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Background: The purpose of this study was to investigate the effects of a home-based muscle power training program on muscle strength and power, functional performance, and physical activity behavior in individuals at least 6 months posttotal knee arthroplasty. Methods: Twelve men and women, mean age 63.9 (6.8) and 6 months to 2 years posttotal knee arthroplasty unilateral or bilateral), completed this study. Participants were randomly assigned to the home-based power training intervention or step-monitoring comparison group. Quadriceps muscle strength and power, 6-minute walk test, functional leg power, and habitual walking behavior (average daily steps, minutes per week of moderate to vigorous physical activity) were assessed before and after intervention and then compared between and within groups. Results: The authors found no significant differences between the groups on amount of change in any of the outcomes, but mixed results on differences within each of the groups on the outcome measures. Conclusion: There were no differences between the groups for amount of change on the outcome measures the authors selected. Although within group differences varied slightly for each group, it was not enough to justify the more expensive home-based power training over the simpler step-monitoring intervention. [ABSTRACT FROM AUTHOR]

Dynamic knee joint stability may be affected by the onset of metabolic fatigue during sports participation that could increase the risk for knee injury. The purpose of this investigation was to determine the effects of metabolic fatigue on knee muscle activation, peak knee joint angles, and peak knee internal moments in young women during 2 jumping tasks. Fifteen women (mean age: 24.6 [+ or -] 2.6 years) participated in one nonfatigued session and one fatigued session. During both sessions, peak knee landing flexion and valgus joint angles, peak knee extension and varus/valgus internal moments, electromyographic (EMG) muscle activity of the quadriceps and hamstrings, and quadriceps/hamstring EMG cocontraction ratio were measured. The tasks consisted of a single-legged drop jump from a 40-cm box and a 20-cm, up-down, repeated hop task. The fatigued session included a Wingate anaerobic protocol followed by performance of the 2 tasks. Although participants exhibited greater knee injury--predisposing factors during the fatigued session, such as lesser knee flexion joint angles, greater knee valgus joint angles, and greater varus/ valgus internal joint moments for both tasks, only knee flexion during the up-down task was statistically significant (p = 0.028). Metabolic fatigue may perhaps predispose young women to knee injuries by impairing dynamic knee joint stability. Training strength-endurance components and the ability to maintain control of body movements in either rested or fatigued situations might help reduce injuries in young women athletes. KEY WORDS ACL, hop, landing; neuromuscular, drop jump

Byline: Alexis Ortiz, PT, PhD, SCS, CSCS (Physical Therapy Program, School of Health Professions, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, alexisortiz@cprs.rcm .upr.edu, Department of Physical Education [...]

Background and Purpose: Test-retest reliability has not been previously reported for the instrumented modified Clinical Test of Sensory Interaction on Balance (i-mCTSIB) utilizing the Neurocom Very Simple Rehab (VSR) Sport force plate. The VSR Sport is a portable, relatively inexpensive force plate system utilized to assess postural stability in various populations. Therefore, the purpose of this study is to determine the test-retest reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of the i-mCTSIB when assessed using the VSR Sport in a sample of healthy, older adults. Methods: This was a methodological study with 20 healthy, older adults between the ages of 65 and 85 years. Participants were tested twice in a single session on the i-mCTSIB utilizing the VSR Sport force plate. The mean sway velocity (°/s) measurements for the 2 trials were compared for each test condition to compute intraclass correlation coefficients (ICCs) for each measurement. Standard error of measurements and minimal detectable change at the 90% confidence level (MDC90) were also calculated. Results and Discussion: The test-retest reliability for each of the test conditions ranged from 0.762 to 0.909, which can be broadly interpreted as good-to-excellent reliability. The ICC(2,k) value of 0.898 for the composite score can also be interpreted as excellent reliability. Our results revealed small SEM for all test conditions (SEM = 0.060-0.101) except for the foam surface, eyes closed condition, with an SEM of 0.481. The MDC90 results for all testing conditions ranged from 0.140 to 0.285 except for the foam surface, eyes closed condition, which had an MDC90 = 1.12. Conclusions: The i-mCTSIB measurements utilizing the VSR Sport demonstrated good-to-excellent test-retest reliability. The clinical relevance of this study is that it demonstrates that the VSR Sport is a feasible alternative to other more expensive computerized systems used for the assessment of postural sway. MDC90 scores allow interpretation of change in i-mCTSIB scores following intervention. Practice effects may have contributed to the larger MDC90 for sway scores in the foam surface, eyes closed condition. [ABSTRACT FROM AUTHOR]

