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Yin-Liang Lin and Andrew Karduna

While synchronous movement of the glenohumeral and scapulothoracic joints has been emphasized in previous kinematics studies, most investigations of shoulder joint position sense have treated the shoulder complex as a single joint. The purposes of this study were to investigate the joint position sense errors of the humerothoracic, glenohumeral, and scapulothoracic joints at different elevation angles and to examine whether the errors of the glenohumeral and scapulothoracic joints contribute to the errors of the humerothoracic joint. Fifty-one subjects with healthy shoulders were recruited. Active joint position sense of the humerothoracic, glenohumeral, and scapulothoracic joints was measured at 50°, 70°, and 90° of humerothoracic elevation in the scapular plane. The results showed that while scapulothoracic joint position sense errors were not affected by target angles, there was an angle effect on humerothoracic and glenohumeral errors, with errors decreasing as the target angles approached 90° of elevation. The results of a multiple regression analysis revealed that glenohumeral errors explained most of the variance of the humerothoracic errors and that scapulothoracic errors had a weaker predictive relationship with humerothoracic errors. Therefore, it may be necessary to test scapular joint position sense separately in addition to the assessment of the overall shoulder joint position sense.

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Yin-Liang Lin and Andrew R. Karduna

The measurement of humeral kinematics with a sensor on the humerus is susceptible to large errors due to skin motion artifacts. An alternative approach is to use data from a forearm sensor, combined with data from either a scapular or thoracic sensor. We used three tasks to assess the errors of these approaches: humeral elevation, elbow flexion and humeral internal rotation. Compared with the humeral method, the forearm methods (using either a scapular or thoracic sensor) demonstrated significantly smaller root mean square errors in humeral elevation and humeral internal rotation tasks. Although the errors of the forearm methods were significantly larger than those of the humeral method during elbow flexion, the errors of the forearm methods still were below 3°. Therefore, these forearm methods may be able to accurately measure humeral motion. In addition, since no difference was found between the forearm methods using the scapular or thoracic sensor, it may be possible to accurately assess both shoulder and elbow kinematics with only two sensors: one on the forearm and one on the scapula.

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Yin-Chou Lin, Angela Thompson, Jung-Tang Kung, Liang-Wei Chieh, Shih-Wei Chou and Jung-Charng Lin

Context:

Elbow injuries are widely reported among baseball players. The elbow is susceptible to injury when elbow-flexor and -extensor forces are imbalanced during pitching or throwing. Assessment of muscle-strength ratios may prove useful for diagnosing elbow injury.

Objective:

The purpose of this study was to assess the relationship between the elbow-flexor and -extensor functional isokinetic ratios and elbow injury in baseball players.

Design:

Retrospective study.

Setting:

Biomechanics laboratory.

Participants:

College baseball players with (n = 9) and without (n = 12) self-reported elbow pain or loss of strength were recruited.

Intervention and Main Outcome Measures:

Trials were conducted using a dynamometer to assess dominant-arm flexor and extensor concentric and eccentric strength at angular velocities of 60° and 240°/s. Functional isokinetic ratios were calculated and compared between groups.

Results:

Regression analysis revealed that a ratio of biceps concentric to triceps concentric strength greater than 0.76 (the median value) significantly predicted elbow injury (P = .01, odds ratio of injury = 24). No other ratios or variables (including position played) were predictive of injury status.

Conclusions:

These findings suggest that the ratio of biceps concentric to triceps concentric functional strength strongly predicts elbow-injury status in baseball players. Assessment of this ratio may prove useful in a practical setting for training purposes and both injury diagnosis and rehabilitation.