Senin, 11 Juni 2012

Jurnal Bola Voli


Syamsuryadin (PKO B)

Movement analysis related to functional characteristics of upper extremities in female junior volleyball players

Rostislav Vorálek, Miroslav Tichý and Vladimír Süss
Department of Sport Games, Faculty of Physical Education and Sport, Charles University, Czech Republic

Summary
The aim of our research report was to demonstrate within a group of female volleyball players how the technique of the overhead pass depends on the functional state of the upper extremities of players. It was a matter of a case study of a descriptive character. The description has been carried out by means of a manual examination of upper extremities and kinematic analysis – 3D. The tested group consisted of 10 female players, all of them members of a youth (under 16) team of the club Olymp Praha. The results of manual examination proved that some functional derangements of joints of upper extremities with female volleyball players were relatively often.
It was supposed and the thesis, that the derangements would affect the kinematic of the movement specific to the overhead passing the ball, has been verified. The results of the research did not confirm this hypothesis.
Key words: volleyball, kinematic 3D analysis, manual examination of the upper extremities, overhead passing
本研究主要是以案例方式來探討排球托球是否會受到上肢的功能性狀況之影響,根據上肢關節肌肉和三度空間運動學來做分析。實驗對象為十位15-16歲奧林匹克布拉格俱樂部的國家級比賽女性排球選手。研究結果發現女性排球選手的上肢關節和肌肉經常有功能性障礙,有證據顯示十位取樣的運動選手中有八位出現上肢功能性異常的狀況。研究結果指出,特別是排球初始訓練期的選手要保持健康,配合有效的補償性運動和發展全動作的技術是必要的,且選手需要定期接受骨骼肌肉系統檢查。此外,研究結果並未證實研究假設。
關鍵字:排球、三度空間運動學分析、人工檢驗上肢、托球
Cílem příspěvku je ukázat na skupině hráček volejbalu, zda je technika provedení odbití míče obouruč vrchem závislá na funkčním stavu horních končetin. Jedná se o případovou studii popisného charakteru. Popis byl prováděn pomocí funkčního vyšetření kloubů a svalů horních končetin a kinematické analýzy – 3D. Výzkumný soubor, tvořilo 10 hráček volejbalového družstva Olympu Praha hrajícího Českou extraligu kadetek ve věku od 15 do 16 let. Výsledky manuálního vyšetření ukázaly, že funkční poruchy kloubů a svalů horních končetin jsou u hráček volejbalu poměrně časté. U našeho souboru se tyto poruchy vyskytly u osmi probandek z deseti. Pro praxi ze zjištěných výsledků vyplývá nutnost důsledněji se věnovat kompenzačním cvičením a rozvoji všech pohybových schopností a to zejména v počátečních fázích sportovní přípravy. Dále, pak na nutnost pravidelného lékařského sledování pohybového aparátu u mladých sportovců.
Předpokládali jsme, že zjištěné dysfunkce kloubů a svalů horních končetin ovlivní kinematiku pohybu při odbití míče obouruč vrchem. Výsledky naší práce však tuto hypotézu nepotvrdily.
Klíčová slova: volejbal, kinematická 3D analýza, manuální vyšetření horních končetin, odbití obouruč vrchem.
Cette enquête, une étude de cas, a été conçue pour montrer si la technique de passe (passe en touche haute) était affectée par la condition fonctionnelle des extrémités supérieures. La recherche était basée sur un examen fonctionnel des articulations et des muscles des extrémités supérieures et sur une analyse cinématique en 3D. L’échantillon de la recherche comprenait 10 joueuses juniors de volley âgées de 15 à 16 ans, dont toutes étaient membres du Club Olympique de Prague, jouant dans la ligue nationale. Le résultat de l’examen a montré que des troubles fonctionnels des articulations des extrémités supérieures sont extrêmement fréquentes chez les joueuses de volley. Il y avait des signes d’un trouble sur 8 des 10 joueuses examinées. Les résultats ont aussi indiqué qu’inclure des exercices de compensation efficaces et développer toutes les techniques de mouvement sont nécessaires pour maintenir la santé du joueur, surtout au stade initial de l’entraînement. Des bilans de santé réguliers du système musculo-squelettique sont aussi recommandés. L’hypothèse, cependant, n’a pas été confirmée par les résultats trouvés.
Mots clés : volley, analyse cinématique en 3D, examen manuel des extrémités supérieures, passe.
O objectivo desta investigação, estudo de caso, foi concebido para mostrar se o passe é afectadado pela condição funcional dos membros superiores. A pesquisa foi baseada numa análise funcional das articulações e músculos dos membros superiores e análise cinemática 3D. A amostra da pesquisa incluiu 10 jovens jogadoras de voleibol com idades entre 15 a 16 anos, sendo todos membros da Praha Olympic Club e jogadoras na liga nacional. Os resultados mostraram que osdistúrbios funcionais das articulações e músculos das extremidades superiores são bastante frequentes em jogadoras de voleibol. As evidências revelaram que 8 num total de 10 jogadoras da amostra sofriam de um distúrbio desses. Os resultados também indicaram que a inclusão de exercícios de compensação e de desenvolvimento das habilidades de todos os movimentos são necessários para manter a saúde do jogador, principalmente na fase inicial do treino. Recomenda-se que haja check-up médico regular do sistema músculo-esquelético. A hipótese, contudo, não foi confirmada pelos resultados encontrados.
Palavras-chave: voleibol, análise cinemática 3D, avaliação manual dos membros superiores, ajuste
El propósito de esta investigación por medio de un estudio de caso, fue el determinar si el pase a dos manos usado en la levantada o acomodo se afecta por el estado funcional de las extremidades superiores. La investigación se basa en un analisis funcional de las extremidades superiores y un análisis cinematográfico tri dimensional. La muestra en esta investigación fueron 10 adolescentes jugadoras de voleibol de 15 y 16 años integrantes del Club Praha Olympic en la liga nacional. Los resultados del examen reflejaron una frecuencia considerablemente mayor de problemas en las articulaciones y músculos de la extremidad superior de las jugadoras. Se encontró evidencia de algún desorden funcional en 8 de 10 jugadoras examinadas. Los resultados también indican la necesidad de incluir ejercicios de compensación y de destrezas de movimeinto para mantener la salud de la jugadora, especialmente en la etapa inicial del entrenamiento. También se recomienda un examen del sistema musculo-esqueletal. La hipótesis planteada en el estudio no se confirmó según los resultados del estudio.
Palabras claves: voleibol, análisis cinemático tri-dimiensional, examen manual extremidades superiores, levantada/acomodo.
Submitted: September, 2009
Accepted: December, 2009

