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Date: 27-Feb-2001
Name: rehabilitation
Database: Medline <1997 to December 2000>
Set Search Results

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001 hip/in or groin/in or pelvis/in 95
002 rehabilitation.af. 10557
003 1 and 2 2
004 athletic injuries/rh 143
005 (hip or groin or pelvi$ or thigh).af. 17776
006 4 and 5 2
007 3 or 6 4
008 2 and 5 463
009 exp sports/ 7905
010 8 and 9 49
011 7 or 10 51
012 limit 11 to english 50
013 from 10 keep 2-3,7,10-12,17-21,23,27-28,30-31,33,35,42,45,47 23
-49
014 13 23
<1>
Unique Identifier
20275112
Authors
Gross MT. Dailey ES. Dalton MD. Lee AK. McKiernan TL. Vernon WL.
Walden AC.
Institution
Program in Human Movement Science, Division of Physical Therapy, The
University of North Carolina at Chapel, 27599-7135, USA
mgross@css.unc.edu
Title
Relationship between lifting capacity and anthropometric measures.
Source
Journal of Orthopaedic & Sports Physical Therapy. 30(5):237-47;
discussion 258-61, 2000 May.
Abbreviated Source
J Orthop Sports Phys Ther. 30(5):237-47; discussion 258-61, 2000 May.
Local Messages
unidentified
Abstract
STUDY DESIGN: Prospective analysis of relationship between lifting
capacity and multiple anthropometric variables. OBJECTIVES: To determine
the relationship between lifting capacity and anthropometric variables
and
to model this relationship quantitatively. BACKGROUND: Low-back injuries
commonly occur in individuals who perform lifting tasks. Objective data
are needed to determine preinjury lifting capacity that, in turn, might
be
used to guide decisions during rehabilitation of these injuries. METHODS
AND MEASURES: We recorded age and sex and measured the following
variables
for 35 men and 23 women between the ages of 22 and 40: height, weight,
percentage of body fat, torso height, pelvic width, pelvic girth, arm
length, thigh girth, and calf girth. Variables were selected for the
study
on the basis of theoretical modeling or previous research regarding the
relationship between study variables and lifting capacity. Subjects also
were tested to determine their maximum lifting capacity by using a
lordotic lumbar spine lifting technique. RESULTS: Stepwise regression
analysis indicated that the combination of sex, age, thigh girth, pelvic
girth, and percentage body fat was significantly related to maximum lift
capacity (multiple R2 = 0.76). The mean absolute difference (+/- SD)
between lifted amount predicted by the regression model and the actual
amount lifted was 118.6 +/- 86 N (26 +/- 19.3 lb), which corresponded to
an average absolute error of 16% (SD = 14%) of the actual weight lifted.
CONCLUSION: The results may be useful in estimating 1 aspect of preinjury
lifting capacity. Similar studies are needed to model the requirements of
frequency of lift, duration of lifting efforts, variety of hand-object
coupling, and combined lifting and reaching.
<2>
Unique Identifier
20313679
Authors
Lemaire ED. Nielen D. Paquin MA.
Institution
Institute for Rehabilitation Research and Development, The Rehabilitation
Centre, Ottawa, Ontario, Canada.
Title
Gait evaluation of a transfemoral prosthetic simulator.
Source
Archives of Physical Medicine & Rehabilitation. 81(6):840-3, 2000 Jun.
Abbreviated Source
Arch Phys Med Rehabil. 81(6):840-3, 2000 Jun.
Local Messages
unidentified
Abstract
OBJECTIVE: To test a prosthetic simulator developed to allow persons
without amputation to walk like a person with a transfemoral (TF)
amputation. PATIENTS: Five able-bodied subjects; comparison with data
from
the literature on persons with TF amputations. SETTING: Motion analysis
laboratory. DESIGN: Two 45- to 60-minute gait training sessions before
subjects walked along a 10-meter walkway. There were 6 trials: 3 walking
with a cane, 3 without a cane. MAIN OBJECTIVE MEASURES: Sagittal plane
kinematic and kinetic analysis of ankle, knee, and hip: angular velocity,
joint moment, and power. RESULTS: Kinematic and kinetic analyses showed
that joint mechanics during walking were similar between the test
subjects
and comparative results from persons with TF amputations (reported in the
literature). Test subjects walked slower and moved their hip and knee
joints faster (higher angular velocity values during the terminal swing)
than the TF amputee subjects, although these results were not
statistically significant (p < .05). These findings were consistent with
new prosthetic users who are more tentative during gait training.
However,
a perfect simulation would show no difference in kinematic results.
CONCLUSION: These results support the use of a TF prosthetic simulator to
help health care professionals experience the process of fitting the
prosthesis from the client's perspective.
<3>
Unique Identifier
20116729
Authors
Neptune RR. Kautz SA. Zajac FE.
Institution
Rehabilitation R & D Center, VA Palo Alto Health Care System, CA 94304,
USA. neptune@roses.stanford.edu
Title
Muscle contributions to specific biomechanical functions do not change in
forward versus backward pedaling.
Source
Journal of Biomechanics. 33(2):155-64, 2000 Feb.
Abbreviated Source
J Biomech. 33(2):155-64, 2000 Feb.
Local Messages
unidentified
Abstract
Previous work had identified six biomechanical functions that need to be
executed by each limb in order to produce a variety of pedaling tasks.
