Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study PDF Free Download
1 / 9/9
100%
Original Research
Using Biomechanical Devices in Elite Baseball Pitchers: A
Preliminary Feasibility Study
Chelsea L. Martin, PT, DPT, SCS1,2a, 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% conZdence 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
Zrst 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
Corresponding Author:
Chelsea Martin
UNC Gillings School of Global Public Health
170 Rosenau Hall
CB #7400
135 Dauer Drive
Chapel Hill, NC 27599-7400
martinlc@unc.edu
a
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
studies on the effect of these devices on preventing injury using training load, kinetic,
and kinematic data monitoring.
INTRODUCTION
Upper extremity injuries are a signiZcant health concern
among baseball pitchers across all levels, resulting in sig-
niZcant time-loss from sport.1‑4 In the last 15 years, injury
incidence rates have ranged from 0.98 to 5.8 injuries per
1000 athlete exposures among high school,2 collegiate,2,
3 and professional players,4 with the greatest proportion
of injuries occurring in the shoulder and elbow. In profes-
sional players 20% of elbow and 7% of shoulder injuries
require a surgical procedure and extensive rehabilitation.5,
6 Preventing upper extremity injuries is a high priority
among players, coaches, and clinicians to improve short
and long-term athlete health and maximize performance.
One approach to try preventing these injuries is through
training load and fatigue monitoring. A proposed strategy
to track training load and fatigue among baseball pitchers
is to leverage technology that tracks measures of training
load and fatigue during training regimens and game out-
ings.7 A novel biomechanical pitch sleeve has been devel-
oped to track pitch counts and intensity, including arm ve-
locity and elbow valgus torque measurements,8 variables
that contribute to training load and are associated with
upper extremity injury.9,10 To measure fatigue, a portable
force plate can be used to perform counter movement
jumps to measure ground reaction force and jump height,
measurements that may serve as an objective proxy mea-
sure for full body fatigue to inform recovery prior to or after
pitching.11 Preliminary research has demonstrated the po-
tential for monitoring countermovement jumps as a proxy
for monitoring pitcher fatigue (i.e., decreased peak force
outputs) given its association with pitch velocity.12,13 By
combining use of both the pitching sleeve and force plate
analysis during training, these devices may emerge as tools
to monitor training load and recovery, which my in turn im-
prove overall performance and control the training process.
New technologies developed for training load or bio-
mechanical data are often validated in throwing sport do-
mains14,15; however, studies on new technology to inves-
tigate player use of these technologies is lacking in this
throwing population. Outcomes such as uptake (i.e., the
initial participation or proportion of use for a tool or in-
tervention) and adherence (i.e., continued participation or
proportion of use of a tool or intervention) are important
outcomes to inform the feasibility of new technologies.16
Investigating the feasibility of biomechanical devices used
by players prior to large scale studies may help discern pro-
portion and pattern of use to maximize future effective
adaptation (and limitations) of these tools in real world set-
tings. Thus, the objectives of this study were to investi-
gate the proportion of collegiate pitchers over one summer
league season who demonstrated uptake and adherence
among a novel biomechanical pitching sleeve and portable
force plate for use as an injury prevention measure.
METHODS
STUDY DESIGN
This feasibility study used a prospective (repeated mea-
sures) design and was conducted during a collegiate devel-
opmental league season from June 2023 to August 2023.
Feasibility is deZned as the extent to which a newly devel-
oped tool or intervention can be successfully used within
the setting of interest.17 Feasibility outcomes were deZned
using the taxonomy proposed by Proctor et al. for imple-
mentation outcomes, speciZcally uptake and adherence for
all combined pitcher activities (bullpen sessions, throwing,
weighted ball training, and long toss) of the biomechanical
devices.16 This study was approved by the Wake Forest
School of Medicine Ethics Board (IRB00095826).
PATIENT AND PUBLIC INVOLVEMENT
Meetings were held prior to study design phase with clin-
icians, researchers, Major League Baseball (MLB) and USA
Baseball, and the summer collegiate league representatives
to discern project direction. These clinicians, baseball rep-
resentatives, and researchers were further included in the
creation of the study aims and research design. Biweekly
meetings were held throughout the season with MLB and
collegiate developmental league afZliates for study updates
and quality management. Results from this study were pre-
sented to coaches and the MLB front ofZce at the end of the
study period for study implications and future recommen-
dations of biomechanical device use.
