Sex differences in elbow and wrist joint loading during the cartwheel and round off with different hand positions performed by young gymnasts

The effect of changes in fundamental skill complexity on upper limb loading and biomechanical characteristics of performance in female gymnastics

Aims of this study were to investigate if changes in elbow and wrist joints loading and biomechanical characteristics of performance existed as a function of (a) different hand placement and (b) fundamental skills development in female gymnastics. Ten female gymnasts performed 54 successful trials of round-off skills (cartwheel [18], round-off [18], round-off to back handspring [18]), with three different hand positions (parallel, T-shape and reverse). Kinematic and kinetic data were collected for each trial. A two-way repeated measures ANOVA was used to analyse the injury risk factors. Findings of the current study showed that an increase in RO skill difficulty level significantly influences the mechanical load on the upper extremities. With the increase in mechanical load on the upper extremities during the reverse and parallel hand positions, this study suggests that that T-shape hand position should be used as the primary technique for the young female. Differences in vertical velocity from touchdown to take-off between the three hand positions for the RO and RO-BH suggested that the reverse position was less effective for young female gymnasts. The findings of the current study demonstrated no clear performance benefits between hand position selection.

Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study

BACKGROUND

Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types: Supracondylar (SC), lateral condyle (LC), and medial epicondyle (ME) fractures.

AIM

To evaluate the epidemiology of pediatric distal humerus fractures (SC, LC, and ME) from an American insurance claims database.

METHODS

A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC, LC and ME fractures based on the IBM Truven MarketScan® Commercial and IBM Truven MarketScan Medicare Supplemental databases. Patients from 2015 to 2020 were queried for treatments, patient age, sex, length of hospitalization, and comorbidities.

RESULTS

A total of 1133 SC, 154 LC, and 124 ME fractures were identified. SC fractures had the highest percentage of operation at 83%, followed by LC (78%) and ME fractures (41%). Male patients were, on average, older than female patients for both SC and ME fractures.

CONCLUSION

In the insurance claims databases used, SC fractures were the most reported, followed by LC fractures, and finally ME fractures. Age was identified to be a factor for how a pediatric distal humerus fractures, with patients with SC and LC fractures being younger than those with ME fractures. The peak age per injury per sex was similar to reported historic central tendencies, despite reported trends for younger physiologic development.

Upper limb biomechanics and dynamics of a core skill on floor exercise in female gymnastics

This study aimed to increase understanding of the biomechanics and dynamics of the upper limbs during the contact phase of the round-off (RO) performed using three techniques. Twenty female gymnasts performed six successful RO trials in each condition: parallel, T-shape and reverse. Kinetic and kinematic data were collected for each trial. All analyses focused on the contact phase for each hand. Continuous joint profiles examined the dynamics of these tasks as well as the kinetic sequencing. In each case, joint angles, angular velocity, moments and powers at the wrist and elbow joint were reported. Difference between the contact phases of the techniques was examined using a one-way ANOVA SPM. The T-shape technique demonstrated negative power at the wrist during contact; however, the elbow joint compensated with a significantly greater positive power generation during the propulsive phase, suggesting a more effective technique compared to the reduced powers of the reverse and parallel. The order of the peak joint powers during the contact phase, the reverse technique, demonstrated a proximal to distal sequence, in contrast to the distal to proximal for the other techniques. These findings highlight the task-specific coordinative structures during this closed chained action.

Current issues and future directions in gymnastics research: biomechanics, motor control and coaching interface

The sport of gymnastics is undergoing a global examination of its culture and the relationship between the gymnast, coach and environment is a central focus. The aim of this review is to explore biomechanics and motor control research in skill development and technique selection in artistic gymnastics with a focus on the underlying concepts and scientific principles that allow performance enhancement, skill development and injury risk reduction. The current review examines peer reviewed papers from 2000 onwards, with a focus on contemporary approaches in the field of gymnastics research, and highlights several key directions for future gymnastics research. Based on our review and the integration of the models of Newell (1986) and Irwin et al. (2005), we recommend that future gymnastics research should embrace at the very least a multidisciplinary approach and aim for an interdisciplinary paradigm.

Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns

Background:

Despite increasing participation rates in youth gymnastics, the majority of epidemiologic literature focuses on older elite athletes or stratifies athletes by level of competition.

Hypothesis:

The authors hypothesized that sex- and age-based patterns in youth gymnastics–related injuries exist, which are otherwise overlooked in an unstratified population.

Study Design:

Descriptive epidemiology study.

Methods:

Publicly available injury data from the National Electronic Injury Surveillance System were collected on pediatric gymnastics injuries presenting to emergency departments in the United States. Participation data from the National Sporting Goods Association were used to calculate national injury incidence rates in 7- to 11-year-olds (childhood) and 12- to 17-year-olds (adolescence) from January 1, 2012, to December 31, 2018. Z tests were conducted for the comparison of injury rates between girls and boys within each age group and for overall injury rate across age groups.

Results:

Girls participated in gymnastics at a frequency 6.5 times that of boys in childhood and 13.5 times that of boys in adolescence. An estimated 72,542 youth gymnastics–related injuries were reported in US emergency departments each year. A large proportion (61.3%) occurred in childhood, with female predominance in both age groups. Overall, there was no difference in weighted annual injury rate (injuries per 100,000 athlete-days per year) by age group (6.9 [childhood] vs 8.8 [adolescence]; P = .19) or sex (7.4 [girls] vs 8.1 [boys]; P = .65). In adolescence, boys were more likely than girls to experience injury (16.47 vs 8.2; P = .003). Wrist and lower arm fractures were more common in childhood than adolescence (1.07 vs 0.43; P = .002) and specifically in girls (childhood vs adolescence, 1.06 vs 0.37; P = .001). Ankle injuries and concussions were more common in adolescence vs childhood (P = .01 and .0002).

Conclusion:

Upper extremity injuries predominated among childhood gymnasts, particularly girls. In adolescence, girls and boys experienced increases in concussions and foot and ankle injuries. Although representing a lower overall number of training gymnasts as compared with girls, adolescent boys experience a higher rate of injuries overall.

Construct validity of gymnastics-specific assessment on the neuromuscular function of shoulder flexor and extensor muscles

The present study examined the construct validity of gymnastics-specific measurements of the shoulder flexor and extensor neuromuscular function. Fifteen male gymnasts and 18 male physical education (PE) students participated voluntarily. The electromyogram (EMG) of 3 flexor and 3 extensor shoulder muscles was assessed during isometric (45, 90, and 135º) and isokinetic (concentric and eccentric 60, 180, and 300º/s) shoulder flexion/extension. Peak torque (PT) and neuromuscular function in terms of neuromuscular efficiency (NME, i.e. torque to EMG ratio) and antagonist/agonist coactivation index were evaluated. The construct validity of the measurements was supported by the ability to discriminate between gymnasts and physical education (PE) students, taking into consideration the shoulders' neuromuscular function parameters (37%-57% of the variability explained). After accounting for the limitations of the study, these findings may assist gymnastics coaches and researchers to develop and evaluate more effective training methods for athletes related to shoulder joint physiological characteristics and level of expertise.