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Ju YY, Chu WT, Shieh WY, Cheng HYK. Elbow, wrist kinematics and shock transmission of backhand stroke in wheelchair tennis players. Sports Biomech 2024; 23:402-416. [PMID: 33594959 DOI: 10.1080/14763141.2020.1862903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
The aim was to compare the differences in kinematics of elbow and wrist and shock transmission of the upper extremity in wheelchair tennis players and able-bodied players (in standing and sitting position) during backhand strokes. Fifteen wheelchair tennis and 15 able-bodied tennis players enrolled. Electromagnetic system and trial-axial accelerometers were used to measure the difference in the kinematic parameters of the upper extremity and the impact vibration transferred across the wrist joint. The results indicated that wheelchair players demonstrated unique elbow and wrist kinematics, especially shorter total swing time, greater elbow flexion at preparation, lower wrist extension acceleration before impact, and smaller racket vibration at impact. Comparing to able-bodied players in standing, wheelchair players and players in sitting demonstrated significantly greater elbow joint flexion/extension angle, angular velocity, angular acceleration during extension, and wrist joint flexion angle. Wheelchair players also differ significantly with the players in sitting regarding elbow joint angular velocity and acceleration, and wrist joint flexion velocity. These adaptations and adjustments can be attributed to the missing lower extremity function and deficient trunk kinetic chain. The differences between wheelchair tennis players and able-bodied players in sitting could represent the progress as the wheelchair players moving from novices to experts.
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Affiliation(s)
- Yan-Ying Ju
- Department of Adapted Physical Education, National Taiwan Sport University, Tao-Yuan, Taiwan
| | - Wan-Ting Chu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Tao-Yuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Hsin-Yi Kathy Cheng
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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Lorenz M, Pelliccia L, Werner M, Scholze M, Klimant P, Heyde CE, Klima S, Hammer N. Wrist at risk? - Considerations derived from a novel experimental setup to assess torques during hip reaming with potential implications on the orthopedic surgeons' health. J Mech Behav Biomed Mater 2020; 113:104160. [PMID: 33129034 DOI: 10.1016/j.jmbbm.2020.104160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 06/26/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022]
Abstract
Orthopedic surgeons endure high physical stresses when performing surgery, as large forces and torques are applied commonly. Occupational risks are consequently higher when compared to other surgical disciplines. One example is the reaming of the acetabula during total hip arthroplasty, using customized instruments. This surgery may predispose the surgeon to overuse-related wrist pathology. In this study, torques acting along the reaming tool were measured, and the resulting forces applied to the orthopedic surgeons' wrists were estimated based on the measured torque data from hip reaming. Different reamer sizes and tool velocities were analyzed to determine how both parameters may influence the torques applied at the surgeon's wrist. Using a highly standardized setup, torques were measured while the reamer was pushed into the acetabula to remove cartilage. Maximum torques and stoppage torques at blocking of the reamer were compared between feed rates and reamer sizes. Peak values of the maximum torques along the reamer axis averaged 1.5-1.8 Nm. No significant difference between maximum torques and reamer sizes was found. A significant difference in maximum torques was noted between feed rates with a large effect (p = 0.010; η2 = 0.214) and a large interaction effect (p = 0.017; η2 = 0.186). Based on this experimental setup, it can be hypothesized that the impulsive behavior of the torque when the milling tool reaches the subchondral lamella could potentially contribute to wrist pathology. These preliminary data warrant further study. Consequently, torque limiters should be implemented in reamers to minimize the risk of occupation-related pathology to the wrist.
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Affiliation(s)
- Mario Lorenz
- Chemnitz University of Technology, Professorship Machine Tool Design and Forming Technology, Professorship Factory Planning and Factory Operation, Institute of Materials Science and Engineering, Straße der Nationen 62, 09111, Chemnitz, Germany; University Hospital Leipzig, Department of Orthopedics, Trauma and Plastic Surgery, Liebigstraße 20, 04103, Leipzig, Germany; Medical University of Graz, Department of Macroscopic and Clinical Anatomy, Harrachgasse 21, 8010, Graz, Austria.
| | - Luigi Pelliccia
- Chemnitz University of Technology, Professorship Machine Tool Design and Forming Technology, Professorship Factory Planning and Factory Operation, Institute of Materials Science and Engineering, Straße der Nationen 62, 09111, Chemnitz, Germany.
