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Abstract

The purpose of this study was to examine the test-retest reliability, minimal detectable change (MDC), and determine normative values of 3 upper extremity (UE) tests of function and power. One hundred eighty participants, men (n = 69) and women (n = 111), were tested on 3 UE strength and power maneuvers in a multicenter study to determine baseline normative values. Forty-six subjects returned for a second day of testing within 5 days of the initial assessment for the reliability component of the investigation. Explosive power was assessed via a seated shot-put test for the dominant and nondominant arms. Relationships between the dominant and nondominant arms were also analyzed. A push-up and modified pull-up were performed to measure the amount of work performed in short (15-second) bursts of activity. The relationship between the push-up and modified pull-up was also determined. Analysis showed test-retest reliability for the modified pull-up, timed push-up, dominant single-arm seated shot-put tests, and nondominant single-arm seated shot-put tests to be intraclass correlation coefficient(3,1) 0.958, 0.989, 0.988, and 0.971, respectively. The MDC for both the push-up and modified pull-up was 2 repetitions. The MDCs for the shot put with the dominant arm and the nondominant arm were 17 and 18 in., respectively. The result of this study indicates that these field tests possess excellent reliability. Normative values have been identified, which require further validation. These tests demonstrate a practical and effective method to measure upper extremity functional power.
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RELIABILITY, MINIMAL DETECTABLE CHANGE, AND NORMATIVE VALUES FOR TESTS OF UPP...
Rodney J Negrete; William J Hanney; Morey J Kolber; George J Davies; Megan K ...
Journal of Strength and Conditioning Research; Dec 2010; 24, 12;
ProQuest Nursing & Allied Health Source
pg. 3318
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
... While functional upper extremity tests exist, including the push-up, pull-up, Y-Balance Test-Upper Quarter, and Closed Kinetic Chain Upper Extremity Test, these are performed in closed kinetic chain positions (where the distal segment is fixed and the proximal segment moves, typically with the hand or forearm fixed against a surface) [8,9]. Many daily shoulder activities, however, occur in an open kinetic chain, where the distal segment moves freely through space while the proximal segment remains relatively fixed, such as reaching, lifting, or throwing movements. ...
... The seated medicine ball throw (SMBT) and unilateral shot-put test (ULSPT) are openchain throwing tests designed to measure functional muscle performance [8,9,11,12]. These tests have primarily been utilized in overhead and upper extremity sports populations to quantify the distance of a chest pass or shot-put throw performed in a seated position, minimizing energy transfer from the lower body [11,13] (Figures 1 and 2). ...
... The ULSPT has demonstrated excellent reliability (ICC = 0.988 dominant, 0.971 nondominant side) in asymptomatic recreationally active adults [9]. Moderate to high associations have been reported between ULSPT and isokinetic pushing peak forces (r = 0.75-0.87) ...
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Background: Rotator cuff-related shoulder pain (RCRSP) is a common musculoskeletal condition characterized by pain, functional disability, reduced mobility, and weakness. There is a need for valid functional tests that can measure shoulder strength and power without exacerbating pain. The Seated Medicine Ball Throw (SMBT) and Unilateral Shot-Put Test (ULSPT) are throwing tests that use a weighted ball in a seated position, measuring throwing distance (m). This study aimed to evaluate the feasibility, discriminative validity, and convergent validity of these tests in individuals with RCRSP. Methods: This cross-sectional study included 64 participants: 30 with RCRSP and 34 asymptomatic controls. Participants completed the QuickDASH and Fear-Avoidance Beliefs Questionnaire (FABQ). Pain was assessed using a 10 cm visual analog scale (VAS) at multiple time points. The SMBT and ULSPT were performed using a 2 kg ball, with throwing distance calculated as the average of three trials. Active shoulder range of motion (AROM) and grip strength were also measured. A two-way mixed-model repeated-measures ANOVA was conducted to examine group effects, with post hoc analyses performed where relevant. Pearson correlations explored associations among outcome measures. Results: The RCRSP group presented with persistent moderate shoulder pain (mean duration = 6.33 ± 5.7 months, VAS = 5.03 ± 1.99 cm, QuickDASH = 26.2 ± 10.54). Pain did not significantly increase after throwing (VAS change = 0.5 ± 1.6 cm, P = 0.4), supporting the tests’ feasibility. ULSPT demonstrated significant differences between the RCRSP and control groups for both symptomatic (2.03 ± 0.81 m) and asymptomatic shoulders (2.04 ± 0.8 m) compared with controls (2.51 ± 0.93 m, P < 0.01). SMBT showed a trend toward group differences (P = 0.05). RCRSP participants showed reduced AROM (166.2 ± 10° vs. 175.1 ± 8.2°) but similar grip strength compared to controls. ULSPT strongly correlated with SMBT (r = 0.92–0.94, P < 0.0001). Both throwing tests correlated moderately with grip strength (r = 0.61–0.81, P < 0.05) and showed mild to moderate correlations with disability, pain, and fear-avoidance measures (r = 0.26–0.48, P < 0.05). Conclusions: The ULSPT demonstrated good discriminative validity in differentiating individuals with RCRSP from controls, while the SMBT showed a trend toward discrimination. Both tests were feasible to administer without significantly exacerbating pain. The strong correlation between ULSPT and SMBT, along with their associations with established measures, supports their potential as functional assessments of upper extremity performance in RCRSP.