PARTICIPANT ELIGIBILITY CRITERIA
Participants were recruited from two teams that were en-
gaged in a single collegiate summer league in the south-
eastern United States. Participant eligibility criteria con-
sisted of 1) pitchers rostered on a collegiate summer league
pitching staff; 2) ability to fully participate in all baseball
related activities without restrictions at beginning of data
collection; 3) consent to participate.
DESCRIPTION OF BIOMECHANICAL DEVICES AND DATA
COLLECTION
Two Nextiles biomechanical devices were included in the
study: 1) pitching sleeve and 2) portable force plate. The
Nextiles (Nextiles Inc., Brooklyn, New York) pitching sleeve
incorporates a fabric-based circuity sensor to track a range
of biomechanical data, including arm speed, force, distance
and direction, and pressure and can be utilized in both on
and off-Zeld settings to passively collect player movements.
The Nextiles jump mat incorporates fabric-based circuity
sensor into the mat to track ground reaction force, time
from takeoff to landing, and pressure.
To collect pitching sleeve data, all throwing and pitching
workouts were tracked. Data per outing were abstracted
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
weekly from the data interface and stored in a de-identiZed
player Zle by an assigned team data coordinator. Only non-
game appearances were considered for the proportion of
initial and continued use due to league wide policies on
prohibiting single pitch or compression sleeve use in
games. Uptake and adherence for in-game use could not be
analyzed.
Game days, off-days, and days lost due to injury or leav-
ing the team due to injury or reaching innings limit were
excluded. The pitch sleeve data interface allowed selection
of pitch related workout activities included pitching
(bullpen), long toss, plyo or weighted ball training, and
warm-up throws. Any pitching session could include one or
a combination of these activities. If the sleeve was used for
at least one of the pitch activities, the session was included
in analysis.
Jump mat sessions consisted of weekly testing to per-
form a counter movement jump test (CMJ) using previously
described methods,18 and as described in Supplemental File
1 as a measure of total body fatigue. Weeks where an ath-
lete left the team due to injury or reaching innings limit
were excluded.
INJURY DEFINITION, ATHLETE EXPOSURE
Athlete exposure was deZned as one athlete participating
in one practice or competition where a player was at risk
of sustaining an injury.8‑10 An index injury was deZned as
an injury to a tendon, ligament, nerve, muscle, or bone
that occurred during any baseball team sponsored activity
or event.19 If a player was removed from the roster due to
an injury or reaching the maximum number of innings, the
time from removal to the end of season was not included as
part of the calculation of the main outcomes. Injuries were
extracted from managerial player status logs.
PARTICIPANT CHARACTERISTICS
Participant self-reported demographic information (sex,
age, height, weight, hand dominance), sport characteristics
(pitching role, team, collegiate division level), and injury
history (current season, previous season, surgical history)
were collected for all pitchers.
MAIN OUTCOMES
UPTAKE
Pitching sleeve uptake was deZned as the proportion of
pitchers who consented into the study that demonstrated
pitch sleeve use during the Zrst practice session they re-
ported to the team. Portable force plate uptake was deZned
as use the portable force plate the Zrst week of the season
by a participant, or within one week that the athlete re-
ported to the team.
ADHERENCE
Adherence analyses were restricted to those who demon-
strated initial uptake. For the biomechanical pitching
sleeve, this was calculated as the proportion of the number
of occurrences the sleeve was used divided by the total
number of opportunities (practice only) to wear the sleeve
over the entire study. For the portable force plate, adher-
ence was calculated the proportion of the number of occur-
rences the force plate was used at least once per week di-
vided by the total number of opportunities to jump on the
portable force plate over the entire study.
STATISTICAL ANALYSES
Participant characteristics were reported as mean (standard
deviation) for continuous variables, and as a count (per-
centage) for categorical variables. Potential non-response
bias (i.e., exploration of a lack of uptake or adherence that
could introduce response bias in a larger effectiveness trial)
than could occur in a hypothetical study using these mea-
sures) was analyzed descriptively to compare pitchers that
demonstrated initial uptake and adherence after the Zrst
session for the Nextiles sleeve (≤ 1 day pitch sleeve use,
>1 day pitch sleeve use) and force plate (≤ 1 week force
plate use, >1 week force plate use). Variables considered
in the potential non-response bias analysis included de-
mographic characteristics, (i.e., age, BMI, hand dominance,
athlete year, collegiate division, pitching role, orthopaedic
surgery history, injury history previous season, upper ex-
tremity function), clinical measures (i.e., shoulder range of
motion, humeral torsion, shoulder strength), athlete game
and pitch exposures. A full description of these variables is
available in Supplemental File 1.
