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1 193 Journal of Exercise Physiologyonline April 2018 Volume 21 Number 2 Editor-in-Chief Official Research Journal of Tommy the American Boone, PhD, Society MBA of Review Exercise Board Physiologists Todd Astorino, PhD Julien Baker, ISSN PhD Steve Brock, PhD Lance Dalleck, PhD Eric Goulet, PhD Robert Gotshall, PhD Alexander Hutchison, PhD M. Knight-Maloney, PhD Len Kravitz, PhD James Laskin, PhD Yit Aun Lim, PhD Lonnie Lowery, PhD Derek Marks, PhD Cristine Mermier, PhD Robert Robergs, PhD Chantal Vella, PhD Dale Wagner, PhD Frank Wyatt, PhD Ben Zhou, PhD Official Research Journal of the American Society of Exercise Physiologists ISSN JEPonline Flexibility Adaptations in Golf Players during a Whole Season Estélio H. M. Dantas 1,2, Estevão Scudese 1, Rodrigo G. S. Vale 3, Gilmar W. Senna 1, Ana Paula de A. Albuquerque 4, Olívia Mafra 5, Fabiana R. Scartoni 1, Mario Cezar S. Conceição 1,3. 1 University of State of Rio de Janeiro, Brazil, 2 Tiradentes University, Sergipe, Brazil, 3 State University of Rio de Janeiro, Brazil, 4 FAMA, Macapá, Brazil, 5 State University of Piauí, Brazil ABSTRACT Dantas EHM, Scudese E, Vale GSR, Albuquerque APA, Mafra O, Senna GW, Conceição MCS. Flexibility Adaptations in Golf Players during a Whole Season. JEPonline 2018;21(2): The aim of the study was to measure the flexibility adaptations after a whole season of periodized training regimen. Ninety-five subjects (15.62 ± 1.32 yrs) were divided into two groups: Experimental Group (EG, n = 50) and Control Group (CG, n = 45). Flexibility was evaluated by the goniometry testing protocol for the following articular movements: shoulder horizontal flexion and extension (SHF/SHE), lumbar spine flexion (LSF), and ankle dorsiflexion and plantarflexion (ADF/APF). The repeated measures ANOVA found an interaction between the groups and moments of the measurements (P<0.001). The Tukey post hoc demonstrated significant flexibility gains in pre- to postseason data for SHF (P=0.002), SHE (P=0.002), LSF (P=0.001), ADF (P=0.002) and APF (P=0.002). For EG vs. CG comparisons, significant differences were found for SHF (P=0.002), SHE (P=0.002), LSF (P=0.001), ADF (P=0.002), and APF (P=0.002). The power of the experiment presented values of 99% for all joint movements analyzed, strengthening the magnitude of the results achieved in the analysis of the sample flexibility level. Thus, the findings indicate that the global training regimen implemented was efficient for improving the golfer s flexibility. Key Words: Exercise, Goniometry, Physical Fitness

