Context. Shoulder injuries are very common in baseball pitchers, and the diagnosis of shoulder injuries is often difficult to obtain as pathologic conditions are numerous. However, there are no universal screening tools that can be used to evaluate predisposing factors before injuries occur. Objective. Since there is little documented literature on what constitutes a proper screening tool, the purpose of this study is to gather the information necessary to create a universal screening tool that will aid in the prevention of shoulder injuries in baseball pitchers. Design. This study was a descriptive prospective study based on the modified Delphi technique. Setting. The study took place at a Division I institution. Patients and other participants. Participants consisted of 19 participants for the first round and thirteen for the second round. The experts were chosen based on their knowledge and expertise in evaluating and preventing shoulder injuries in baseball pitchers. Other inclusion criteria were based on studies published in the literature, by their presentations at professional conferences, and by their clinical experience with baseball pitchers. Interventions. Three questionnaires were utilized in this study. The demographic questionnaire and the first questionnaire were sent to the participants that included possible components of a screening tool for shoulder injuries. The participants were asked to rate the components on a 5-point Likert scale. After rating the components, the participants returned the questionnaires. A second questionnaire, based on the results from the first round, was then developed. If a consensus was reached (75% or a mean score of 4), the components remained on the second questionnaire. Any write in information that was added by the participants was also included. This was sent out to the participants who were asked again to rate each component. The responses from the second questionnaire served as the answers to develop a universal screening tool. Main outcome measures. With a consensus of the participants (75%, or mean score of 4), the entire evaluation process of the shoulder joint and shoulder girdle will be similar. There will also be an individual hypothesis for each component of the screening tool. These hypotheses will include the following: with a consensus of the participants (75%, or mean score of 4), the responses for the history, subjective complaints, observation and palpations, range of motion, manual muscle testing, functional testing, and special tests sections of the screening tool will be similar. Results. All of the components from the first round remained on the second questionnaire. There were several additional comments from the first round that were added to the second questionnaire. The components that were added were number of pitches thrown per game and average number of innings per season or year (history section), and hand held dynamometer (manual muscle testing section). The final screening tool consisted of what should be included in a preventative shoulder screening tool based on the opinions of a panel of experts. All components in the history, subjective complaints, and observation/palpations sections remained. The Apley scratch test was removed from range of motion/flexibility. All components remained in the manual muscle testing section. The lower abdominal exercise progression (all levels), single-leg squat test, Rhomberg's test, and Balance Error Scoring System were removed from functional testing. Lastly, reflexes, peripheral nerves (radial, medial), capillary refill, and pulses were removed from the special testing section. Conclusions. Findings were consistent with the original hypotheses as the majority of the responses from each participant were similar, except for ROM/flexibility, functional testing, and special tests.APPENDIX A THE PROBLEM Research Questions The glenohumeral (GH) joint is one of the most frequently injured areas of the body in competitive sports. Studies indicate that 8-20% of injuries in athletics involve the shoulder.1, 2 Of those sports, baseball injuries are quite ... pitchers, in particular, are subjected to significant forces at the shoulder each time they throw the baseball, thus leading to injury.
|Title||:||The Development of a Screening Tool for the Prevention of Shoulder Injuries in Baseball Pitchers|
|Author||:||Erica L. Smrzley|
|Publisher||:||ProQuest - 2007|