| | - Michael Werner
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, Nöthnitzer Straße 44, 01187, Dresden, Germany; Orthopaedicus Clinics, Lortzingstraße 15, 04105, Leipzig, Germany.
| | - Mario Scholze
- Chemnitz University of Technology, Professorship Machine Tool Design and Forming Technology, Professorship Factory Planning and Factory Operation, Institute of Materials Science and Engineering, Straße der Nationen 62, 09111, Chemnitz, Germany; Medical University of Graz, Department of Macroscopic and Clinical Anatomy, Harrachgasse 21, 8010, Graz, Austria.
| | - Philipp Klimant
- Chemnitz University of Technology, Professorship Machine Tool Design and Forming Technology, Professorship Factory Planning and Factory Operation, Institute of Materials Science and Engineering, Straße der Nationen 62, 09111, Chemnitz, Germany; Fraunhofer Institute for Machine Tools and Forming Technology IWU, Nöthnitzer Straße 44, 01187, Dresden, Germany.
| | - Christoph-E Heyde
- University Hospital Leipzig, Department of Orthopedics, Trauma and Plastic Surgery, Liebigstraße 20, 04103, Leipzig, Germany.
| | - Stefan Klima
- University Hospital Leipzig, Department of Orthopedics, Trauma and Plastic Surgery, Liebigstraße 20, 04103, Leipzig, Germany; Orthopaedicus Clinics, Lortzingstraße 15, 04105, Leipzig, Germany.
| | - Niels Hammer
- University Hospital Leipzig, Department of Orthopedics, Trauma and Plastic Surgery, Liebigstraße 20, 04103, Leipzig, Germany; Fraunhofer Institute for Machine Tools and Forming Technology IWU, Nöthnitzer Straße 44, 01187, Dresden, Germany; Medical University of Graz, Department of Macroscopic and Clinical Anatomy, Harrachgasse 21, 8010, Graz, Austria.
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Stuelcken M, Mellifont D, Gorman A, Sayers M. Wrist Injuries in Tennis Players: A Narrative Review. Sports Med 2018; 47:857-868. [PMID: 27699697 DOI: 10.1007/s40279-016-0630-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The wrist/hand complex forms the crucial final link in the kinetic chain between the body and the racquet and therefore has a number of important roles in the production of all tennis strokes. However, the internal and external loads that are created at the wrist during these strokes have the potential to contribute to pain and injury. Therefore, the purposes of this narrative review are to (1) determine the extent of the problem of wrist pain/injury in tennis players, (2) identify bony and soft tissue structures of the wrist that are susceptible to damage as a result of tennis play and (3) explore factors that may influence the development of wrist pain/injury in tennis players. The epidemiological data revealed two important points. First, some evidence suggests wrist pain/injury accounts for a higher percentage of total injuries in more recent studies (2014-2015) than in early studies (1986-1995). Second, the relative frequency of wrist pain/injury compared with other well-recognized problem areas for tennis players such as the shoulder complex, elbow and lumbar spine is noticeably higher in more recent studies (2014-2015) than in early studies (1986-1995), particularly among females. Collectively, this would seem to indicate that the problem of wrist pain/injury has increased in the modern game. In fact, some wrist injuries appear to be related to the use of certain forehand grip types and the predominant use of the two-handed backhand. While the loads experienced at the wrist during tennis stroke production seem to be below threshold levels for a single event, the cumulative effects of these loads through repetition would appear to be an important consideration, especially when inadequate time is allowed to complete normal processes of repair and adaptation. This is supported by the evidence that most wrist injuries in tennis are associated with overuse and a chronic time course. The complex interaction between load, repetition, and training practices in tennis, particularly among young developing players who choose a path of early specialization, needs to be further explored.