The proportions of uptake and adherence for the pitch
sleeve and force plate, and the proportion of pitch sleeve
activities (bull-pen session, long-toss, plyo ball work, and
warm up throws) were reported with 95% conZdence in-
tervals (95% CI) calculated using the Clopper-Pearson
method. Lasagna plots were created to visualize all
recorded uses of device to discern patterns of use through-
out the season for the pitch sleeve and the force plate.20
All analyses were performed in R 4.12 R Core Team
(2021). R: A language and environment for statistical com-
puting. R Foundation for Statistical Computing, Vienna,
Austria. URL https://www.R-project.org/. The GenBi-
nomAppa package was used to calculate the Clopper-Pear-
son conZdence intervals. All analysis code is available in
Supplemental File 2.
RESULTS
A total of thirty-four pitchers were eligible but twelve
pitchers did not consent to participate in the study, result-
ing in twenty-two baseball pitchers who were included in
the analysis. Most pitchers were right-handed (19, 86%),
Division I (15, 68%), and reported performing both starter
and reliever roles (10, 45%) (Table 1). For the exploration of
potential non-response bias, pitchers that did not continue
to use the Nextiles pitch sleeve after initial testing reported
a higher proportion of injuries the previous season (8 in-
jured pitchers, 50.0%) compared to pitchers who demon-
strated use after the initial session (0 injured pitchers,
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
0.0%) (Table 1). Pitchers that demonstrated pitch sleeve
use beyond the Zrst session reported a higher mean season
pitch count volume compared to pitchers who did not re-
port use beyond the Zrst session (432.7 versus 271.9
pitches) (Supplemental File 3). Clinical variables were gen-
erally similar between sleeve use groups (Supplemental File
4). No notable differences were observed comparing use
and non-use groups for the force plate (Supplemental Files
5-7).
UPTAKE AND ADHERENCE OF PITCH SLEEVE
For all teams combined, uptake of the pitching sleeve was
0.55 (95% CI: 0.32, 0.76). Among the athletes that demon-
strated initial uptake of the pitch sleeve, adherence of the
pitch sleeve was 0.13 (95% CI: 0.10, 0.17). Of 52 pitch sleeve
uses recorded, the most performed activity was bullpen ses-
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
throws (n=8, 15.7%, 95% CI: 7.0%, 28.6%), and plyo or
weighted ball throws (n=3 5.9%, 95% CI: 1.6, 16.2%). Figure
1 demonstrates use of the pitch sleeve throughout the sea-
son for all recorded sessions. Of the athletes that used the
pitch sleeve beyond the Zrst recorded session, an observed
pattern of use one to two times per week was observed. A
total of 60% (95% CI: 36%, 81%) of athletes did not con-
tinue use of the pitch sleeve after the Zrst recorded session.
PITCHER INITIATED AND CONTINUED NEXTILES FORCE
PLATE USE
The proportion of athletes that initiated use of the force
plate during the Zrst week was 0.32 (95% CI: 0.14, 0.55).
Among athletes that demonstrated initial uptake of the
force plate, the proportion of athletes that continued to
use the force plate was 0.46 (95% CI: 0.31, 0.70). Figure 2
provides visual evidence of force plate use over the dura-
tion of the season with 33% (95% CI: 18%, 52%) of ath-
letes demonstrating weekly use through the duration of the
study time frame, or prior to right censoring (i.e., reached
innings limit, loss to injury).
