Martin CL, Evenson KR, Moore JB, et al.

Using Biomechanical Devices in Elite Baseball

Pitchers: A Preliminary Feasibility Study. IJSPT. 2025;20(5):687-695.
doi:10.26603/001c.134013

Original Research

Using Biomechanical Devices in Elite Baseball Pitchers: A

Preliminary Feasibility Study
a
Chelsea L. Martin, PT, DPT, SCS1,2 , Kelly R. Evenson, PhD, MS1, Justin B. Moore, PhD, MS3, Stephen Marshall, PhD1,
Jakob Wolf, MS4, Garrett Fernandez, BS4, Kristen Nicholson, PhD4, Franco Impellizzeri, PhD5, Patrick Ward, PhD6,
Ian Shrier, MD, PhD7, Nathan O'Connell, PhD8, Charles Thigpen, PT, PhD, ATC9, Ellen Shanley, PT, PhD, OCS, CSCS9,
Daniel Kline, PT, DPT, SCS, ATC9, Matthew Hartshorne, PT, DPT, OCS10, Garrett Bullock, PT, DPT, DPhil11,12,13
1 Epidemiology, University of North Carolina at Chapel Hill, 2 Injury Prevention Research Center, University of North Carolina at Chapel Hill,
3 Implementation Science, Wake Forest University, 4 Orthopaedic Surgery & Rehabilitation,, Wake Forest University, 5 School of Sport, Exercise, and
Rehabilitation, University of Technology Sydney, 6 Seattle Seahawks, 7 Centre for Clinical Epidemiology, Lady Davis Institute, McGill University,
8 Department of Biostatistics and Data Science, Wake Forest University, 9 ATI Physical Therapy, 10 Human Movement Science Curriculum, University

of North Carolina at Chapel Hill, 11 Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University, 12 Department of Biomedical
Engineering, Wake Forest University, 13 Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford
Keywords: baseball pitchers, upper extremity injury, training monitoring, biomechanical devices, feasibility research
https://doi.org/10.26603/001c.134013

International Journal of Sports Physical Therapy

Vol. 20, Issue 5, 2025

Background
Baseball clinicians, coaches, and players have sought to leverage biomechanical devices
to inform training and prevent injury. However, discerning feasibility is sparse for novel
biomechanical devices to inform adoption of these technologies. The objective of this
study was to investigate the uptake (i.e., proportion of initial use) and adherence (i.e.,
proportion of continued use) of wearable and portable biomechanical devices among
collegiate baseball pitchers during a single summer training season.

Methods
Uptake, adherence and 95% confidence intervals (95% CI) were calculated for a
commercially available biomechanical pitching sleeve during practice, and use of a force
plate during a countermovement jump task for a minimum of one time per week per the
established protocol. Potential non-response bias analyses were assessed descriptively by
comparing medical history, clinical measures, and pitching patterns among athletes that
continued and discontinued using the biomechanical devices.

Results
Twenty-two pitchers participated. The uptake for initiating force plate use was 0.32
(95%CI: 0.14, 0.55); uptake for the pitching sleeve was 0.55 (0.32, 0.76). Adherence for
force plate use was 0.46 (0.31, 0.70), compared to 0.13 (0.09, 0.17) for the pitch sleeve.
Potential non-response bias analysis revealed pitchers with no previous upper extremity
injury in the prior season (n=14) were more likely to use the pitching sleeve beyond the
first session (43%) than those who had reported a previous season UE injury at study
baseline (13%).

Conclusions
Variable uptake and adherence was observed across devices and players. Addressing
barriers/facilitators to increase uptake and adherence is necessary to inform future

a Corresponding Author:
Chelsea Martin
UNC Gillings School of Global Public Health
170 Rosenau Hall
CB #7400
135 Dauer Drive
Chapel Hill, NC 27599-7400
[email protected]
 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

studies on the effect of these devices on preventing injury using training load, kinetic,
and kinematic data monitoring.