Background: Aerobic and muscle-strengthening activities are related to morbidities and mortality. Resistance exercise/strength training items are included in national surveys, but the manner in which muscle-strengthening activity is queried varies among these surveys. Purpose: The purpose of this study was to use different selfreport measures to examine the prevalence of meeting the 2008 Physical Activity Guidelines for Americans regarding muscle-strengthening activities among women. Methods: We surveyed 606 community-dwelling women at 4 points in time across a 1.5- to 3-year time period to determine whether the respondents met the national physical activity guidelines for performing muscle-strengthening activities ≥ 2 days per week. Results: Results were consistent across time but depended on the manner in which the question was asked. If asked to reflect over the past month or a general question about the typical number of days engaged, approximately 40% of women reported engaging in ≥ 2 days per week of resistance exercise/strength training. However, when reports were obtained weekly for 13 weeks, only approximately 18% of respondents met the guidelines. Conclusion: Results indicate that the timing and nature of questioning can substantially influence the selfreported prevalence of muscle-strengthening physical activities for community-dwelling women. [ABSTRACT FROM AUTHOR]

Objective: To identify whether patients in the subacute stage of stroke, with foot drop, would have better gait outcomes when using a double-adjustable AFO (DA AFO) or a posterior leaf spring AFO (PLS AFO) at baseline without practice and to determine whether one week of practice would significantly change gait outcomes with either of the AFOs. Design: Within-subject 2 × 2 repeated measures design. Setting: Postacute and outpatient rehabilitation center. Participants: Twenty individuals with mean age of 57 years (SD: 12.0 years) with subacute stroke. Interventions: Participants were measured using DA AFO and PLS AFO at baseline. Follow-up measurements were taken after one week of practice with each type of AFO in randomly assigned order. Outcome Measures: Gait endurance (6-Minute Walk Test (6MWT)), gait symmetry, and gait velocity at self-selected and fast-paced velocity measured using GAITRite gait analysis system and patient report of AFO preference. Results: At baseline, no significant differences were found between the 2 AFOs (P > 0.05). There was no significant interaction (P > 0.05) of AFO and practice for gait endurance, symmetry, and velocity. Main effect of practice was significant for gait endurance (P < 0.001), self-selected velocity (P = 0.001), and fast-paced velocity (P < 0.001). In all, 16 participants preferred using DA AFO for walking. Conclusions: No difference between DA AFO and PLS AFO was found on measures of gait endurance, symmetry, and velocity at baseline or after practice. With practice over time, participants improved in gait endurance and velocity regardless of AFO type. [ABSTRACT FROM AUTHOR]

Context: The Star Excursion Balance Test (SEBT) is often used to train and assess dynamic balance and neuromuscular control. Few studies have examined hip- and thigh-muscle activation during the SEBT. Objective: To quantify hip- and thigh-muscle activity during the SEBT. Design: Repeated measures. Setting: Laboratory. Participants: 22 healthy individuals, 11 men and 11 women. Methods: EMG measurements were taken as participants completed 3 trials of the anterior (A), medial (M), and posteromedial (PM) reach directions of the SEBT. Main Outcome Measures: Mean EMG data (% maximal voluntary isometric contraction) from the gluteus medius (Gmed), gluteus maximus (Gmax), and vastus medialis (VM) were measured during the eccentric phase of each SEBT reach direction. Test-retest reliability of EMG data across the 3 trials in each direction was calculated. EMG data from each muscle were compared across the 3 reach directions. Results: Test-retest reliability ranged from ICC3,1 values of .91 to .99. A 2-way repeated-measure ANOVA revealed a significant interaction between muscle activation and reach direction. One-way ANOVAs showed no difference in GMed activity between the A and M directions. GMed activity in the A and M directions was greater than in the PM direction. There was no difference in GMax and VM activity across the 3 directions. Conclusion: GMed was recruited most effectively when reaching was performed in the A and M directions. The A, M, and PM directions elicited similar patterns of muscle recruitment for the GMax and VM. During all 3 SEBT directions, VM activation exceeded the 40-60% threshold suggested for strengthening effects. GMed activity also exceeded the threshold in the M direction. GMax activation, however, was below the 40% threshold for all 3 reach directions, suggesting that performing dynamic lower extremity reaching in the A, M, and PM directions may not elicit strengthening effects for the GMax. [ABSTRACT FROM AUTHOR]

