Patrick Shu-Hang Yung *, Romy Hing-Kwan Chanc, Fiona Chui-Yan Wong Et.Al Did a Survey
Karnataka,Bangalore
Annexure II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / Name of the candidate and address (in block letters) / SUSMITA SHAKYA
Dr. M. V. SHETTY COLLEGE OF PHYSIOTHERAPY,
VIDYA NAGAR, KULOOR,
MANGALORE-575013
2. / Name of the Institution / Dr. M. V. SHETTY COLLEGE OF PHYSIOTHERAPY
3. / Course of study and subject / MASTER OF PHYSIOTHERAPY IN
MUSCULO SKELETAL DISORDERS AND SPORTS PHYSIOTHERAPY
4. / Date of admission / 3 rd JULY 2012
5. / Title of the Topic / EFFECT OF TAPING ON GLENOHUMERAL ROTATIONAL RANGE OF MOTION IN COLLEGE LEVEL BADMINTION PLAYERS.
6. / Brief Resume of the Intended Work
6.1) Introduction and Need of the Study:
Badminton is one of the most popular sports in the world and can be played recreationally from childhood to old age, as well as competitive sports played at various levels.1
Bodily movements during badminton playing involve abrupt jerking movements and staccato foot works1. It alsorequires a lot of over shoulder motion with the shoulder in abduction and external rotation repetitively, which can result in anterior shoulder instability and eventually microtrauma of the soft tissues surrounding the glenohumeral joint, so shoulder pain is a common problem in world class badminton players4,11,17.
A number of studies have documented significant glenohumeral internal rotation deficit in dominant arm of overhead athletes which predispose them to shoulder dysfunction and pain4. GIRD (glenohumeral internal rotation deficit) is defined as loss of greater than25 degrees of glenohumeral internal rotation of throwing shoulder compared to non-throwing shoulder in which internal rotation
loss exceeds the external rotation gain17. Tightness of posterior capsule and stiffness of posterior rotator cuff musculature have both been described as factors that limit glenohumeral joint rotation. Posterior capsule tightness and increase anterior capsule laxity will lead to excessive anterior translation of humeral head during shoulder movements17. It is suggested that these changes in arthrokinematics lead to the alteration to osteokinematics including GIRD.
A study has shown that joint mobilization, stretching, splinting, and a supervised exercise program can all increase joint range of motion8. Use of taping has also been widely reported in literature. The therapeutic effect of taping has been hypothesized to include joint stabilization, reducing pain, increased joint torque, enhancingproprioception and facilitation or inhibition of muscle activity. Tape provides a feedback mechanism allowing the patient to feel normal alignment and positioning of the shoulder.11
Need of the study:
It has also been proved that the specific application of tape can immediately increase rotational ROM in dominant arm of elite tennis players3. However further study has been recommended to determine the mechanism responsible for the increase3. Also previous researches primarily focus on scapular taping whereas glenohumeral taping has not been done much. Hence the need of study arises.
The main purpose of this study is to examine the effect of tape on glenohumeral internal, external and total rotational range of motion in college level badminton players as repetitive smashing at high velocities leads to altered range of motion and in overtime leads to chronic adaptation to soft and osseous tissues in glenohumeral joint.
Research Question:
Will there be any significant effect of taping on glenohumeral rotational range of motion in college level badminton players?
Hypothesis:
HYPOTHESIS
• There will be significant effect of taping on glenohumeral rotational range of motion in college level badminton players.
NULL HYPOTHESIS
• There will be no significant effect of taping on glenohumeral rotational range of motion in college level badminton players.
6.2) REVIEW OF LITERATURE :
•Couppe C, Thorborg K, Hansen M et. al conducted a study on ‘Shoulder rotational profiles in young healthy elite female and male badminton players’ whose aim was to profile shoulder PROM & isometric strength for ER & IR as a part of screening in adolescent national badminton players. The study showed that TROM i.e. EROM+IROM was reduced on the dominant side as compared with the non dominant side irrespective of the gender. No rotational strength differences existed between the dominant and non dominant side in male players, but in female players a higher IR strength o on the dominant side was not balanced by a higher ER strength.2
- M. Falhstorm and K.Soderman conducted a study on ‘Decreased shoulder function and pain common in recreational badminton players’. A questionnaire study was performed which found that previous or present pain in the dominant shoulder was reported by 52% of the players. Sixteen percent of the players had on-going shoulder pain associated with badminton play. Furthermore, range of active pain-free shoulder abduction was decreased.19
- Patrick Shu-Hang Yung *, Romy Hing-Kwan Chanc, Fiona Chui-Yan Wong et.al did a survey on ‘Epidemiology of Injuries in Hong Kong Elite Badminton Athletes’ . Retrospective study was conducted. Team training records and medical records were reviewed to obtain information regarding injuries. A total of 253 injuries (128 recurrent and 125 new injuries) were recorded, which accounted for an overall incidence rate of 5.04 per 1,000 player hours. Elite senior athletes had a higher incidence rate of recurrent injuries, while elite junior and potential athletes had a higher incidence rate of new injuries. The most frequently injured body sites were the back (17 injuries), the shoulder (15 injuries), the thigh (15 injuries), and the knee (15 injuries).
