Changes in Shoulder Kinematics Following an Isokinetic Fatigue Protocol in Tennis Players

Fatigue Clinical Trial

Official title:

Changes in Shoulder Kinematics Following an Isokinetic Fatigue Protocol in Tennis Players

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04900922
• Other study ID #: C109047
• Status: Completed
• Start date: November 10, 2021
• Est. completion date: March 5, 2022

Study information

• Verified date: August 2022
• Source: National Yang Ming University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

A typical tennis match can take 1 to 5 hours. Tennis serve can be divided into eight stages and three phases. Injuries usually happen in the cocking stage and acceleration phase of the serve, where it requires large shoulder range of motion and proper scapular motion, including sufficient scapular upper rotation, external rotation, and posterior tilt to produce a powerful serve. Altered shoulder kinematics are associated with shoulder injuries in tennis players, including delayed shoulder horizontal adduction, and early external rotation. Due to the long duration and repetition of activity in a match, fatigue may happen and result in decreases in sensory input, passive range of motion, ball speed, and muscle strength. These changes may further lead to altered glenohumeral and scapular kinematics. However, previous studies mainly focused on the effects of fatigue on scapular kinematics in constrain movements and applied different fatigue protocols, which lead to inconsistent results. Tennis serve in cocking stage and the acceleration phase require high activation of shoulder external rotators and internal rotators, including infraspinatus, pectoralis major, subscapularis, latissimus dorsi and serratus anterior. However, to our knowledge, no study has investigated how fatigue of shoulder rotators influences shoulder kinematic as well as scapular kinematics during the late cocking stage and acceleration phase of tennis serve. Therefore, the investigators aim to investigate whether fatigue of shoulder rotator affects shoulder kinematics in healthy tennis players during the late cocking stage and acceleration phase of tennis serve.This is a single group, pretest-posttest measurement study. In a fatigue protocol, investigators use an isokinetic dynamometer to induce fatigue of shoulder rotators. Outcome measures will be tested before and after the fatigue protocol, including peak torque of shoulder rotators, humerothoracic kinematics, scapulothoracic kinematics, and median power frequency recorded by a surface electromyography. Peak torque of shoulder rotators will be measured with an isokinetic dynamometer. Surface electromyography will be used to measure peripheral muscle fatigue by maximum voluntary isometric contraction. Humerothoracic kinematics and scapulothoracic kinematics during a functional tennis serve and scaption will be collected with a motion capture system.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 26
• Est. completion date: March 5, 2022
• Est. primary completion date: March 5, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years to 45 Years

Eligibility

Inclusion Criteria:

Healthy tennis players

1. Age ranges from 20-45 years old

2. Engaging in tennis for at least 1 year

3. Routine training 3 times a week

4. No history of cervical and/or shoulder injury in the past one year, or injury with VAS (visual analog pain scale) lower than 3 and without cervical-shoulder pain 7 days before testing

5. No operation on the shoulder, no shoulder subluxation, labral tear, and rotator cuff tear.

6. Neer's test, empty can test, and Hawkins Kennedy test are negative.

Exclusion Criteria:

1. History of cervical and/or shoulder injury in the past one year, or injury with VAS (visual analog pain scale) bigger than 3 and with cervical-shoulder pain 7 days before testing

2. Operation on the shoulder, history of shoulder subluxation, labral tear, and rotator cuff tear.

3. One of the three test results is positive: Neer's test, empty can test, and Hawkins Kennedy test.

4. Perform upper extremity resist training and tennis training 24 hours before testing.

Related Conditions & MeSH terms

• Fatigue

Intervention

Device:
• isokinetic dynamometer
We will use an isokinetic dynamometer to conduct the concentric isokinetic fatigue protocol. The start position is shoulder abduction 90°, elbow flexion 90°and range of motion is set from 0 ° (internal rotation) to 90 ° (external rotation) under 120°/s. To calculate maximum torque of shoulder external and internal rotation, the subject will perform maximum isokinetic test 5 times before fatigue. Fatigue protocol include 10 sets, and each set include 32 repetitions with 30 seconds of rest between sets. The fatigue protocol will be stopped under three conditions: 1. the torque decreases 50% of maximum torque three times in one set or 2.rating of perceived exertion (RPE) abrove 15 and players can not perform the fatigue protocol or 3. finish the whole test.

Locations

Country	Name	City	State
Taiwan	Fu Jen catholic University	New Taipei City

Sponsors (2)

Lead Sponsor	Collaborator
National Yang Ming University	Fu Jen Catholic University

Country where clinical trial is conducted

Taiwan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Serve sequence pattern	Including the timing of shoulder horizontal adduction above 0 degree and the timing of shoulder external rotation above 90 degree during a tennis serve. Time would be normalized into 100 percentage and calculate the difference between shoulder horizontal adduction and external rotation described with percentage (%).	immediately after the intervention (fatigue protocol)
Primary	Scapular kinematics	Including anterior/posterior tilt, upward/downward rotation, and internal/external rotation during arm elevation in scapular plane at 30°, 60°, 90°, and 120°, and during late cocking stage of tennis serve and at the end of acceleration phase of the serve. Scapulothoracic kinematics will be calculated and will be described with degree (°).	immediately after the intervention (fatigue protocol)
Primary	Shoulder kinematics	Including shoulder external/internal rotation, horizontal adduction/abduction, elevation in the cocking stage of tennis serving and at the end of acceleration phase,will be calculated and will be described with degree (°).	immediately after the intervention (fatigue protocol)
Secondary	Median frequency	The median frequency calculated from electromyographic data of infraspinatus, pectoralis major, anterior deltoid, and latissimus dorsi. The percentage change in median frequency will be calculated and will be described with percentage (%).	immediately after the intervention (fatigue protocol)
Secondary	Shoulder internal and external rotation torque	The first three and the last three of shoulder rotation torque will be recorded and be described with Newton metre (Nm).	immediately after the intervention (fatigue protocol)
Secondary	Relative fatigue ratio	Last three torque of shoulder external rotation and internal rotation will be divided by the first three torque of shoulder external rotation and internal rotation described with percentage (%).	immediately after the intervention (fatigue protocol)
Secondary	ER/IR ratio	The torque of shoulder external rotation divided by the torque of shoulder internal rotation and will be described with ratio before and after fatigue protocol.	immediately after the intervention (fatigue protocol)