Background: Self-report measures have been validated and are widely used. Interest currently lies in the development of simple, valid methods that can be used in any location to determine level of PA in large populations/samples. The purpose of this report is to illustrate tracking of physical activity behaviors and musculoskeletal injury reports on a weekly basis via the Internet. Methods: The Women's Injury Study (WIN) methodology includes use of BRFSS-related physical activity items that are completed online by more than 900 women weekly for an average of 3 years. Results: With more than 45,000 weekly physical activity and injury logs, the percentage of total logs submitted via online records is 91%. Self-reported pedometer steps are consistent with similar, smaller research samples. Conclusions: This report suggests that Internet tracking is a viable means of assessing nearly real-time physical activity, describes the process of developing and monitoring self-reported physical activity behaviors via the Internet, and provides recommendations for others considering such methods. [ABSTRACT FROM AUTHOR]

Background: Effect of muscle strength and balance on falls has not been well researched in healthy older women. The purpose of this study was to compare lower extremity strength and balance in older healthy women during each decade of life and to investigate which factors are different in women with a history of falling. Methods: We retrospectively studied 240 women age 50-89 y. Measures of muscle strength, postural stability, and incidence of falls over the past year were obtained from client charts at Texas Woman's University's Health Promotion & Research Center from 1996 to 2002. Results: Strength declined signify scantly with age in all muscle groups except knee extensors. Age, hip flexor and abductor strength, and postural stability were signify scantly different in women who had fallen. Conclusions: Strength decline was not consistent across muscle groups. Women who were older, had less hip flexor or abductor strength, or less balance were more likely to have fallen. [ABSTRACT FROM AUTHOR]

Background: There is evidence that Botulinum Toxin-A (BTX-A) reduces focal spasticity associated with equinovarus to improve gait in patients poststroke. However, there is little research examining whether gait improvements are maintained after the effectiveness period of BTX-A injections. The purpose of this observational study was to determine whether there was a difference in gait parameters in three patients before BTX-A injection versus four and ten weeks after. Case Series: Three women, ages 63, 60, and 42 postischemic stroke with hemiparesis and equinovarus underwent measurements for: plantar flexor spasticity, ankle dorsiflexion ROM, temporal–spatial gait parameters, and gait endurance. All participants improved in ankle ROM. At week 10, spasticity had returned to initial measurement levels in participants A and C. Base of support and step length symmetry ratios did not improve following injections. Participants A and B, who received physical therapy during the study, showed modest gains in gait endurance and velocity. Conclusion: Although BTX-A injections improved spasticity, this improvement did not translate to gait outcomes. Addition of physical therapy interventions appeared to improve gait outcomes in this case series. We suggest future randomized control studies to compare effects of physical therapy alone to BTX-A combined with physical therapy on gait outcomes. [ABSTRACT FROM AUTHOR]

