Search

The purpose of this study was to develop a three-dimensional (3D) motion analysis based anatomical wrist joint coordinate system for measurement of in-vivo wrist kinematics. The convergent validity and reliability of the 3D motion analysis implementation was quantified and compared with manual and electrogoniometry techniques on 10 cadaveric specimens. Fluoroscopic measurements were used as the reference. The 3D motion analysis measurements (mean absolute difference [MAD] = 3.6°) were significantly less different (P < .005) than manual goniometry (MAD = 5.7°) but not (P = .066, power = 0.45) electrogoniometry (MAD = 5.0°) compared with fluoroscopy. The intraclass correlation coefficient (ICC[2,1]) was highest for 3D motion analysis compared with manual and electrogoniometry, suggesting better reliability for this technique. To demonstrate the utility of this new wrist joint coordinate system, normative data from 10 healthy subjects was obtained while throwing a dart. [ABSTRACT FROM AUTHOR]

The purpose of our study was to establish criterion-related validity and repeatability of a shoulder biomechanics testing protocol involving an electromagnetic tracking system (Flock of Birds [FoB]). Eleven subjects completed humeral elevation tasks in the sagittal, scapular, and frontal planes on two occasions. Shoulder kinematics were assessed with a digital inclinometer and the FoB. Intrasession and intersession repeatability for orthopedic angles, and humeral and scapular kinematics ranged from moderate to excellent. Correlation analyses revealed strong relationships between inclinometer and FoB measures of humeral motion, yet considerable mean differences were noted between the measurement devices. Our results validate use of the FoB for measuring humeral kinematics and establish our testing protocol as reliable. We must continue to consider factors that can impact system accuracy and the effects they may have on kinematic descriptions and how data are reported. [ABSTRACT FROM AUTHOR]

Context: A valgus position of the knee on functional loading tasks has been reported to be associated with patellofemoral-joint pain. Training programs to reduce knee valgus have been shown to be effective but take time. It would appear logical to use a brace or strap to help control this knee motion to reduce symptoms. Objective: To assess the impact of the SERF strap on knee valgus and patellofemoral-joint pain. Design: Repeated measures. Setting: University human performance laboratory. Participants: 12 women with patellofemoral pain (mean age 24 ± 3.2 y). Intervention: Application of SERF strap. Main Outcome Measures: Knee-valgus angle on single-leg squat and step landing and visual analog scale pain score. Results: The application of the SERF brace significantly reduced the pain (P < .04) and knee valgus (P < .034) during both tasks. Conclusion: The SERF brace brings about a significant reduction in pain during functional tasks. Although the brace brought about a significant reduction in knee valgus, this failed to exceed the smallest-detectable-difference value, so the difference is likely to be related to measurement error. The mechanism as to why this the reduction in pain occurs therefore remains unclear, as this study in line with many others failed to demonstrate meaningful changes in kinematics that could provide an obvious explanation. [ABSTRACT FROM AUTHOR]

Context: Limited ankle DF (DF) range of motion (ROM) resulting from restricted gastrocnemius and soleus mobility is associated with a variety of lower extremity pathologies. Several techniques are used clinically to measure ankle DF. Objectives: To evaluate the reliability and minimal detectable change of DF ROM measurement, determine whether there is a difference in measured DF between techniques, and quantify the electromyographic (EMG) activity of the soleus and tibialis anterior muscles associated with the techniques. Design: Repeated measures. Setting: Controlled laboratory setting. Participants: 39 healthy subjects, age 22-33. Main Outcome Measures: DF measurements using 5 different techniques including active and passive DF with the knee extended and flexed to 90° and a modified lunge. EMG activity of the soleus and anterior tibialis muscles. Results: Intrarater reliability values (ICC3,1) ranged from .68 to .89. Interrater reliability (ICC2,1) ranged from .55 to .82. ICCs were the greatest with the modified lunge. The minimal detectable change (MDC95) ranged from 6° to 8° among the different techniques. A significant difference in DF ROM was found between all methods. Measurements taken with active DF were greater than the same measures taken passively. The lunge position resulted in greater DF ROM than both active and passive techniques. EMG activity of the soleus was greater with active DF and the lunge than with passive DF. Conclusions: The modified lunge, which demonstrated excellent intrarater and interrater reliability, may best represent maximal DF. Active end-range DF was significantly greater than passive end-range DF when measured at either 0° or 90° knee flexion. Greater active DF was not explained by inhibition of the soleus. Finally, using the modified lunge, a difference between 2 measurements over time of 6° or more suggests that a meaningful change has occurred. [ABSTRACT FROM AUTHOR]

The effectiveness of wrist guards and modifying elbow posture for reducing impact-induced accelerations at the wrist and elbow, for the purpose of decreasing upper extremity injury risk during forward fall arrest, has not yet been documented in living people. A seated human pendulum was used to simulate the impact conditions consistent with landing on outstretched arms during a forward fall. Accelerometers measured the wrist and elbow response characteristics of 28 subjects following impacts with and without a wrist guard, and with elbows straight or slightly bent. Overall, the wrist guard was very effective, with significant reductions in peak accelerations at the elbow in the axial and off-axis directions, and in the off-axis direction at the wrist by almost 50%. The effect of elbow posture as an intervention strategy was mixed; a change in magnitude and direction of the acceleration response was documented at the elbow, while there was little effect at the wrist. Unique evidence was presented in support of wrist guard use in activities like in-line skating where impacts to the hands are common. The elbow response clearly shows that more proximal anatomical structures also need to be monitored when assessing the effectiveness of injury prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Voluntary posterior instability of the shoulder is a rare condition in which the patient is able to cause a subluxation by voluntary muscle activation. A shoulder rehabilitation program aimed to correct abnormal muscle patterns and restore correct scapular motion may provide good results and improve the quality of life of these patients. Methods: Fifteen subjects (six males, nine females; mean age 19 years) underwent physical examination and clinical tests [Disability of the Arm, Shoulder and Hand (DASH) score, Shoulder Pain and Disability Index (SPADI), and modified Rowe score] and compiled the patient global assessment (PGA). Articular or rotator cuff lesions were excluded by X-rays and MRI. The rehabilitation program included three phases: (1) assessment and correction of abnormal muscle patterns, (2) restoration of correct scapular motion, and (3) strengthening of scapular and posterior glenohumeral muscles. Follow-up was at 3, 6, 12, and 24 months. Results: DASH and SPADI scores improved significantly at 3 ( p < 0.01), 6 ( p < 0.009), 12 ( p < 0.001), and 24 months ( p < 0.001). The Rowe score was fair at 3 months and good at 6, 12, and 24 months. Active flexion, abduction, and external rotation increased at all follow-up points ( p < 0.01), whereas internal rotation remained unchanged ( p > 0.05). PGA values were high. Compliance was good without serious adverse events reported during the treatment. A correlation was found between age and DASH changes (Spearman's ρ −0.56; p = 0.0455). Conclusions: Our findings stress the value of a rehabilitation program that teaches subjects with voluntary instability how to correct abnormal muscle patterns to restore scapular motion, and the importance of adopting home rehabilitation exercises as a part of the normal lifestyle. [ABSTRACT FROM AUTHOR]

