Journal of Bodywork & Movement Therapies 27 (2021) 127e133

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Journal of Bodywork & Movement Therapies

journal homepage: www.elsevier.com/jbmt

Prevention and Rehabilitation

Biomechanics of core musculature on upper extremity performance in

basketball players
Chandrakala Arora a, Piyush Singh a, Vicky Varghese b, *
a
Department of Sports Physiotherapy, Indian Spinal Injuries Centre Institute of Rehabilitation Sciences, New Delhi, 110070, India
b
Biomechanics Engineer, Biomechanics Lab, Indian Spinal Injuries Centre, New Delhi, 110070, India

a r t i c l e i n f o a b s t r a c t

Article history: Introduction: Basketball is a dynamic team sport which involves skilled movement and activities.
Received 27 May 2020 Shooting is considered to be an essential part of the game for scoring points. The core strength is an
Received in revised form important preconditioning for the sport, and it influences the performance of the player.
19 January 2021
Method: In this study the subjects included thirty-six male basketball players divided into two groups of
Accepted 28 February 2021
high and low core groups. The subjects performed one arm hop test and modified upper quarter y
balance test (mUQYBT) under with and without core activation condition. The performance of the
Keywords:
subjects was evaluated using one way analysis of variance (ANOVA) with Tukeys HSD. Statistical sig-
Functional performance test
Upper extremity
nificance was set at p  0.05 as significant. Value of confidence interval was set at 95%.
Core stability Results: Based on the study, significant difference (p < 0.05) in performance for one arm hop test was
Basketball observed among all the four groups of core muscles (group 1: high core with core activation, group 2
high core without core activation, group 3 low core with core activation and group 4 low core without
core activation). Whereas, no significant difference (p > 0.05) in performance for mUQYBT was observed
among all four groups.
Discussion: Core training is the basis for many functional movements and has become the norm in
athletic training programs. Broad benefits of core stabilization have been overlooked, from improving
athletic performance to preventing injuries in the sports medicine world.
Conclusion: In the present study, core activation was associated with improved stability and mobility of
basketball players during the upper extremity performance test, and the greatest influence of core
activation was seen in individuals with lower core scores.
© 2021 Elsevier Ltd. All rights reserved.

1. Introduction release speed etc.(Drinkwater et al., 2008; Oudejans et al., 2012;

Ziv and Lidor, 2009) Shots performed from significant range
Basketball is the second most popular sports in the world, and require higher impulse to propel the ball towards the basket
according to the International Basketball Federation (FIBA), it is because the horizontal virtual target decreases as the shooting
played by more than 450 million people worldwide.(“Interna- distance increases. Researches have shown an increase in the ball
tional Basketball Federation (FIBA) - FIBA.basketball,” n.d.) It in- release velocity when the shooting distance is increased(Okazaki
volves skilled movement which includes shooting, defense, and and Rodacki, 2012). Shoulder goes in a typical range of motion
dribbling(Çetin and Muratlı, 2014; Stojanovic et al., 2018; Tsai pattern of excessive external motion and compromised internal
et al., 2006). The two-legged jump shot constitutes over 70% of rotation during throwing movement, due to laxity in the domi-
all the shots during a game, where the athlete jumps to increase nant glenohumeral joint(Allegrucci et al., 1995). Researchers have
the ball release height(Struzik et al., 2014). Previous studies have found a nonsignificant difference (5 ) in elbow angle in prepa-
explored different aspects concerning jump shot such as the ef- ration for the two-or three-point jump shot along with increased
fects of fatigue, shooting distance, fitness, release angle and shoulder and wrist range of motion(Knudson, 1993). Motion at
the lower limbs is required for a connection and coordination to
complete a shooting action. On the other hand strong tensile
muscular forces are also needed at the upper limb during a jump
* Corresponding author.
E-mail address: [email protected] (V. Varghese). shot(Struzik et al., 2014).

https://doi.org/10.1016/j.jbmt.2021.02.023
1360-8592/© 2021 Elsevier Ltd. All rights reserved.
C. Arora, P. Singh and V. Varghese Journal of Bodywork & Movement Therapies 27 (2021) 127e133

