Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Alicia Fernandez-Fernanez

Date of original Performance / Presentation

January 2023

Publication Date / Copyright Date

1-1-2023

Abstract

Background: Strength training for youth baseball athletes is a common area in rehabilitation and injury prevention programs. However, there is a lack of research concerning which specific upper extremity strength value is needed for the high school-aged (HSA) baseball athlete. Purpose: To analyze upper extremity strength percentage ratios (SPR) and their utilization as criterion for return to throwing in HSA baseball athletes. Methods: Male baseball athletes (14-18 years-old) who were throwing without pain were recruited. Each subject met in-person and performed two trials of strength testing for their throwing arm shoulder external rotation (ER) and internal rotation (IR) in neutral (in 30 degrees abduction and external rotation), at 90 degrees abduction and 45 degrees IR, and elbow extension & flexion. All strength measurements were tested using a digital handheld dynamometer (HHD) with force applied against an externally fixated device (EFD) and normalized to throwing arm ulnar length and analyzed through descriptive statistics. Pre and post-season data were obtained regarding throwing with pain. Additionally, to understand the current landscape of how physical therapists (PT) utilize strength percentage ratios in their practice, licensed physical therapists in the United States who provide care to the HSA baseball athletes were anonymously surveyed online and analyzed through frequency data summary statistics. Results: The mean average strength percentage ratios of 34 HSA baseball athletes (average age 15.7 ±1.2) revealed shoulder ER/IR at neutral 64.02%, shoulder ER/IR at 90 degrees abduction 69.69%, and elbow extension/flexion 70.11% (intra-tester reliability intraclass correlation coefficient (ICC) .822-.902). Pre and post-season data regarding throwing with pain displayed fair test-rest reliability (ICC .539). The PT survey demonstrated those who were board certified, had less years of experience, and attended a continuing education course specific to the baseball athlete had the highest probability of using the best available evidence established for the adult baseball athlete for within limb SPR for shoulder ER/IR between 66-71%, elbow extension/flexion ≥76%, and a between limb SPR 80-94% for return to throwing. Conclusion: The SPR used by PTs were higher than what was displayed by the HSA baseball athlete. Further evidence should continue to quantify which SPR predicts injury in the HSA baseball athlete. Clinical Relevance: The strength testing protocol provides reliable methods to utilize for the younger baseball athlete. Additional literature should examine if the best available evidence for the adult athlete can be applied to the younger athlete.

Disciplines

Physical Therapy

Keywords

Baseball; High School; Upper Extremity

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