Background/Purpose: The squat is a fundamental movement of many athletic and daily activities. Methods to clinically assess the squat maneuver range from simple observation to the use of sophisticated equipment. The purpose of this study was to examine the reliability of Coach's Eye (TechSmith Corp), a 2-dimensional (2D) motion analysis mobile device application (app), for assessing maximal sagittal plane hip, knee, and ankle motion during a functional movement screen deep squat, and to compare range of motion values generated by it to those from a Vicon (Vicon Motion Systems Ltd) 3-dimensional (3D) motion analysis system. Methods: Twenty-six healthy subjects performed three functional movement screen deep squats recorded simultaneously by both the app (on an iPad [Apple Inc]) and the 3D motion analysis system. Joint angle data were calculated with Vicon Nexus software (Vicon Motion Systems Ltd). The app video was analyzed frame by frame to determine, and freeze on the screen, the deepest position of the squat. With a capacitive stylus reference lines were then drawn on the iPad screen to determine joint angles. Procedures were repeated with approximately 48 hours between sessions. Results: Test-retest intrarater reliability (ICC3,1) for the app at the hip, knee, and ankle was 0.98, 0.98, and 0.79, respectively. Minimum detectable change was hip 6°, knee 6°, and ankle 7°. Hip joint angles measured with the 2D app exceeded measurements obtained with the 3D motion analysis system by approximately 40°. Differences at the knee and ankle were of lower magnitude, with mean differences of 5° and 3°, respectively. Bland-Altman analysis demonstrated a systematic bias in the hip range-of-motion measurement. No such bias was demonstrated at the knee or ankle. Conclusions: The 2D app demonstrated excellent reliability and appeared to be a responsive means to assess for clinical change, with minimum detectable change values ranging from 6° to 7°. These results also suggest that the 2D app may be used as an alternative to a sophisticated 3D motion analysis system for assessing sagittal plane knee and ankle motion; however, it does not appear to be a comparable alternative for assessing hip motion. [ABSTRACT FROM AUTHOR]

Background: Pitchers may be at greater risk of injury in comparison to other overhead throwing athletes due to the repetition of the pitching motion. It has been reported that approximately 30% of all baseball injuries occur in the lower body. This may be related to limited hip mobility, which can compromise pitching biomechanics while placing excessive stress on the trunk and upper quarter. Hip motion and strength measurements have been reported in professional baseball pitchers but have not been reported in collegiate pitchers. Purpose: The purpose of this study was to report preliminary findings for passive hip motion and isometric hip muscle strength in collegiate pitchers and compare them to previously published values for professional level pitchers. Study Design: Cross sectional study Methods: Twenty-nine collegiate baseball pitchers (age = 20.0 + 1.4 years, height = 1.88 + 0.06 m; weight = 89.3 + 10.7 kg; body mass index = 25.3 + 2.5 kg/m2) were recruited. Subjects were assessed for hip internal rotation (IR) and external rotation (ER) passive motion, hip anteversion or retroversion, gluteus maximus, gluteus medius, hip internal rotator, hip external rotator strength, and lumbo-pelvic control with the prone active hip rotation test as described by Sahrmann. Statistical analysis included calculation of subject demographics (means and SD) and use of a two-tailed t-test (p >0.05). Results: Fifty-two percent of the right-handed and 50% of the left-handed pitchers demonstrated poor lumbo-pelvic motor control with an inability to stabilize during active hip IR and ER even though isolated strength deficits were not detected at a significant level. There were no significant differences in hip passive motion or gluteus medius strength between right and left-handed pitchers. Differences did exist between collegiate data and previously published values for professional pitchers for IR motion measured in prone and gluteus maximus strength. Hip retroversion was present in 55% of the pitchers primarily in both limbs with four of the pitchers presenting with retroversion singularly in either the stride or trail limb where the ER rotation motion was greater than the IR. Conclusion: Assessing mobility and muscle strength of the lower quarter in isolation can be misleading and may not be adequate to ensure the potential for optimal pitching performance. These findings suggest that lumbo-pelvic control in relation to the lower extremities should be assessed as one functional unit. This is the first study to explore hip motion, strength, and lumbo-pelvic control during active hip rotation in collegiate baseball pitchers. [ABSTRACT FROM AUTHOR]

The article presents research which examined the association of pelvic incidence with pincer as well as cam lesions. Topics covered include the regulation of pelvic orientation and lumbar lordosis as well as decrease in PI in patients with regulated pelvic orientation. Also mentioned is the examination of the conditions of participants' acetabulum, sacropelvis and proximal femur.

The article discusses research which investigated the effects whole-body vibration had on trunk muscle functioning in young healthy adults. Researchers evaluated 15 male and 15 female subjects who underwent whole body vibration. They found that short term whole body vibration led to improved trunk extensor strength and could be useful in preventing sports injuries.

Purpose/hypothesis: The purpose of this study was to determine the reliability and validity of two smartphone applications: (1) GetMyROM - inclinometery-based and (2) DrGoniometry - photo-based in the measurement of active shoulder external rotation (ER) as compared to standard goniometry (SG). Participants: Ninety-four Texas Woman's University Doctor of Physical Therapy students from the School of Physical Therapy - Houston campus, were recruited to participate in this study. Materials/methods: Two iPhone applications were compared to SG using both novice and experienced raters. Active shoulder ER range of motion was measured over two time periods in random order by blinded novice and experienced raters. Results: Intra-rater reliability using novice raters for the two applications ranged from an intraclass correlation coefficient (ICC) of 0.79 to 0.81 with SG at 0.82. Inter-rater reliability (novice/expert) for the two applications ranged from an ICC of 0.92 to 0.94 with SG at 0.91. Concurrent validity (when compared to SG) ranged from 0.93 to 0.94. There were no significant differences between the novice and experienced raters. Conclusion: Both applications were found to be reliable and comparable to SG. A photo-based application potentially offers a superior method of measurement as visualizing the landmarks may be simplified in this format and it provides a record of measurement. Clinical relevance: Further study using patient populations may find the two studied applications are useful as an adjunct for clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the concurrent validity and reliability of the Simple Goniometer (SG) iPhone® app compared to the Universal Goniometer (UG). Design: Within subject comparison design comparing the UG with the SG app. Setting: James Cook University, Townsville, Queensland, Australia. Participants: Thirty-six volunteer participants, with a mean age of 60.6 years (SD 6.2). Interventions: Not applicable. Main outcome measure: Thirty-six participants performed three standing lunges during which the knee joint angle was measured with the SG app and the UG. Results: There were no significant differences in the measures of individual knee joint angles between the UG and the SG app. Pearson correlations of 0.96-0.98 and intraclass correlation coefficients of 0.97-0.99 (95% confidence interval: 0.95-1.00) were recorded for all measures. Using the Bland-Altman method, the standard error of the mean of the differences and the standard deviation of the mean of the differences were low. Conclusion: The measurements from the SG iPhone® app were reliable and possessed concurrent validity for this sample and protocol when compared to the UG. [ABSTRACT FROM AUTHOR]

