Internal Rotation Deficit of the Glenohumeral Joint in Advanced-level Handball Players (GIRDH)

Evaluation of the Internal Rotation Deficit of the Glenohumeral Joint in Advanced-level Handball Players Occurring Over One Training Season

The main objective of this study is to estimate the incidence and prevalence of Internal Rotation Deficit (IRD) defined by a measure of IRD 2 (Internal Rotation Deficit in position 2) strictly greater than 20 ° in a population of advanced-level handball players over a training season.

Study Overview

• Status: Completed
• Conditions: Athletic Injuries; Articulation Disorders; Internal Rotation Contracture-shoulder

Detailed Description

The secondary objectives of this study are :

A- To estimate and compare the prevalence of Internal Rotation Deficit within groups

B- To assess the association between the Internal Rotation Deficit and the appearance of a shoulder pain and/or discomfort when throwing

C- To assess the association between Internal Rotation Deficit and the appearance of a shoulder pathology demonstrated by clinical examination by at least one abnormality in one of the following three tests: the arming apprehension test, the relocation test or the O'Brien test

D- Assess changes in values of IRD 2, the ratio IRD 2/GRE 2, and the Total Range of Motion over the training season

E- Evaluate the association between the values of IRD 2 and the appearance of shoulder pain or discomfort when throwing

F- To evaluate the association between IRD 2 values and the appearance of a shoulder pathology (at least one anomaly in one of three tests: the arming apprehension test, the relocation test or the O'Brien test).

G- To assess the association between values of the IRD 2/GRE 2 ratio and the appearance of shoulder pain or discomfort when throwing

H- To assess the association between values of the IRD 2/GRE 2 ratio and the appearance of a shoulder pathology (at least one anomaly in one of three tests: the arming apprehension test, the relocation test or the O'Brien test).

I- To estimate the optimal threshold value of the IRD 2/GRE 2 ratio that would define an Internal Rotation Deficit in a more relevant fashion as compred to the IRD 2 alone

• Study Type: Observational
• Enrollment (Actual): 86

Contacts and Locations

Study Locations

• France
  • Nîmes Cedex 9, France, 30029
    • CHRU de Nîmes - Hôpital Universitaire Carémeau

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The study population is composed of all members of the professional and pre-professional handball clubs in the city of Nîmes, France (the USAM and HBCN clubs). Younger players who are members of the training centers associated with these same clubs will also be included.

Description

Inclusion Criteria:

• The subject or his/her legal guardian must have given his/her informed and signed consent
• The subject must be insured or beneficiary of a health insurance plan
• The subject is a member of the professional and pre-professional handball clubs in Nîmes, France (the USAM or HBCN clubs) -- OR-- a member of the training centers associated with the same clubs whose parents or legal representatives have given informed consent

Exclusion Criteria:

• The subject is under judicial protection, under tutorship or curatorship
• The subject or his/her legal respresentative refuses to sign the consent
• It is impossible to correctly inform the subject
• The subject is pregnant, parturient, or breastfeeding
• The subject has been operated for shoulder instability, regardless of the surgical technique used
• The subject has a history of fracture of the proximal end of the humerus and / or elbow
• The subject has a history of rotator cuff surgery
• The subject has neurological or spinal problems, or has received physiotherapy on the shoulder complex within 30 days prior to the study assessment

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort
Professional players, men; This group includes professional, male, handball players meeting study inclusion criteria.
Professional players, women; This group includes professional, female, handball players meeting study inclusion criteria.
Junior players, men; This group includes junior, male, handball players meeting study inclusion criteria.
Junior players, women; This group includes junior, female, handball players meeting study inclusion criteria.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Presence/absence of an internal rotation deficit (IRD 2 > 20°)	IRD 2 = internal rotation deficit in position 2 Position 2 = dominant arm in abduction at 90°	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Presence/absence of an internal rotation deficit (IRD 2 > 20°)		baseline (Day 0)
Presence/absence of an internal rotation deficit (IRD 2 > 20°)		3 months
Measure of the internal rotation deficit		baseline (day 0)
Measure of the internal rotation deficit		3 months
Measure of the internal rotation deficit		6 months
The ratio of DRI 2 / GRE 2	GRE 2 = measure of the external gain in rotation in position 2 Position 2 = dominant arm in abduction at 90°	baseline (day 0)
The ratio of DRI 2 / GRE 2		3 months
The ratio of DRI 2 / GRE 2		6 months
Measure of the total range of motion		baseline (day 0)
Measure of the total range of motion		3 months
Measure of the total range of motion		6 months
Presence/absence of pain when throwing (yes/no)		baseline (day 0)
Presence/absence of pain when throwing (yes/no)		3 months
Presence/absence of pain when throwing (yes/no)		6 months
Presence of discomfort when throwing (visual analog scale from 0 to 100)		baseline (day 0)
Presence of discomfort when throwing (visual analog scale from 0 to 100)		3 months
Presence of discomfort when throwing (visual analog scale from 0 to 100)		6 months
Presence/absence of shoulder pathology		baseline (day 0)
Presence/absence of shoulder pathology		3 months
Presence/absence of shoulder pathology		6 months
Shoulder clinical exam: the arming apprehension test		baseline (day 0)
Shoulder clinical exam: the arming apprehension test		3 months
Shoulder clinical exam: the arming apprehension test		6 months
Shoulder clinical exam: relocation test		baseline (day 0)
Shoulder clinical exam: relocation test		3 months
Shoulder clinical exam: relocation test		6 months
Shoulder clinical exam: the O'Brien test		baseline (day 0)
Shoulder clinical exam: the O'Brien test		3 months
Shoulder clinical exam: the O'Brien test		6 months

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nīmes

Study record dates

Study Major Dates

• Study Start: January 1, 2014
• Primary Completion (Actual): August 1, 2014
• Study Completion (Actual): August 1, 2014

Study Registration Dates

• First Submitted: December 9, 2013
• First Submitted That Met QC Criteria: December 10, 2013
• First Posted (Estimate): December 13, 2013

Study Record Updates

• Last Update Posted (Estimate): March 26, 2015
• Last Update Submitted That Met QC Criteria: March 25, 2015
• Last Verified: March 1, 2015

More Information

Terms related to this study

• Keywords: deficit; internal rotation; gleno humeral articulation; hand ball
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Wounds and Injuries; Neurobehavioral Manifestations; Joint Diseases; Musculoskeletal Diseases; Muscular Diseases; Language Disorders; Communication Disorders; Speech Disorders; Athletic Injuries; Contracture; Articulation Disorders
• Other Study ID Numbers: LOCAL/2013/OM-01; 2013-A01183-42 (Other Identifier: RCB number)