Background/Aims: Dual tasking exacerbates gait deficits in people with Parkinson's disease. This pilot study aimed to examine the effect of aerobic exercise on dual-task gait in individuals with Parkinson's disease and begin to identify the impact of volitional pedal rate. act Methods: Twenty people with Parkinson's disease were recruited and tested at baseline, post-intervention, and follow-up for motor (Unified Parkinson's Disease Rating Scale) and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status) and dual-task gait (Time Up and Go) conditions (manual and cognitive). A 12-week aerobic exercise intervention of cycle ergometry was carried out three times a week for 60 minutes each session. To assess our intervention, separate repeated measures of analysis of variance were conducted. As determined a priori, to assess the impact of volitional pedal rate, participants were divided after the intervention into a high-pedal rate group (>60 rpm) and a low-pedal rate group (≤60 rpm) based upon average maximal pedal rate throughout the intervention and analysed with the Mann Whitney U test and Related Samples Wilcoxon Signed Rank Test. Findings: Overall, motor function (P=0.580), cognitive function (P=0.077), and motor-cognitive interplay (P=0.168) did not improve after aerobic exercise. However, pedal rate groups were different for TUGmanual and TUGcognitive, but not on motor or cognitive function. Only low-pedal rate group improved over time (P=0.028 on TUGmanual) and demonstrated reduced dual task cost after the aerobic exercise (>Minimal Detectible Change of 18.1%). Conclusions: Though the low-pedal rate group experienced greater motor-cognitive interference, persons who pedalled at the slower rate demonstrated the most improvement in dual-task activities. [ABSTRACT FROM AUTHOR]

Aims: To identify if dual task gait differed between persons with PD (high versus low physical activity levels) and healthy peers. Methods: Persons with PD (n = 19) and matched healthy controls (HC) (n = 19) completed Timed Up and Go single (TUGalone) and dual task conditions (TUGmotor/TUGcognitive), Beck Depression Inventory-II (BDI-II), and step activity monitoring. Participants with PD were classified low active (LAPD; n = 11) or high active (HAPD; n = 8) using HC mean steps/day cut-point (M = 4,658). Results: PD groups were equivalent for mental status, disease severity, and PD duration. LAPD steps/day (M = 2,482.00 ± 1,466.33) differed from HAPD (M = 5,675.13 ± 1,198.93) and HC (M = 4,657.74 ± 1,604.99) (p = 0.001). LAPD completed the TUG slower than HAPD and HC (MANOVA, p < 0.02; post-hoc analysis, p < 0.04). BDI-II scores were greater in LAPD than HC (p = 0.013). Conclusions: Physical activity impacted mobility and depression. HAPD were similar to HC in walking activities and affect but LAPD walked slower with higher levels of depression. [ABSTRACT FROM AUTHOR]

Background: Researchers have demonstrated moderate evidence for the use of exercise in the treatment of subacromial impingement syndrome (SAIS). Recent evidence also supports eccentric exercise for patients with lower extremity and wrist tendinopathies. However, only a few investigators have examined the effects of eccentric exercise on patients with rotator cuff tendinopathy. Purpose: To compare the effectiveness of an eccentric progressive resistance exercise (PRE) intervention to a concentric PRE intervention in adults with SAIS. Study Design: Randomized Clinical Trial Methods: Thirty-four participants with SAIS were randomized into concentric (n = 16, mean age: 48.6 ± 14.6 years) and eccentric (n = 18, mean age: 50.1 ± 16.9 years) exercise groups. Supervised rotator cuff and scapular PRE's were performed twice a week for eight weeks. A daily home program of shoulder stretching and active range of motion (AROM) exercises was performed by both groups. The outcome measures of the Disabilities of the Arm, Shoulder, and Hand (DASH) score, pain-free arm scapular plane elevation AROM, pain-free shoulder abduction and external rotation (ER) strength were assessed at baseline, week five, and week eight of the study. Results: Four separate 2x3 ANOVAs with repeated measures showed no significant difference in any outcome measure between the two groups over time. However, all participants made significant improvements in all outcome measures from baseline to week five (p < 0.0125). Significant improvements also were found from week five to week eight (p < 0.0125) for all outcome measures except scapular plane elevation AROM. Conclusion: Both eccentric and concentric PRE programs resulted in improved function, AROM, and strength in patients with SAIS. However, no difference was found between the two exercise modes, suggesting that therapists may use exercises that utilize either exercise mode in their treatment of SAIS. [ABSTRACT FROM AUTHOR]

The article focuses on a randomized controlled trial which explores the effects of weight bearing aerobic exercise and resistance strengthening exercise on postmenopausal women with low bone mass. It cites three risk factors for fall-related fracture in women such as decreased strength, poor balance and low bone mineral density. Furthermore, it suggests the significance of hip extensor strength for postural stability and fall prevention.

