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To examine the quadriceps strength (QUADS) on the surgical (SURG) and non-surgical (Non-SURG) limbs in adolescent male and female athletes at pre-operative (PRE), 12 weeks post-operative (12WK), and return to sport (RTS) time points following ACL injury and reconstruction. Prospective cohort study design. Clinical Research Laboratory. 66 adolescent athletes. Isokinetic QUADS of the SURG and Non-SURG limbs at the PRE, 12WK, and RTS time points were assessed and compared between each time point. Both male and female participants had significantly lower 12 WK QUADS in the SURG limb than the PRE QUADS, but the RTS QUADS was significantly greater than the 12WK QUAD (p < 0.05). However, only female participants had greater RTS QUADS as compared to the PRE QUADS (p < 0.001). For the Non-SURG limb, only male participants had a significant improvement over time (PRE vs RTS; p < 0.001). Adolescent males and females differ in their QUADS recovery across the continuum of care following ACLR. Clinicians should consider this pattern of recovery when treating adolescent males and females. • Adolescent males and females differ in their QUADS recovery in SURG and Non-SURG limbs following ACLR. • For the SURG limb, only female athletes made a significant improvement of the QUAD strength from PRE to RTS. • For the Non-SURG limb, only male athletes made significant improvement of the QUAD strength from PRE to RTS. • The LSI may overestimate the QUAD strength of the SURG limb. [ABSTRACT FROM AUTHOR]

To determine the validity and inter-session reliability of the Vail Sport Test™. Cohort study-exploratory methodological research design. Clinical Research Laboratory. Forty-eight participants who underwent ACL-R. Participants performance on the Vail Sport Test™ was graded by an experienced rater in real-time, and simultaneously recorded by a three-dimensional (3D) motion capture system. Construct validity was assessed using the reference standards of the camera system and the IKDC short form. To determine the between-day reliability, a subset of participants returned to repeat the test. There were no significant difference between the scores collected in real-time and from the kinematic data on the involved limb (p = 0.222). There was a significant difference for the uninvolved limb (p = 0.015). There was no significant difference between the scores collected in real time and those of the IKDC (p = 0.885). Good inter-session reliability (ICC = 0.787) was found for the involved limb. The results of this study showed good reliability and partially support the validity of the Vail Sport Test as a measure of readiness to return to play. • The Vail Sports Test is utilized as part of return to play testing to assist in clinical decision making. • It was found to be valid as compared to motion capture grading for the injured limb. • It was found to have good inter-session reliability and previously shown to have good intra-rater reliability. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the psychometric properties of pressure pain threshold (PPT) testing in adults with and without neck-shoulder pain and tenderness and to compare the differences in PPT measurements between the seated and prone positions. Thirty asymptomatic adults and 30 symptomatic patients with intermittent neck-shoulder pain and tenderness completed the study. A pressure algometer was used to assess PPTs at specific points on the middle deltoid, levator scapulae, and upper trapezius muscles of the dominant side of the asymptomatic individuals and the painful side of the patients. Four trials were performed on each muscle in both the seated and prone positions. To determine between-day reliability, a subset of the participants returned to repeat the testing. The intraclass correlation coefficients showed good to excellent within-session reliability and fair to excellent between-day reliability of PPT measurements in both the seated and prone positions for both groups. There were significant differences between groups for all muscles in both positions (P <.05) except for the upper trapezius muscle in the prone position. In addition, significant differences were found between the 2 testing positions for the middle deltoid and upper trapezius muscles in the symptomatic group and for the middle deltoid muscle in the asymptomatic group. The results of the study suggest that PPT testing could be useful for distinguishing individuals with and without neck-shoulder pain and tenderness. Further, the patient's position should be considered when testing PPT, specifically at the middle deltoid or upper trapezius muscles. [ABSTRACT FROM AUTHOR]