Background: Electromagnetic tracking systems have enabled some investigators and clinicians to measure tri-planar scapular motion; yet, they are not practical and affordable options for all clinicians. Currently, the ability to affordably quantify scapular motion is limited to monitoring only the motion of scapular upward rotation, with use of a digital inclinometer. Hypothesis/Purpose: The objective of this study was to determine the criterion-related validity of a modified digital inclinometer when used to measure the motion of scapular anterior-posterior (AP) tilt. Materials & Methods: Thirteen volunteers, free from any history of shoulder injury, reported for a single testing session. Each subject underwent a brief shoulder and posture examination in order to confirm the absence of pathology. Subjects actively performed clinically relevant amounts of humeral elevation in the scapular plane while in a seated position. An electromagnetic tracking system (Ascension Technology, Burlington, VT) and a modified inclinometer (Pro 360, Baseline®, Fabrication Enterprises, White Plains, NY) were used to acquire scapular AP tilt over the same shoulder motions. Criterion-related validity was determined using Pearson Product Moment correlations. Results: Correlation analyses revealed significant moderate to good associations (r = 0.63 to 0.86, p < 0.01) between scapular AP tilt measures obtained with a digital inclinometer and an electromagnetic tracking system. Conclusions A modified digital inclinometer is a moderately valid device to use for the quantification of scapular AP tilt. Further study is warranted to establish reliability and to validate use of the device in patients with shoulder injury or pathology. The modified inclinometer expands the clinician's ability to quantify scapular kinematic motion during the clinical evaluation and rehabilitation process. [ABSTRACT FROM AUTHOR]

Purpose: A source of radiological bias occurs when the axial rotation of the pelvis is disregarded in hip and spine biomechanics analyses. The EOS imaging system (EOS Imaging, France) offers the possibility of detecting and measuring the axial rotation of bones. Reproducibility and accuracy have not been documented in the case of the pelvis. Methods: A dry pelvis has been X-rayed with the EOS system every 5° from 30° left to 30° right according to a laser line reference goniometer. Three observers have measured the rotation. One observer did it 3 times. The intra- and inter-observer reproducibility and the accuracy have been calculated using the root mean square standard deviation calculation. The relationship between the axial rotation and the offset between the left and right acetabulae on the lateral view was investigated. Results: The 95 % CI was ±0.23° for the intra-observer and ±0.33° for the inter-observer reliability. The mean of signed differences between the software calculation and the actual axial rotation of the pelvis was −0.39° (SD 0.77°). The lateral acetabular offset was proportional to the sin of the rotation. Approximately, 30 mm offset corresponded to about 10° rotation. Conclusions: The 3D slot scanning imaging system demonstrated significant reproducibility and accuracy for the assessment of the axial rotation of the pelvis. [ABSTRACT FROM AUTHOR]

Background: Several glenohumeral joint (GHJ) positions have been recommended for assessing and correcting posterior shoulder tightness (PST) however, there is no agreement on which position is better for differentiating posterior muscle tightness from posterior capsular tightness. The purpose of this study was to compare the range of motion change before and after an external humeral rotator muscle fatigue protocol in order to identify a position that shows maximum range of motion change. Methods: ROM changes across four PST measurements were compared before, immediately after, at 24 hours after, and 48 hours after an external rotator fatigue protocol. Muscle stiffness of the infraspinatus and the teres minor (using a myotonometer) and external rotation force production (using hand-held dynamometry) were measured to verify muscle fatigue. Results: There was a statistically significant interaction between measurement and condition (F = 2.47, p = 0.02). The planned one factor repeated measure ANOVA for each condition revealed that ROM change was statistically significant between PST measurements for all conditions. Post hoc comparisons indicated statistically significant greater overall ROM changes in a measurement combining GHJ extension and internal rotation compared to other tested measurements. There was also a main effect of time on infraspinatus muscle stiffness (F = 10.5, p < 0.0001). Post hoc comparison indicated a statistically significant increase in infraspinatus stiffness immediately after the fatigue protocol (p < 0.05). Conclusion: Immediate ROM reduction was observed across all the measurements except horizontal adduction (HAD). Maximum ROM reduction after an external rotation fatigue protocol was measured in a position of GHJ extension. Clinical Relevance: Posterior muscle tightness may influence the internal rotation range of motion to a greater extent when measured in glenohumeral joint extension. [ABSTRACT FROM AUTHOR]