2 194 INTRODUCTION Golf is a worldwide practiced sport that is rapidly gaining popularity. Also, of considerable interest to many people is that Golf returned for the Olympic Games in 2016 (16,22). Within the growing interest in its practice, recent scientific investigations have been carried out to identify the key factors that influence an athlete s performance (3,13,14). Specifically, to perform well in golf, professionals have emphasized the importance of improving specific tasks and gestures that allow for excellence in the golf swing kinematics (17,24). As an example, it has been showed that enhancements in strength, power, and flexibility help to improve the club head speed and ball driving distance (10,12). Sell and colleagues (18) examined the elite golf athletes physical characteristics and concluded that those with increased strength, power, and flexibility demonstrated higher skill level and proficiency. Thus, with the growing interest for improving the elite athlete s performance, training regimens should focus on strength and power development as well as improvement in flexibility to achieve proper technique and avoid injuries (11). In fact, the flexibility is considered an essential fitness component for successfully perfecting the golf swing (18). Vandervoort et al. (22) indicated that elite golf players present increased levels of musculoskeletal range of motion. Additionally, it is very likely the specific enhancement due to adaptive changes triggered by the repetitive task that exposes the joint to a specific range of motion help to perform a sportive gesture (22). It is well known that flexibility is one of the major s physical fitness attributes. An adequate range of motion without the risk of injury to a given joint or a group of joints is necessary to enhance athletic performance (6,7,8). The improvement in the athlete s flexibility can be achieved by the adequate addition of periodized programs specific to each sport modality. With appropriate use of stretching exercises and progression, sport specific skills can be performed with a greater range of motion, strength, velocity, and efficiency (1). Although this concept is well established, it is important to continue the research in what constitutes flexibility, how to increase it without harming the muscles and joints, and how the increase in range of motion can be used to improve athletic performance. Therefore, the aim of this investigation was to measure the effects of flexibility training on young golf players throughout a whole season of periodized training regimen. METHODS Subjects The sample consisted of 95 participants, 46 females and 49 males from 14 to 18 yrs of age. The subjects were randomly assigned to two distinct groups: Experimental Group (EG) composed by amateur golf players (n = 50; ± 1.36 yrs) and Control Group (CG) composed by regular students (n = 45; ± 1.30 yrs). The EG practiced golf on an average of 6 d wk -1 and presented a general skillset handicap ranging from 7 to 8 strokes. To determine the sample characteristics, the following inclusion criteria were adopted: (a) voluntary from 12 to 19 yrs; (b) with golf interest; and (c) with no physical and psychological limitations. Exclusion criteria were obligatory to frequency superior of 85% in training sessions. All volunteers read and signed a consent form in accordance with the Helsinki

3 Declaration, and with Brazilian National Health Council resolution (nº 466/2012). This study was submitted and approved by the local ethics committee under protocol number Procedures Anthropometric and Preliminary Procedures Assessment The anthropometric evaluation and preliminary procedures were performed following this order: (a) anamnesis to obtain information on eating habits, physical activity, drugs used, and pathological history; and (b) assessment of height and body mass to identify BMI. For this purpose, a Filizola clinical scale (Brazil), equipped with a stadiometer that was accurate to 0.1 kg with a capacity range between 0 and 150 kg was used. The stadiometer was accurate to 0.5 cm, and its scale ranged from 0 to 190 cm. Goniometer Test For the flexibility test, a steel 360º goniometer (Lafayette Goniometer Set, EUA) was used for the following joint movements: (a) shoulder horizontal flexion (SHF); (b) shoulder horizontal extension (SHE); (c) lumbar spine flexion (LSF); (d) ankle dorsi flexion (ADF); and (e) ankle plantar flexion (APF). The flexibility was assessed on two non-consecutive days, always in the morning, by at least two experienced evaluators. The environment temperature was held constant on both visits, approximately at 25ºC. All subjects were previously instructed to not perform any vigorous physical activity for at least 24 hrs before each flexibility test. The stretching intensity was controlled via PERFLEX perceived effort scale specifically designed for this purpose, and the values were held between 81 and 90 (9). Experimental Procedures To observe any possible adaptations, all the initial evaluation tests were replicated at the end of the one season of intervention (1 yr). During this period of time, the EG subjects received a periodized flexibility training regime that consisted of the performance of distinct exercises and intensities. The stretching intensity was controlled via PERFLEX. The moderate-intensity was implemented for the warm-up and relaxation strategies independently of the training period. Maximal intensity of the stretch was defined as sustaining the position 8 to 10 sec depending on the method that was applied (i.e., static stretching or PNF, proprioceptive neuromuscular facilitation. At the warm-up strategy, the subjects were instructed to perform 3 repetitions of mixed stretching exercises, holding the positions for 4 sec in a static form, and another additional 4 sec in a dynamic form. The following exercises were implemented: (a) shoulder protraction; (b) shoulder adduction and abduction (with elbows extended); (c) neck flexion; (d) torso flexion; (e) knee extension; (f) knee flexion; and (g) plantar flexion. The level of intensity applied to the initial and final parts was held between 31 and 60 from the PERFLEX perceived effort scale to maintain a submaximal effort. The results were presented by the final mean of every daily intervention. The stretching performed at maximal intensity occurred on specific sessions designed for the fundamental base of the periodization consisting of static stretching and specific phase with PNF. Static stretching was performed 5 d wk -1 in which the subjects underwent 3 sets until they reached the discomfort threshold indicated by the perceived effort (2), and then they held the position for 6 sec. After this point, the subjects performed a slight flexion and 195

