Throwers Ten Exercises On Upper Extremity Function and Explosive Power in Wheelchair Basketball and Basketball Players

Study Overview
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Brief Summary
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Basketball is a challenging sport that requires participants to demonstrate physical fitness and special athletic skills at high levels. Players avoid contact while attempting to prevent the opponent from running, passing and shooting. Although basketball includes avoiding contact as a rule, contact between players is inevitable. Various injuries occur in basketball because it is a contact sport and includes sudden movements, such as bouncing, running and turning. Wheelchair (WC) basketball is characterised by manoeuvres and high-intensity activities such as rolling, rebounding, passing and overhead shooting. In WC basketball players, thoracic kyphosis is increased because of atrophy of the upper back and shoulders muscles resulting from the body posture required for WC propulsion in the sitting position as well as the effect of gravity. This sitting posture is characterised by scapular protraction and internal rotation of the humerus, and it impedes shoulder movements during upper-extremity use. Overhead throwing is a movement that involves high speed and repetitive movement that leads to upper-extremity injuries. It is important to develop muscle strength and proprioception to protect against these injuries. Throwers Ten exercise programme is a programme designed to improve the power, strength and endurance of large muscle groups required for the throwing activity. It consists of exercises involving the movement of upper limb joints in full range of joint motion (ROM) or at specified specific angles, with the help of a resistance band and weights specific to individual athletes. In the literature, no study has demonstrated the effectiveness of Throwers Ten exercise programme in these sports groups. The aim of this study was to evaluate the effectiveness of Throwers Ten exercise programme on upper-extremity function and explosive power in the WC basketball players and stand-up basketball players.

Detailed Description
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Basketball is a challenging sport that requires participants to demonstrate physical fitness and special athletic skills at high levels. Players avoid contact while attempting to prevent the opponent from running, passing and shooting. Although basketball includes avoiding contact as a rule, contact between players is inevitable. Various injuries occur in basketball because it is a contact sport and includes sudden movements, such as bouncing, running and turning. Wheelchair (WC) basketball is characterised by manoeuvres and high-intensity activities such as rolling, rebounding, passing and overhead shooting. In WC basketball players, thoracic kyphosis is increased because of atrophy of the upper back and shoulders muscles resulting from the body posture required for WC propulsion in the sitting position as well as the effect of gravity. This sitting posture is characterised by scapular protraction and internal rotation of the humerus, and it impedes shoulder movements during upper-extremity use. The force balance changes because of humeral internal rotation and scapular protraction, and the internal rotator and adductor muscles become stronger than their antagonists. In basketball, throwing and pushing are used to pass the ball to the target. In throwing, the force of the dominant upper extremity comes into play with the internal rotation of the humerus. In this movement, the humerus is almost horizontal and parallel to the ground. Increased use of the upper extremities in WC users increases upper-extremity load. For this reason, upper-extremity muscle strength, endurance and explosive power are of great importance. Rotational muscle strength of the shoulder has critical roles in activities specific to basketball as well as WC control in WC basketball players. Overhead throwing is a movement that involves high speed and repetitive movement that leads to upper-extremity injuries. It is important to develop muscle strength and proprioception to protect against these injuries. Throwers Ten exercise programme is a programme designed to improve the power, strength and endurance of large muscle groups required for the throwing activity. It consists of exercises involving the movement of upper limb joints in full range of joint motion (ROM) or at specified specific angles, with the help of a resistance band and weights specific to individual athletes. In a study conducted by Wilk et al., it was reported that muscle strength and endurance were improved by increasing muscle activation and facilitation, and achieving dynamic stabilisation by adding isometric contractions to the concentric/eccentric contractions applied in the Throwers Ten exercise programme. In the literature, no study has demonstrated the effectiveness of Throwers Ten exercise programme in these sports groups. The aim of this study was to evaluate the effectiveness of Throwers Ten exercise programme on upper-extremity function and explosive power in the WC basketball players and stand-up basketball players. In addition, because the WC basketball players and stand-up basketball players were evaluated in this study, our secondary aim was to elucidate the differences in responses to the exercise programme between a group without lower-extremity use and incomplete strength distribution and a group with complete strength distribution.