- Brad McIntosh conducted a study on ‘The Effect of Tape on Glenohumeral Rotation Range of Motion in Elite Junior Tennis Players’ and found that the specific application of tape to the glenohumeral joint can immediately increase rotational range of motion in the dominant arm of elite tennis players and he also suggested that further study is recommended for finding out the mechanism responsible for the increase.3
- Williams JW Jr , Holleman DR Jr and Simel DLconducted a study on Measuring shoulder function with the Shoulder Pain and Disability Index which concluded that SPADI is highly correlated with the original VAS version of the SPADI and also SPADI is responsive to change and accurately discriminates among patients who are improved or worsened.5
- Helen H Host conducted a case study on scapular taping in the treatment of anterior shoulder impingement. A right handed, 40 yrs old caucasian man, with the diagnosis of right shoulder pain, who had an 8 month old history of progressively worsening symptoms was evaluated. He was seen for 3 months with a total of 10 visits. The case report demonstrated that the patient was able to return to all of his regular overhead sports activities without pain, following scapular taping used in combination with the home exercise programme. It was felt that through the use of scapular taping, the treatment was of shorter duration than it would have been without the taping technique.11
- Mary Paul Clapper and Steven Wolf conducted a study onComparison of the Reliability of the Orthoranger and the Standard Goniometer for Assessing Active Lower Extremity Range of Motion. The purpose of the study was to determine the reliability of the Orthoranger, specific methods for applying the Orthoranger, and whether a correlation exists between the measurements obtained with the Orthoranger and those obtained with a standard goniometer. 10 men and 10 women participated in the study and both orthoranger and goniometer was used to measure each joint 3 times during the 5 session. Results indicated that both instruments were reliable for assessing active lower extremity joint ROM. Compared with a manual goniometer, the added costs for purchase and use of the Orthoranger appear to be unnecessary until such time that factors enhancing its inherent reliability are identified.
- Dan L Riddle, Jules M Rothstein and Robert L Lamb conducted a study on Goniometric Reliability in a Clinical Setting.main purpose of their study was to The purpose of their study was to examine the intratester and intertester reliabilities for clinical goniometric measurements of shoulder passive range of motion (PROM) using two different sizes of universal goniometers. Two groups of 50 subject each participated in the study and repeated PROM measurements of shoulder flexion, extension, abduction, shoulder horizontal abduction, horizontal adduction, lateral (external) rotation, and medial (internal) rotation were taken. They concuded that the Goniometric PROM measurements for the shoulder appeared to be highly reliable when taken by the same physical therapist, regardless of the size of the goniometer used.15
- Kevin E. Wilk, Leonard C. Macrina, Glenn S Fleisig et. al conducted a study on Correlation of Glenohumeral Internal Rotation Deficit and Total Rotational Motion to Shoulder Injuries in Professional Baseball Pitchers. Main purpose of their study was to to determine whether GIRD and a deficit in total rotational motion (external rotation + internal rotation) correlates with shoulder injuries in professional baseball pitchers ascompared with the non throwing shoulder. PROM measurements were evaluated on the dominant and nondominant shoulders of 170 pitcher-seasons over 3 competitive seasons. They concluded that pitchers with GIRD were nearly twice as likely to be injured as those without it. Hence, pitchers with GIRD appear to be at a higher risk for injury and shoulder surgery.16
- Mark D. Thelen, James A.Daubeer, 2008 et al conducted a study. The purpose of the study was to determine the short term clinical efficacy of kinesio tape when applied to college students with shoulder pain as compared to sham tape application. Forty-two subjects clinically diagnosed with rotator cuff, tendonitis/impingement were randomly assigned to 1 or 2 groups therapeutic kinesio tape or sham tape participated in the study. The result of the study shows that kinesio tape may be of some assistance to clinicians in improving pain free active ROM immediately after tape application for patients with shoulder pain.
- To determine the effectiveness of taping on glenohumeral rotational range of motion in college level badminton players
7. / MATERIALS AND METHODS:
7.1) STUDY DESIGN:
Quasi experimental.
7.2)
7.2 (I)DEFINITION OF THE STUDY SUBJECTS:
College level badminton players who have played at least for a year in the age group 18-26 will be recruited for the study.
7.2 (II)INCLUSION AND EXCLUSION CRITERIA:
Inclusion criteria
- Informed consent
- Asymptomatic College level badminton players
- Age : 18-26
- Played for at least a year
- Non players
- Any recent history of fracture or dislocation
- Allergic to tape
- Any nerve lesion of upper limb
- Any recent surgery in and around shoulder joint.
Sample design and method :
Purposive sampling technique
Sample size:
Around 60 patients will be selected.
7.2( IV)FOLLOW UP:
Not applicable (one time study).
7.2 (V)PARAMETERS USE FOR COMPARISON AND STATISTICAL TEST
Collective data will be analyzed with paired ‘t’ test.