DISCUSSION
This is the Zrst study to report feasibility outcomes for
wearable and portable technological devices among base-
ball players, addressing a major gap in discerning use pat-
terns in technology commonly used in this target popula-
tion. This study found 55% volitional uptake of the pitch
sleeve, only 40% of whom used it more than once, and with
reduced continued adherence throughout the season. No-
tably, results from the potential non-response bias analy-
sis demonstrated that pitchers that did not continue to use
the Nextiles pitching sleeve after initial testing reported
a higher proportion of injuries the previous season (47%)
compared to those who continued to use the Nextiles pitch-
ing sleeve (14%). Among pitchers that continued to wear
the pitch sleeve during the season, speciZc use patterns
were observed, with an average of two uses between pitch-
Table 1. Participant Characteristics
Overall
(n=22)
≤ 1 day
pitch
sleeve
use
following
initial
uptake
(n=15)
>1 day
pitch
sleeve
use
following
initial
uptake
(n=6)
Age (years) 19.7(1.3) 19.6(1.2) 20.2(1.5)
BMI
(kg/m2) 26.5(1.8) 26.2(1.8) 27.2(1.6)
Hand Dominance
Right 19(86.4%) 15(93.8%) 4(66.7%)
Left 3(13.6%) 1(6.3%) 2(33.3%)
Athlete Year
Freshman 4(18.2%) 4(25.0%) 0(0.0%)
Sophomore 10(45.5%) 2(12.5%) 3(50.0%)
Junior 5(22.7%) 2(12.5%) 1(16.7%)
Senior 3(13.6%) 8(50.0%) 2(33.3%)
Division
Division I 15(68.2%) 10(62.5%) 5(83.3%)
Division II 3(13.6%) 2(12.5%) 1(16.7%)
Division III 2(9.1%) 2(12.5%) 0(0.0%)
Junior
College 2(9.1%) 2(12.5%) 0(0.0%)
Pitching Role
Starter 7(31.8%) 5(31.3%) 2(33.3%)
Reliever 5(22.7%) 4(25.0%) 1(16.7%)
Both 10(45.5%) 7(43.8%) 3(50.0%)
Orthopaedic Surgery History
Yes 5(22.7%) 4(25.0%) 1(16.7%)
No 15(68.2%) 10(62.5%) 5(83.3%)
Missing 2(9.1%) 2(12.5%) 0(0.0%)
Injuries Previous Spring Season
Yes 8(36.4%) 8(50.0%) 0(0.0%)
No 14(63.6%) 8(50.0%) 6(100.0%)
SANE score (%)
Throwing
shoulder 90.0(9.5) 89.4(10.8) 91.7(5.2)
Non-
Throwing
shoulder 96.1(9.5) 95.6(10.9) 97.5(4.2)
Complete Season
Yes 10(45.5%) 7(43.8%) 3(50.0%)
No* 12(54.5%) 9(56.3%) 3(50.0%)
Continuous descriptors reported as mean (standard deviation), categorical descriptors as
count (%)
SANE: Single Assessment Numeric Evaluation; BMI: Body mass index
*Season completion: athletes who did not complete season were due to reaching inning
limit or injury
ing appearances and an activity preference for bullpen ses-
sions and long toss. In contrast, there was only 10% force
plate volitional uptake, with 56% adherence observed
among participants that demonstrated initial uptake.
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
21.png" data-medium-image-
url="https://s3.amazonaws.com/
production.scholastica/public/attachments/
f5b12a4e-0726-4272-bb5a-f95c4206aff3/
medium/
Figure_1._Lasagna_Plot:_Pitching_Sleeve_Adherence_Patterns2
1.png" alt="A graph showing the number of days
since baseline Description automatically
generated">
Figure 1. Lasagna Plot: Pitching Sleeve Adherence
Patterns21
*: Athlete left team due to injury and/or leaving team; Shaded blocks are compliant use
of pitch sleeve during practice, opportunities; Non-shaded regions indicate pitch sleeve
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-
ence.
21.png" data-medium-image-
url="https://s3.amazonaws.com/
production.scholastica/public/attachments/
ecd78476-c6bf-43d7-b5bf-eb11bd20600e/
medium/
Figure_2._Lasagna_Plot:_Force_Plate_Use_Patterns_Adherence_Pattern2
1.png" alt="A graph of blue squares Description
automatically generated">
Figure 2. Lasagna Plot: Force Plate Use Patterns
Adherence Pattern 21
*: 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-
use; Plot Represents all uses recorded by device, and sorted by individual adherence.