Official Title
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The Effect of Thrower's Ten Exercise Programme On Upper Extremity Muscle Power, Range of Motion and Explosive Power in Wheelchair Basketball and Basketball Players

Conditions
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Muscle Weakness, Upper Extremity Injury, Sport Injury, Shoulder Pain

Intervention / Treatment
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* Other: The effect of throwers ten exercise programme on wheelchair basketball and ambulant basketball players


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Asymptomatic athletes Professional athlete who plays at least 10 years Subjects who are voluntary to participate in the study Exclusion Criteria: Upper extremity related surgery in past 6 months Rotator cuff tears in past 3 months Current pain in shoulder and neck

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Interventional Model Description: 13 players from the North Cyprus wheelchair Basketball Team and 15 players from the Koop Bank Basketball Men's Team voluntarily will participate in the study. Subjects will include to study if they fulfil criteria. J-Tech medical tracker freedom will use for measuring upper extremity muscle power and range of motion. Medicine ball throw test will use for plyometric power. Athletes will involve in 8 weeks Thrower's Ten exercise program. After 8. Weeks and 12. Weeks assessments will be repeated. The exercise programme will conduct 3 days a week, with 2 days a week as a group under the supervision of a physiotherapist in the rehabilitation center and 1 day at the homes of the participants without any supervision. The home programme will be monitored by contacting the players over the telephone. The training is planned to progress every 3 weeks, and progression programme will plan individually according to player progression.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Wheelchair basketball and ambulant basketball players<br>13 players from the North Cyprus wheelchair Basketball Team and 15 players from the Koop Bank Basketball Men's Team voluntarily will participate in the study. Subjects will include to study if they fulfil criteria. Athletes will involve in 8 weeks Thrower's Ten exercise program. After 8. Weeks and 12. Weeks assessments will be repeated. | Other: The effect of throwers ten exercise programme on wheelchair basketball and ambulant basketball players<br>* Throwers Ten exercise programme is a programme designed to improve the power, strength and endurance of large muscle groups required for the throwing activity. It consists of exercises involving the movement of upper limb joints in full range of joint motion or at specified specific angles, with the help of a resistance band and weights specific to individual athletes. In the literature, no study has demonstrated the effectiveness of Throwers Ten exercise programme in wheelchair basketball and ambulant basketball players.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of Muscle Strength (Absolute Values Are Being Reported) | The strength of shoulder flexion, abduction, external rotation (E.R), internal rotation(İ.R) and elbow flexion will measure as isometric muscle strength in kg by J-Tech Medical/USA Tracker Freedom Isometric Muscle Test. | All measurements will repeat three times at 5-s intervals and the mean value will be taken. Baseline, 8 and 12 Weeks reported. | 
| Medicine Ball Throwing Test (Absolute Values Are Being Reported) | In this test, the distance that a 3-kg ball can be thrown will measure to assess upper-extremity explosive strength. The test will conduct in two different positions. In the first test, the participant will seat in a chair of sufficient height without armrests so that the scapula will be in a free position. The ball is then grasp with both hands and throw forward overhead, and the distance will record. In the second test, the participant is in the same starting position and throw the ball forward with two hands after bringing it to the chest level, and the distance will record. | All measurements will repeat three times at 5-s intervals and the mean value will be taken. Baseline, 8 and 12 Weeks reported. | 
| Hand Grip Test (Absolute Value Are Being Reported) | Hand-grip strength will measure with a J-Tech Medical/USA Tracker Freedom Grip in kg. | All measurements will repeat three times at 5-s intervals and the mean value will be taken. Baseline, 8 and 12 Weeks reported. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of Range of Motion (Absolute Values Are Being Reported) | Shoulder flexion, abduction and external rotation (E.R), internal rotation (İ.R) range of movement will measure in degrees by J-Tech Medical/US Tracker Freedom Goniometer. | All measurements will repeat three times at 5-s intervals and the mean value will be taken. Baseline, 8 and 12 Weeks reported. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sports for Persons with Disabilities, Basketball, Exercise