7.2 (VI)DURATION OF STUDY:
Durationof the study will be12 months.
7.2 (VII)METHODOLOGY:
College level badminton players will be initially assessed in the physiotherapy department for inclusion and exclusion criteria. Informed consent will be obtained from them. Patients will be explained about taping and oriented about the study being done.Subjects will be divided into 3 groups: contol, sham tape and therapeutic tape group.
Passive glenohumeral joint rotation will be measured using universal goniometer in both the dominant and non dominant arm. The taping technique involves the application of hypoallergic tape from the anterior aspect of the humeral head.The tape will be passed from over and just lateral to the acromion process to finish at the inferior angle of the scapula.Two pieces of non stretch sports tape will then be applied using same landmarks, while one hand provides a maximal posterior force to the humeral head. The sham tape will be applied in the same identical position as the therapeutic tape but without any posterior force to the humeral head.
7.3) Does the study require any investigations to be conducted on patients or other human or animal if so please describe briefly?
Yes. Range of motion and SPADI(shoulder pain and disability index)
7.4) Has ethical clearance been obtained from your institution incase of 7.3.
Yes
8. / List of References :
1.Martin Fahlström, Hakan Alfredson, Ronny Lorentzon. Painful conditions in the Achilles tendon region-a common problem in middle-aged competitive badminton players. Knee Surg, Sports Traumatol, Arthrosc (2002) 10 :57–60
2. Couppé C, Thorborg K, Hansen M et.al. Shoulder rotational profiles in young healthy elite female and male badminton players. Article first published online: 22 MAY 2012.DOI: 10.1111/j.1600-0838.2012.01480.x
3. Brad McIntosh BSc (Ex Sci), MPT, DPT. Sports & Orthopaedic Physiotherapy, Sydney, Australia. The Effect of Tape on Glenohumeral Rotation Range of motion in junior elite tennis player.
4. Martin Fahlström1, Joo Seng Yeap2, Håkan Alfredson et al. Shoulder pain – a common problem in world-class badminton players. Scandinavian Journal of Medicine & Science in Sports Volume 16, Issue 3, pages 168–173, June 2006.
5.Williams JW Jr, Holleman DR Jr, Simel DL et al. Measuring shoulder function with the Shoulder Pain and Disability Index. The Journal of Rheumatology [1995, 22(4):727-732].
6.Y P Lo, Y C Hsu, K M Chan. Epidemiology of shoulder impingement in upper arm sports events. Br J Sports Med 1990;24:173-177 doi:10.1136/bjsm.24.3.173.
7.Jorgensen, Uffe, Winge et al. Injuries in Badminton.
8.Susan L Michlovitz, Bette Ann Harris, Mary P Watkins et. al. Therapy interventions for improving joint range of motion: a systematic review.
9.K. Hoy, B.E Lindblad, C.J. Terkels et. al. Badminton injuries-a prospective epidemiological and socioeconomic study. Br J Sports Med 1994;28:276-279 doi:10.1136/bjsm.28.4.276.
10. Burkhart SS, Morgan CD, Kibler WB. Shoulder injuries in overhead athletes. The "dead arm revisited. Clin Sports Med. 2000;19(1):125-58.
11.Helen H Host. Scapular taping in treatment of anterior shoulder impingement. Phys Ther.1995; 75:803-812.
12. Tracy Spigelman, MEd, ATC • University of Kentucky. Identifying and Assessing Glenohumeral Internal-Rotation Deficit. © 2006 Human Kinetics · ATT 11(3), pp. 32-34.
13. Stephen S. Burkhart, M.D., Craig D. Morgan, M.D., and W. Ben Kibler, M.D. The Disabled Throwing Shoulder: Spectrum of Pathology.Part I: Pathoanatomy and Biomechanics.
14. Verhagen E.A.L.M., van der Beek A.J., van Mechelen W. The Effect of Tape, Braces and Shoes on Ankle Range of Motion. Sports Medicine, Volume 31, Number 9, 2001 , pp. 667-677(11).
15. Dan L Riddle, Jules M Rothstein and Robert L Lamb. Goniometric Reliability in a Clinical Setting. Journal of American Physical Therapy Association. May 1987 vol. 67 no. 5 668-673.
16. Kevin E. Wilk, Leonard C. Macrina, Glenn S Fleisig et. al. Correlation of Glenohumeral Internal Rotation Deficit and Total Rotational Motion to Shoulder Injuries in Professional Baseball Pitchers. Am J Sports Med February 2011 vol. 39 no. 2 329-335.
17. John M. Tokish , Michael S. Curtin , Young-Kyu Kim et. al. Glenohumeral internal rotation deficit in the asymptomatic professional pitcher and its relationship to humeral retroversion. ©Journal of Sports Science and Medicine (2008) 7, 78-83.
18. Mark D Thelen, James A Dauber, et al. The clinical efficacy of kinesio tape for shoulder pain: randomized double blinded clinical trial. 2008; 38;389-395.
19. M.Falhstorm . k soderman. Decreased shoulder function and pain common in recreational badminton players.