This study evaluated the inter-rater reliability of select examination procedures in patients with neck pain (NP) conducted over a 24- to 48-h period. Twenty-two patients with mechanical NP participated in a standardized examination. One examiner performed standardized examination procedures and a second blinded examiner repeated the procedures 24-48 h later with no treatment administered between examinations. Inter-rater reliability was calculated with the Cohen Kappa and weighted Kappa for ordinal data while continuous level data were calculated using an intraclass correlation coefficient model 2,1 (ICC2,1). Coefficients for categorical variables ranged from poor to moderate agreement (-0.22 to 0.70 Kappa) and coefficients for continuous data ranged from slight to moderate (ICC2,1 0.28-0.74). The standard error of measurement for cervical range of motion ranged from 5.3° to 9.9° while the minimal detectable change ranged from 12.5° to 23.1°. This study is the first to report inter-rater reliability values for select components of the cervical examination in those patients with NP performed 24-48 h after the initial examination. There was considerably less reliability when compared to previous studies, thus clinicians should consider how the passage of time may influence variability in examination findings over a 24- to 48-h period. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the type of shoulder conditions presenting to public physiotherapy departments and the outcomes of such presentations. Methods: Demographic, diagnostic, and outcome data were collected from people with shoulder pain presenting to 10 public outpatient physiotherapy services in NSW, Australia, from 1 April 2007 to 30 September 2007. Pearson's correlation and paired T tests were used to determine relationships and significance of changes in the defined outcomes. Results: One hundred fifty-three people were included in this study. The most common presentations based on physiotherapist's diagnoses were rotator cuff tear, impingement, and postfracture rehabilitation. Significant improvements (p< 0.05) were demonstrated in outcome measures across all diagnostic groups, with average improvements: self-reported visual analogue scale (39.2 mm (±25.3)); flexion range (38.2° (±33.6)); hand behind back range (8.0 cm (±9.2 cm)); and global perceived effect (3.4 (±1.3)). These improvements occurred during an average of 6.7 treatment sessions. Conclusions: Physiotherapy in NSW Public Health settings manages a wide variety of shoulder conditions with benefits observed across all patient presentations and diagnoses. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work was to study the relationship of torsional and rotational parameters of the lower limb with a specific angular position of the cleat to establish whether these variables affect the adjustment of the cleat. Design: Correlational study. Setting: Motion analysis laboratory. Participants: Thirty-seven male cyclists of high performance. Interventions: The variables studied of the cyclist's lower limb were hip rotation (internal and external), tibial torsion angle, Q angle, and forefoot adductus angle. Main Outcome Measures: The cleat angle was measured through a photograph of the sole and with an Rx of this using the software AutoCAD 2008. The variables were photograph angle (photograph), the variable denominated cleat-tarsus minor angle, and a variable denominated cleat-second metatarsal angle (Rx). Analysis included the intraclass correlation coefficient for the reliability of the measurements, Student's t test performed on the dependent variables to compare side, and the multiple linear regression models were calculated using the software SPSS 15.0 for Windows. Results: The Student's t test performed on the dependent variables to compare side showed no significant differences (P = 0.209 for the photograph angle, P = 0.735 for the cleat-tarsus minor angle, and P = 0.801 for the cleat-second metatarsal angle). Values of R and R2 for the photograph angle model were 0.303 and 0.092 (P = 0.08), the cleat/tarsus minor angle model were 0.683 and 0.466 (P < 0.001), and the cleat/second metatarsal angle model were 0.618 and 0.382, respectively (P < 0.001). Conclusions: The equation given by the model was cleat-tarsus minor angle = 75.094 - (0.521 × forefoot adductus angle) + (0.116 × outward rotation of the hips) + (0.220 × Q angle). [ABSTRACT FROM AUTHOR]

BACKGROUND: Evaluation of range of motion (ROM) is integral part of assessment of musculoskeletal system. This is required in health fitness and pathological conditions; also it is used as an objective outcome measure. Several methods are described to check spinal flexion range of motion. Different methods for measuring spine ranges have their advantages and disadvantages. Hence, a new device was introduced in this study using the method of dual inclinometer to measure lumbar spine flexion range of motion (ROM). OBJECTIVES: To determine Intra and Inter-rater reliability of mobile device goniometer in measuring lumbar flexion range of motion. METHOD: iPod mobile device with goniometer software was used. The part being measure i.e the back of the subject was suitably exposed. Subject was standing with feet shoulder width apart. Spinous process of second sacral vertebra S2 and T12 were located, these were used as the reference points and readings were taken. Three readings were taken for each: inter-rater reliability as well as the intra-rater reliability. Sufficient rest was given between each flexion movement. RESULTS: Intra-rater reliability using ICC was r=0.920 and inter-rater r=0.812 at CI 95%. Validity r=0.95. CONCLUSION: Mobile device goniometer has high intra-rater reliability. The inter-rater reliability was moderate. This device can be used to assess range of motion of spine flexion, representing uni-planar movement. [ABSTRACT FROM AUTHOR]

Deficiencies in upper-limb motor function and executive functioning can compromise an affected individual’s ability to complete everyday activities. Impaired motor and executive functioning therefore pose a risk to increasing numbers of veterans who have been diagnosed with acquired brain injury. This article reports on changes in upper-limb motor function and executive functioning of 12 adult participants with chronic acquired brain injury using a novel, computer-based, motor and cognitive rehabilitation program called PreMotor Exercise Games (PEGs). Manual muscle, goniometric range of motion, and dynamometer assessments were used to determine motor functioning while the Executive Function Performance Test measured cognitive functioning. A three-level repeated measures design was conducted to determine changes pre- and postintervention. Participants demonstrated significant improvement in shoulder (p = 0.01) and wrist (p = 0.01) range of motion and clinically relevant improvement for elbow range of motion. Participants demonstrated clinically relevant improvement in shoulder, elbow, and wrist strength. Finally, participants demonstrated significant improvement in executive functioning (p < 0.05). Using PEGs as a modality for both motor and cognitive intervention is a potentially beneficial adjunct to rehabilitation and warrants further study. [ABSTRACT FROM AUTHOR]

Copyright of Ergoscience is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses a study which compares the effects of static stretching and self-administered proprioceptive neuromuscular facilitation (PNF) on flexibility and range of motion which indicates that self-PNF can be substituted for stretching. Topics include hip range of motion and hip, back, and shoulder flexibility.

The article presents a study that evaluates the incidence of roof impingement by the native anterior cruciate ligament (ACL) in hyperextensible knees. The study examines the risk of roof impingement by anatomic placement of the ACL graft in hyperextensible knees. It urges surgeons to consider roof impingement after anatomic double-bundle ACLreconstruction in patients with a hyperextensible knee.

Peak joint angles assumed during the stance phase of running may indicate a runner's ability to sense limb position in space. Joint position sense can be assessed through weight bearing and non-weight bearing tasks. The purpose of this investigation was to determine if weight bearing and non-weight bearing knee and hip joint replication tasks elicited similar joint position sense test results. Absolute replication error was measured during sagittal plane knee and frontal plane hip conditions on 23 healthy runners. Three-dimensional kinematics was recorded during running. Intraclass correlation coefficients (ICCs) determined agreement between the two measures of joint position sense. Pearson's correlation coefficients measured the relationship between hip and knee absolute error and peak joint angles during running. Despite similar mean absolute error, ICCs indicated low agreement between weight bearing and non-weight bearing conditions at each joint. The results indicate the tests are not interchangeable. Absolute error for non-weight bearing hip replication was correlated with peak stance hip adduction during running. Weight bearing and non-weight bearing joint position sense tasks within the knee and hip joints measure joint position sense differently. Therefore, a task that is relevant to the activity of interest should be selected to measure joint position sense. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The purposes of this study were to validate a tape measure method for measuring cervical spine range of motion compared with a universal goniometer in all planes of motion and to derive equations to convert a linear measurement to an angular distance. Methods: Participants were healthy volunteers. Measurements of flexion/extension, rotation, and lateral flexion were made with the universal goniometer and tape measure, in the neutral position, extreme of motion, and 2 positions between. Measurements from the 2 techniques were compared with Pearson correlation coefficient and simple linear regression to determine R 2, the regression coefficient and the regression equation. Reliability was assessed using the intraclass correlation coefficient. Results: There were 40 participants with a mean age of 30.5 (SD, 9.1) years. Goniometer measurements had good to excellent correlation with both absolute and percentage change in tape measurement (correlation coefficients, 0.74-0.94 and 0.75-0.91, respectively). Correlation was highest for flexion and extension, lowest for rotation and lateral flexion. The amount of variability in the data explained by the linear regression models (R 2) varied from 55% to 89%. Intraclass correlation coefficient ranged from 0.44 to 0.69 and 0.38 to 0.59 for intrarater and interrater reliability, respectively. Reliability was greatest for flexion and extension, lowest for rotation and lateral flexion. Conclusion: This study demonstrated that tape measurements correlated well with a universal goniometer. The tape measure may be useful for measuring cervical spine range of motion where availability, simplicity, and low cost are important considerations such as with conduct of research or patient management. [Copyright &y& Elsevier]