... The patient should have their back against a chair or doorway, to allow for unrestricted glenohumeral extension as part of the test. Generally, three trials are performed with a rest period between trials ranging from 30 seconds to 2 minutes (46,47). Bilateral comparison in a healthy population of men and women demonstrated a 9% deficit in the nondominant shoulder vs. the dominant shoulder (47). ...
... Generally, three trials are performed with a rest period between trials ranging from 30 seconds to 2 minutes (46,47). Bilateral comparison in a healthy population of men and women demonstrated a 9% deficit in the nondominant shoulder vs. the dominant shoulder (47). A minimal detectable change of 17 (nondominant) and 18 (dominant) inches exists (47). ...
... Bilateral comparison in a healthy population of men and women demonstrated a 9% deficit in the nondominant shoulder vs. the dominant shoulder (47). A minimal detectable change of 17 (nondominant) and 18 (dominant) inches exists (47). This provides an objective goal when testing for return to sport. ...
... 11,21,45 Functional tests, when incorporated into RTS decision-making, may identify limitations and deficits that are associated with reduced performance and increased reinjury risk. 8,30,37,50,52,56,60 Further, to ensure athletes can carry out the specific demands of their sport, functional performance testing should correlate with the required actions necessary for competition. While the importance of physical performance on functional tests is well documented, psychological readiness is an emerging key aspect of RTS. ...
... 20,52,56,60 The SSPT is a functional test of upper extremity power that has demonstrated good reliability in male and female college athletes. 8,37 Participants sat with their backs against a wall, their feet flat on the floor, and their knees bent to 90°. The hand of their nontesting shoulder was positioned across their chest. ...
Article
Background Traumatic shoulder instability is a common injury in the general population and the military. Surgical stabilization surgery reduces recurrence rates compared with nonsurgical management. Time since surgery is generally the primary measure of return to sport. There is a gap in knowledge on psychological variables and time since surgery and their relationship to rotator cuff strength and functional performance. Hypothesis It was hypothesized that, after shoulder stabilization surgery, psychological factors and time since surgery will be associated positively with objective physical performance tests, that physical performance will differ significantly between postsurgery cadets and healthy controls, and that surgical stabilization of the nondominant arm will demonstrate greater range of motion deficits than surgical intervention on the dominant arm. Study Design Case-control study. Level of Evidence Level 4. Methods The 52 participants (26 postsurgical [6-24 months after surgery] and 26 healthy controls) were all military cadets. Outcome measures were patient-reported outcomes, range of motion, isometric strength, and functional performance. Results No significant relationships existed between time since surgery and psychological factors to rotator cuff strength or functional performance. Significant differences were found between groups in self-reported outcomes, including the Shoulder Instability Return to Sport After Injury scale, Single Assessment Numeric Evaluation, Numeric Pain Rating Scale, quickDASH, flexion and external rotation (ER), and ER limb symmetry. Those who received dominant-sided shoulder surgery demonstrated a greater mean active range of motion deficit than those who received nondominant-sided surgery. Both groups demonstrated a significant loss in ER, but dominant-sided surgical participants also demonstrated significant flexion loss. Conclusion Time since surgery and psychological variables did not demonstrate a relationship to rotator cuff strength and functional performance. Significant differences existed between the stabilization surgical participants and healthy controls in all patient-reported outcomes. Surgical participants with dominant-sided shoulder surgery demonstrated a greater mean motion deficit when compared with those who received nondominant-sided surgery.