INTRODUCTION METHODS

Upper extremity injuries are a significant health concern STUDY DESIGN

among baseball pitchers across all levels, resulting in sig-
nificant time-loss from sport.1‑4 In the last 15 years, injury This feasibility study used a prospective (repeated mea-
incidence rates have ranged from 0.98 to 5.8 injuries per sures) design and was conducted during a collegiate devel-
1000 athlete exposures among high school,2 collegiate,2, opmental league season from June 2023 to August 2023.
3 and professional players,4 with the greatest proportion Feasibility is defined as the extent to which a newly devel-
of injuries occurring in the shoulder and elbow. In profes- oped tool or intervention can be successfully used within
sional players 20% of elbow and 7% of shoulder injuries the setting of interest.17 Feasibility outcomes were defined
require a surgical procedure and extensive rehabilitation.5, using the taxonomy proposed by Proctor et al. for imple-
6 Preventing upper extremity injuries is a high priority mentation outcomes, specifically uptake and adherence for
among players, coaches, and clinicians to improve short all combined pitcher activities (bullpen sessions, throwing,
and long-term athlete health and maximize performance. weighted ball training, and long toss) of the biomechanical
One approach to try preventing these injuries is through devices.16 This study was approved by the Wake Forest
training load and fatigue monitoring. A proposed strategy School of Medicine Ethics Board (IRB00095826).
to track training load and fatigue among baseball pitchers
is to leverage technology that tracks measures of training PATIENT AND PUBLIC INVOLVEMENT
load and fatigue during training regimens and game out-
ings.7 A novel biomechanical pitch sleeve has been devel- Meetings were held prior to study design phase with clin-
oped to track pitch counts and intensity, including arm ve- icians, researchers, Major League Baseball (MLB) and USA
locity and elbow valgus torque measurements,8 variables Baseball, and the summer collegiate league representatives
that contribute to training load and are associated with to discern project direction. These clinicians, baseball rep-
upper extremity injury.9,10 To measure fatigue, a portable resentatives, and researchers were further included in the
force plate can be used to perform counter movement creation of the study aims and research design. Biweekly
jumps to measure ground reaction force and jump height, meetings were held throughout the season with MLB and
measurements that may serve as an objective proxy mea- collegiate developmental league affiliates for study updates
sure for full body fatigue to inform recovery prior to or after and quality management. Results from this study were pre-
pitching.11 Preliminary research has demonstrated the po- sented to coaches and the MLB front office at the end of the
tential for monitoring countermovement jumps as a proxy study period for study implications and future recommen-
for monitoring pitcher fatigue (i.e., decreased peak force dations of biomechanical device use.
outputs) given its association with pitch velocity.12,13 By
PARTICIPANT ELIGIBILITY CRITERIA
combining use of both the pitching sleeve and force plate
analysis during training, these devices may emerge as tools
Participants were recruited from two teams that were en-
to monitor training load and recovery, which my in turn im-
gaged in a single collegiate summer league in the south-
prove overall performance and control the training process.
eastern United States. Participant eligibility criteria con-
New technologies developed for training load or bio-
sisted of 1) pitchers rostered on a collegiate summer league
mechanical data are often validated in throwing sport do-
pitching staff; 2) ability to fully participate in all baseball
mains14,15; however, studies on new technology to inves-
related activities without restrictions at beginning of data
tigate player use of these technologies is lacking in this
collection; 3) consent to participate.
throwing population. Outcomes such as uptake (i.e., the
initial participation or proportion of use for a tool or in-
DESCRIPTION OF BIOMECHANICAL DEVICES AND DATA
tervention) and adherence (i.e., continued participation or COLLECTION
proportion of use of a tool or intervention) are important
outcomes to inform the feasibility of new technologies.16 Two Nextiles biomechanical devices were included in the
Investigating the feasibility of biomechanical devices used study: 1) pitching sleeve and 2) portable force plate. The
by players prior to large scale studies may help discern pro- Nextiles (Nextiles Inc., Brooklyn, New York) pitching sleeve
portion and pattern of use to maximize future effective incorporates a fabric-based circuity sensor to track a range
adaptation (and limitations) of these tools in real world set- of biomechanical data, including arm speed, force, distance
tings. Thus, the objectives of this study were to investi- and direction, and pressure and can be utilized in both on
gate the proportion of collegiate pitchers over one summer and off-field settings to passively collect player movements.
league season who demonstrated uptake and adherence The Nextiles jump mat incorporates fabric-based circuity
among a novel biomechanical pitching sleeve and portable sensor into the mat to track ground reaction force, time
force plate for use as an injury prevention measure. from takeoff to landing, and pressure.
To collect pitching sleeve data, all throwing and pitching
workouts were tracked. Data per outing were abstracted