BACKGROUND: Hip range of motion is an important component in assessing clinical orthopedic conditions of the hip, low back and lower extremities. However it remains unclear as to what constitutes the best tool for clinical measurement. The purpose of this study was to investigate the concurrent validity of passive range of motion (ROM) measurements of hip extension and hip internal and external rotation using a digital inclinometer and goniometer. DESIGN: Criterion Standard. SETTING: Clinical research laboratory. PARTICIPANTS: 30 healthy subjects without pain, radicular symptoms or history of surgery in the low back or hip regions. MAIN OUTCOME MEASURES: Passive hip range of motion for extension, hip internal rotation and hip external rotation. A digital inclinometer and universal goniometer were utilized as the tools for comparisons between measurements. RESULTS: There was a statistically significant difference (p < 0.05) between the goniometer and digital inclinometer in measured hip ROM except for measurements of right hip external rotation (p > 0.05). The mean difference between the goniometer and digital inclinometer in left hip extension, internal rotation and external rotation were 3.5°, 4.5° and 5.0° respectively. The mean difference between the two devices in right hip extension, internal rotation and external rotation were 2.8°, 4.2° and 2.6° respectively. On average, the difference between the goniometer and digital inclinometer in extension was 3.2°, internal rotation was 4.5° and external rotation was 3.8°. The digital inclinometer had greater measurement during EXT and ER. Furthermore, there was no statistically significant difference (p > 0.05) in hip ROM between the left and right side for either goniometric or digital inclinometer measurements. CONCLUSIONS: This results of this study indicate that a significant difference exists between the two devices in all measurements with exception of right hip extension. The differences were noted to be between 3-5 degrees for all planes measured. These findings suggest that caution should be used if these two devices are to be used interchangeably to quantify passive hip range of motion in either clinical practice or when comparing studies that utilize different instruments. LEVEL OF EVIDENCE: 2b. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: Cross-sectional. OBJECTIVES: To compare lower extremity balance and shoulder range of motion in baseball players with ulnar collateral ligament (UCL) tears to a healthy cohort. BACKGROUND: Throwing is a complex motion that requires balance and coordination to effectively transfer energy through the kinetic chain. In theory, poorer balance could negatively affect throwing mechanics and lead to injury. METHODS: Thirty baseball players (mean SD age, 18.5 ± 1.9 years) with a diagnosis of a UCL tear of their throwing arm were compared to 30 players (age, 19.0 ± 1.1 years) without a UCL tear. All participants were competing at either the high school or collegiate level and reported an average ± SD of 13.5 ± 1.7 years of playing experience. The Y Balance Test composite scores were calculated for the stance and lead lower extremities of all players. Shoulder range of motion was used to calculate glenohumeral internal rotation deficit and side-to-side differences in total rotational motion. Group comparisons were made between participants with and without UCL tears using independent t tests. RESULTS: Baseball players with UCL tears scored significantly lower on the Y Balance Test for both the stance (P<.001) and lead (P<.001) lower extremities compared to the noninjured cohort. No between-group differences were noted in glenohumeral internal rotation deficit (P = .453), whereas the mean ± SD side-to-side difference in total rotational motion was -6.0° ± 9.6° for the injured group, compared to -0.4° ± 9.6° for the control group (P = .028). CONCLUSION: Participants with a UCL tear demonstrated decreased performance for their stance and lead lower extremities during the Y Balance Test. These data are consistent with a clinical hypothesis of a potential association between impaired balance and UCL tears in high school and collegiate baseball players. The lower total rotational motion of the dominant shoulder in participants with UCL tears needs to be considered in the interpretation of those results. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to determine the efficiency of a rehabilitation programme over standard physiotherapy practices in the improvement of function in metal-on-metal hip resurfacing arthroplasty patients. It says that the participants completed other measures such as the Hip disability and Osteoarthritis Outcome Score (HOOS), quality of life, and the EuroQol (EQ-5D-3L). It concludes that a tailored physiotherapy approach improves functional outcomes in the patients.

STUDY DESIGN: Laboratory study, repeated- measures design. OBJECTIVES: To quantify differences in sciatic and tibial nerve biomechanics (strain and excursion) during common variations of the straight leg raise (SLR) test. BACKGROUND: Hip flexion and ankle dorsi- flexion are the primary movement components of the SLR. It has been suggested that the nervous system is loaded differently when ankle dorsiflexion is added before or after hip flexion. There are, however, no data to either support or refute this suggestion. METHODS: Strain and excursion in the sciatic and tibial nerve were measured in the hip, knee, and ankle regions during 2 movement sequences for the SLR test in 10 embalmed cadavers. The proximal-to-distal sequence consisted of hip flexion followed by ankle dorsiflexion; the distal-to- proximal sequence consisted of ankle dorsiflexion followed by hip flexion. RESULTS: In the SLR end position, strain and excursion were comparable for both sequences for the sciatic and tibial nerve at the knee (P>.24). Strain in the tibial nerve at the ankle was greater with the proximal-to-distal sequence (P = .008), but the actual difference was small (0.8%). The pattern of strain increase and nerve excursion varied between sequences (P ≤.009), with nerve strain increasing earlier and being maintained longer in regions closest to the joint that was moved first in the movement sequence. CONCLUSION: Varying the movement sequence does not substantially impact excursion and strain in the end position of the SLR. Therefore, if neurodynamic test sequencing is useful in the differential diagnosis of neuropathies, it is not likely due to differences in strain in the end position of testing. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the reliability of passive stiffness, passive torque, range of motion (ROM), and electromyography (EMG) of the biceps femoris during passive thigh flexion motions intended to assess the ROM of the posterior muscles of the hip and thigh during manual versus automated assessment techniques. Eleven healthy men (mean ± sage = 22 ± 4 years; mass = 85 ± 12 kg; and height = 178 ± 4 cm) and nine healthy women (age = 19 ± 1 years; mass = 66 ± 15 kg; and height = 164 ± 5 cm) completed four randomly ordered passive straight-legged ROM assessments. Two ROM assessments were performed using a manual technique, which consisted of the primary investigator applying slow passive resistance against a load cell attached to the heel while the foot was moved toward the head. Two automated ROM assessments were also performed using a Biodex System 3 isokinetic dynamometer programmed in passive mode to move the foot toward the head at 0.087 rad · s−1. The intraclass correlation coefficients (ICCs) for passive stiffness measured with the manual technique ranged from 0.81–0.86, while for the automated technique they were 0.72–0.92. Standard error of measurement (SEM) values for passive stiffness expressed as a percentage of the mean ranged from 15.5–21.7% for the manual and 17.8–23.7% for the automated technique. Both techniques (manual and automated) were comparably reliable across the three trials, which suggested that the manual technique could be applied outside the laboratory. [ABSTRACT FROM PUBLISHER]