... Similarly, men tend to perform more push-ups, averaging 31.3 repetitions compared to 21.8 repetitions for women . These findings are consistent with normative trends observed in the general population, where men typically demonstrate an average hand grip strength of 47 kg compared to around 31 kg for women (Massy-Westropp et al., 2011) and perform an average of 20.8 push-ups compared to 14.89 for females (Negrete et al., 2010). Integrating knowledge of biological sex-specific physical disparities into paramedicine training is essential for optimising job readiness and patient care outcomes. ...
... Shoulder pain, function, and performance were measured by NRPS, shoulder pain and disability index (SPADI) [25], and timed push-up test [26], respectively. The shoulder muscle's peak isometric strength was measured by a hand-held dynamometer [27]. ...
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Subcoracoid impingement occurs due to mechanical encroachment of the subscapularis tendon in the subcoracoid space between the coracoid process and lesser tuberosity of the humerus. Although physical therapy is known to have a crucial role in managing this condition, to the best of our knowledge, there is no established physical therapy program in the literature. This case report aims to provide a detailed presentation and diagnosis of a subcoracoid impingement case and to investigate the effects of physical therapy on pain, disability, performance, muscle strength, and ultrasound measurements over a one-year follow-up period. The patient was a 24-year-old male working as a jeweler who had been suffering from dull anterior left shoulder pain for five years. The modified Hawkins-Kennedy test was positive. Additionally, palpation was pain-free, except for severe pain in the coracoid area. The patient was injected with xylocaine into the subcoracoid space and demonstrated a spontaneous relief of pain. Ultrasound imaging showed a narrower coracohumeral distance from full internal rotation on the affected side (0.85 cm) compared to the non-affected side (1.22 cm). Six weeks of multimodal physical therapy program was delivered to the patient. It consisted of electrophysical agents, manual therapy, and therapeutic exercise. Electrophysical agents included conventional transcutaneous electrical nerve stimulation, ice, and phonophoresis. Manual therapy included shoulder mobilization, myofascial release, thoracic mobilization, and posterior capsule stretches. Additionally, scapular muscle-strengthening and Rotator cuff strengthening exercises were delivered to the patient. The patient received 18 sessions for 6 weeks, at a rate of three times per week. Shoulder pain, function, and performance were measured by a numeric rating pain scale, shoulder pain and disability index, and timed push-up test, respectively. The shoulder muscle's peak isometric strength was measured by a hand-held dynamometer. Acromiohumeral distance, coracohumeral distance, supraspinatus thickness, and subscapularis thickness were measured by ultrasound imaging. Six weeks of multimodal physical therapy is a successful intervention for patients with subcoracoid impingement. It resulted in improvements in pain, function, performance, and muscle strength. An increase in coracohumeral distance from full internal rotation was observed at the end of the intervention, as well as after three months and one year.
... (MDC). The MDC, also known as the within-subject standard deviation, represents the extent by which a value must change to surpass the anticipated magnitude of measurement error (Beekhuizen et al., 2009;Negrete et al., 2010;Furlan and Sterr, 2018;Piedrahita-Alonso et al., 2022). It is expressed in the unit of measurement (e.g., for ductions, in degrees, and for indices, arbitrary units) and is derived from the standard error of measurement (Eq. ...
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Currently, there is no established system for quantifying patterns of ocular ductions. This poses challenges in tracking the onset and evolution of ocular motility disorders, as current clinical methodologies rely on subjective observations of individual movements. We propose a protocol that integrates image processing, a statistical framework of summary indices, and criteria for evaluating both cross-sectional and longitudinal differences in ductions to address this methodological gap. We demonstrate that our protocol reliably transforms objective estimates of ocular rotations into normative patterns of total movement area and movement symmetry. This is a critical step towards clinical application in which our protocol could first diagnose and then track the progression and resolution of ocular motility disorders over time.
... Postural control was assessed utilizing the Stork balance test [35]. Medicine ball throws [36] were performed using a 3 kg medicine ball with a diameter of 21.5 cm. The T-half test [37] was conducted to determine agility. ...