4 reached for the maximum range of movement remaining at the final position for another 10 sec (5,23). The PNF phase was performed 3 d wk -1 in which the subjects underwent 3 sets of stretching, maintaining each phase for 8 sec. All exercises were like the warm-up, although with distinct implementation and execution according to the specific characteristics of the method. The stretching intensity (i.e., maximum perceived intensity range) reached the range of discomfort, which was between levels 61 and 80 of the PERFLEX. The results were represented by the final mean of all daily intervention mean scores. In contrast, the CG participated regularly in physical education high school classes for the same duration as the EG intervention. However, with clear directions on not performing stretching exercises throughout the whole experiment duration. Statistical Analyses All data were analyzed using descriptive analysis. Results were presented by its means ± SD and percentage differences ( %). All statistical calculations were performed by SPSS 20.0 software (IBM, Inc). The normality and the homogeneity of data variance were verified by Shapiro-Wilk and Levene tests, respectively. The analysis of variance with repeated measures (ANOVA) was applied for the groups (EG vs. CG) and times (pre- vs. post-) followed by a Tukey post hoc to identify possible differences for all comparisons. In addition, the effect size (ESs) was present for all variables and the thresholds proposed by Cohen (4) were applied to determine the magnitude of effects. The level of P 0.05 was adopted for the statistical significance. RESULTS Repeated measures ANOVA found an interaction between the groups and times of the measurements (P<0.001). The intra- and inter-group data resulting from the experimental (flexibility intervention) and Control Group for distinct joint movement, pre- and post-one whole season on young golf athletes can be observed in Figure 1. Results presented in Figure 1 relate to absolute values pre- and post-condition for flexibility measures. When analyzing the intra-group comparisons, there was a significant joint range of motion improvement observed in the EG for the following: LSF (P=0.002); SHF (P=0.002); SHE (P=0.001); ADF (P=0.002); and APF (P=0.002). The CG did not present any significant changes between the pre- and post-condition. Additionally, when comparing the inter-group results, we found significant improvements in post-condition verification in the EG for the following: LSF (P=0.002); SHF (P= 0.002); SHE (P=0.001); ADF (P=0.002); and APF (P=0.002). In addition, the pre-evaluation inter-group comparison did not present any significant changes. Table 3 shows the values of the percentage differences and ESs of the joint movements analyzed in this study. The ESs was a high value for EG (ESs >0.08), which means that a large proportion of the subjects improved their results (4). This shows that the magnitude of the significance of the increased range of motion after the intervention period was great. 196

5 197 FIGURE 1. Comparison between Groups (CG and EG) for Pre- and Post-Flexibility Values. P<0.05 for the intra-group comparison; P<0.05 for the inter-group comparison; CG = Control Group (students); EG = Experimental Group (athletes); LSF = Lumbar Spine Flexion; SHF = Shoulder Horizontal Flexion; SHE = Shoulder Horizontal Extension; ADF = Ankle Dorsi Flexion; APF = Ankle Plantar Flexion Table 3. Analysis of the Percentage Differences and Effect Size in the Joint Movements. LSF SHF SHE ADF Δ% EG Δ% CG ESs CG = Control Group (students); EG = Experimental Group (athletes); LSF = Lumbar Spine Flexion; SHF = Shoulder Horizontal Flexion; SHE = Shoulder Horizontal Extension; ADF = Ankle Dorsiflexion; APF = Ankle Plantar Flexion; Δ% = Percentage Differences; ESs = Effect Size DISCUSSION The major finding of this study was that young golfers submitted to a flexibility-training program throughout a whole season presented significant increases in their range of motion of specific movements. This kind of improvement in flexibility is also observed in other studies. For instance, Doan et al. (10) investigated the effects of a fitness program on the club head speed, consistency, and putting distance on a heterogenic group of 10 men and 6 women golfers from the first division of the National Collegiate Athletic Association. The program consisted of a mixed strength, power, and flexibility training performed 3 times wk -1 for 11 wks. Performance tests were done before and after the training period and the results

