planned from seven three-day microcycles, representing a period with a low volume and intensity. During this period, the swimmers competed in various international competitions in order to fulfill the scales of participation in the Olympic Games (Tokyo-2020).

Investigation of the range of motion of the shoulder joint in subjects with rotator cuff arthropathy while performing daily activities

Background: Patients who have rotator cuff arthropathy experience a limited range of motion (ROM) of the shoulder joint and experience problems in performing their daily activities; however, no evidence is available to suggest the exact ROM of the shoulder joint in this population. Therefore, this study sought to determine the degree of motion of the shoulder joint in three planes during different activities.Methods: Five subjects with rotator cuff injuries participated in this study. The motion of the shoulder joints on both the involved and normal sides was assessed by a motion analysis system while performing forward abduction (task 1), flexion (task 2), and forward flexion (task 3). The OpenSIM software program was used to determine the ROM of the shoulder joints on both sides. The difference between the ranges of motion was determined using a two-sample t-test. Results: The ROMs of the shoulder joint in task 1 were 35°±16.5°, 72.1°±2.6°, and 103.9°±28.7° degrees for flexion, abduction, and rotation, respectively, on the normal side and 28°±19.8°, 31°±31.56°, and 48°±33.5° on the involved side (p<0.05). There was no significant difference between the flexion/extension and rotation movements of the shoulder joint when performing task 1. However, the difference between flexion and rotation movements of the shoulder joints for the second task was significant (p˃0.05).Conclusions: Those with rotator cuff arthropathy have functional limitations due to muscle weakness and paralysis, especially during the vertical reaching task. However, although these individuals have decreased ROM for transverse reaching tasks, the reduction was not significant.

POS1399 ALGORITHM FOR DIFFERENTIAL DIAGNOSIS OF ARTHROPATHIES USING OSTEOSCINTIGRAPHY

Background:Joint bone scintigraphy is a promising method for diagnosing of inflammatory joint diseases. However, its scintigraphic semiotics remains to be developed.Objectives:To develop an algorithm for the differential diagnosis of the most common arthropathies based on quantitative osteoscintigraphy.Methods:This single-center study included inpatients with clinical diagnoses of rheumatoid arthritis (RA), axial spondyloarthritis (including ankylosing spondylitis - aSPA), peripheral spondyloarthritis (including reactive arthritis - pSpA), psoriatic arthritis (PsA), and osteoarthritis (ОА) established by a rheumatologist and meeting the relevant criteria, Three hours after the injection of pyrophosphate, labeled with Tc-99m, scintigraphy of the skeletal bones was carried out according to the “whole body” program. The joint / bone accumulation ratio (AR) was calculated as the ratios of counts in relevant areas. All AR were recalculated into T-score for each joint based on data from control group. The CHAID algorithm for classification trees constructing was used. The significance of the division in the nodes was estimated with Bonferroni adjustment.Results:266 patients were included in the study aged 46.6±14.3 years, men - 134 (50.4%). aSPA was diagnosed in 40 patients, pSpA in 87, RA in 45, ОА in 68, PsA in 26. 2279 joints were analyzed. A classification tree for differential diagnosis of arthropathies has been built (Pict.). Key indicators for identifying subgroups in the algorithm: AR in the wrist, knee and hip joints.At the first step of the classification tree, the sum of the T-scores of the wrist joints is determined. If this amount exceeds 7.76 (node 2), the most likely diagnosis is RA (58.5% of patients in the subgroup of this node). Patients with the sum of the T-scores in the wrist joints less than 7.76 (node 1), in turn, were divided depending on the sum of the T-scores of hip joints. Those with this value less than 3.25 (node 3), mainly suffered from OA (48.7%), less often in this subgroup were diagnosed pSpA (16.7%) and PsA (14.1%). Patients in whom the sum of the T-score in the hips was more than 3.245 (node 4) were further subdivided depending on the sum of the T-scores in the shoulder joints. If it was more than 4.21 (node 8), then pSpA was most likely (58.7%). If the sum of the T-scores of the shoulder joints was in the range from 2.05 to 4.21 (node 7), then these are mainly patients with spondyloarthritides (56.2% with aSPA and 31.2% with pSpA) and a small number of patients (10%) with PsA. In the subgroup with the sum of T-scores of the shoulder joints <2.05 (node 6), patients with PSA (40%) prevailed, with a significant proportion of persons with OA (27.5%). Thus, out of the final branches formed by the tree (node 2, 3, nodes 6-8), four correspond to certain diseases (node 2 - PA, node 3 - OA, node 7 - aSPA, node 8 - pSpA). Node 6 includes patients with various diseases with a predominance of PsA. The level of significance of differences between the formed groups at all branch points of the tree is p = 0.001 or less (Bonferroni adjusted). In the training sample, 51.5% of observations are correctly classified. According to cross-validation data, the expected rate of correct classifications in real application of the algorithm is 38.0%.Conclusion:An algorithm for the differential diagnosis of the most common inflammatory diseases of the joints has been developed, which makes it possible to use the data of quantitative osteoscintigraphy in the process of diagnosing arthritis.Acknowledgements:MD. PhD Constantin V. Kushnir, Main hospital of police.Disclosure of Interests:None declared

