@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2020;12(1):19-27

Background
Wheelchair basketball athletes, as a group of people with spinal cord injury, are at risk for upper cross syndrome.
Previous Studies
… [1-14]. Most studies have reported improvements in upper cross syndrome in healthy individuals. In the study, the effect of three combined corrective exercises, upper limb, and lower limb, upper limb alone, and lower limb alone were examined on the quality of life and forward head angle in people with upper cross syndrome and the results indicated an improvement in the forward head angle after combined exercises. The reason underlying was reported the myofascial connections between the muscles and an increase or a decrease in stress on a muscle is effective on other muscles in more distant places [15]. … [16-19].
Aim(s)
The purpose of the present study was to investigate the effect of a corrective exercise program based on scapular stability on upper cross syndrome in wheelchair basketball athletes.
Research type
This research was a semi-experimental study.
Research society, place and time
This study was conducted in 2017-2018 on 24 veteran and handicapped wheelchair basketball athletes who had spinal cord injury with upper cross syndrome in Mashhad.
Sampling method and number
To determine the minimum number of samples, the G * power 3.0.10 software was used with a test power of 0.8, an effect size of 0.53 and a significance level of 0.05.
Used devices&materials
Shoulder pain was measured based on the WUSPI, which is the wheelchair user pain index (r = 0.99). First, in a meeting, complete information about the research objectives and measurement methods was given to the subjects to make them informed and obtain their consent to participate in the research. Then, before any measurement, the measurement method and status and the considered test were explained to the subjects, then the test was performed. After the initial evaluation, the cases group was subjected to training protocol for 8 weeks and 5 days a week (3 days of strengthening exercises and stretching exercises every day) through a maximum of 60 min (10 min of warm-up, 10 min of stretching movements, a maximum of 30 min of strength training, and 10 min of cooling), whereas other subjects had their routine exercises [22]. At the end of 8 weeks, all subjects performed all the tests. The severity of rounded shoulders was measured using body profile imaging. To measure the thoracic curve, spinous processes of the second and twelfth thoracic vertebrae were touched and marked (Figure 1) [14, 18]. Also, the forward head angle was measured using body profile imaging (Figure 2) [14, 23].Exercise protocol: each training session lasted a maximum of 60 min, including 10 min of warm-up, 10 min of stretching exercises and range of motion after warming up or cooling down, a maximum of 30 min of strength training and postural training based on scapula stabilization and 10 min of cooling. The subjects were fully informed about the exercise program and performing correct movements. Athletes were then asked to perform the exercises in each session based on the training given by the bodybuilding instructor. In addition, they were provided with a training booklet explaining the method and frequency of the exercises using images. The advanced resistance exercise program was designed using GIM training for people with spinal cord injuries provided by the Harborview Medical Center in accordance with the guidelines by the American College of Sports Medicine (ACSM) [22, 25]. Data analysis was performed by SPSS 23 software using independent T-test, paired T-test, one-way analysis of variance and Tukey’s post-hoc test.
Findings by Text
There was no statistically significant difference between the control and case groups in terms of demographic variables, such as age, weight and sitting height (P <0.05; Table 1).In the pre-test stage, there was no significant difference between the case and control groups in terms of kyphosis, forward head and rounded shoulders degrees (p <0.05). However, in the post-test stage, the degree of kyphosis, forward head, and rounded shoulders in the case group decreased significantly compared with the control group (p <0.05). Also, the degree of kyphosis, forward head and rounded shoulders in the control group in the post-test stage did not have a significant difference compared with the pre-test stage (P <0.05). However, in the case group, these anomalies showed a significant decrease in the post-test stage than the pre-test phase (p <0.05; Table 2).The kyphosis, forward head and rounded shoulders degrees in different sports classes was significantly different (Table 3).After paired comparison of the sports classes, the degree of kyphosis, forward head and rounded shoulders abnormalities in the sports class 3 to 4.5 showed a significant difference with classes 1 to 1.5 and 2 to 2.5 (p = 0.001); however, the rate of these anomalies in sports classes 1 to 1.5 and 2 to 2.5 did not differ significantly (p <0.05).
Main comparison to the similar studies
The results of the present study showed that the degree of kyphosis in cases in the case group decreased, which is consistent with previous results [16, 18, 19]. Some studies prefer comprehensive exercise in reducing kyphosis to topical exercise [21]. It is obvious that shortening of the shortened muscles and strengthening of their antagonistic muscles is effective in improving the incorrect physical condition of the patients [34]. … [35-39].
Suggestions
It is suggested that similar studies be performed on other wheelchair basketball groups (e.g., amputees) and female wheelchair basketball players.
Limitations
The limitations of the present study were the relatively small sample size due to lack of access and study conditions, as well as the lack of complete control of the subject in performing the training program (due to secondary problems caused by spinal cord injury).
Conclusions
The corrective exercises based on scapula stability are one of the most useful training methods for restoring muscle balance and preventing and correcting abnormalities in wheelchair basketball athletes.
Acknowledgments
Thanks to the veteran and disabled wheelchair basketball players of Imam Khomeini and Shahid Fayyazbakhsh Rehabilitation Centers in Mashhad who participated in this research.
Conflict of interest
None declared.
Ethical Permissions
The subjects' consent was obtained and they were assured of the confidentiality of information and possibility of withdrawal from the study whenever desired.
Funding Sources
This research was extracted from the PhD thesis of the first author.

TABLES and CHARTS

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