INTRODUCTION
One of the factors limiting sport performance in particular sports is a decreased range of motion in joints. Although game performance in volleyball does not exert extreme demands on flexibility, it is very important to develop optimal range of motion in joints and related functions of individual muscles and muscle groups. A better understanding of movement system functions is one of conditions for cultivation and development of game performance in volleyball.
Our aim is to find out, with aid of kinematic analysis, whether joint and muscle dysfunctions affect movement performance in overhead passing.
Kinematic analysis has become a commonly used method in sports which allows us to gain objective basis for a more effective training process. Results of kinematic analysis enable more objective models of optimal movement performance and determination of kinematic barriers of movement performance (Tůma, 2001, Janura a Zahálka, 2004).
By means of kinematic analysis some volleyball skills were tested. However, we have found any studies about kinematic analysis of overhead passing neither in Czech, nor in foreign professional literature. In Czech volleyball literature, the following authors deal with examination of movement kinematics of game skills with aid of kinematic analysis: Analysis of a spike serve in five top volleyball players by means of 3D video-graphic method at European Championship 2001 was carried by Lehnert, Stromšík, Janura and Háp (2001).
By means of 3D video-graphic method the movement of a volleyball player in blocks (Lehnert, Janura, Stromšík and Vaverka (2001) and spikes (Zahálka and Süss, 2002) was analyzed. In foreign professional literature Huang, Liu and Sheu (1997) deal with volleyball skills examined by kinematic analysis. They recorded a take-off with one leg in the spike. Testing of the spike service by means of 3D kinematic analysis was carried by Coleman (2003). Kinematic analysis of a back row attack was examined by Huang, Liu and Sheu (1999). Methods in these studies do not vary practically in Czech and foreign authors. However, the described methods have particular imperfections. Relatively slow recording frequency is appropriate for relatively slow movements, but inter-individual comparison of players is rather problematic. Thus phenomena, whose cause is unknown, are observed.
In our study we attempt to eliminate these defects so that:
• we use high-frequency infrared cameras (240 Hz)
• we label body segments by markers
• we manually examine joints and muscles of upper extremities to assess their functional status