Hamstring stretching is a common practice in physical therapy to change not only hamstring muscle length (HML), but also lumbar flexion range of motion (LROM) or lumbar curvature (LC). Yet limited published research compares the effectiveness of two commonly used hamstring stretch positions, sitting and standing. The purposes of this study were to determine the effect of (1) stretch position on HML; and 2) HML on LROM and LC. Thirty-six participants ( M==44.8 years, SD==17.1) with short HML (i.e., with shortness for men ≥≥45°° and for women ≥≥24°° of active knee flexion with 90°° hip flexion) were measured for HML, LROM, and LC; randomly allocated to one of three groups: (1) hamstring stretching in sitting (SI); (2) standing (ST); or (3) no stretching (control); and remeasured after 4 weeks. Participants in the stretching groups performed two 30-second static stretches 4 days per week for 4 weeks. Multivariate analysis of covariance (MANCOVA) showed significance between the stretching groups and nonstretching group for HML only. Nonsignificance was shown for HML between the stretch positions (i.e., SI--active knee extension (AKE) and ST-AKE), indicating that both were equally effective for increasing HML. However, there was no change in LROM or in LC even though HML increased. [ABSTRACT FROM AUTHOR]

The article discusses a study which established the normotive values of lumbar flexion and extension for women of different age and racial groups. The study included free-living women, aged 20 to 83, who underwent orthopedic examinations. It found that the normotive values of lumbar extension are different between white and African American women. It also discovered that lumbar flexion and extension values differ among age groups.

The article discusses the results of a study into the concordance of a classification system for lumbar spine syndrome in patients with chronic lower back pain (LBP) based on movement impairment. The study reportedly finds 75 percent agreement between examiners who classified patients with chronic LBP into one of five lumbar spine movement categories.

Introduction: Both gait speed and gait endurance directly impact independence and community engagement for individuals with Parkinson's disease (PD). However, factors accounting for variability in gait speed and gait endurance performance are unclear. The purpose of this study was to investigate whether key factors associated with gait speed in individuals with PD also predicted gait endurance.Methods: Community dwelling ambulatory individuals with PD were recruited for a single session. Key measures included 10 Meter Walk Test (10MWT) and 6 Minute Walk Test (6MWT) and key factors: age, disease severity [Movement Disorders Society United Parkinson's Disease Rating Scale (motor scale only) (MDS-UPDRS motor)], plantar flexor strength [Calf Raise Senior (CRS)], fatigue [Fatigue Severity Scale (FSS)], cognition [Montreal Cognitive Assessment (MoCA)], and balance [Four Square Step Test (FSST)]. Multiple linear regression analyses were conducted to determine clinical relationships.Results: Seventy-two individuals with PD (mean (standard deviation) (age = 70.83 (7.91) years; 50 males; MDS-UPDRS motor = 30.67 (13.50)) completed all assessments. The model predicting gait speed was significant, F(6, 65) = 15.143, p <.001, accounting for 54 % of the variance. Of the predictor variables age, MDS-UPDRS motor, CRS, MoCA and FSST scores were significant predictors. The model predicting gait endurance was significant, F(6, 65) = 15.608, p <.001, accounting for 55 % of the variance. Of the predictor variables, age, MDS-UPDRS motor scale, and CRS scores were significant predictors.Discussion: Gait speed and gait endurance are similarly influenced by age, motor impairment, and plantarflexion strength. However, cognition and balance were predictors only of gait speed, which may suggest unique task differences exist between gait speed and gait endurance. [ABSTRACT FROM AUTHOR]