Cross-Sectional study with control group, Level II.

Background GIRD is a condition resulting in the loss of internal rotation of the glenohumeral joint as compared to the contralateral side. Mechanism of GIRD is caused by repetitive throwing such as a handball throw. Difference between total shoulders range of motion (ROM) more than 25°is considered as GIRD positive sign. Objective To compare glenohumeral rotation motion between dominant and non-dominant shoulder in handball players. Design Cross sectional study. Setting Elite handball division players. Participants The pilot studies included 48 professional handball players of average age 24.0±4.5 years, height 187.1±5.9 cm, weight 91.0±11.6 kg.Interventions All handball players were tested for internal (IR) and external (ER) glenohumeral rotation range of motion. Mean values, minimum, maximum and standard deviation were calculated. Differences between the dominant (D) and non-dominant (ND) shoulder were determined. T-Test for two independent samples was used to analyze differences between D and ND shoulder. Statistical significance was set at P<.05. Main OutcomesROM. Results We obtained:for ER_D 60.63°±13.23°and for ED_ND 58.65°±13.98°, respectively; for IR_D: 92.60°±6.92°and for IR_ND 88.96°±6.99°. Total ROM values were 153.23°±17.79°f or D and 147.60°±18.76°for ND shoulder. Differences between D and ND shoulders was statistically significant only for IR: 3.65°± 4.34°; P=.0118. For ER: 1.98°±4.92°and Total ROM: 5.63°± 7.76°there was no significant differences (P>.05). Conclusions However there are some cases with glenohumeral internal rotation deficit there is more evidence that such a deficit does not exists in handball players. To verify this results further study with grater sample size should be conducted in comparison to other professional overhead athletes.

Background Proprioception is a specialized variation of the sensory modality of touch that includes the sensation of joint motion and joint position. It is an essential part of shoulder stability and neuromuscular control. It is controversial whether throwing sports and sports training effects shoulder proprioception. Objective To analyse the shoulder proprioceptive abilities of professional handball players. Design Prospective study with control group and descriptive analysis. Setting Elite division handball players. Participants 70 professional handball players from top national league and 25 healthy volunteers as control. Interventions Shoulder proprioception was evaluated by measuring error of active reproduction of joint position (EARJP). Own construction electronic goniometer (Propriometer) with accuracy of 0,1o was used for measurements. Both dominant and non-dominant shoulders were evaluated. EARJP was measured in 4 directions and 3 positions for each direction: flexion and abduction (60o, 90o, 120o), external and internal rotation (30o, 45o, 60o). Three repetitions for each position were performed to obtain an average EARJP for every subject and position. Results Based on statistical analysis there was significantly better proprioceptive control (lower EARJP) in throwing versus non throwing and throwing versus control group shoulder. No difference in proprioception when comparing dominant and non-dominant shoulders in control group. Higher reference angles correlated with better proprioception. Increased external rotation correlated with better shoulder control in mid range of external rotation. Conclusions Throwing sport affects neuromuscular shoulder control. Handball players show significantly better proprioceptive abilities when compared to control normal population. Throwing shoulder has better neuromuscular control then the opposite one.

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Introduction Shoulder stability is secured by dynamic and static stabilizers. Rotator cuff is responsible for dynamic stabilization. In cases of shoulder instability their activity is disturbed. Capsulolabral repair restores mainly static stabilization. This surgery treatment technique of shoulder instability was first described by Bankart in 1923. His idea, with further modifications, is commonly used up to this day. Evaluation of muscle shoulder recovery after stabilization should be one of the important criteria to allow patient to return to sport and work. However, not much isokinetic assessment after capsulolabral repair was described. The aim of this study were the following: the comparative assessment of the shoulder rotatory strength in patients following arthroscopic capsulolabral repair of unilateral anterior traumatic instability and clinical assessment with comparison of pre and post-operative results. Material and methods Forty-five patients, 14 women and 31 men, with an average follow-up of 4.4 years were tested bilaterally for internal and external rotation strength at four angular velocities. ASES and UCLA tests were collected before and after surgery. Results The values of peak moment and muscle power parameters were slightly lower for an operated shoulder in comparison to a healthy shoulder for the external rotation. Total work parameter in external rotation was significantly lower for the operated shoulder in comparison to the non-operated side. The internal/external muscle group balance was lower for the operated shoulder in comparison to reference values in the women group. Furthermore, both ASES and UCLA scores were significantly higher after operation. Conclusions After arthroscopic capsulolabral shoulder stabilization, slight differences in isokinetic evaluation, especially in external shoulder rotation, occur. It affects rotators muscle balance. In functional evaluation significant improvement in shoulder function occurs.

Background: Preterm delivery (PTD) is a major cause of perinatal mortality and delayed psychomotor development in children. The application of new biochemical and biophysical markers can improve the accuracy of the prediction of spontaneous PTD.Objectives: To examine the performance of screening for spontaneous PTD by a combination of maternal history, biochemical and biophysical markers at 11 + 0 -13 + 6 weeks' (wks) gestation. Material and methods:This was a case-control study of 180 pregnant women between 11-13 + 6 weeks' gestation. Study group consisted of 100 healthy participants and 80 participants with at least one risk factor of spontaneous PTD in their medical history. Following parameters were recorded: Maternal history, cervical length (Cx), uterine artery pulsatility index (UtA PI), pregnancy-associated plasma protein A (PAPP-A), free beta subunit of human chorionic gonadotropin (β-hCG), alpha-fetoprotein (AFP). Based on the gestational age at delivery the study group was retrospectively divided into three groups: 1. Patients who delivered at term (control group); 2. Patients who delivered before 34 weeks' gestation (early PTD); 3. Patients who delivered between 34 and 37 weeks' gestation (late PTD). In these groups potential biomarkers for spontaneous PTD were analysed.Results: A multivariable stepwise logistic regression analysis indicated that early PTD can be predicted based on a combined analysis of maternal history, cervical length and AFP and PAPP-A concentrations: Detection rate (DR): 93%; false positive rate (FPR): 10%. The performance of screening for late PTD is less effective: Combined analysis of maternal risk factors, cervical length and AFP and PAPP-A concentrations allows to detect 88% of cases at a FPR of 10%. Conclusions:The best fitted model for the prediction of spontaneous preterm delivery before 34 weeks is based on a combined analysis of maternal risk factors, measurement of the cervical length and measurement of AFP and PAPP-A concentrations. The best fitted model for the prediction of preterm delivery between 34-37 weeks' gestation is based on a combined analysis of maternal factors, measurement of the cervical length and measurement of AFP concentrations.