International Journal of Sports Physical Therapy

 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

weekly from the data interface and stored in a de-identified sleeve, this was calculated as the proportion of the number
player file by an assigned team data coordinator. Only non- of occurrences the sleeve was used divided by the total
game appearances were considered for the proportion of number of opportunities (practice only) to wear the sleeve
initial and continued use due to league wide policies on over the entire study. For the portable force plate, adher-
prohibiting single pitch or compression sleeve use in ence was calculated the proportion of the number of occur-
games. Uptake and adherence for in-game use could not be rences the force plate was used at least once per week di-
analyzed. vided by the total number of opportunities to jump on the
Game days, off-days, and days lost due to injury or leav- portable force plate over the entire study.
ing the team due to injury or reaching innings limit were
excluded. The pitch sleeve data interface allowed selection STATISTICAL ANALYSES
of pitch related workout activities included pitching
(bullpen), long toss, plyo or weighted ball training, and Participant characteristics were reported as mean (standard
warm-up throws. Any pitching session could include one or deviation) for continuous variables, and as a count (per-
a combination of these activities. If the sleeve was used for centage) for categorical variables. Potential non-response
at least one of the pitch activities, the session was included bias (i.e., exploration of a lack of uptake or adherence that
in analysis. could introduce response bias in a larger effectiveness trial)
Jump mat sessions consisted of weekly testing to per- than could occur in a hypothetical study using these mea-
form a counter movement jump test (CMJ) using previously sures) was analyzed descriptively to compare pitchers that
described methods,18 and as described in Supplemental File demonstrated initial uptake and adherence after the first
1 as a measure of total body fatigue. Weeks where an ath- session for the Nextiles sleeve (≤ 1 day pitch sleeve use,
lete left the team due to injury or reaching innings limit >1 day pitch sleeve use) and force plate (≤ 1 week force
were excluded. plate use, >1 week force plate use). Variables considered
in the potential non-response bias analysis included de-
INJURY DEFINITION, ATHLETE EXPOSURE mographic characteristics, (i.e., age, BMI, hand dominance,
athlete year, collegiate division, pitching role, orthopaedic
Athlete exposure was defined as one athlete participating surgery history, injury history previous season, upper ex-
in one practice or competition where a player was at risk tremity function), clinical measures (i.e., shoulder range of
of sustaining an injury.8‑10 An index injury was defined as motion, humeral torsion, shoulder strength), athlete game
an injury to a tendon, ligament, nerve, muscle, or bone and pitch exposures. A full description of these variables is
that occurred during any baseball team sponsored activity available in Supplemental File 1.
or event.19 If a player was removed from the roster due to The proportions of uptake and adherence for the pitch
an injury or reaching the maximum number of innings, the sleeve and force plate, and the proportion of pitch sleeve
time from removal to the end of season was not included as activities (bull-pen session, long-toss, plyo ball work, and
part of the calculation of the main outcomes. Injuries were warm up throws) were reported with 95% confidence in-
extracted from managerial player status logs. tervals (95% CI) calculated using the Clopper-Pearson
method. Lasagna plots were created to visualize all
PARTICIPANT CHARACTERISTICS recorded uses of device to discern patterns of use through-
out the season for the pitch sleeve and the force plate.20
Participant self-reported demographic information (sex, All analyses were performed in R 4.12 R Core Team
age, height, weight, hand dominance), sport characteristics (2021). R: A language and environment for statistical com-
(pitching role, team, collegiate division level), and injury puting. R Foundation for Statistical Computing, Vienna,
history (current season, previous season, surgical history) Austria. URL https://www.R-project.org/. The GenBi-
were collected for all pitchers. nomAppa package was used to calculate the Clopper-Pear-
son confidence intervals. All analysis code is available in
MAIN OUTCOMES Supplemental File 2.