Background: Research indicates that rectus femoris muscle flexibility assessment techniques suffer from multiple sources of measurement error. Objective: To examine whether scoring of rectus femoris muscle flexibility from digital photographs of clinical examination using the modified Thomas test would be highly reliable. Methods: Twenty-eight individuals were digitally photographed while having their rectus femoris muscle flexibility evaluated using the modified Thomas test. Therapists were then asked to view these digital photographs and score participant's flexibility using modified Thomas test scoring criteria. A retest session was completed approximately 1-week later. Results: Kappa values for positive/negative scoring (intra-rater experienced X¯  =  0.86, in-experienced X¯  =  0.98; interrater experienced X¯  =  0.95, in-experienced X¯  =  0.99) and ICC values for goniometer scoring (intra-rater experienced X¯  =  0.98, in-experienced X¯  =  0.98; interrater experienced X¯  =  0.97, in-experienced X¯  =  0.98) indicated very high levels of reliability. Measurement error values (SEM  =  1.0°, ME  =  1.53°, and CV  =  3%) and Bland and Altman plots (with 95% limits of agreement) further illustrated the very small degree of scoring variance. Conclusions: Results indicate that goniometer and positive/negative scoring of rectus femoris muscle flexibility from digital photographs of clinical examination using the modified Thomas test were highly reliable. This finding suggests that using digital photography as a means to document patient function during clinical examination may serve as a method to help standardize physical assessment, minimize error measurement, and assist the clinician/researcher in establishing whether an observed change between testing sessions is clinically significant. [ABSTRACT FROM AUTHOR]

Context: Amiel-Tison method is a commonly used technique for assessing tone and neurological status of infants. There is a paucity of data on the reliability of visual assessment of angles, a component of this method. Subjects and Methods: We compared the visual and the goniometric assessment of adductor and popliteal angles in infants with hypertonia and neurologically normal controls. A total of 16 infants with hypertonia and 15 normal infants underwent blinded assessment of the adductor and popliteal angles. Statistical Analysis: The mean and standard deviation for the difference between visual and goniometric measurements were calculated for popliteal and adductor angles. Results: The mean differences between visual and goniometric measurements for the popliteal angle were 4.94 (SD3.40) and 8.73 (SD6.10) degrees for the cases and controls respectively. Similarly, the values for adductor angle measurements were 8.94 (SD8.23) and 14.47 (SD8.47) degrees respectively. Conclusion: The deviation of visual assessment from goniometric measurement was found to be less for popliteal angle measurement as compared to adductor angle measurements. It was note-worthy that the difference was less for the measurements of children with spasticity. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: Within-subject, repeated- measures design. OBJECTIVES: To determine the influence of pelvis position and hip angle on activation of the hip abductors while performing the clam exercise. BACKGROUND: Therapeutic exercises are regularly employed to strengthen the hip abductors to improve lower-limb and pelvis stability. While previous studies primarily have compared the activity of hip abductor muscles between various exercises, few studies have examined the influence of varying the techniques of particular exercises on the relative activation of hip abductor muscles. Such information could be used to facilitate appropriate exercise instruction. METHODS: Muscle activation in 17 healthy, asymptomatic volunteers during 6 variations of the clam exercise was analyzed with surface electromyography. Electromyographic signals were recorded from the gluteus maximus, gluteus medius, and tensor fasciae latae. Normalized data were examined using 2-way, repeated-measures analyses of variance. RESULTS: The magnitude of gluteus maximus and gluteus medius activation was significantly greater when the pelvis was in neutral rather than reclined. Furthermore, gluteus medius activation was greatest when the hip was flexed to 60°. Activation of the tensor fasciae latae was not influenced by pelvis position or hip angle. CONCLUSION: A neutral pelvis position is advocated to optimize recruitment of the gluteus maximus and gluteus medius during the clam exercise. Increasing the hip flexion angle increases activation of the gluteus medius. Tensor fasciae latae activity was relatively low and generally unaffected by variations of the clam exercise. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: Randomized clinical trial. To compare the effects of thrust and nonthrust manipulation and exercises with and without the addition of myofascial therapy for the treatment of acute inversion ankle sprain. BACKGROUND: Studies have reported that thrust and nonthrust manipulations of the ankle joint are effective for the management of patients post-ankle sprain. However, it is not known whether the inclusion of soft tissue myofascial therapy could further improve clinical and functional outcomes. METHODS: Fifty patients (37 men and 13 women; mean ± SD age, 33 ± 10 years) post-acute inversion ankle sprain were randomly assigned to 2 groups: a comparison group that received a thrust and nonthrust manipulation and exercise intervention, and an experimental group that received the same protocol and myofascial therapy. The primary outcomes were ankle pain at rest and functional ability. Additionally, ankle mobility and pressure pain threshold over the ankle were assessed by a clinician who was blinded to the treatment allocation. Outcomes of interest were captured at baseline, immediately after the treatment period, and at a 1-month follow-up. The primary analysis was the group-by-time interaction. RESULTS: The 2-by-3 mixed-model analyses of variance revealed a significant group-by-time interaction for ankle pain (P<.001) and functional score (P = .002), with the patients who received the combination of nonthrust and thrust manipulation and myofascial intervention experiencing a greater improvement in pain and function than those who received the nonthrust and thrust manipulation intervention alone. Significant group-by-time interactions were also observed for ankle mobility (P<.001) and pressure pain thresholds (all, P<.01), with those in the experimental group experiencing greater increases in ankle mobility and pressure pain thresholds. Between-group effect sizes were large (d>0.85) for all outcomes. CONCLUSION: This study provides evidence that, in the treatment of individuals post-inversion ankle sprain, the addition of myofascial therapy to a plan of care consisting of thrust and nonthrust manipulation and exercise may further improve outcomes compared to a plan of care solely consisting of thrust and nonthrust manipulation and exercise. However, though statistically significant, the difference in improvement in the primary outcome between groups was not greater than what would be considered a minimal clinically important difference. Future studies should examine the long-term effects of these interventions in this population. LEVEL OF EVIDENCE: Therapy, level lb- [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Muscle imbalance between the abductor hallucis (AbdH) and adductor hallucis (AddH) has been demonstrated in hallux valgus (HV). Clinically, the short-foot (SF) is performed for strengthening foot intrinsic muscle. The toes-spread-out (TSO), the newly introduced, was devised to correct HV deformity. However, there was no study to determine which exercise is effective in balancing the ratio of activation between AbdH and AddH muscles. The purpose of this study was to compare the muscle activities of the AbdH and AddH between SF and TSO exercises in subjects with mild HV. METHODS: Eighteen subjects with mild HV participated. The muscle activity of AbdH and AddH and the angle of first metatarsophalangeal (MTP) joint in the horizontal plane were measured during the SF and TSO exercises. Values of dependent variables were compared using a paired t-test between the SF and TSO exercises. RESULTS: The TSO exercise showed significantly greater activation of the AbdH than did the SF exercise (mean difference=44.96% of maximum voluntary isometric contraction; p< 0.001). There was no significant difference between the SF and TSO exercises in activating the AddH (mean difference=8.28% of maximum voluntary isometric contraction; p=0.271). The ratio of AbdH to AddH muscle activity was significantly higher in the TSO exercise than in the SF exercise (mean difference=0.54; p=0.001). The angle of the first MTP joint in the horizontal plane during the TSO was significantly greater than that in the SF exercise (mean difference=9.60°; p<0.001). CONCLUSIONS: These results suggest that the TSO exercise can be recommended for preventing or correcting HV deformity at an early stage. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the reliability and validity of the Electronic Cervical Range of Motion (CROM) Goniometer in measurement of cervical spine mobility in adults with and without neck pain. METHODS: A cross-sectional reliability study was conducted on 54 subjects (26 neck pain and 26 non-neck pain) aged from 20-70 years old. The Numerical Pain Rating Scale and Chinese version of Northwick Park Neck Pain Questionnaire were used to assess neck pain severity and disability respectively. The CROM was measured in sitting position except left to right rotation was measured in supine lying. All the cervical active movements were measured by using the Electronic CROM Goniometer from ARCON TM Functional Capacity Evaluation (FCE) systems. RESULTS: The intra-tester and inter-tester reliability were high in both normal and chronic neck pain groups with ICC coefficients ranged from 0.75-*0.92. There was significant difference in the total CROM between the normal (374.7°) and chronic neck pain group (292.6°). CONCLUSION: The ACRON cervical goniometer was found to be reliable for measuring cervical mobility in 3 planes for both normal and patient subjects. Construct validity of the goniometer was supported as the test's result documented significant difference in CROM between the control and the neck pain groups. [ABSTRACT FROM AUTHOR]