Abstract Background Reduced lumbar multifidus (LM) muscle contraction has been observed in patients with low back pain (LBP). Clinicians often use various strategies to ensure LM activation, including tactile feedback and verbal instruction. However, the effects of tactile feedback on muscle activation have not been studied previously. Therefore, the purpose of this study was to investigate whether or not tactile feedback would increase LM muscle activity in adults with and without LBP. Methods Twenty asymptomatic adults and 20 patients with existing LBP completed the study. Two electromyographic (EMG) electrodes were applied to both sides of the LM at the L5 segment. EMG activity was collected three times at rest with and without tactile feedback, then five times during contralateral arm lifts with and without tactile feedback. The tactile feedback was applied by direct and continuous hand contact to the bilateral LM over the lumbosacral area. Lastly, two 5-second trials of maximum voluntary isometric contraction (MVIC) during a bilateral arm lift were performed. EMG activity collected at rest and during contralateral arm lifts was normalized to that collected during MVIC. Normalized EMG values of the right side of the asymptomatic group and the painful side of the LBP group were used for data analysis. Results Statistical analysis showed significantly decreased LM EMG activity with tactile feedback both at rest and during contralateral arm lifts compared to LM EMG activity without tactile feedback. There was no difference in LM EMG between the asymptomatic and the LBP groups. Conclusions The results of the study showed that adding tactile stimulation to verbal instruction appeared to provide an inhibitory effect on LM activity in both asymptomatic healthy adults and patients with LBP. Contrary to common belief, tactical feedback via direct hand contact may reduce LM muscle recruitment, and may lessen the desired treatment effect. [ABSTRACT FROM AUTHOR]

Objective The purposes of this study were to determine the reliability of using a skin-surface device to measure global and segmental thoracic and lumbar spine motion in participants with and without low back pain (LBP) and to compare global thoracic and lumbar motion between the 2 groups. Methods Forty participants were included in the study (20 adults with LBP and 20 age- and sex-matched adults without LBP). On the same day, 2 raters independently measured thoracic and lumbar spine motion by rolling a skin-surface device along the spine from C7 to S3, with participants at their end range of standing flexion and extension. Results In participants with LBP, global thoracic and lumbar flexion and extension end-range motion testing yielded fair-to-high intrarater reliability (intraclass correlation coefficient [ICC] = 0.76-0.96) and good-to-high interrater reliability (ICC = 0.82-0.98). Interrater reliability was fair to high (ICC = 0.77-0.93) for segmental lumbar flexion measurements in participants with LBP. No significant differences were found in global thoracic and lumbar flexion or extension end-range mobility between participants with and without LBP. Conclusions Global thoracic and lumbar end-range motion measurement using a skin-surface device has acceptable reliability for participants with LBP. Reliability for segmental end-range motion measurement was only acceptable for lumbar flexion in participants with LBP. [ABSTRACT FROM AUTHOR]

Objective To determine whether a relationship exists between sagittal plane hip range of motion loss and sagittal plane lumbar Movement System Impairment (MSI) categories in patients with low back pain (LBP). Design Correlational study. Setting University outpatient physical therapy clinic. Participants Subjects (N=40) with LBP. Interventions Not applicable. Main Outcome Measures Classification into a flexion- or extension-based lumbar MSI category, and bilateral passive hip flexion and extension range of motion testing. Using predefined criteria, subjects in each MSI category were subclassified into 1 of 3 hip stiffness categories: (1) a considerable loss of either flexion or extension (pattern A); (2) a considerable loss of both flexion and extension (pattern B); or (3) minimally limited flexion or extension (pattern C). Results Pattern A occurred in 23 (57.5%) subjects, with the primary direction of hip motion loss agreeing with the MSI category 78.3% of the time (φ=.56; P =.007). Pattern B occurred in 10 (25%) subjects, with the primary direction of hip motion loss agreeing with the MSI category 70% of the time (φ=.47; P =.197). Pattern C occurred in 7 (17.5%) subjects, with the primary direction of hip motion limitation agreeing with the MSI category 42.9% of the time (φ=−.40; P =.290). Conclusions Considerable unidirectional hip motion loss in the sagittal plane was a common finding among subjects with LBP and yielded a strong positive relationship with the same direction MSI category. These results may inform future studies investigating whether treatment of hip stiffness patterns could improve outcomes in LBP management. [ABSTRACT FROM AUTHOR]