UPTAKE
RESULTS
Pitching sleeve uptake was defined as the proportion of
pitchers who consented into the study that demonstrated A total of thirty-four pitchers were eligible but twelve
pitch sleeve use during the first practice session they re- pitchers did not consent to participate in the study, result-
ported to the team. Portable force plate uptake was defined ing in twenty-two baseball pitchers who were included in
as use the portable force plate the first week of the season the analysis. Most pitchers were right-handed (19, 86%),
by a participant, or within one week that the athlete re- Division I (15, 68%), and reported performing both starter
ported to the team. and reliever roles (10, 45%) (Table 1). For the exploration of
potential non-response bias, pitchers that did not continue
ADHERENCE to use the Nextiles pitch sleeve after initial testing reported
a higher proportion of injuries the previous season (8 in-
Adherence analyses were restricted to those who demon- jured pitchers, 50.0%) compared to pitchers who demon-
strated initial uptake. For the biomechanical pitching strated use after the initial session (0 injured pitchers,

International Journal of Sports Physical Therapy

 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

0.0%) (Table 1). Pitchers that demonstrated pitch sleeve Table 1. Participant Characteristics
use beyond the first session reported a higher mean season
pitch count volume compared to pitchers who did not re- ≤ 1 day >1 day
port use beyond the first session (432.7 versus 271.9 pitch pitch
sleeve sleeve
pitches) (Supplemental File 3). Clinical variables were gen- use use
erally similar between sleeve use groups (Supplemental File following following
4). No notable differences were observed comparing use initial initial
Overall uptake uptake
and non-use groups for the force plate (Supplemental Files
(n=22) (n=15) (n=6)
5-7).
Age (years) 19.7(1.3) 19.6(1.2) 20.2(1.5)

UPTAKE AND ADHERENCE OF PITCH SLEEVE BMI

(kg/m2) 26.5(1.8) 26.2(1.8) 27.2(1.6)
For all teams combined, uptake of the pitching sleeve was Hand Dominance
0.55 (95% CI: 0.32, 0.76). Among the athletes that demon- Right 19(86.4%) 15(93.8%) 4(66.7%)
strated initial uptake of the pitch sleeve, adherence of the Left 3(13.6%) 1(6.3%) 2(33.3%)
pitch sleeve was 0.13 (95% CI: 0.10, 0.17). Of 52 pitch sleeve
Athlete Year
uses recorded, the most performed activity was bullpen ses-
Freshman 4(18.2%) 4(25.0%) 0(0.0%)
sions (n=22, 43.1%, 95% CI: 29.3%, 57.8%) and long toss
(n=18, 35.3%, 95% CI: 22.4, 49.9), followed by warm up Sophomore 10(45.5%) 2(12.5%) 3(50.0%)

throws (n=8, 15.7%, 95% CI: 7.0%, 28.6%), and plyo or Junior 5(22.7%) 2(12.5%) 1(16.7%)
weighted ball throws (n=3 5.9%, 95% CI: 1.6, 16.2%). Figure Senior 3(13.6%) 8(50.0%) 2(33.3%)
1 demonstrates use of the pitch sleeve throughout the sea- Division
son for all recorded sessions. Of the athletes that used the Division I 15(68.2%) 10(62.5%) 5(83.3%)
pitch sleeve beyond the first recorded session, an observed
Division II 3(13.6%) 2(12.5%) 1(16.7%)
pattern of use one to two times per week was observed. A
Division III 2(9.1%) 2(12.5%) 0(0.0%)
total of 60% (95% CI: 36%, 81%) of athletes did not con-
tinue use of the pitch sleeve after the first recorded session. Junior
College 2(9.1%) 2(12.5%) 0(0.0%)

