The Effect of neuromuscular training program on functional characteristics of upper extremity in handball and basketball players

Abstract

Introduction. Basketball and handball are physically demanding team sports and are characterized by intense activities including running, sprinting, jumping, ball throwing, blocking and pushing between players (1,2). Interest in basketball and handball is growing annually, and injury rates are very high in comparison with other professional Olympic team sports (3). Neuromuscular training is a multi-intervention program with a combination of muscle strength, balance, plyometric, stability and sport-specific exercises to improve neuromuscular control and to reduce risk of injury (4). Research aim: To evaluate the effect of neuromuscular training program on functional characteristics of handball and basketball players. Research methods and organization. The study was approved by Research Ethics Committee (Nr. BEC-SR (M)- 162). All participants signed the informed consent form before taking part in this study. Fifteen professional male basketball players and sixteen professional male handball players aged 20 – 35, without any upper extremity injuries in the past 1 year, without any musculoskeletal pain, and with a minimum of 10 years of training period, participated in the study. Neuromuscular training (NMT) was conducted 3 times a week with sessions lasting 30 minutes, for the period of one month. The program consisted of proprioception-enhancing exercises, plyometric exercises, rotator cuff muscle-strengthening exercises, scapular stabilization exercises, proprioceptive neuromuscular facilitation (PNF) D2 exercises for the upper extremities, and rhythmic stabilization exercises. The exercises were performed after a warm-up, before the main part of the training. Participants were evaluated before and after neuromuscular training program. Scapular dyskinesis was evaluated by tests, described by McClure et. al. (2009). For upper extremity dynamic stability measurement, The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) was used. Upper extremity muscle strength was evaluated with Seated Medicine Ball Throw Test (SMBTT). Data was analyzed by using the program SPSS 27.0. Non-parametric dependent values were compared with Wilcoxon test. Two independent values were compared with non-parametric Mann-Whitney test. Quantitative data results are presented as median (xme), minimum (xmin), maximum (xmax) value and mean (x̄) – xme (xmin – xmax; x̄). Qualitative data were compared by using McNemar’s Chi-squared test, and the data were presented as percentages. The difference was considered statistically significant when p < 0.05. Results. Scapular dyskinesis. Handball players: scapular dyskinesis display decreased in the dominant (χ2=6,32; p=0,012) and in the non-dominant arm (χ2=4,15; p=0,042) after NMT. Before NMT, scapular dyskinesis in the dominant arm was detected in 7 players (43.8%) and after NMT, in 5 players (31.3%). In the non-dominant arm before NMT, 7 players had scapular dyskinesis (43.8%), and after NMT, 4 players (25%). Basketball players: scapular dyskinesis display decreased in the dominant arm after NMT (χ2=4,18; p=0,041), but not in the non-dominant arm (χ2=0,744; p=0,388). Before NMT, scapular dyskinesis in the dominant arm was detected in 9 players (60%), and after NMT, in 6 players (40%). In the non-dominant arm, 13 players (86.7%) had scapular dyskinesis before NMT, compared to 8 players (53.3%) after NMT. No statistically significant differences were found in scapular dyskinesis display in the dominant arm between basketball players and handball players before and after NMT. Non-dominant arm scapular dyskinesis display among basketball players occurred more often than handball players before NMT (χ2=4,495; p=0,034), but no statistically significant differences were found between groups after NMT. Closed kinetic chain upper extremity stability test. There were increases in handball players (Z=-3,559; p…[…].