Article
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Age-related differences in physical activity (PA), maturity status (PHV), physical performance (PP), and academic achievement (AA) among schoolchildren in Qatar were examined. Sixty-nine students from a school in Doha were categorized into three equal (n = 23) groups: 11-year-old students (U11; male: n = 14), 12-year-old students (U12: male: n = 7), and 13-year-old students (U13: male: n = 11). The testing process comprised a medicine ball throw, Stork balance test, hand grip strength test, the T-half test (PP), GPA in Arabic, mathematics, science (AA), International Physical Activity Questionnaire Short Form (PA), and Moore’s equations (PHV). Relevant age-related differences (p < 0.001) were identified in mathematics, science, the T-half test, maturity, and arm span. Notably, differences between adjacent age groups were evident between U11 and U12, concerning arm span, maturity, mathematics, and science, and between U12 and U13 (the T-half test, mathematics, science). Concerning AP, the performance maxima were calculated for U12 (mathematics, science) and U11 (Arabic). Regarding PP, performance maxima were only observed for U13. Except for the moderate level, the highest levels of PA were detected in U13. Maturity status and anthropometric parameters did not differ significantly between age groups. However, AA demonstrated the most notable age-related differences. Specifically, mathematics showed substantial differences between adjacent age groups.
... Postural control was assessed using the stork Balance Test [27]. The medicine ball overhead throw [28] was conducted using a 3 kg medicine ball with a diameter of 21.5 cm. A standard adjustable digital handgrip dynamometer (T.K.K. 5401, Tokyo, Japan) was used to determine the handgrip strength of the dominant hand, with a sensitivity of 10 N. Detailed descriptions of all the PP tests employed can be found in the prior literature [17]. ...
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Background: The relationship between physical activity (PA), health-related physical performance (PP), and academic achievement (AA) plays an important role in childhood. This study examined the differences in PA, sedentary behavior, health-related PP, maturity status, and AA between normal-weight and obese school children in Qatar. Methods: Eighty schoolchildren were recruited (age: 12.1 ± 0.6 years). Based on age-specific BMI percentiles, the children were classified as normal weight (n = 40) or obese (n = 40). Moore’s equations were used to estimate their maturity status (PHV). The measurements encompassed anthropometric data as well as PP tests (medicine ball throw, postural stability, handgrip strength). AA was assessed by reviewing school records for grade point average in Mathematics, Science, and Arabic courses. The total amount of time spent participating in PA each week was calculated using the International Physical Activity Questionnaire Short Form. Results: Handgrip strength was the only parameter that showed a relevant group difference (p < 0.001, ηp2 = 0.15; normal weight: 19.7 ± 3.46 N; obese: 21.7 ± 2.80 N). We found only one moderate correlation between PHV and handgrip strength (r = 0.59). Conclusions: The findings suggest that obesity status alone might not serve as a sufficient predictor of AA in school or PA levels.
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Injuries are commonplace in the overhead athlete, with many occurring to the shoulder and elbow. The increasing prevalence of injuries to the shoulder and elbow has been discussed at length in recent years, with increased research focus being placed on arm care for rehabilitation and prevention strategies. Even though the pitching motion is well-established as a whole-body kinetic chain movement, most attention in rehabilitation and prevention efforts is often placed on the upper extremity. The purpose of this clinical commentary is to highlight the impact the lower extremity and trunk have on the upper extremity during the throwing motion, better equipping clinicians to treat this patient population. Additionally, this clinical commentary highlights the current literature and recommendations regarding examination of the entire kinetic chain and concludes with a review of current evidence and recommendations regarding treatment of impairments and functional limitations identified in the proximal kinetic chain. In leaving no stone unturned, clinicians can address all components of the kinetic chain in throwers, maximizing performance and mitigating risk of injury. Level of Evidence: 5
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This study determines the test-retest reliability and equivalence reliability (i.e., defined as consistency of 2 tests designed to measure the same construct) of the push-up and the modified pull-up tests from both norm-referenced and criterion-referenced frameworks. Sixty-two (30 boys and 32 girls) 5th- and 6th-grade students (mean age = 11.4 0.9 years) were administered 2 test trials for both the push-up and modified pull-up tests following a 4-week fitness unit. The norm-referenced test-retest reliability estimates, using intraclass correlations from a one-way analysis of variance (ANOVA), were consistently high for 2 trials of both the push-up and modified pull-up (R = .99) and also high for 1 trial (R = .98 for push-up, R = .97 for modified pull-up). Moderately high correlations between the push-up and modified pull-up were obtained (r .74). Criterion-referenced reliability was estimated with proportion of agreement (Pa), modified kappa (Kq), and Phi coefficient using the FITNESSGRAM(r) standards (Cooper Institute for Aerobics Research, 1999). Criterion-referenced test-retest reliability estimates were high for the push-up (Pa = .97, Kq = .94) and the modified pull-up (Pa = .95, Kq = .90). Equivalence reliability estimates were considerably lower between push-up and modified pull-up test Trial 1 (Pa = .69, Kq = .38, and Phi = .50) and test Trial 2 (Pa = .71, Kq = .42, and Phi = .52). Norm-referenced and criterion-referenced test-retest reliability estimates in this study were acceptable. However, criterion-referenced equivalence reliability findings were not acceptable. Equating of standards between fitness tests designed to measure the same component of fitness should be examined.