PITCHER INITIATED AND CONTINUED NEXTILES FORCE Pitching Role

PLATE USE Starter 7(31.8%) 5(31.3%) 2(33.3%)
Reliever 5(22.7%) 4(25.0%) 1(16.7%)
The proportion of athletes that initiated use of the force Both 10(45.5%) 7(43.8%) 3(50.0%)
plate during the first week was 0.32 (95% CI: 0.14, 0.55).
Orthopaedic Surgery History
Among athletes that demonstrated initial uptake of the
Yes 5(22.7%) 4(25.0%) 1(16.7%)
force plate, the proportion of athletes that continued to
use the force plate was 0.46 (95% CI: 0.31, 0.70). Figure 2 No 15(68.2%) 10(62.5%) 5(83.3%)
provides visual evidence of force plate use over the dura- Missing 2(9.1%) 2(12.5%) 0(0.0%)
tion of the season with 33% (95% CI: 18%, 52%) of ath- Injuries Previous Spring Season
letes demonstrating weekly use through the duration of the Yes 8(36.4%) 8(50.0%) 0(0.0%)
study time frame, or prior to right censoring (i.e., reached
No 14(63.6%) 8(50.0%) 6(100.0%)
innings limit, loss to injury).
SANE score (%)
Throwing
DISCUSSION shoulder 90.0(9.5) 89.4(10.8) 91.7(5.2)
Non-
This is the first study to report feasibility outcomes for Throwing
wearable and portable technological devices among base- shoulder 96.1(9.5) 95.6(10.9) 97.5(4.2)
ball players, addressing a major gap in discerning use pat- Complete Season
terns in technology commonly used in this target popula- Yes 10(45.5%) 7(43.8%) 3(50.0%)
tion. This study found 55% volitional uptake of the pitch No* 12(54.5%) 9(56.3%) 3(50.0%)
sleeve, only 40% of whom used it more than once, and with
reduced continued adherence throughout the season. No- Continuous descriptors reported as mean (standard deviation), categorical descriptors as
count (%)
tably, results from the potential non-response bias analy-
SANE: Single Assessment Numeric Evaluation; BMI: Body mass index
sis demonstrated that pitchers that did not continue to use *Season completion: athletes who did not complete season were due to reaching inning
the Nextiles pitching sleeve after initial testing reported limit or injury

a higher proportion of injuries the previous season (47%)

compared to those who continued to use the Nextiles pitch- ing appearances and an activity preference for bullpen ses-
ing sleeve (14%). Among pitchers that continued to wear sions and long toss. In contrast, there was only 10% force
the pitch sleeve during the season, specific use patterns plate volitional uptake, with 56% adherence observed
were observed, with an average of two uses between pitch- among participants that demonstrated initial uptake.

