The purpose of this study was to examine the effects of using a force measurement device on riding technique in mogul skiing. A mock-up version of such a device was positioned between ski boot and binding. Data on three-dimensional kinematics and perception were collected for eight subjects skiing down a mogul course. Parameters analysed were knee angle, side and forward lean of the trunk and hip, and the path of the body's centre of mass. A perception questionnaire was used on selective aspects to assess the skiers' perception of the performances. Perception ratings showed no significant detrimental effects. All assessed components showed a trend of improvement from the first to last run, thus suggesting familiarisation was achieved. Kinematic analysis revealed that no significant alterations occurred. In conclusion, it is intended to utilise a functional force plate similar to the one presented by Kiefmann et al. (2006) for future studies in freestyle skiing.

Objectives To evaluate the clinical and radiographic outcome of low-demand patients with massive rotator cuff tears undergoing arthroscopic debridement in mid- and long-term follow-up, as well as the rate of conversion to reverse shoulder arthroplasty. Methods We performed a retrospective analysis of 19 patients with a mean age at surgery of 68 years (range, 55–80 years) from a previously described consecutive cohort and after a mean follow up of 47 month (FU1) and 145 month (FU2). The functional outcome was evaluated with the VAS score, the American Shoulder and Elbow Surgeons (ASES) score, and the age- and gender-adjusted Constant (aCS) score. The radiographic outcome was classified according to the Hamada classification. Non-parametric analyses were carried out with the Mann-Whitney U for independent samples and the Wilcoxon signed-rank test for related samples. Results Five patients (26%) developed symptomatic cuff tear arthropathy and underwent reverse shoulder arthroplasty after a mean time of 63 months (range, 45–97 months). These patients were excluded from further analyses. The mean VAS score of the remaining 14 patients at FU1 was significantly lower compared to preoperatively (P = .041), while there were no significant differences between the VAS score at FU1 and FU2 (P = 1.0). The ASES score of the affected shoulder at FU1 was significantly higher compared to prior to surgery (P = .028), while there were no significant differences between the scores of the affected shoulder between FU1 and FU2 (P = .878). While the ASES score of the contralateral shoulder at FU1 was significantly higher than the score of the affected shoulder (P = .038), there were no significant differences in the ASES scores of the affected and the healthy shoulder at FU2 (P = .575). The evaluation of the aCS produced similar results. A progression of the Hamada grade was documented in 6 patients. Conclusions Arthroscopic debridement is a safe and valid option for low-demand middle-age or elderly patients with symptomatic massive rotator cuff tears, leading to a significant pain relief and significantly improved functional outcome at mid- and long-term follow up. However, about a quarter of the patients in our cohort had to undergo reverse shoulder arthroplasty due to symptomatic cuff tear arthropathy. Furthermore, some of the remaining patients continued to undergo radiographic progression. This might be due to the natural history of their disease and/or the surgical procedure, and the clinical relevance of this finding should be evaluated in further studies.

Background WATSU (portmanteau word: water and shiatsu) is a form of passive hydrotherapy in chestdeep thermoneutral water (35˚C = 95˚F = 308.15 K). It combines elements of myofascial stretching, joint mobilization, massage, and shiatsu and is reported to be used to address physical and mental issues. The objective of this systematic review (PROSPERO Registration No. CRD42016029347) and the meta-analyses was to assess the applications, indications, and the effects of WATSU to form a basis for further studies. MethodsA search for "WATSU OR watershiatsu OR (water AND shiatsu)" was conducted without any restrictions in 32 databases. Peer reviewed original articles addressing WATSU as a stand-alone hydrotherapy were assessed for risk of bias. Quantitative data of effects on pain, physical function, and mental issues were processed in random model meta-analyses with subgroup analyses by study design. Effect sizes were expressed as Hedges's g (± 95% confidence intervals). ResultsOf 1,906 unique citations, 27 articles regardless of study design were assessed for risk of bias. WATSU has been applied to individuals of all ages. Indications covered acute (e.g. pregnancy related low back pain) and chronic conditions (e.g. cerebral palsy) with beneficial effects of WATSU regarding e.g. relaxation or sleep quality. Meta-analyses suggest beneficial effect sizes of WATSU on pain (overall Hedges's g = -0.71, 95% CI = -0.91 to -0.51), physical function (overall Hedges's g = -0.76, 95% CI = -1.08 to -0.44), and mental issues (overall Hedges's g = -0.68, 95% CI = -1.02 to -0.35). ConclusionVarious applications, indications and beneficial effects of WATSU were identified. The grade of this evidence is estimated to be low to moderate at the best. To strengthen the findings of this study, high-quality RCTs are needed. IntroductionWATSU (portmanteau word: English "water" and Japanese 指圧 "Shiatsu") was first described by its originator Dull in the 1980s as a treatment consisting of Japanese Shiatsu bodywork applied in thermal water [1]. To practice WATSU, a therapist stands in thermoneutral water (35˚C = 95˚F = 308.15 K), supporting the supine receiver with hands, forearms, or shoulders and softly moving her / him in slow and spacious circular motion sequences following elaborate movement patterns related to receiver's and therapist's level of experience [1]. The hands of the therapist function as a grip to facilitate movement and at the same time to stimulate acupuncture points. Gentle traction is applied to the body of the receiver to mobilize joints and stretch myofascial structures, as well as meridians, channels through which the life-energy (Chinese 氣 "qi", flows in the concept of Traditional Chinese Medicine [1,2]. During immersion, hydrostatic pressure influences fluid distribution, metabolism, and respiration. The impact of gravity is greatly reduced, thus decreasing joint loads and allowing maximal flexibility in the positioning of the treated individual [3,4]. The thermoneutral temperature of 35˚C is recommended because it all...

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Vogler, T, Schorn, D, Gosheger, G, Kurpiers, N, Schneider, K, Rickert, C, Andreou, D, and Liem, D. Adaptive changes on the dominant shoulder of collegiate handball players—A comparative study. J Strength Cond Res 33(3): 701–707, 2019—Handball players are susceptible to adaptive bony and soft-tissue changes of the dominant shoulder. Our goal was to compare the glenohumeral range of motion and posterior capsule thickness between the dominant and nondominant arm of throwing athletes and between the dominant arm of nonthrowers and throwing athletes. Twenty-three collegiate handball players and 23 nonthrowing athletes underwent an examination of the dominant and the nondominant shoulder. Humeral retroversion and posterior capsule thickness were assessed with an ultrasound examination, whereas external rotation and internal rotation were determined with a digital inclinometer. The dominant shoulder of handball players had a significantly higher external rotation compared with their nondominant shoulder and the dominant shoulder of nonthrowing athletes. Furthermore, the dominant shoulder of handball players had a significantly lower internal rotation compared with their nondominant shoulder, with no differences compared with the dominant shoulder of the nonthrowing athletes. There was a trend for an increased posterior capsule thickness and an increased humeral retroversion between the dominant and the contralateral shoulder of handball players. Moreover, we found a significant increase in the capsule thickness of the dominant shoulder of throwing athletes compared with the dominant shoulder of nonthrowers. However, there were no differences in humeral retroversion. Our analysis suggests that a comparison of the dominant shoulder of overhead throwing athletes with the dominant shoulder of nonthrowing athletes might be more appropriate than the comparison of the dominant and the nondominant shoulder to evaluate the adaptive changes on the dominant side.