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The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) is a tool developed and used in the clinic to evaluate progress during upper extremity rehabilitation. A need exists for reference values of CKCUEST for use in a clinical setting. To calculate reference values for the CKCUEST that may assist clinicians in developing goals and objectives for male collegiate baseball players who are recovering from injuries to the upper extremity. To determine if differences exist in scores according to playing position. The sample consisted of 77 collegiate, male baseball players between the ages of 18 and 22 who reported no recent history of injuries to the shoulder, elbow, or the hand-wrist complex. The CKCUEST was administered three times to the athletes and the number of touches when performing the CKCUEST during the 15-second test was measured and recorded. An average of the three tests was used for data analysis. No significant differences existed according to playing position. The data did not differ from the normal distribution; therefore, reference values were calculated and reported for use by clinicians in development of goals and objectives for this population. The CKCUEST appears to be a clinically useful test for upper extremity function.
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Article
1. Telemetrische Elektromyographie-Registrierungen und Leistungsmessungen beim Kugelstossen und Ballwerfen gesunder Rechts- und Linkshnder werden beschrieben. Vergleiche der dominanten (gebten) und nicht-dominanten (ungebten) Seite bei Tranierten und Nichtrainierten ermglichen eine Differenzierung des motorischen Lernens und der Seitendominanz. 2. Beim tranierten Kugelstoss findet sich eine geregelte Innervationsfolge der gesamten Krpermuskulatur, die der finalen Extension des stossenden Armes vorausgeht. Beim Abstossen bertrgt der gestreckte Arm die Schubkraft des ganzen Krpers auf die Kugel nach koordinierter Aktivierung von Rumpf-, Arm-, und Beinmuskeln beider Seiten mit Rumpfdrehung und Streckung. Daher ist die Tricepsaktivierung der letzten Armextension nicht strker als die Innervation der brigen Muskeln. 3. Bei Stoss und Wurf mit dem nicht-trainierten Arm fehlt die Koordination des kontralateralen dominanten Armes, obwohl dieser fr Stossen und Werfen trainiert ist. 4. Beim Untrainierten wird der Kugelstoss vorwiegend durch Armextension durchgefhrt, aber die Mitinnervation des kontralateralen Armes fehlt beim Rechtsstoss und Linksstoss. Die vorbereitende Sttzaktion und Bewegungsabfolge des Rumpfes ist unvollkommener, die Tricepsaktivierung des stossenden Armes dagegen strker und lnger als beim Trainierten. Die Stossweite erreicht bei Ungebten nur 1/5 bis 1/3 des Hochtrainierten. 5. Beim Ballwurf finden sich hnliche Muskelkoordinationen vom Arm, Rumpf und Bein und beim Abwurf eine Koaktivierung von Biceps und Triceps brachii. Rechtshnder erreichen beim Linkswurf mit geringer Mitarbeit des rechten Armes und des brigen Krpers nur die halbe Wurfweite des gebten Rechtswurfes und schlechtere Zielleistungen als rechts. 6. Bei trainierten Sportlern ist die Kugelstossweite mit dem gebten rechten Arm etwa 27% grer als mit dem ungebten linken Arm. Dagegen sind die Rechts-Links-Unterschiede der Kugelstossweite bei Ungebten mit 8% sehr gering. 7. Biomechanisch ist die Leistungssteigerung der Kugelstossweite bei Trainierten gegenber Ungebten zum Teil durch verschiedene Schubkraft der energiebertragenden Masse zu erklren: Der Trainierte stsst mit der ganzen Krpermasse, der Ungebte mehr mit dem Arm, der weniger als 5% der Krpermasse hat. 8. Da nicht die Hemisphrendominanz als solche, sondern bilaterale bung entscheidend fr Bewegungsprogramm und Mehrleistung ist, folgt aus 3 konstanten Ergebnissen: a) optimale Kugelstossweiten und Ballwurfweiten mit bilateralem Innervationsmuster bei Trainierten, b) minimale Rechts-Links-Differenzen bei Untrainierten und c) fehlende Mitarbeit des rechten (dominanten) Armes beim Linksstoss und Linkswurf Rechtstrainierter. 1. Muscle action potentials and efficiency were measured during shot putting and ball throwing in right and left handed normals. The dominant and the nondominant side were compared in trained and untrained persons in order to investigate motor learning effects. 