International Journal of Sports Physical Therapy

 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

portion of missing data) until solutions to improve adher-

21.png" data-medium-image- ence are identified.
url="https://s3.amazonaws.com/ Uptake and adherence of wearable and portable biome-
production.scholastica/public/attachments/ chanical devices are likely informed by athlete behaviors
f5b12a4e-0726-4272-bb5a-f95c4206aff3/ influenced by team environments, personal knowledge of
the device, athlete motivation, and potential for health pro-
medium/
moting behavior 2 that are dynamic as training situations
Figure_1._Lasagna_Plot:_Pitching_Sleeve_Adherence_Patterns
change. 26,27 In this study, pitchers that reported use of
1.png" alt="A graph showing the number of days
the pitching sleeve beyond the first opportunity were less
since baseline Description automatically likely to report an injury the prior season (14.3% vs 46.7%).
generated"> This finding may be indicative of pitchers that present with
Figure 1. Lasagna Plot: Pitching Sleeve Adherence ‘health promoting behaviors’ such as a regimented training
Patterns21 routine or regular engagement in arm care programs, and
*: Athlete left team due to injury and/or leaving team; Shaded blocks are compliant use thus have a propensity for adapting training devices that
of pitch sleeve during practice, opportunities; Non-shaded regions indicate pitch sleeve may further inform these training practices.21,28 In con-
non-use; Includes all pitching activities in practice (plyo balls, long toss, Bullpens,
throwing); Plot represents all uses recorded by device and sorted by individual adher-
trast, athletes with an injury history may display hesitancy
ence. in engaging in wearable technology due to fear of underper-
formance that the data may demonstrate (i.e., lower veloc-
ity). Specific to the force plate, higher adherence observed
21.png" data-medium-image- compared to the pitch sleeve may be due to decreased ath-
lete burden (i.e., less technology use sessions required),
url="https://s3.amazonaws.com/
or team training environment allowing for easy incorpora-
production.scholastica/public/attachments/ tion of weekly jump test sessions.27 Training optimization
ecd78476-c6bf-43d7-b5bf-eb11bd20600e/ strategies that incorporate wearable and portable technol-
medium/ ogy may need to align with team schedules, and ensure that
Figure_2._Lasagna_Plot:_Force_Plate_Use_Patterns_Adherence_Pattern health promoting behavior 2 is encouraged while providing
1.png" alt="A graph of blue squares Description education that minimizes potential for fear avoidance be-
automatically generated"> haviors to improve adherence and hence athletes’ buy-in.27,
29
Figure 2. Lasagna Plot: Force Plate Use Patterns
Adherence Pattern21 Lasagna plots revealed patterns for pitch sleeve use
among users who demonstrated initial uptake, with a pitch
*: Athlete left team due to injury and/or leaving team; Shaded blocks are compliant use
of force plate for 1x per week per protocol; Non-shaded regions indicate force plate non- sleeve use pattern of twice per week. A majority of sessions
use; Plot Represents all uses recorded by device, and sorted by individual adherence. captured were bullpen sessions (43.1%) or long toss
(35.3%). Understanding biomechanical device use patterns
Use of wearable and portable biomechanical pitch and frequency may help form recommendations that are
sleeves may play an important role in understanding how feasible for the athlete and for implementation in larger
to prevent upper extremity injuries by tracking important studies. Prior research among neuromuscular training pro-
training load variables and proxy measures for fatigue in grams have demonstrated potential variability in program
order to establish their potential causal role. Although a frequency and intervention activities, highlighting the im-
moderate uptake was observed, the pitch sleeve was uti- portance of the need for subcomponent analysis of inter-
lized in only 13% of the potential use opportunities among vention strategies.30 However, further qualitative research
players that initially used the pitch sleeve (uptake). Com- is needed to highlight specific barriers or facilitators that
pared to the pitch sleeve, a lower initial uptake was ob- may inform this pattern of use, such as environmental con-
served for the force plate with 32% of athletes demon- straints, or user knowledge.31
strating initial use during the first week. However, a higher
adherence was observed, with 56% of these athletes LIMITATIONS
demonstrating continued use for all potential use opportu-
This study is not without limitations. First, these data were
nities. Prior literature on feasibility or implementation out-
collected on a small sample, resulting in wide 95% CI for
comes among wearable and portable technology in throw-
adherence, uptake, and activity specific proportion mea-
ing sports is nonexistent; in other widely studied
sures. While these results provide some preliminary infor-
interventions such as neuromuscular training programs,
mation about the feasibility of these technologies, caution
injury reductions have been observed, but the magnitude
is needed in generalizing the findings league wide within a
of the effect differs based on adherence, demonstrating a
summer league season or among other levels of play. Sim-
dose-response relationship.22‑25 Given the low to moderate
ilarly, inferences on discerning differences between users
levels of uptake and continued adherence observed, stud-
and non-users of the devices need to be further confirmed
ies using these devices to investigate causal relations or
among larger studies or qualitative studies to discern barri-
for prognostic and diagnostic research may not be feasible
ers and facilitators for device use. Third, due to league wide
(e.g., high risk of potential non-response bias and high pro-
restrictions in sleeve use among players in games, adher-
ence and uptake for in-game use could not be analyzed.

International Journal of Sports Physical Therapy

 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

CONCLUSION had a pattern of two times per week use for long toss and
bullpen sessions. Future research will need to identify spe-
Understanding the feasibility of technologies in real sce- cific barriers and facilitators to use of each device to better
narios is important to investigate whether these can be suc- inform their implementation in research and practice.
cessfully implemented in baseball athletes for large scale
studies or for routine monitoring. This study showed only Submitted: October 01, 2024 CDT. Accepted: February 22, 2025
55% uptake with 13% adherence for the pitch sleeve, and CDT. Published: May 01, 2025 CDT.
only 32% uptake with 46% adherence for the force plate. For © The Author(s)
the pitch sleeve, players that demonstrated continued use

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International Journal of Sports Physical Therapy