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Affiliation(s)
- Max Stuelcken
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, QLD, 4558, Australia.
| | - Daniel Mellifont
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, QLD, 4558, Australia
| | - Adam Gorman
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, QLD, 4558, Australia
| | - Mark Sayers
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, QLD, 4558, Australia
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Mohandhas BR, Makaram N, Drew TS, Wang W, Arnold GP, Abboud RJ. Racquet string tension directly affects force experienced at the elbow: implications for the development of lateral epicondylitis in tennis players. Shoulder Elbow 2016; 8:184-91. [PMID: 27583017 PMCID: PMC4950282 DOI: 10.1177/1758573216640201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/29/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lateral epicondylitis (LE) occurs in almost half of all tennis players. Racket-string tension is considered to be an important factor influencing the development of LE. No literature yet exists that substantiates how string-tension affects force transmission to the elbow, as implicated in LE development. We establish a quantitative relationship between string-tension and elbow loading, analyzing tennis strokes using rackets with varying string-tensions. METHODS Twenty recreational tennis players simulated backhand tennis strokes using three rackets strung at tensions of 200 N, 222 N and 245 N. Accelerometers recorded accelerations at the elbow, wrist and racket handle. Average peak acceleration was determined to correlate string-tension with elbow loading. RESULTS Statistically significant differences (p < 0.05) were observed when average peak acceleration at the elbow at 200 N string-tension (acceleration of 5.58 m/s(2)) was compared with that at 222 N tension (acceleration of 6.83 m/s(2)) and 245 N tension (acceleration of 7.45 m/s(2)). The 200 N racket induced the least acceleration at the elbow. CONCLUSIONS Although parameters determining force transmission to the elbow during a tennis stroke are complex, the present study was able to control these parameters, isolating the effect of string-tension. Lower string-tensions transmit less force to the elbow in backhand strokes. Reducing string-tension should be considered favourably with respect to reducing the risk of developing LE.
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Affiliation(s)
| | | | | | | | | | - Rami J Abboud
- Rami J Abboud, Institute of Motion Analysis and Research (IMAR), Tayside Orthopaedic and Rehabilitation Technology (TORT) Centre, Ninewells Hospital and Medical School, University of Dundee, James Arrott Drive, Dundee DD1 9SY, UK. Tel: +44 (0)1382 383502.
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WANG LINHWA, LIN HWAITING. MOMENTUM TRANSFER OF UPPER EXTREMITY IN TENNIS ONE-HANDED BACKHAND DRIVE. J MECH MED BIOL 2011. [DOI: 10.1142/s0219519405001436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Study Design: Linear momentum and angular momentum in trunk and upper extremity segments in one-handed backhand drive were calculated.Objective: To investigate the characteristics and transfer of linear momentum and angular momentum from the trunk and upper extremity to racket during tennis one-handed backhand drive.Background: Backhand stroke is one of the most frequently used techniques in playing tennis. Very few studies have taken the point of view from the transfer linear and angular momentum of the trunk and upper extremity to racket during tennis one-handed backhand drive.Methods: Six right-handed elite male tennis players participated in this study. Mean age was 26 ± 2.71 years. Sixteen markers were attached on the selected anatomic landmarks unilaterally and three markers attached on the racket to define the coordinate system of the trunk, upper arm, forearm, hand, and racket.Results: Hand contributed the most force for the changes of both linear momentum (leading and vertical direction) and angular momentum (supination). Racket and hand had similar curves in the three directions, which shows the main control racket is from hand and obvious effect in one-handed backhand stroke performance.Conclusions: An understanding of kinetics of the backhand stroke is essential for understanding injury mechanisms and prevention.
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Affiliation(s)
- LIN-HWA WANG
- Department of Physical Education, National Cheng Kung University, Tainan, Taiwan, ROC
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - HWAI-TING LIN
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
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Pluim BM, Staal JB, Windler GE, Jayanthi N. Tennis injuries: occurrence, aetiology, and prevention. Br J Sports Med 2006; 40:415-23. [PMID: 16632572 PMCID: PMC2577485 DOI: 10.1136/bjsm.2005.023184] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2006] [Indexed: 01/02/2023]
Abstract
A systematic search of published reports was carried out in three electronic databases from 1966 on to identify relevant articles relating to tennis injuries. There were 39 case reports, 49 laboratory studies, 28 descriptive epidemiological studies, and three analytical epidemiological studies. The principal findings of the review were: first, there is a great variation in the reported incidence of tennis injuries; second, most injuries occur in the lower extremities, followed by the upper extremities and then the trunk; third, there have been very few longitudinal cohort studies that investigated the association between risk factors and the occurrence of tennis injuries (odds ratios, risk ratios, hazard ratios); and fourth, there were no randomised controlled trials investigating injury prevention measures in tennis. More methodologically sound studies are needed for a better understanding of risk factors, in order to design useful strategies to prevent tennis injuries.
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