Severe erosive lesion of the glenoid in gouty shoulder arthritis: a case report and review of the literature

Background Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. Gout has been reported in many locations but is rarely localized in the shoulder joint. We describe a rare case of gouty arthritis involving bilateral shoulder joints and leading to severe destructive changes in the right shoulder glenoid. Case presentation A 62-year-old male was referred for pain and weakness in the right shoulder joint for two years, and the pain had increased in severity over the course of approximately nine months. A clinical examination revealed gout nodules on both feet and elbows. A laboratory examination showed a high erythrocyte sedimentation rate (ESR), high levels of C-reactive protein and hyperuricemia, and an imaging examination showed severe osteolytic destruction of the right shoulder glenoid and posterior humeral head subluxation. In addition, the left humeral head was involved and had a lytic lesion. Because a definite diagnosis could not be made for this patient, a right shoulder biopsy was performed. The pathological examination of the specimen revealed uric acid crystal deposits and granulomatous inflammation surrounding the deposits. After excluding infectious and neoplastic diseases, the patient was finally diagnosed with gouty shoulder arthritis. Conclusions Gout affecting the bilateral shoulder joints is exceedingly uncommon, and to our knowledge, severe erosion of the glenoid has not been previously reported. When severe erosion is present, physicians and orthopedic surgeons should consider gouty shoulder arthritis according to previous medical history and clinical manifestations.

Exploring Neurofeedback Training for BMI Power Augmentation of Upper Limbs: A Pilot Study

Electroencephalography neurofeedback (EEG-NFB) training can induce changes in the power of targeted EEG bands. The objective of this study is to enhance and evaluate the specific changes of EEG power spectral density that the brain-machine interface (BMI) users can reliably generate for power augmentation through EEG-NFB training. First, we constructed an EEG-NFB training system for power augmentation. Then, three subjects were assigned to three NFB training stages, based on a 6-day consecutive training session as one stage. The subjects received real-time feedback from their EEG signals by a robotic arm while conducting flexion and extension movement with their elbow and shoulder joints, respectively. EEG signals were compared with each NFB training stage. The training results showed that EEG beta (12–40 Hz) power increased after the NFB training for both the elbow and the shoulder joints’ movements. EEG beta power showed sustained improvements during the 3-stage training, which revealed that even the short-term training could improve EEG signals significantly. Moreover, the training effect of the shoulder joints was more obvious than that of the elbow joints. These results suggest that NFB training can improve EEG signals and clarify the specific EEG changes during the movement. Our results may even provide insights into how the neural effects of NFB can be better applied to the BMI power augmentation system and improve the performance of healthy individuals.

Sanitary losses of servicemen with gunshot wounds of major joints

The paper analyzes the structure of sanitary losses within 2015–2020 in servicemen with gunshots of major joints during military participation in Joint Forces Operation on the East of Ukraine. The knee-joint damages prevailed in the structure of the gunshots, the ankle-joint and shoulder-joints damages took the second and the third places, respectively. By the shell type, the bullet wounds prevailed that is caused to our opinion by target-orients defeat by a marksman. That results in the resignation of a military serviceman from the Ukrainian Armed Forces and long-term treatment.

Self-massage as a preventive means for osteochondrosis

The article presents an assessment and analysis of mobility and pain threshold in the cervico thoracic spine in women 55-65 years of age undergoing preventive treatment with a diagnosis of osteochondrosis of the cervico thoracic spine. It was revealed that in the examined set of parameters of possible movements in the cervical spine, the most problematic positions are flexion and extension. Testing of the mobility of the cervico thoracic spine was performed on ten positions, the assessment of which revealed the need not only to restore painless movement in the cervico thoracic spine, but also to activate mobility in the shoulder joints. Since, as a result of age-related changes, in 90% of cases, the mobility in the shoulder joints decreases and, as a result, the variety of movements is limited. The paper considers the possibility of influencing the musculo-ligamentous apparatus of elderly women. Massage exercises are presented, with a detailed description of the technique and methodology for using the developed self-massage movements in an independent mode. The main purpose of which is to restore the mobility of the cervico thoracic spine, improve the elasticity of the muscles of the investigated spine and restore the normalization of blood and lymph circulation in the most important part of the spine.