METHODS AND PROCEDURES
The aim of our research was to investigate which joint and muscle dysfunctions occur in the upper extremities in young women volleyball players and to verify whether the ascertained joint and muscle dysfunctions of the upper extremities affect the technique of the overhead passing. The research sample consisted of 10 women players of the club Olymp Praha competing in the Czech Extraleague of the youth. At the time of measurements all women players actively played volleyball for 4 – 5 years and trained 4 times a week.

Table 1 Sample Characteristics:

Assessment of functional status of joints and muscles of the upper extremities (the arm, elbow and wrist) rises from the concept of functional manual medicine described by Tichý (2005). An advantage of this concept, in contrast to other techniques, is that it enables three-dimensional conception of functions of joints and muscles moving with a joint. This allows us to compare the results of movement kinematics better.
The principle of assessment, which is considerably dependent on examiner’s experience, was done in this way:
a) a passive examination of big joints of both upper extremities (the shoulder joint, elbow joint, wrist) in excessive positions of all basic movements (shoulder joint: flexion – extension, abduction – adduction, external rotation – internal rotation; elbow: flexion – extension, supination – pronation; wrist: palmar flexion – dorsal flexion, radial duction – ulnar duction) toward the first resistance (a physiological barrier). After a physiologic barrier, joint motion toward an anatomic barrier was assessed in a qualitative way (present – absent).
b) palpatory examination of the main muscles which perform basic movements in particular joints stated in the paragraph a). Muscle tension was estimated by a touch according to the resistance of muscle tissue to the examining fingers. The result was evaluated relatively based on the comparison of identical muscles assessment in both upper extremities.
For observation of the determining motor skill we used an optoelectronic system QUALISYS and 8 infrared cameras Qualisys ProReflex240 for 3D analysis.
The data gained from manual examination of joints and muscles of the upper extremity and 3D analysis were processed and evaluated by means of descriptive statistics
Proceeding
After a warm-up, the techniques of manual medicine were performed. Consequently, we labeled the markers directly on the skin and on the points with good touchable bone shapes.
It was a matter of these points:
Metacarpus I, III, V – on the left and right limb
Acromion – on the left and right limb
Epicondylus humeri medialis and lateralis – on the left and right limb
Olecranon – on the left and right limb
Distal ends of the ulna and radius – on the left and right limb
Spinous processes - of the 1st and 3rd thoracic vertebrae
Then, the overhead passing was recorded for 30 seconds.
Cameras were set on tripods at the height of 2 meters and were placed in an ellipse shape around the limited area so that each marker would be recorded by two cameras every moment (Fig 1).
All women players had earlier experience with the examined manner of the passing. The passing was performed within a limited area at the distance of 5 m. A player standing in the circle was concentrated in the passing position and receiveda ball, which fell down above her forehead, so that the player did not need to take steps and then she passed the ball. Totally there were recorded 6 cycles of the passing.
From the obtained data we used:
• in the shoulder: maximum and minimum ranges of abduction and adduction
• in the elbow: maximum and minimum ranges of flexion and extension
• in the wrist: maximal and minimal ranges of flexion and extension

RESULTS
We found out a relatively high occurrence of functional joints and muscle derangements in the upper extremities in our participants (Table 2).
These derangements induce flexion or extension pathological chains in all participants. Concretely, from total 60 examined joints, there were functional derangements in 30, i.e. 50%. Functional impairments of joints were more often than structural impairments, in ratio 28 : 2. Derangements of the left upper extremity were more often than in the right one and it was in ratio 7 : 3. Extension pathological chains in the upper extremities were more often than flexion chains, in ratio 6 : 2. In this case, we have not included the result of participant 1 whose both elbow joints were structurally impaired. In eight participants out of a total of ten participants (80%) we found out functional derangements at least in one upper extremity; in two participants out of a total of ten (20%) we recorded functional impairment in both upper extremities and in two participants out of a total of ten (20%) we assessed both upper extremities healthy.
For transparence, we present the table which includes maximum and minimum angles in particular joints in one to three repetitions of the overhead passing in one participant out of a total ten participants obtained by means of 3D analysis.