The main muscle groups of the upper limb that intervenes tightness and systemic disease. Each subject signed a statement of
during the action of the shooting are the flexors of the arm (anterior informed consent before participation. Before testing, participants
deltoid, biceps, coracobrachialis), forearm(brachialis) and hand age, dominant throwing arm, and upper limb length were recorded.
during the handling phase, along with extensors (triceps) and Upper limb length of a participant was measured in an upright
pronators (pronator teres) of the forearm during the finishing stage standing position with the shoulder abducted to ninety degrees,
of the shot. The muscles of the lower limb contracts isometrically the elbow fully extended, and the participant's hand in a neutral
until the player does not bend and works concentrically (knee position. The tester measured the participant's upper limb length
flexors) during the step of bending. The muscles (knee extensors) from C7 to the tip of their middle finger with a measuring tape.
work eccentrically, and the force applied on the ground increases Participants performed the testing procedures barefoot to elimi-
after bending when the player stretches the lower limbs to perform nate any stability and balance issues from footwear. The testing
a jump. During the release phase of the ball, the muscles of the procedure was approved by the Institutional Review Board of the
lower limbs work concentrically, thereby pushing strong on the Indian Spinal Injuries Centre at New Delhi, India (Ref ISIC/IIRS/RP/
ground and increasing the forces(Raiola and D'isanto, 2016). The 2018/153).
proper function of these active muscles and the velocity at which
the ball is released is crucial in determining a shot success(Knud- 2.2. Testing procedure
son, 1993). Muscular strength and endurance are required around
the lumbar spine to maintain functional stability during both upper Core assessment of selected basketball players was performed
and lower limb movements. This region includes the abdominal using Sahrmann core testing progression.(Akuthota and Nadler,
muscles anteriorly, the paraspinals and gluteus posteriorly, the 2004; Faries and Greenwood, 2007). The Sahrmann protocol aims
diaphragm superiorly, and the pelvic floor and hip girdle muscu- to assess the ability of the core musculature to stabilize the spine
lature inferiorly are referred as “core”(Radwan et al. (2014)). The and includes five levels of testing each designed to make it
proximal core muscles stabilize the spinal and its poor function is increasingly challenging to maintain a neutral spinal position using
associated with dysfunctional movement pattern. The Core has the the core stabilizers involved. Subjects were grouped according to
purpose of controlling and stabilizing the lumbosacral region and their core stabilization scores (Sahrmann scores) into LOW core
allows as a connection between the upper and lower part of the strength (Sahrmann score 0) and HIGH core strength (Sahrmann
body and aids in distribution of forces generated by upper and score 1 to 5).
lower limbs.(Sannicandro and Cofano, 2017). The subjects from each group were then randomly assigned and
In sports, core becomes particularly important as it provides instructed to perform upper extremity performance tests with core
‘proximal stability for distal mobility’(Akuthota et al., 2008). Core activation and without core activation. Subjects in the category of
stability proves to be an essential component of biomechanical core activation were instructed to engage their abdominal muscles
efficiency as it leads to maximum force production thereby while performing the upper extremity performance tests.
reducing the loads over peripheral joints (Radwan et al., 2014). The Group 1- High core group with core activation
core muscles of the trunk and pelvis are responsible for main- Group 2- High core group without core activation
taining the stability of the spine and pelvis and are critical for the Group 3- Low core group with core activation
transfer of energy from larger torso to smaller extremities during Group 4- Low core group without core activation.
many sports activities (Sharrock et al., 2011). The test procedure has been is depicted in the form of a flow-
Despite the current interest surrounding core stability, a limited chart (Fig. 1).
body of evidence exists to support the relationship of core stability Prior to commencement, players performed their general warm
strength and performance enhancement amongst athletes. The up and practice trials of the upper extremity performance tests to
purpose of the current study is to examine the influence of different ensure that they were comfortable with the study procedures. The
level of core musculature strength on the athlete's upper extremity subject first watched an instructional video depicting the test
performance measures in basketball players. protocols. The current study used to two performance tests to
assess the upper extremity performance: One arm hop test and
2. Methods modified upper quarter Y balance test. One arm hop test is a closed
kinetic chain movement, but it requires both concentric and
2.1. Subjects eccentric muscle strength and control with an external load on the
upper extremity, similar to the shot performance of basketball.
The subjects were thirty-six male basketball players from Delhi Modified Y balance test challenges the proprioception, balance,
University College and Army Headquarters. The average age was strength, and range of motion of upper extremity and trunk and
21.11 years (17e25 years), the average height of 1.83 ± 0.07 m thus allowing the assessment of mobility and stability of scapular
(range-1.7e2.08 m), weight 75.77 ± 7.48 kg (range 58e88 kg), BMI and thoracic movement outside base of support. Although modified
22.72 ± 1.86 kg/m2 (19.44e25.71 kg/m2). Only healthy male sub- Y balance test is a closed kinetic chain test as compared to shot
jects were included to avoid the confounding effect of health status performance in basketball which is an open kinetic chain activity, it
and gender. The inclusion criteria included subjects with normal is the only reliable measure available for assessing the dynamic
ROM at lumbar spine, shoulder, elbow and wrist joints and were balance of upper limb in athletes.
comprehensive in speaking and understanding English and Hindi.
The measurement to determine normal ROM was done using a  One arm Hop test:
universal goniometer and an active range of motion (the arc of
motion attained by a subject during unassisted voluntary joint For testing, subjects assumed a one-arm push-up position with
motion) was assessed as per the definition of American Academy of his back flat, his feet and shoulders apart, and his dominant weight-
Orthopedic Surgeons (AAOS). Subjects were excluded if they had bearing upper extremity positioned perpendicular to the floor. The
any history of injury or surgery in upper extremity or spine in the participant placed his non-weight bearing hand on the posterior
last six months, the complaint of any pain in upper extremity or lower back. A 10.2-cm step (Aerobic stepper, De Jure Fitness, New
spine, vestibular problems (example-vertigo), visual disturbances Delhi, India) was immediately placed laterally to the test hand of
or any associated neurological problems, hip flexor musculature the subject. Upon reaching the position, the subject used the
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C. Arora, P. Singh and V. Varghese Journal of Bodywork & Movement Therapies 27 (2021) 127e133