2. Trained shot putters show a coordinated sequence of activation of trunk, leg and arm muscles of both sides which precedes the final arm extension. After turning the body from an initially inclined and twisted position the final arm extension transfers the force of the accelerated body mass to the shot. 3. When shot putting or throwing is performed by the nondominant arm in subjects trained for the dominant arm the coordination of the contralateral dominant arm is lacking, in contrast to the performance by the trained arm. 4. In untrained persons the shot putting is effected mainly by arm extension on either side. The preceding trunk and leg action is very incomplete and without coordination of the contralateral arm, whereas the shot putting arm shows stronger triceps brachii innervation. The distances achieved by untrained shot putters reach only one-fifth or one-third of those of highly trained persons. 5. In ball throwing the throwing arm shows final coactivation of the biceps and triceps muscles coordinated with trunk and contralateral arm movements The distances reached by throwing with the untrained arm are about half of those of the trained dominant arm. 6. Trained sportsmen put the shot with the untrained nondominant arm to 73% of the distance achieved by the trained arm. Untrained persons, however, show an approximately equal, smaller range of shot with the dominant and nondominant arm (8% side difference). 7. A biomechanical factor causing different performances of trained and untrained persons in shot putting is the different force of the energy transferring mass: the untrained person thrusts mainly with the arm which has barely 1/20 of the mass of the whole body, used by the trained shot putter. 8. That bilateral training and not hemispheric dominance is the decisive factor producing the improved efficiency is demonstrated by three observations: a) the maximal efficiency and bilateral coordination of shot putting in trained persons, b) the lack of contralateral activation of the dominant arm in shot putting and throwing by the nondominant arm, and c) the minimal left and right side differences in performance of untrained persons.
Article
1. Muscle action potentials and efficiency were measured during shot putting and ball throwing in right and left handed normals. The dominant and the nondominant side were compared in trained and untrained persons in order to investigate motor learning effects. 2. Trained shot putters show a coordinated sequence of activation of trunk, leg and arm muscles of both sides which precedes the final arm extension. After turning the body from an initially inclined and twisted position the final arm extension transfers the force of the accelerated body mass to the shot. 3. When shot putting or throwing is performed by the nondominant arm in subjects trained for the dominant arm the coordination of the contralateral dominant arm is lacking, in contrast to the performance by the trained arm. 4. In untrained persons the shot putting is effected mainly by arm extension on either side. The preceding trunk and leg action is very incomplete and without coordination of the contralateral arm, whereas the shot putting arm shows stronger triceps brachii innervation. The distances achieved by untrained shot putters reach only one-fifth or one-third of those of highly trained persons. 5. In ball throwing the throwing arm shows final coactivation of the biceps and triceps muscles coordinated with trunk and contralateral arm movements. The distances reached by throwing with the untrained arm are about half of those of the trained dominant arm. 6. Trained sportsmen put the shot with the untrained nondominant arm to 73% of the distance achieved by the trained arm. Untrained persons, however, show an approximately equal, smaller range of shot with the dominant and nondominant arm (8% side difference). 7. A biomechanical factor causing different performances of trained and untrained persons in shot putting is the different force of the energy transferring mass: the untrained person thrusts mainly with the arm which has barely 1/20 of the mass of the whole body, used by the trained shot putter. 8. That bilateral training and not hemispheric dominance is the decisive factor producing the improved efficiency is demonstrated by three observations: a) the maximal efficiency and bilateral coordination of shot putting in trained persons, b) the lack of contralateral activation of the dominant arm in shot putting and throwing by the nondominant arm, and c) the minimal left and right side differences in performance of untrained persons.