Statistics
The goal of the statistic evaluation was to find out whether there are differences in angles of maximum extension and flexion in particular joints between the left and the right upper extremity and whether the correlation between functional status of these joints and ranges of maximum and minimum angles exist.
For each participant, we assessed mean values of the differences in the examined parameter (maximum extension and flexion in joints) between the left and right upper extremity (UE), standard deviation, standard error mean for each point of the UE in extension and flexion. From these values, a table for each point (joint) and status (extension, flexion) was created where instead of differences there is an order according to the size of the difference between the left and right UE in absolute value from the lowest difference 1 toward to biggest difference 10 (Table 4).

Legend:
0 – Without a pathological finding (healthy joint)
F – Functional barrier - flexion
E – Functional barrier - extension
S – Structural barrier


Legend:
Sum. Order - Sum of all 6 orders (3 points -wrist, elbow, shoulder- and 2 states – extension, flexion)
Final Order - Assigned order from the lowest sum. order toward the biggest one
Finding UE - blank – without any finding, L - finding on the left side of UE; R - finding on the right side of UE; LP - findings on both UE
The most significant differences between the left and right UE were in a healthy (without a finding) participant 5 (V.D.) and the lowest differences were in participant 6 (R.V) with findings on both UE (extension chain). Angle values on the right UE in healthy participants are higher in five cases out of a total of 6 (apart from wrist flexion). Angle values on the right UE in participants with findings at least on 1 UE are higher in 3 cases out of a total of 6.