Fig. 1. Flowchart of test procedure protocol.

weight-bearing arm to hop on the step and land with the entire to the floor using athletic tape matching the angles (90 and two
hand on the step. Then participant used the weight-bearing arm to 135 ) of the upper quarter Y balance test (UQYBT). Before starting
hop off to the step and return his hand to the starting position.(- each participant was provided with a demonstration of the pro-
Fig. 2) This movement was repeated five times as quickly as cedures and standardized instructions. The starting position was
possible by the participant. One trial was performed during the test defined as the feet placed shoulder-width apart in a pushup posi-
with acceptable technique and if the test was performed with an tion with the tested hand on the stance platform and the thumb
improper technique, 1 min rest was given to the subject before adducted. With the free hand the participant pushes the wooden
performing another trial. An acceptable test was defined as a test in box along the tape, by contacting only the side of the wooden box.
which the participant hopped entirely onto the step, did not use the Three trials for the mUQYBT were recorded for the dominant upper
other hand, did not touch down with a knee, and kept his back flat limb (superolateral, medial, inferolateral) in the standardized order.
and his feet in the same position. Time taken was recorded as the The maximum reach distance was measured at the point where the
participant completes one set of hop with the weight-bearing arm. most distal part of the hand reached by reading the tape measure at
the edge of the reach indicator.
 Modified Y e Balance Test A performance trial was not accepted if the following occurred:

A modified upper quarter Y balance test (mUQYBT) is con- a) The participant failed to maintain unilateral stability
structed (as shown in Fig. 3). It consisting of three wooden blocks (participant fell over or placed their free hand on the ground
measuring 2  4x8 inches and three cloth measuring tapes affixed for support/stability),

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C. Arora, P. Singh and V. Varghese Journal of Bodywork & Movement Therapies 27 (2021) 127e133

2.3. Data analysis

The subject demographics (age, height, weight,BMI), the time to

perform the One Arm Hop Test and the maximum reach distance in
the Modified Upper Quarter Y- Balance Test (mUQYBT) were
separately compared between the four groups using One way
Analysis of variance which was performed with Tukeys HSD to
analyze the difference in mean using R (Rstudio, Version .3.1043,
RStudio: Integrated Development for R. RStudio, PBC, Boston, MA
URL http://www.rstudio.com/). Statistical significance was set at
p  0.05 as significant. Value of confidence interval was set at 95%.

3. Results

The distribution of descriptive statistics of age, height, weight,

and BMI for the four groups namely high core with core activation
(Group 1), high core without core activation (Group 2), low core
with core activation (Group 3) and low core without core activation
(Group 4) is shown in Table 1. There is no significant difference
(p < 0.05) among the subjects participating in the groups.

