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Cátia Paixão, Ana Tavares, and Alda Marques

, 3-item Rosow–Breslau scale) ( Hebert et al., 2010 ; Rycroft et al., 2018 ). Few studies have addressed the essential role of the upper extremity in performing ADLs ( Kumahara, Tanaka, & Schutz, 2004 ), despite knowing that upper extremity functional activity limitations lead to a higher level of

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Olivia Bartlett and James L. Farnsworth II

kinesiophobia in patients with upper-extremity injuries. Upper-extremity injuries can negatively impact activities of daily living (eg, driving, changing clothes, reaching), leading to diminished quality of life and overall well-being. 7 The substantial influence that the upper-extremity has on an individual

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Mark A. Sutherlin

measures may not be equivalent across sports. Swimming is another overhead sport where the majority of injuries occur at the shoulder. 4 Clinicians who administer PRO measures during care may then opt to implement a single shoulder-specific or upper extremity region-specific PRO measure to help reduce

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Kyle Southall, Matt Price, and Courtney Wisler

Key Points ▸ This case presents the signs and symptoms of an athletics-related Morel-Lavallée lesion in the upper extremity. ▸ Morel-Lavallée lesions in the athletics setting can be easily misdiagnosed and/or mismanaged. ▸ Proper management can significantly decrease prolonged symptoms and long

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Allison J. Nelson, Patrick T. Hall, Katherine R. Saul, and Dustin L. Crouch

, muscle activations and joint moments) during motor tasks. Many existing WPSEs were designed and evaluated for occupational settings to support the weight of the upper extremity while the shoulder maintains static elevated postures. 29 , 30 However, it is unclear whether a WPSE designed for static tasks would be

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Gary B. Wilkerson, Dustin C. Nabhan, and Ryan T. Crane

upper-extremity visual-motor test for measurement of Simple RT failed to demonstrate a difference between recently concussed and control athletes, 6 which suggests that the simple task may have been insufficiently sensitive to detect a subtle difference in performance capabilities. 5 Decisions about

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Kevin E. Wilk, Christopher A. Arrigo, and James R. Andrews

The use of closed kinetic chain exercise has grown in the past several years. Closed kinetic chain exercises for the lower extremity have been firmly established in the literature and have been strongly recommended as an integral part of rehabilitation of the patient with anterior cruciate ligament injury. While the scientific and clinical rationale for using closed kinetic chain exercise for the lower extremity appears obvious, the scientific rationale for using closed kinetic chain exercise for the upper extremity is less clear. The purpose of this manuscript is to discuss the scientific rationale for closed kinetic chain for the upper extremity patient. In addition, exercise drills to enhance dynamic stability of the glenohumeral joint are discussed, and a rationale for using these exercises for specific glenohumeral joint pathologies is provided. The concepts of closed and open kinetic chain as applied to the lower extremity may not apply to the upper extremity due to the unique anatomical and biomechanical features as well as the function of the shoulder. It is recommended that clinicians use both closed kinetic chain and open kinetic chain exercises when treating the shoulder patient.

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Elizabeth Lawinger, Tim L. Uhl, Mark Abel, and Srinath Kamineni

Objective:

The overarching goal of this study was to examine the use of triaxial accelerometers in measuring upper-extremity motions to monitor upper-extremity-exercise compliance. There were multiple questions investigated, but the primary objective was to investigate the correlation between visually observed arm motions and triaxial accelerometer activity counts to establish fundamental activity counts for the upper extremity.

Study Design:

Cross-sectional, basic research.

Setting:

Clinical laboratory.

Participants:

Thirty healthy individuals age 26 ± 6 y, body mass 24 ± 3 kg, and height 1.68 ± 0.09 m volunteered.

Intervention:

Participants performed 3 series of tasks: activities of daily living (ADLs), rehabilitation exercises, and passive shoulder range of motion at 5 specific velocities on an isokinetic dynamometer while wearing an accelerometer on each wrist. Participants performed exercises with their dominant arm to examine differences between sides. A researcher visually counted all arm motions to correlate counts with physical activity counts provided by the accelerometer.

Main Outcome Measure:

Physical activity counts derived from the accelerometer and visually observed activity counts recorded from a single investigator.

Results:

There was a strong positive correlation (r = .93, P < .01) between accelerometer physical activity counts and visual activity counts for all ADLs. Accelerometers activity counts demonstrated side-to-side difference for all ADLs (P < .001) and 5 of the 7 rehabilitation activities (P < .003). All velocities tested on the isokinetic dynamometer were shown to be significantly different from each other (P < .001).

Conclusion:

There is a linear relationship between arm motions counted visually and the physical activity counts generated by an accelerometer, indicating that arm motions could be potentially accounted for if monitoring arm usage. The accelerometers can detect differences in relatively slow arm-movement velocities, which is critical if attempting to evaluate exercise compliance during early phases of shoulder rehabilitation. These results provide fundamental information that indicates that triaxial accelerometers have the potential to objectively monitor and measure arm activities during rehabilitation and ADLs.

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Karyn L. Hamilton, Michael C. Meyers, William A. Skelly, and Robert J. Marley

The purpose of this study was to investigate the influence of creatine monohydrate (CrH2O) on upper extremity anaerobic response in strength-trained females involved in overhand sports. Two movements were utilized in this evaluation: elbow flexion (EF) and shoulder internal rotation (IR). Subjects were pair-matched and assigned to receive placebo (n = 13) or 25 g CrH2O (n = 11) for 7 days. Pre- and post-treatment measurements included peak concentric and eccentric isokinetic torque, isotonic 1RM, and fatigue (FAT) during EF; isotonic 1RM, FAT, and peak velocity during IR; and body weight. MANOVAs revealed significant interaction between treatment and trial for EF (p < .05) but not for IR or weight. Univariate analysis indicated a significantly greater change in EFFAT following CrH2O than following placebo. Thus, CrH2O did not influence peak EF or IR strength, IR work to fatigue, or IR velocity, but was associated with greater work capacity during fatiguing EF. These data suggest that CrH2O may enhance upper extremity work capacity, but this enhancement may not extend to the muscles primarily responsible for overhand sports performance.

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Todd A. McLoda, Kate M. Murphy, and Steve Davison

Context:

Inertial training of the shoulder.

Objective:

To determine the differences of functional and EMG measures between a control group and an exercise group of overhead throwers.

Design:

Repeated measures.

Setting:

Research laboratory.

Participants:

17 intercollegiate baseball players and 19 intercollegiate softball players divided into 2 equal-size groups, control and exercise.

Main Outcome Measures:

Preliminary data were recorded, including throwing velocity, throwing accuracy, and EMG activity of the biceps brachii, upper pectorals, and posterior deltoid. The exercise group completed a 4-week training regimen on the Impulse Inertial Trainer. All participants returned for follow-up measures.

Results:

No significant group-by-time interaction occurred relative to ball velocity, accuracy, or EMG activity.

Conclusion:

For experienced throwers, functional measures and muscle activity during throwing were not affected by inertial training of the upper extremity.