 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

REFERENCES

1. Shanley E, Rauh MJ, Michener LA, Ellenbecker TS. 11. Claudino JG, Cronin J, Mezêncio B, et al. The
Incidence of injuries in high school softball and countermovement jump to monitor neuromuscular
baseball players. J Athl Train. 2011;46(6):648-654. status: A meta-analysis. J Sci Med Sport.
doi:10.4085/1062-6050-46.6.648 2017;20(4):397-402. doi:10.1016/j.jsams.2016.08.011

2. Wasserman EB, Sauers EL, Register-Mihalik JK, et 12. Sakurai M, Qiao M, Szymanski DJ, Crotin RL.
al. The first decade of web-based sports injury Countermovement jump and momentum generation
surveillance: descriptive epidemiology of injuries in associations to fastball velocity performance among
US high school boys’ baseball (2005-2006 through division I collegiate pitchers. J Strength Cond Res.
2013-2014) and National Collegiate Athletic 2024;38(7):1288-1294. doi:10.1519/
Association men’s baseball (2004-2005 through JSC.0000000000004776
2013-2014). J Athl Train. 2019;54(2):198-211.
doi:10.4085/1062-6050-239-17 13. Mayberry J, Mullen S, Murayama S. What can a
jump tell us about elbow injuries in professional
3. Boltz AJ, Powell JR, Robison HJ, Morris SN, Collins baseball pitchers? Am J Sports Med.
CL, Chandran A. Epidemiology of injuries in National 2020;48(5):1220-1225. doi:10.1177/
Collegiate Athletic Association men’s baseball: 0363546520905543
2014-2015 through 2018-2019. J Athl Train.
2021;56(7):742-749. doi:10.4085/1062-6050-432-20 14. Fleisig GS, Slowik JS, Wassom D, Yanagita Y,
Bishop J, Diffendaffer A. Comparison of marker-less
4. Posner M, Cameron KL, Wolf JM, Belmont PJ, and marker-based motion capture for baseball
Owens BD. Epidemiology of Major League Baseball pitching kinematics. Sports Biomech. Published online
injuries. Am J Sports Med. 2011;39(8):1676-1680. May 19, 2022:1-10. doi:10.1080/
doi:10.1177/0363546511411700 14763141.2022.2076608

5. Ciccotti MG, Pollack KM, Ciccotti MC, et al. Elbow 15. Loushin SR, Verhoeven M, Christoffer DJ, Camp
injuries in professional baseball: epidemiological CL, Kaufman KR. Are 4D motion sensors valid and
findings from the major league baseball injury reliable for studying baseball pitching? Am J Sports
surveillance system. Am J Sports Med. Med. 2023;51(6):1608-1614. doi:10.1177/
2017;45(10):2319-2328. doi:10.1177/ 03635465231166423
0363546517706964
16. Proctor EK, Silmere H, Raghavan R, et al.
6. Cross KM, McMurray M, Hertel J, et al. Shoulder Outcomes for implementation research: conceptual
and elbow injury rates and characteristics among distinctions, measurement challenges, and research
collegiate baseball student-athletes. Int J Sports Phys agenda. Adm Policy Ment Health. 2011;38(2):65-76.
Ther. 2020;15(5):792-803. doi:10.26603/ doi:10.1007/s10488-010-0319-7
ijspt20200792
17. Karsh BT. Beyond usability: designing effective
7. Dowling B, McNally MP, Chaudhari AMW, Oñate technology implementation systems to promote
JA. A Review of workload-monitoring considerations patient safety. Qual Saf Health Care.
for baseball pitchers. J Athl Train. 2020;55(9):911-917. 2004;13(5):388-394. doi:10.1136/qhc.13.5.388
doi:10.4085/1062-6050-0511-19
18. Markovic G, Dizdar D, Jukic I, Cardinale M.
8. Arm Sleeve | Nextiles Website. Accessed August 28, Reliability and factorial validity of squat and
2024. https://www.nextiles.com/arm-sleeve countermovement jump tests. J Strength Cond Res.
2004;18(3):551-555. https://doi.org/10.1519/
9. Anz AW, Bushnell BD, Griffin LP, Noonan TJ, Torry 1533-4287(2004)18%3C551:RAFVOS%3E2.0.CO;2
MR, Hawkins RJ. Correlation of torque and elbow
injury in professional baseball pitchers. Am J Sports 19. Kennedy RA, Drake D. The effect of acute fatigue
Med. 2010;38(7):1368-1374. doi:10.1177/ on countermovement jump performance in rugby
0363546510363402 union players during preseason. J Sports Med Phys
Fitness. 2017;57(10):1261-1266. doi:10.23736/
10. Bushnell BD, Anz AW, Noonan TJ, Torry MR, S0022-4707.17.06848-7
Hawkins RJ. Association of maximum pitch velocity
and elbow injury in professional baseball pitchers.
Am J Sports Med. 2010;38(4):728-732. doi:10.1177/
0363546509350067

