Study of Arm and Putter Movement in Golfers With Golfer's Cramp

Study Overview
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Brief Summary
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The investigators will investigate golfers with visual evidence of an involuntary movement while putting before and after treatment with a low dose of propranolol.

Detailed Description
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Dystonia affecting athletes has received little research attention and there has been a lack of awareness or interest among both physicians and athletes. Task-specific dystonias or occupational cramps affect people while writing, typing, and or playing a musical instrument. Our group has previously shown that a subset of golfers who complain of the yips appear to have a task-specific dystonia or golfer's cramp. The yips are characterized by an inability to appropriately complete a golf stroke, most often putting and chipping strokes. Most individuals with the yips describe a jerking or shaking movement that interrupts their swing. In many cases the yips are disabling and the golfer, including professional tour players, give up golfing. Golfers who have evidence of golfer's cramp will putt a series of putts during which they will be monitored for arm movements and putter movements. They will then be treated with a low dose of propranolol to see if there is a change in these parameters.

Official Title
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Golfer's Cramp: Correlation of Wrist Movements and Surface EMG With Putter Movements

Conditions
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Occupational; Cramp(s)

Intervention / Treatment
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* Drug: Propranolol
* Device: Opal Device
* Procedure: Science and Motion PuttLab (SAM)
* Device: Surface Electromyography EMG


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Age 18-75 Complaint of golfer's cramp/yips Visual evidence of a movement disorder during putting Able to complete 80 putts during the session Exclusion criteria: Contraindication to treatment with propranolol Movement disorder not when putting

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

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: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Golfers With Golfer's Cramp<br>Subjects in this arm will be tested with the Opal device, the Science and Motion PuttLab (SAM), and the Surface Electromyography (EMG) to collect movement parameters while putting before and after a single dose of 10 mg Propranolol. | Drug: Propranolol<br>* Single oral dose of 10 mg propranolol<br>* Other names: Inderal;Device: Opal Device<br>* The Opal Device (APDM, Inc.) will be used to measure wrist movement.<br>Procedure: Science and Motion PuttLab (SAM)<br>* The SAM will be used to study putter stroke movement and ball movement.<br>Device: Surface Electromyography EMG<br>* The surface EMG will be used to evaluate co-contraction of the wrist flexor/extensor muscle groups and the wrist pronator/supinator muscle groups.<br>|
| Other: Golf Pros<br>Subjects in this arm will be tested with the Opal device, the Science and Motion PuttLab (SAM), and the Surface Electromyography (EMG) to collect movement parameters while putting. The subjects in this arm will not receive any study drug. | Device: Opal Device<br>* The Opal Device (APDM, Inc.) will be used to measure wrist movement.<br>Procedure: Science and Motion PuttLab (SAM)<br>* The SAM will be used to study putter stroke movement and ball movement.<br>Device: Surface Electromyography EMG<br>* The surface EMG will be used to evaluate co-contraction of the wrist flexor/extensor muscle groups and the wrist pronator/supinator muscle groups.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Dynamic Change of Rotation at Impact | Dynamic change of rotation at impact is the velocity of rotation of the putter from the start of the forward swing until the time of impact with the golf ball. | baseline, approximately 45 minutes after propranolol dosing | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Total Putter Face Rotation Before Impact | Total putter face rotation before impact is the degrees of rotation of the putter from the start of the forward swing until the time of impact with the golf ball. | baseline, approximately 45 minutes after propranolol dosing | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Occupational; Cramp(s)