Objectives: To compare and investigate the relationships between Q-angle values and measures of pain, muscular, and functional performances. Methods: Measures of Q-angles, pain, and muscular and functional performances were obtained in 30 elderly women with bilateral knee osteoarthritis. Pearson correlation coefficients were employed to evaluate relationships between the assessed variables (P < .05). Results: Lower Q-angle values were found in the most symptomatic knee, but no statistically significant correlations were found between the Q-angle and the other evaluated measures. Conclusions: Lower Q-angle values were found on the most symptomatic knee and they were not associated with pain, muscular, or functional performance. [ABSTRACT FROM AUTHOR]

Purpose/Aim: This purpose of this study was to investigate the reliability, minimal detectable change (MDC), and concurrent validity of active spinal mobility measurements using a gravity-based bubble inclinometer and iPhone® application. Materials/Methods: Two investigators each used a bubble inclinometer and an iPhone® with inclinometer application to measure total thoracolumbo-pelvic flexion, isolated lumbar flexion, total thoracolumbo-pelvic extension, and thoracolumbar lateral flexion in 30 asymptomatic participants using a blinded repeated measures design. Results: The procedures used in this investigation for measuring spinal mobility yielded good intrarater and interrater reliability with Intraclass Correlation Coefficients (ICC) for bubble inclinometry . 0.81 and the iPhone® . 0.80. The MDC90 for the interrater analysis ranged from 4° to 9°. The concurrent validity between bubble inclinometry and the iPhone® application was good with ICC values of . 0.86. The 95% level of agreement indicates that although these measuring instruments are equivalent individual differences of up to 18‹ may exist when using these devices interchangeably. Conclusions: The bubble inclinometer and iPhone® possess good intrarater and interrater reliability as well as concurrent validity when strict measurement procedures are adhered to. This study provides preliminary evidence to suggest that smart phone applications may offer clinical utility comparable to inclinometry for quantifying spinal mobility. Clinicians should be aware of the potential disagreement when using these devices interchangeably. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the effect a short proprioceptive neuromuscular facilitation stretching bout had on quadriceps neuromuscular function, flexibility and vertical jump performance. Researchers evaluated the stretching bout with 12 healthy men and looked at the effect it had on range of motion, vertical jump performance and quadriceps neuromuscular function. They found that the bout did not effect any of the variables that they investigated.