6 showed significant increases (P=0.05) in all tests. Specifically, regarding physical fitness, the flexibility component demonstrated improvements between 7.61 and 16.35%. Despite the distinct intervention periods, the improved flexibility is on par with the data obtained in the present investigation. In addition, Lephard et al. (15) investigated the effects of a specific golf exercise program on physical characteristics of the golfers swing kinematics and golf technique performance after 8 wks of intervention. Fifteen trained male players at US Golf Association Handicap submitted at least 3 to 4 times wk -1 during the season transitional period. The results demonstrate significant improvement in shoulder and hip flexibility. Note that although with similar results, this sample differed from the present study (given that no women were trained or tested and the men tested were distinctly older), and yet Lephard and colleagues results present a higher sportive qualification when compared to the present investigation. In this regard, Thompson and Osness (19) investigated the effects of a physical activity program on golf performance. Previously, the authors assessed strength, flexibility, and the golf club rotation speed of 31 elderly athletes who were divided into an Experimental Group and a Control Group. The EG underwent an 8-wk training program (24 sessions) containing strength and flexibility exercises. The results showed a significant improvement in favor of the EG compared to the CG. Specifically, regarding the flexibility values, although all 9 ranges of motion evaluated presented a tendency for higher values in the EG compared to the CG, only 4 had significantly greater values, which is unlike our study where all evaluated movements showed significant improvements. It is important to note that this outcome might be in part due to the much longer intervention duration of the present study. Another difference important to highlight is the sample characteristics. For instance, Thompson and Osness (19) utilized a much older population when compared to the present investigation. Thompson et al. (20) determined the effect of the training program on the speed of the golf club and physical fitness in 18 golfers who were elderly males. The golfers were randomly assigned to an EG or a CG. The EG participated in a progressive functional training program over an 8-wk period that included flexibility, abdominal strength, balance, and endurance exercises. Results showed significant improvements in golf club speed, flexibility, and other functional components of fitness. The studies mentioned above, although present methodological differences, show an overall increase in flexibility when designed as part of a training program. Additionally, these studies show that the flexibility training promoted gains in range of motion that seemed to contribute in the golfers performance regardless of the length of the intervention and population investigated (i.e., with some minor peculiarities). Thus, a systematic practice of stretching is likely to provide significant increases in flexibility and those enhancements will likely enhance the performance of athletes that practice such a technique demanding sport as golf. CONCLUSIONS Our results appear to be aligned with the current state of the application in sport-oriented flexibility training, suggesting that flexibility training is of a vital importance throughout the season in young golfers. Also, when using periodized methods of flexibility training, we 198

7 observed a chronic increase in flexibility in several movements resulting from approximately 1 yr of training. These findings may contribute to future recommendations and prescriptions focused on the performance of this sport mainly in view of the need for physical valence of flexibility for golf related movements. However, we strongly recommend future studies that verify other forms of training and the interaction of increments of different physical valences. 199 ACKNOWLEDGMENTS The authors would like to thank the support of the Rio de Janeiro State Research Aid Foundation (FAPERJ) that partially financed this study. Address for correspondence: Gilmar W. Senna, PhD, Federal University of State of Rio de Janeiro, Xavier Sigaud Street Praia Vermelha, , Rio de Janeiro, RJ, Brazil. sennagw@gmail.com REFERENCES 1. American College of Sports Medicine Position Stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7): Branco VR, Negrão Filho RF, Padovani CR, Azevedo FM, Alves N, Carvalho AC. Relação entre a tensão aplicada ea sensação de desconforto nos músculos isquiotibiais durante o alongamento. Rev Bras Fisiot. 2006;10(4): Bull M, Bridge MW. The effect of an 8-week plyometric exercise program on golf swing kinematics. Int J Golf Sci. 2012;1(1): Cohen J. Statistical Power Analysis for the Behavioral Sciences. (2nd Edition). Hillsdale, MI: Lawrence Erlbaum, Conceição MCSC, Sampaio AO, Vale, RGS, Achour Júnior A, Nodari Junior RJ, Dantas EHM. Chronic effects of static flexibilizing on neuromuscular parameters in young adults. Rev Bras Med Esporte. 2012;18(3): Conceição MCSC, Vale RGS, Bottaro M, Dantas EHM, Novaes JS. Effects of four different permanence times of the static overstretching on the flexibility's young adults. Fit Perform J. 2008;7(2): Dantas EHM, Carvalho JLT, Fonseca RM. O protocolo LABIFIE de goniometria. Rev Trein Desport. 1997;2(3):21-34.

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