International Journal of Sports Physical Therapy

 Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study

20. Swihart BJ, Caffo B, James BD, Strand M, Schwartz 26. Lutfey KE, Wishner WJ. Beyond “compliance” is
BS, Punjabi NM. Lasagna plots: a saucy alternative to “adherence”. Improving the prospect of diabetes care.
spaghetti plots. Epidemiology. 2010;21(5):621-625. Diabetes Care. 1999;22(4):635-639. doi:10.2337/
doi:10.1097/EDE.0b013e3181e5b06a diacare.22.4.635

21. Keats MR, Emery CA, Finch CF. Are we having fun 27. McKay CD, Verhagen E. “Compliance” versus
yet? Fostering adherence to injury preventive “adherence” in sport injury prevention: why
exercise recommendations in young athletes. Sports definition matters. Br J Sports Med.
Med. 2012;42(3):175-184. doi:10.2165/ 2016;50(7):382-383. doi:10.1136/
11597050-000000000-00000 bjsports-2015-095192

22. Sugimoto D, Myer GD, Bush HM, Klugman MF, 28. Mcauley E, Courneya KS. Adherence to exercise
Medina McKeon JM, Hewett TE. Compliance with and physical activity as health-promoting behaviors:
neuromuscular training and anterior cruciate Attitudinal and self-efficacy influences. Applied and
ligament injury risk reduction in female athletes: a Preventive Psychology. 1993;2(2):65-77. doi:10.1016/
meta-analysis. J Athl Train. 2012;47(6):714-723. S0962-1849(05)80113-1
doi:10.4085/1062-6050-47.6.10
29. Collado-Mateo D, Lavín-Pérez AM, Peñacoba C, et
23. Silvers-Granelli HJ, Bizzini M, Arundale A, al. Key factors associated with adherence to physical
Mandelbaum BR, Snyder-Mackler L. Higher exercise in patients with chronic diseases and older
compliance to a neuromuscular injury prevention adults: an umbrella review. Int J Environ Res Public
program improves overall injury rate in male football Health. 2021;18(4). doi:10.3390/ijerph18042023
players. Knee Surg Sports Traumatol Arthrosc.
2018;26(7):1975-1983. doi:10.1007/ 30. Räisänen AM, van den Berg C, Owoeye OBA,
s00167-018-4895-5 McKay CD, Emery CA. Running every time, planking
sometimes: youth adherence to a neuromuscular
24. Steffen K, Emery CA, Romiti M, et al. High training program. Transl J Am Coll Sports Med.
adherence to a neuromuscular injury prevention 2022;7(4). doi:10.1249/TJX.0000000000000209
programme (FIFA 11+) improves functional balance
and reduces injury risk in Canadian youth female 31. Creaser AV, Clemes SA, Costa S, et al. The
football players: a cluster randomised trial. Br J Sports acceptability, feasibility, and effectiveness of
Med. 2013;47(12):794-802. doi:10.1136/ wearable activity trackers for increasing physical
bjsports-2012-091886 activity in children and adolescents: A systematic
review. Int J Environ Res Public Health. 2021;18(12).
25. Emery CA, van den Berg C, Richmond SA, et al. doi:10.3390/ijerph18126211
Implementing a junior high school-based programme
to reduce sports injuries through neuromuscular
training (iSPRINT): a cluster randomised controlled
trial (RCT). Br J Sports Med. 2020;54(15):913-919.
doi:10.1136/bjsports-2019-101117

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