DISCUSSION
Results of the manual assessment proved that functional derangements of joints of the upper extremities are quite often in women volleyball players. In our sample, these derangements occurred in eight participants out of a total of ten participants. This high occurrence may be explained by the fact that volleyball is a physically demanding sport which includes very fast changes of body positions both in terms of space and mutual positions of body segments (jumping, techniques of going to the floor, fast changes of the direction).
The dominant upper extremity is usually loaded more; in our sample it was the right one in all participants (all players were right handed). However, higher load of the right upper extremities is not in accordance with our results which revealed more functional derangements in the left upper extremities. Therefore, it is possible that the left extremities are less muscularly developed in right handed people, i.e. they are weaker and worst coordinated.
Ferretti 1994, Ferretti, De Carli, Calderaro and Conteduca (1998) and Parkanová (2001) analyzed number of occurrences of individual body segments injuries in volleyball players and found out that one of the most injured joints was the shoulder. The shoulder is a crucial joint for the whole upper extremity and its injury consequently affects functional status of all joints of the upper extremity.
In our sample, functional joint derangements were more often than structural impairments. It can be explained by a few arguments. Our participants were 15 – 16 years old; it is the age when abrasion of structures of the movement system is rather rare. Functional impairments tend to be secondary, i.e. applied. It means that the primary cause may be completely different and distant and it may be transferred to the upper extremity as a consequence of nerve and mechanic chains, especially by means of skeletal muscles. These relationships are described in Czech physiotherapeutic literature by Janda (1984), Lewit (2003). Foreign professional literature does not deal very much with this theme. We have found only two variants of pathological chains in the upper extremities in our sample and it was either flexion or extension chain. Flexion chains were characterized by a higher range of hypertonic flexors and all flexion movements in joints. The situation was different in extension chains. These are in consonance with description by Tichý (2005) who has found them in his patients during their rehabilitation. From his conclusions and our results we may suggest that their occurrence is not characteristic only for volleyball players, but it is a matter of a general phenomenon. Primary cause of the found chains could have been located out of the upper extremity, in area of the neck or trunk.
Extension chains were more often in our participants than flexion chains. The reason could be the fact that extensors of the upper extremities are more loaded in the overhead passing than flexors.
An overloaded muscle is anatomically shortened and induces the functional barrier in the joint where it performs the movement (Horáčková et al. 2003, Tichý 2003, Tichý et al. 2003).
One of the goals of our research was to examine, whether the functional status of joints and muscles of the upper extremities demonstrates in kinematics of the movement of the upper extremities. In other words, if, e.g. the flexion chain in one upper extremity leads to an increased range of flexion movements of particular joints in comparison to the other healthy upper extremity. Hypothetically, we supposed that it should be like that on the basis of the available literature. However, our results showed that this hypothesis can not be verified.
The slightest differences in joint angles between the left and right upper extremity were recorded in participant 6, who had pathological chains in both upper extremities. On the contrary, two healthy participants 5 and 9 without any pathological chains had one of the worst results when comparing kinematics of the left and right upper extremity and they were on the 7th and 10th place out of a total of ten participants, while the results of their assessment should be hypothetically the best.
The reason may be the fact that performance of a visible movement is dependent on more factors: The elementary precondition for success of such experiment is that all participants have mastered techniques of the selected skills, in our case it was the overhead passing in volleyball. Our participants have trained volleyball under expertise supervision for 4 – 5 years and some of them were the representatives of the Czech Republic; therefore we may consider them the players who mastered the volleyball technique on the top level.
The next factor was an accuracy of a tossed ball. The ball was tossed by the participants’ coach, but despite his big effort, he did not always manage to toss the ball exactly to the identical place. Unfortunately, we are not aware of any device which would be used for similar reasons in the Czech Republic or abroad. For analysis of the overhead passing we selected only these cases, where the ball was correctly tossed. Inaccurate ball toss would obviously lead to the situation when participants had to move to a totally new position of the trunk before the passing the ball, so that the ball would fall over their forehead just as it results from the right methodology of the overhead passing (Císař 2005, Buchtel 2005).
It resulted into many cases when the left and right upper extremities were in a different position (abduction angle) to the trunk. A different abduction angle in shoulder naturally influenced initial and final positions in other joints of the upper extremities (elbows, wrists).
From this asymmetric mutual position of the upper extremities and the trunk it follows that one upper extremity had to develop more muscle strength in the passing than the other one. A different muscle activity set particular joints to the different position.
It is inevitable to realize that the next factor significantly influencing position of the joints of the upper extremities is symmetry, or asymmetry of the falling ball on the both hands. In asymmetrically falling ball, more loaded wrist is more bent that the other one; it activates a chain reaction in the whole upper extremity and asymmetric angle position of elbows and shoulders.
We may conclude that for other studies of this problem it is necessary to ensure that the ball is tossed always in the same way into the same point in order to minimize risks of eventual errors stated above. However, it means to develop an appropriate device.

CONCLUSION
Our study may be regarded as a pilot study in this area because it attempts to compare a clinical, functional status of joints and muscles with movement stereotypes performance. We suppose that this procedure is unique in examination of the game skills and it was used firstly in our republic. A common practice is that in physiotherapeutic literature, only clinical status of the movement system is evaluated by means of mainly manual methods, or in biomechanic literature only movement kinematics is assessed without examination of functional status of the movement system.
It seems that for better understanding of fundamentals of movement as a visible phenomenon it will be essential to perform studies similar to our research when during one experiment results of manual and device assessment would be compared.
Despite the fact that our study has not definitely answered this question, it suggested the way which a science should take in this area.

IMPLICATIONS FOR COACHING
Results indicated necessity of regular involvement of compensation exercises in training sessions and consistent control over its performance from youth categories. It is advised to insert compensation exercises at the beginning and end of a training session. The beginning of the training session (within preparation of an organism for a concrete performance) should include both intentional stretching and strengthening exercises. The purpose of strengthening exercises is improving efficiency of impaired muscles or muscles with tendency for impairments. At the end of the training session there should be stretching and relaxing exercises.
Results pointed out a requirement for regular controls of players’ movement systems and close cooperation between the coach, doctors and physiotherapists, and need for appropriate load regarding age categories and individual differences of particular players.
For future of assessment of motor skills in volleyball it is essential to examine next factors affecting player’s performance and performance of game skills. One of possible ways is a triangulation of scientific methods as kinematic analysis and assessment methods from area of rehabilitation and physical medicine.

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