Use of wearable and portable biomechanical pitch
sleeves may play an important role in understanding how
to prevent upper extremity injuries by tracking important
training load variables and proxy measures for fatigue in
order to establish their potential causal role. Although a
moderate uptake was observed, the pitch sleeve was uti-
lized in only 13% of the potential use opportunities among
players that initially used the pitch sleeve (uptake). Com-
pared to the pitch sleeve, a lower initial uptake was ob-
served for the force plate with 32% of athletes demon-
strating initial use during the Zrst week. However, a higher
adherence was observed, with 56% of these athletes
demonstrating continued use for all potential use opportu-
nities. Prior literature on feasibility or implementation out-
comes among wearable and portable technology in throw-
ing sports is nonexistent; in other widely studied
interventions such as neuromuscular training programs,
injury reductions have been observed, but the magnitude
of the effect differs based on adherence, demonstrating a
dose-response relationship.22‑25 Given the low to moderate
levels of uptake and continued adherence observed, stud-
ies using these devices to investigate causal relations or
for prognostic and diagnostic research may not be feasible
(e.g., high risk of potential non-response bias and high pro-
portion of missing data) until solutions to improve adher-
ence are identiZed.
Uptake and adherence of wearable and portable biome-
chanical devices are likely informed by athlete behaviors
in[uenced by team environments, personal knowledge of
the device, athlete motivation, and potential for health pro-
moting behavior that are dynamic as training situations
change.26,27 In this study, pitchers that reported use of
the pitching sleeve beyond the Zrst opportunity were less
likely to report an injury the prior season (14.3% vs 46.7%).
This Znding may be indicative of pitchers that present with
‘health promoting behaviors’ such as a regimented training
routine or regular engagement in arm care programs, and
thus have a propensity for adapting training devices that
may further inform these training practices.21,28 In con-
trast, athletes with an injury history may display hesitancy
in engaging in wearable technology due to fear of underper-
formance that the data may demonstrate (i.e., lower veloc-
ity). SpeciZc to the force plate, higher adherence observed
compared to the pitch sleeve may be due to decreased ath-
lete burden (i.e., less technology use sessions required),
or team training environment allowing for easy incorpora-
tion of weekly jump test sessions.27 Training optimization
strategies that incorporate wearable and portable technol-
ogy may need to align with team schedules, and ensure that
health promoting behavior is encouraged while providing
education that minimizes potential for fear avoidance be-
haviors to improve adherence and hence athletes’ buy-in.27,
29
Lasagna plots revealed patterns for pitch sleeve use
among users who demonstrated initial uptake, with a pitch
sleeve use pattern of twice per week. A majority of sessions
captured were bullpen sessions (43.1%) or long toss
(35.3%). Understanding biomechanical device use patterns
and frequency may help form recommendations that are
feasible for the athlete and for implementation in larger
studies. Prior research among neuromuscular training pro-
grams have demonstrated potential variability in program
frequency and intervention activities, highlighting the im-
portance of the need for subcomponent analysis of inter-
vention strategies.30 However, further qualitative research
is needed to highlight speciZc barriers or facilitators that
may inform this pattern of use, such as environmental con-
straints, or user knowledge.31
LIMITATIONS
This study is not without limitations. First, these data were
collected on a small sample, resulting in wide 95% CI for
adherence, uptake, and activity speciZc proportion mea-
sures. While these results provide some preliminary infor-
mation about the feasibility of these technologies, caution
is needed in generalizing the Zndings league wide within a
summer league season or among other levels of play. Sim-
ilarly, inferences on discerning differences between users
and non-users of the devices need to be further conZrmed
among larger studies or qualitative studies to discern barri-
ers and facilitators for device use. Third, due to league wide
restrictions in sleeve use among players in games, adher-
ence and uptake for in-game use could not be analyzed.
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
CONCLUSION
Understanding the feasibility of technologies in real sce-
narios is important to investigate whether these can be suc-
cessfully implemented in baseball athletes for large scale
studies or for routine monitoring. This study showed only
55% uptake with 13% adherence for the pitch sleeve, and
only 32% uptake with 46% adherence for the force plate. For
the pitch sleeve, players that demonstrated continued use
had a pattern of two times per week use for long toss and
bullpen sessions. Future research will need to identify spe-
ciZc barriers and facilitators to use of each device to better
inform their implementation in research and practice.
© The Author(s)
Submitted: October 01, 2024 CDT. Accepted: February 22, 2025
CDT. Published: May 01, 2025 CDT.
This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License
(CCBY-NC-4.0). View this license’s legal deed at https://creativecommons.org/licenses/by-nc/4.0 and legal code at https://cre-
ativecommons.org/licenses/by-nc/4.0/legalcode for more information.