Objectives. To compare the shoulder mobility, muscular strength, and quality of life (QOL) among breast cancer survivors with and without Tai Chi (TC) Qigong training to those of healthy individuals and to explore the associations between shoulder impairments and QOL in breast cancer survivors with regular TC Qigong training. Methods. Eleven breast cancer survivors with regular TC Qigong training, 12 sedentary breast cancer survivors, and 16 healthy participants completed the study. Shoulder mobility and rotator muscle strength were assessed by goniometry and isokinetic dynamometer, respectively. QOL was assessed using the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Results. Goniometric measurements of the active range of motion in the flexion, abduction, and hand-behind-the-back directions were similar among the three groups. The TC Qigong-trained breast cancer survivors had significantly higher isokinetic peak torques of the shoulder rotator muscles (at 180°/s) than untrained survivors, and their isokinetic shoulder muscular strength reached the level of healthy individuals. Greater shoulder muscular strength was significantly associated with better functional wellbeing in breast cancer survivors with TC Qigong training. However, no significant between-group difference was found in FACT-B total scores. Conclusions. TC Qigong training might improve shoulder muscular strength and functional wellbeing in breast cancer survivors. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare isometric strength of elbow extensors measured in supine- and prone-lying positions at elbow flexion angles of 45 and 90 degrees. Twenty-two male subjects under single-blind procedures participated in the study. Each subject participated in both supine-lying and prone-lying measuring protocols. Calibrated cable tensiometer was used to measure isometric strength of the right elbow extensors and a biofeedback electromyography was used to assure no substitution movements from shoulder girdle muscles. The mean values of isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees were 11.1 ± 4.2 kg and 13.1 ± 4.6 kg, while those measured from prone-lying position were 9.9 ± 3.6 kg and 12 ± 4.2 kg, respectively. There is statistical significant difference between the isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees compared to that measured from prone-lying position (p < 0.05). The results suggest that in manual muscle testing starting position can affect the isometric strength of elbow extensors since supine-lying starting position is better than prone-lying starting position. [ABSTRACT FROM AUTHOR]

The article presents information on a study conducted to determine the efficacy of the Swedish version of the Patient Specific Functional Scale (PSFS) in patients with surgically treated carpometacarpal (CMC) joint osteoarthritis (OA). In the study, pain intensity, joint movement of CMC joint, and grip strength were assessed. The study concluded that PSFS can be reliable when used on patients surgically treated for CMC joint OA.

Background: Posterior shoulder tightness (PST) has been implicated in the etiology of numerous shoulder disorders. Although reliable and valid measures have been described for the non-operative population one does not exist for the post-operative population. Study Design: Blinded repeated measures design. Purpose: Investigate the intrarater reliability, minimal detectable change at the 90% confidence interval (MDC90) and construct validity of an inclinometric measurement designed to quantify PST in the post-operative population. Methods: One investigator performed PST measurements on the operative shoulder of 23 participants. Passive internal and external rotation measurements were performed for the validity component of the investigation. Results: Intrarater reliability using an intraclass correlation coefficient (ICC) model 3,k was good (ICC = 0.79). The MDC90 indicated that a change of greater than or equal to 8 degrees would be required to be 90% certain that a change in the measurement would not be the result of inter-trial variability or measurement error. Construct validity was supported by a statistically significant relationship between PST and internal rotation r = 0.54 and by a relationship between PST and external rotation r = 0.30 which was not statistically significant. Conclusion: The sidelying procedure described in this investigation appears to be a reliable and valid means for quantifying PST in the post-operative population. Moreover, the use of inclinometry provides an absolute angle of tightness that may be used for intersubject comparison, documenting change, and to determine reference values. [ABSTRACT FROM AUTHOR]

The article discusses a study carried out in Forth Worth, Texas to compare the shoulder range of motion (ROM) deficits of baseball players diagnosed with ulnar collateral ligament (UCL) tear to players without UCL tear. It describes that the study was made on 60 male competitive high school and collegiate baseball players, subsequently tested and analyzed for data. Subjects diagnosed with UCL tear showed greater deficits in total rota- tional motion (TRM) compared to those without UCL tears.

The article assesses the potential of remplissage repair in prevention of recurrent shoulder instability. A survey was made on the patients suffering from Hill-Sachs and Bankart lesions, who were then evaluated based on remplissage and Bankart repair. It led to significant improvement of active forward elevation and internal rotation compared with baseline assessment. It concludes that remplissage enables the surgeon to address large humeral defects with a low postoperative recurrence.

The article reports on research conducted to examine the alterations to knee and ankle angle occurring from static measures to active pedaling across intensities experienced by cyclists during a graded exercise protocol. Researchers evaluated 34 cyclists. They found that significant alterations to pedal stroke occur from stationary measures to active pedaling and that plantar flexion increased when moving from stationary measures to active pedaling, resulting in an increase in knee angle.

OBJECTIVE. I evaluated the effectiveness of the California Tri-Pull Taping method for clients with poststroke inferior shoulder subluxation of the glenohumeral joint. METHOD. Ten participants were followed for 9 wk using an interrupted time series quasi-experimental single-subject ABA design to examine shoulder pain, activities of daily living (ADL) function, active range of motion, tape comfort, and subluxation. RESULTS. The California Tri-Pull Taping method decreased inferior subluxation significantly from baseline to intervention but not at postintervention. Active range of motion was significantly increased in shoulder flexion and abduction between the baseline and intervention and the intervention and postintervention phases. Functional ADL scores were significant. The taping was reported to be comfortable. No significant difference in pain was found. CONCLUSION. This intervention is a promising adjunct to the management of the hemiplegic subluxed shoulder that warrants further research. [ABSTRACT FROM AUTHOR]

The article discusses a study that adopted a laboratory approach for a complete quantification of anterior arthroscopic reach with ankle in full plantar flexion. The results of computed tomography simulation demonstrate that the medial and lateral arthroscopic reaches, both are highly affected by clinical plantarflexion. The talar dome is shown to be accessible anterior to the anterior distal tibial rim.

Background. Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking. Objective. The aims of this study were to determine the interobserver reliability of measurements of passive range of motion (PROM) over time, explore sources of variation associated with these measurement results, and generate smallest detectable differences for clinical decision making. Design. This investigation was a measurement-focused study with a longitudinal design, nested within a 2-arm randomized controlled trial. Methods. Two trained physical therapists assessed 7 arm movements at baseline and after 4, 8, and 20 weeks in 48 people with subacute stroke using a standardized protocol. One physical therapist performed the passive movement, and the other read the hydrogoniometer. The therapists then switched roles. The relative contributions of several sources of variation to error variance were explored with analysis of variance. Results. Interobserver reliability coefficients ranged from .89 to .97. The PROM measurements were influenced by error variance ranging from 31% to 50%. The participant X time interaction made the largest contribution to error variance, ranging from 59% to 81%. Smallest detectable differences were 6 to 22 degrees and were largest for shoulder movements. Limitations. Verification of shoulder pain and hypertonia as sources of error variance led to a substantial number of unstable variance components, necessitating a simpler analysis. Conclusions. The assessment of PROM with a standardized protocol, a hydro- goniometer, and 2 trained physical therapists yielded high interobserver reliability indexes for all arm movements. Error variance made a large contribution to the variation in measurement results. The resulting smallest detectable differences can be used to interpret future hemiplegic arm PROM measurements with more confidence. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the effect stretch frequency and sex had on the rate of gain and loss in muscle flexibility during a hamstring stretching program. Researchers evaluated 53 subjects over an eight week period. They found that while women were more flexible than men there was no sex difference in terms of stretching response.