3.1. One arm hop test

The results of one arm hop test are presented in Fig. 4. Time was
highest for group 4 at 7.72 ± 0.75 s, whereas it was lowest for group
1 at 5.03 ± 0.67 s. In both high and low core groups, the time was
highest for groups 2 and 4 (5.86 ± 0.70 and 7.72 ± 0.75 s respec-
Fig. 2. Subject positioned for one-arm hop test. tively). Based on statistical analysis (Table 2), in high core group
there is a significant difference in one arm hop test at (p  0.05)
between group 1 and group 2. Similarly, in case of low core group
there is a significant difference (p  0.05) between group 3 and
group 4. In case of core activation group there is a significant dif-
ference (p  0.05) between group 1 and group 3, similarly in case of
without core activation, there is a significant difference (p < 0.05)
group 2 and group 4. The difference was not significant (p > 0.05)
between group 2 and group 3.

3.2. Modified upper quarter Y balance test (mUQYBT)

The results of mUQYBT are presented in Fig. 5. The highest

composite score was obtained in group 3 at 89.99 ± 4.93% whereas
it was lowest in group 4 at 88.97 ± 6.42%. Based on statistical
analysis (Table 2), in case of the high core group, there was no
significant difference (p > 0.05) between group 1 (89.36 ± 3.10%)
and group 2 (89.39 ± 6.94%). Similarly, in the case of the low core
group, there was no significant difference (p > 0.05) between group
3 (89.99 ± 4.93%) and group 4 (88.97 ± 6.42%). Similar no significant
difference was observed for other combinations (group 1 vs group
3, group 4 vs group 1, group 3 vs group 2, and group 4 vs group 2).

4. Discussion

Core training is the basis for many functional movements and

Fig. 3. Subjects positioned for Modified Upper Quarter Y e Balance test. has become the norm in athletic training programs. Broad benefits
of core stabilization have been overlooked, from improving athletic
performance to preventing injuries in the sports medicine world.
b) Participant did not maintain contact with the block,
Core training found to be an essential precondition for many high
c) Participant had improper hand placement on the block
impact sports such as football, basketball and in track and field
(placed hand on top of block instead of fingertips on closest
events. The results of the current study match with the studies in
side),
the literature. In a study by Falsone et al. (2002) using one arm hop
d) Participant lifted a foot off the floor.
test by male collegiate wrestlers and football players had the

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C. Arora, P. Singh and V. Varghese Journal of Bodywork & Movement Therapies 27 (2021) 127e133

Table 1
Descriptive statistics of age, height, weight, BMI of the subjects in different groups.

Parameters Group 1 (HCCA) Group 2 (HCWCA) Group 3 (LCCA) Group 4 (LCWCA)

N 9 9 9 9
AGE Minimum 20 19 17 18
(years) Maximum 25 24 23 23
Mean (SD) 22.22 (1.78) 21.67 (1.80) 20.33 (1.87) 20.22 (1.71)
HEIGHT Minimum 1.75 1.73 1.70 1.75
(m) Maximum 1.87 2.08 1.94 1.90
Mean (SD) 1.82 (0.04) 1.85 (0.10) 1.83 (0.07) 1.79 (0.05)
WEIGHT Minimum 63 69 58 70
(kg) Maximum 88 88 88 81
Mean (SD) 73.78 (7.85) 78.89 (6.43) 75.22 (10.59) 75.22 (3.73)
BMI Minimum 19.44 19.60 19.70 21.60
(kg/m2) Maximum 25.71 25.46 25.71 25.46
Mean (SD) 22.12 (2.13) 23.12 (1.90) 22.27 (2.14) 23.37 (1.08)

Fig. 4. Comparing the effects of all four groups on one arm hop test. Fig. 5. Comparing the effects of all four groups on modified upper quarter Y balance
test.