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
REFERENCES
1. Shanley E, Rauh MJ, Michener LA, Ellenbecker TS.
Incidence of injuries in high school softball and
baseball players. J
Athl
Train. 2011;46(6):648-654.
doi:10.4085/1062-6050-46.6.648
2. Wasserman EB, Sauers EL, Register-Mihalik JK, et
al. The Zrst decade of web-based sports injury
surveillance: descriptive epidemiology of injuries in
US high school boys’ baseball (2005-2006 through
2013-2014) and National Collegiate Athletic
Association men’s baseball (2004-2005 through
2013-2014). J
Athl
Train. 2019;54(2):198-211.
doi:10.4085/1062-6050-239-17
3. Boltz AJ, Powell JR, Robison HJ, Morris SN, Collins
CL, Chandran A. Epidemiology of injuries in National
Collegiate Athletic Association men’s baseball:
2014-2015 through 2018-2019. J
Athl
Train.
2021;56(7):742-749. doi:10.4085/1062-6050-432-20
4. Posner M, Cameron KL, Wolf JM, Belmont PJ,
Owens BD. Epidemiology of Major League Baseball
injuries. Am
J
Sports
Med. 2011;39(8):1676-1680.
doi:10.1177/0363546511411700
5. Ciccotti MG, Pollack KM, Ciccotti MC, et al. Elbow
injuries in professional baseball: epidemiological
Zndings from the major league baseball injury
surveillance system. Am
J
Sports
Med.
2017;45(10):2319-2328. doi:10.1177/
0363546517706964
6. Cross KM, McMurray M, Hertel J, et al. Shoulder
and elbow injury rates and characteristics among
collegiate baseball student-athletes. Int
J
Sports
Phys
Ther. 2020;15(5):792-803. doi:10.26603/
ijspt20200792
7. Dowling B, McNally MP, Chaudhari AMW, Oñate
JA. A Review of workload-monitoring considerations
for baseball pitchers. J
Athl
Train. 2020;55(9):911-917.
doi:10.4085/1062-6050-0511-19
8. Arm Sleeve | Nextiles Website. Accessed August 28,
2024. https://www.nextiles.com/arm-sleeve
9. Anz AW, Bushnell BD, GrifZn LP, Noonan TJ, Torry
MR, Hawkins RJ. Correlation of torque and elbow
injury in professional baseball pitchers. Am
J
Sports
Med. 2010;38(7):1368-1374. doi:10.1177/
0363546510363402
10. Bushnell BD, Anz AW, Noonan TJ, Torry MR,
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
11. Claudino JG, Cronin J, Mezêncio B, et al. The
countermovement jump to monitor neuromuscular
status: A meta-analysis. J
Sci
Med
Sport.
2017;20(4):397-402. doi:10.1016/j.jsams.2016.08.011
12. Sakurai M, Qiao M, Szymanski DJ, Crotin RL.
Countermovement jump and momentum generation
associations to fastball velocity performance among
division I collegiate pitchers. J
Strength
Cond
Res.
2024;38(7):1288-1294. doi:10.1519/
JSC.0000000000004776
13. Mayberry J, Mullen S, Murayama S. What can a
jump tell us about elbow injuries in professional
baseball pitchers? Am
J
Sports
Med.
2020;48(5):1220-1225. doi:10.1177/
0363546520905543
14. Fleisig GS, Slowik JS, Wassom D, Yanagita Y,
Bishop J, Diffendaffer A. Comparison of marker-less
and marker-based motion capture for baseball
pitching kinematics. Sports
Biomech. Published online
May 19, 2022:1-10. doi:10.1080/
14763141.2022.2076608
15. Loushin SR, Verhoeven M, Christoffer DJ, Camp
CL, Kaufman KR. Are 4D motion sensors valid and
reliable for studying baseball pitching? Am
J
Sports
Med. 2023;51(6):1608-1614. doi:10.1177/
03635465231166423
16. Proctor EK, Silmere H, Raghavan R, et al.
Outcomes for implementation research: conceptual
distinctions, measurement challenges, and research
agenda. Adm
Policy
Ment
Health. 2011;38(2):65-76.
doi:10.1007/s10488-010-0319-7
17. Karsh BT. Beyond usability: designing effective
technology implementation systems to promote
patient safety. Qual
Saf
Health
Care.
