Occupational; Cramp(s)
Conditions
Keywords
Occupational; Cramp(s)
Brief summary
The investigators will investigate golfers with visual evidence of an involuntary movement while putting before and after treatment with a low dose of propranolol.
Detailed description
Dystonia affecting athletes has received little research attention and there has been a lack of awareness or interest among both physicians and athletes. Task-specific dystonias or occupational cramps affect people while writing, typing, and or playing a musical instrument. Our group has previously shown that a subset of golfers who complain of the yips appear to have a task-specific dystonia or golfer's cramp. The yips are characterized by an inability to appropriately complete a golf stroke, most often putting and chipping strokes. Most individuals with the yips describe a jerking or shaking movement that interrupts their swing. In many cases the yips are disabling and the golfer, including professional tour players, give up golfing. Golfers who have evidence of golfer's cramp will putt a series of putts during which they will be monitored for arm movements and putter movements. They will then be treated with a low dose of propranolol to see if there is a change in these parameters.
Interventions
DRUGPropranolol
Single oral dose of 10 mg propranolol
DEVICEOpal Device
The Opal Device (APDM, Inc.) will be used to measure wrist movement.
PROCEDUREScience and Motion PuttLab (SAM)
The SAM will be used to study putter stroke movement and ball movement.
DEVICESurface Electromyography EMG
The surface EMG will be used to evaluate co-contraction of the wrist flexor/extensor muscle groups and the wrist pronator/supinator muscle groups.
Sponsors
Mayo Clinic
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18-75 * Complaint of golfer's cramp/yips * Visual evidence of a movement disorder during putting * Able to complete 80 putts during the session
Exclusion criteria
* Contraindication to treatment with propranolol * Movement disorder not when putting
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Dynamic Change of Rotation at Impact | baseline, approximately 45 minutes after propranolol dosing | Dynamic change of rotation at impact is the velocity of rotation of the putter from the start of the forward swing until the time of impact with the golf ball. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean Total Putter Face Rotation Before Impact | baseline, approximately 45 minutes after propranolol dosing | Total putter face rotation before impact is the degrees of rotation of the putter from the start of the forward swing until the time of impact with the golf ball. |
Countries
United States
Participant flow
Recruitment details
Subjects were recruited from Mayo Clinic in Arizona.
Participants by arm
| Arm | Count |
|---|---|
| Golfers With Golfer's Cramp Subjects in this arm will be tested with the Opal device, the Science and Motion PuttLab (SAM), and the Surface Electromyography (EMG) to collect movement parameters while putting before and after a single dose of 10 mg Propranolol. | 27 |
| Golf Pros Subjects in this arm will be tested with the Opal device, the Science and Motion PuttLab (SAM), and the Surface Electromyography (EMG) to collect movement parameters while putting. The subjects in this arm will not receive any study drug. | 11 |
| Total | 38 |
Baseline characteristics
| Characteristic | Golfers With Golfer's Cramp | Golf Pros | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 11 Participants | 0 Participants | 11 Participants |
| Age, Categorical Between 18 and 65 years | 16 Participants | 11 Participants | 27 Participants |
| Region of Enrollment United States | 27 participants | 11 participants | 38 participants |
| Sex: Female, Male Female | 2 Participants | 5 Participants | 7 Participants |
| Sex: Female, Male Male | 25 Participants | 6 Participants | 31 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 27 | 0 / 11 |
| serious Total, serious adverse events | 0 / 27 | 0 / 11 |
Outcome results
Primary
Mean Dynamic Change of Rotation at Impact
Dynamic change of rotation at impact is the velocity of rotation of the putter from the start of the forward swing until the time of impact with the golf ball.
Time frame: baseline, approximately 45 minutes after propranolol dosing
Population: This variable was measured at baseline and then again approximately 45 minutes after propranolol in the group with golfer's cramp on the same day. The pro golfers did not take propranolol so they were only tested once, at baseline.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Golfers With Golfer's Cramp | Mean Dynamic Change of Rotation at Impact | No propranolol | -38.4 degrees/sec | Standard Deviation 26.1 |
| Golfers With Golfer's Cramp | Mean Dynamic Change of Rotation at Impact | After propranolol | -36.5 degrees/sec | Standard Deviation 36.5 |
| Golf Pros | Mean Dynamic Change of Rotation at Impact | No propranolol | -32.5 degrees/sec | Standard Deviation 9.8 |
| Golf Pros | Mean Dynamic Change of Rotation at Impact | After propranolol | NA degrees/sec | — |
Secondary
Mean Total Putter Face Rotation Before Impact
Total putter face rotation before impact is the degrees of rotation of the putter from the start of the forward swing until the time of impact with the golf ball.
Time frame: baseline, approximately 45 minutes after propranolol dosing
Population: This variable was measured at baseline and then again approximately 45 minutes after propranolol in the group with golfer's cramp on the same day. The pro golfers did not take propranolol so they were only tested once, at baseline.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Golfers With Golfer's Cramp | Mean Total Putter Face Rotation Before Impact | No propranolol | 3.3 degrees | Standard Deviation 1.3 |
| Golfers With Golfer's Cramp | Mean Total Putter Face Rotation Before Impact | After propranolol | 3.4 degrees | Standard Deviation 1.9 |
| Golf Pros | Mean Total Putter Face Rotation Before Impact | No propranolol | 3.1 degrees | Standard Deviation 0.6 |
| Golf Pros | Mean Total Putter Face Rotation Before Impact | After propranolol | NA degrees | — |