Table 2
One way Anova results for One Arm Hop test and Modified Y balance Test between assessment of joint stability and mobility of the upper quarter and
the different groups. trunk as suggested in the literature(Gorman et al., 2012). One arm
hop test is a closed kinetic chain movement, but it requires both
Confidence interval
concentric and eccentric muscle strength and control with an
One arm hop test Mean difference Lower limit Upper limit p value external load on the upper extremity, similar to the shot perfor-
group 2 vs group 1 0.83 0.03 1.63 0.04
group 3 vs group 1 1.44 0.64 2.24 <0.01
mance of basketball. Modified Y balance test challenges the pro-
group 4 vs group 1 2.69 1.89 3.49 <0.01 prioception, balance, strength, and range of motion of upper
group 3 vs group 2 0.61 0.19 1.41 0.18 extremity and trunk and thus allowing the assessment of mobility
group 4 vs group 2 1.86 1.06 2.66 <0.01 and stability of scapular and thoracic movement outside base of
group 4 vs group 3 1.25 0.45 2.05 <0.01
support. Although modified Y balance test is a closed kinetic chain
modified Y Balance test test as compared to shot performance in basketball which is an
group 2 vs group 1 0.03 7.07 7.12 >0.99 open kinetic chain activity, it is the only reliable measure available
group 3 vs group 1 0.63 6.47 7.72 >0.99 for assessing the dynamic balance of upper limb in athletes. Sahr-
group 4 vs group 1 0.39 7.48 6.71 >0.99 mann core testing protocol, is one of the most practical and
group 3 vs group 2 0.60 6.49 7.70 >0.99
group 4 vs group 2 0.42 7.51 6.68 >0.99
objective methods to evaluate core stability in the athletic popu-
group 4 vs group 3 1.02 8.11 6.08 >0.99 lation. Aggarwal et al. (2011) found Sahrmann core testing protocol
as more reliable measure in evaluating function of deep abdominal
muscles. Shirley et al. (Shirey et al. (2012)) in their research
performance in the range of (2.95e7.07 s) and 3.24e9.95 s mentioned that Sahrmann is the only core testing protocol which
respectively. Similarly, in a study by Cramer et al. (2017) for requires low level of abdominal muscle activation during the initial
modified y balance test the results were in the range of values level and becomes increasingly difficult with the progression of
(composite score 60e98). Sannicandro et al. (Sannicandro and levels, similar to most of the athletic activities.
Cofano, 2017) tested the effect of core stability and jump perfor- The novelty of the study is that results demonstrated an increase
mance and concluded that jumping performance was improved in upper extremity performance in subjects with greater core
with core stability training in young basketball players.In a study by activation(Niewolna and Zwierko, 2015; Shirey et al., 2012). There
Xie (Xie, 2014) concluded that the core strength training could was a significant improvement in the performance scores of one
improve the shooting average and stability of basketball athletes. arm hop test and modified upper quarter Y balance with intentional
The current study used one arm hop test and modified Y balance core activation as compared to no core activity. This might be
test as it represents dynamic movement testing, which involves attributed due to the effect of core muscles on spinal loading.

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C. Arora, P. Singh and V. Varghese Journal of Bodywork & Movement Therapies 27 (2021) 127e133

Results of our research are consistent with Shirey et al., 2012, where Funding
they concluded that core activation influenced hip and knee kine-
matics during single-leg squats with more significant positive effect This study was non funded.
noted in the individuals with poor core stability. The results suggest
that subjects with higher core score and core activation showed Ethical approval
higher scores in physical performance measure. This phenomenon
can be attributed to the core musculature which gets activated All procedures performed in studies involving human partici-
involuntarily during functional activities. This fact is already sup- pants were in accordance with the ethical standards of the insti-
ported by Radwan et al., 2014, Brumitt et al. (Brumitt and Dale, tutional research committee (Indian Spinal Injuries Centre at New
2009) and Willardson et al. (Willardson, 2007) which states that Delhi, India (Ref ISIC/IIRS/RP/2018/153)) and with the 1964 Helsinki
trunk musculature becomes activated in a feed-forward manner declaration and its later amendments or comparable ethical
during the upper or lower limb movements in individuals with standards.
competent core strength. The study done by Hodges and
Richardson (1997) concludes that trunk muscle activity, specif- Informed consent
ically the transversus abdominis and multifidus gets activated
before the arm motion to contribute to the stability of the adjacent Informed consent was obtained from all individual participants
joints and control the position within the base of support. included in the study.
Likewise, statistical estimation between individuals of lower
core scores with core activation has shown better performance
Declaration of competing interest
than the individuals without core activation. This possible outcome
suggests that with core activation, the trunk stability increases in
All authors have no conflict of interest.
lower core scores individuals during the performance activities. In a
study by Sannicandro et al. (Sannicandro and Cofano, 2017) on pre-
pubertal basketball players demonstrates enhancement in the References
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