2004;13(5):388-394. doi:10.1136/qhc.13.5.388
18. Markovic G, Dizdar D, Jukic I, Cardinale M.
Reliability and factorial validity of squat and
countermovement jump tests. J
Strength
Cond
Res.
2004;18(3):551-555. https://doi.org/10.1519/
1533-4287(2004)18%3C551:RAFVOS%3E2.0.CO;2
19. Kennedy RA, Drake D. The effect of acute fatigue
on countermovement jump performance in rugby
union players during preseason. J
Sports
Med
Phys
Fitness. 2017;57(10):1261-1266. doi:10.23736/
S0022-4707.17.06848-7
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
20. Swihart BJ, Caffo B, James BD, Strand M, Schwartz
BS, Punjabi NM. Lasagna plots: a saucy alternative to
spaghetti plots. Epidemiology. 2010;21(5):621-625.
doi:10.1097/EDE.0b013e3181e5b06a
21. Keats MR, Emery CA, Finch CF. Are we having fun
yet? Fostering adherence to injury preventive
exercise recommendations in young athletes. Sports
Med. 2012;42(3):175-184. doi:10.2165/
11597050-000000000-00000
22. Sugimoto D, Myer GD, Bush HM, Klugman MF,
Medina McKeon JM, Hewett TE. Compliance with
neuromuscular training and anterior cruciate
ligament injury risk reduction in female athletes: a
meta-analysis. J
Athl
Train. 2012;47(6):714-723.
doi:10.4085/1062-6050-47.6.10
23. Silvers-Granelli HJ, Bizzini M, Arundale A,
Mandelbaum BR, Snyder-Mackler L. Higher
compliance to a neuromuscular injury prevention
program improves overall injury rate in male football
players. Knee
Surg
Sports
Traumatol
Arthrosc.
2018;26(7):1975-1983. doi:10.1007/
s00167-018-4895-5
24. Steffen K, Emery CA, Romiti M, et al. High
adherence to a neuromuscular injury prevention
programme (FIFA 11+) improves functional balance
and reduces injury risk in Canadian youth female
football players: a cluster randomised trial. Br
J
Sports
Med. 2013;47(12):794-802. doi:10.1136/
bjsports-2012-091886
25. Emery CA, van den Berg C, Richmond SA, et al.
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
26. Lutfey KE, Wishner WJ. Beyond “compliance” is
“adherence”. Improving the prospect of diabetes care.
Diabetes
Care. 1999;22(4):635-639. doi:10.2337/
diacare.22.4.635
27. McKay CD, Verhagen E. “Compliance” versus
“adherence” in sport injury prevention: why
deZnition matters. Br
J
Sports
Med.
2016;50(7):382-383. doi:10.1136/
bjsports-2015-095192
28. Mcauley E, Courneya KS. Adherence to exercise
and physical activity as health-promoting behaviors:
Attitudinal and self-efZcacy in[uences. Applied
and
Preventive
Psychology. 1993;2(2):65-77. doi:10.1016/
S0962-1849(05)80113-1
29. Collado-Mateo D, Lavín-Pérez AM, Peñacoba C, et
al. Key factors associated with adherence to physical
exercise in patients with chronic diseases and older
adults: an umbrella review. Int
J
Environ
Res
Public
Health. 2021;18(4). doi:10.3390/ijerph18042023
30. Räisänen AM, van den Berg C, Owoeye OBA,
McKay CD, Emery CA. Running every time, planking
sometimes: youth adherence to a neuromuscular
training program. Transl
J
Am
Coll
Sports
Med.
2022;7(4). doi:10.1249/TJX.0000000000000209
31. Creaser AV, Clemes SA, Costa S, et al. The
acceptability, feasibility, and effectiveness of
wearable activity trackers for increasing physical
activity in children and adolescents: A systematic
review. Int
J
Environ
Res
Public
Health. 2021;18(12).
doi:10.3390/ijerph18126211
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
SUPPLEMENTARY MATERIALS
Supplemental File
Download: https://ijspt.scholasticahq.com/article/134013-using-biomechanical-devices-in-elite-baseball-pitchers-a-
preliminary-feasibility-study/attachment/275451.docx
Using Biomechanical Devices in Elite Baseball Pitchers: A Preliminary Feasibility Study
International
Journal
of
Sports
Physical
Therapy
