Search

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]

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., Level of Evidence: Therapy, level 1b.

Background: Neuromuscular electrical stimulation initiated by a surface electromyographic biofeedback threshold (sEMG-triggered NMES) has been studied in populations of patients with neurological problems, but has not been applied to orthopedic populations., Objectives: The purpose of this single-blinded, randomized clinical trial was to investigate sEMG-triggered NMES on knee extension active range of motion (AROM), function, and torque in patients with post-operative arthroscopic knee surgery., Methods: Twenty-five participants were randomly assigned to either: (1) sEMG-triggered NMES with exercise group, or (2) exercise-only comparison group. Participants received outpatient physical therapy treatment 2 to 3 times a week for 12 visits. Knee AROM and function determined by the lower extremity functional scale (LEFS) were collected at the first, sixth, and twelfth visits. Peak isometric extensor torque was assessed using an electromechanical dynamometer at 3 months post surgery. Two analysis of variance tests with repeated measures were used to analyze knee AROM and LEFS data. An independent samples t-test was used to analyze the peak torque index (%) of the involved extremity compared to the uninvolved., Results: A significant difference in AROM was found between groups. No significant difference was found between groups in the LEFS, nor in the peak isometric extensor torque. A 72.5% strength deficit was found compared to the uninvolved extremity., Conclusion: Using sEMG-triggered NMES intervention improved extension AROM but did not improve function or torque.

Background: Jumping and landing tasks are commonly used functional measurement tools to assess lower extremity performance in female athletes. However, few studies have established the number of trials needed to achieve reliability of measurement for evaluating landing mechanics., Objective: To determine the reliability of peak hip and knee joint angles and peak ground reaction forces during two anterior-posterior unilateral functional tasks performed by young women., Methods: Sixteen young women (28.5 ± 4.2 years; 162.2 ± 4.8 cm; 59.5 ± 8.1 kg) participated in this investigation. Each participant performed five trials of a 40-cm single leg drop jump and two trials of a ten-repetition, 20-cm, single leg up-down hop task during the same session. Peak hip and knee joint angles, peak vertical ground reaction forces, and ground contact time were measured. Intraclass correlation coefficients (ICC), standard errors of measurement, and 95% confidence intervals were calculated for all variables measured during multiple trials for both tasks., Results: The five-trial mean ICC values of the drop jump were ≥ 0.75 for all variables. The single and two to four-trial average ICC values yielded good reliability for only some variables. Single-trial and two-trial mean ICC values for the up down test were ≥ .77., Discussion and Conclusion: The use of five-trial averages for the 40-cm drop jump and a single trial for the 20-cm, up-down hop task showed that for these functional tasks performed by young adult women, reliable measurement of lower extremity landing mechanics can be achieved.