Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial

Mohsen Moradi, Malihe Hadadnezhad, Amir Letafatkar, Zohre Khosrokiani, Julien S Baker, Mohsen Moradi, Malihe Hadadnezhad, Amir Letafatkar, Zohre Khosrokiani, Julien S Baker

Abstract

Background: The Glenohumeral internal-rotation deficit (GIRD) is related to the altered eccentric external-rotator (ER), the concentric internal-rotator (IR), muscle strength, and the ER: IR ratio. GIRD has been documented as a risk factor for shoulder injuries. However, few studies have investigated the effect of an exercise training on these parameters in athletes with GIRD. Therefore, the purpose of this study was to evaluate the effects of an 8-week throwing exercise with a TheraBand for retraining the rotator cuff on Electromyography (EMG) activity of selected muscles, rotator cuff muscle strength, the glenohumeral (GH) joint IR range of motion (ROM) and GH joint position sense in asymptomatic male volleyball players with GIRD.

Methods: Sixty male volleyball players with GIRD were randomized into either a training group or a control group. The experimental group underwent an 8-week throwing exercise with a TheraBand including 5 sessions of stretching and 3 sessions of strengthening exercises per week. The control group received an active self-exercise program. EMG (onset time and muscle activation), shoulder range of motion (ROMs), strength and GH joint position sense were all assessed pre and post trainings.

Results: There were statistically significant within-group differences in the EMG activity of the anterior deltoid (p = 0.005), middle deltoid (p = 0.007), posterior deltoid (p = 0.004), infraspinatus (p = 0.001) and supraspinatus (p = 0.001) muscles, IR ROM (p = 0.001), rotator cuff muscle strength ratio (p = 0.001), and GH joint position sense (p = 0.033) in the experimental group. A 2 × 2 analysis of variance with a mixed model design and independent and paired t-tests were used for statistical analysis.

Conclusions: Throwing exercise with a TheraBand improved shoulder muscle activation, IR ROM, rotator cuff muscle strength ratio and GH joint position sense in participants with GIRD. These findings may improve the treatment of GIRD in a clinical setting. Although the results are significant, further studies should follow up the long-term effects of the Throwing exercise with a TheraBand on GIRD.

Trial registration: Current Controlled Trials using the UMIN-RCT website with ID number of, UMIN000038416 "Retrospectively registered" at 2019/10/29.

Keywords: Glenohumeral internal-rotation deficit; Injury prevention; Volleyball player.

Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Consort flow diagram
Fig. 2
Fig. 2
Muscle activation (%MVC) alteration from pretest to post-test
Fig. 3
Fig. 3
Muscle onset time (ms) alteration from pretest to post-test
Fig. 4
Fig. 4
Internal rotation ROM, Eccentric strength for external rotators, Concentric strength internal rotators, Joint position sense error, and Functional strength ratio (Eccentric ER strength:concentric IR strength)

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Source: PubMed

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