The
functions can be organized into three antagonistic pairs: an Ext/Flex
pair
that accelerates the foot into extension or flexion with respect to the
pelvis, an Ant/Post pair that accelerates the foot anteriorly or
posteriorly with respect to the pelvis, and a Plant/Dorsi pair that
accelerates the foot into plantarflexion or dorsiflexion. Previous
analyses of experimental data have inferred that muscles perform the same
function during different pedaling tasks (e.g. forward versus backward
pedaling) because the EMG timing was similar, but they did not present
rigorous biomechanical analyses to assess whether a muscle performed the
same biomechanical function, and if so, to what degree. Therefore, the
objective of this study was to determine how individual muscles
contribute
to these biomechanical functions during two different motor tasks,
forward
and backward pedaling, through a theoretical analysis of experimental
data. To achieve this objective, forward and backward pedaling
simulations
were generated and a mechanical energy analysis was used to examine how
muscles generate, absorb or transfer energy to perform the pedaling
tasks.
The results showed that the muscles contributed to the same primary
Biomechanical functions in both pedaling directions and that synergistic
performance of certain functions effectively accelerated the crank. The
gluteus maximus worked synergistically with the soleus, the hip flexors
worked synergistically with the tibialis anterior, and the vasti and
hamstrings functioned independently to accelerate the crank. The rectus
femoris used complex biomechanical mechanisms including negative muscle
work to accelerate the crank. The negative muscle work was used to
transfer energy generated elsewhere (primarily from other muscles) to the
pedal reaction force in order to accelerate the crank. Consistent with
experimental data, a phase shift was required from those muscles
contributing to the Ant/Post functions as a result of the different limb
kinematics between forward and backward pedaling, although they performed
the same biomechanical function. The pedaling simulations proved
necessary
to interpret the experimental data and identify motor control mechanisms
used to accomplish specific motor tasks, as the mechanisms were often
complex and not always intuitively obvious.
<4>
Unique Identifier
99401157
Authors
Schache AG. Bennell KL. Blanch PD. Wrigley TV.
Institution
School of Physiotherapy, The University of Melbourne, 200 Berkeley St.,
Carlton, Melbourne, Australia. a.schache@pgrad.unimelb.edu.au
Title
The coordinated movement of the lumbo-pelvic-hip complex during running:
a
literature review. [Review] [138 refs]
Source
Gait & Posture. 10(1):30-47, 1999 Sep.
Abbreviated Source
Gait Posture. 10(1):30-47, 1999 Sep.
Local Messages
unidentified
Abstract
The purpose of this review article is to summarise the literature to date
regarding the movement of the lumbar spine, pelvis and hips during
running
gait. Both two-dimensional and three-dimensional studies are analysed to
illustrate the apparent coordination in the angular kinematics of each of
these segments during running. Knowledge of this coordination is
essential
in order to facilitate the successful rehabilitation of running injuries
to the back, pelvis, hip and thigh. [References: 138]
<5>
Unique Identifier
99438480
Authors
Carson PA.
Title
The rehabilitation of a competitive swimmer with an asymmetrical
breaststroke movement pattern.
Source
Manual Therapy. 4(2):100-6, 1999 May.
Abbreviated Source
Manual Ther. 4(2):100-6, 1999 May.
Local Messages
unidentified
Abstract
This case study describes the treatment and management of an 11-year-old
competitive swimmer who was repeatedly disqualified from races because of
an asymmetrical movement pattern, otherwise called stroke. The treatment
was based on the impairments found during the physical examination that
were considered relevant to the physical dysfunction resulting in the
asymmetrical stroke. This gave rise to the hypothesis that muscle
imbalances around the right shoulder and left hip, together with a
relative restriction of motion in these joints, were resulting in the
transmission of forces up and down the kinetic chain and that these were
contributing factors to the asymmetrical breaststroke stroke. An eclectic
approach was used in the analysis, and the subsequent treatment and
management, of the problem. To achieve the goal of a symmetrical stroke,
the muscle balance/imbalance approaches of Janda (1994), Sahrmann (1988)
and Kendall et al. (1993) were used. The joint impairments were treated
with techniques described by Maitland (1986) and Mulligan (1996), while
the exercise programme included the core/stabilizing approach presented
by
Blanch (1997). The treatment period consisted of four phases of 3 weeks
each. The result indicates that early identification and treatment of
muscle imbalance syndromes and relative joint restrictions by the
physiotherapist and coach working together may be useful in establishing
good movement patterns and technique for competitive swimmers.
<6>
Unique Identifier
99387873
Authors
Tyson SF.
Institution
Centre for Research in Rehabilitation, Department of Health Studies,
Brunel University, Isleworth, UK. sarah.tyson@brunel.ac.uk
Title
Trunk kinematics in hemiplegic gait and the effect of walking aids.
Source
Clinical Rehabilitation. 13(4):295-300, 1999 Aug.
Abbreviated Source
Clin Rehabil. 13(4):295-300, 1999 Aug.
Local Messages
unidentified
Abstract
OBJECTIVE: To establish baseline measurements of trunk movements during
hemiplegic gait, to assess the relationship between trunk movements and
walking ability, and to investigate the effect of walking aids on the
trunk movements. METHOD: Twenty subjects with a chronic hemiplegia from a
stroke, who could walk independently, were recruited. Lateral and
vertical
movements of the pelvis, and symmetry of these movements were measured
using CODA (a three-dimensional movement analysis system) as the subjects
walked at their own pace without an aid. They were also tested as they
walked with a stick and a tripod to assess the effect of different
walking
aids. Mean values for the trunk movements and symmetry were calculated,
Pearson's correlations assessed the relationship between each trunk
movement and gait velocity (a measure of overall walking ability), and
the
influence of the different aids was assessed using a one-way repeated
measures ANOVA. RESULTS: Lateral displacement was large (mean = 9.9 cm,
SD
3.9) and orientated to the sound side, vertical displacement was small
(mean = 2.45 cm, SD 1.4). The movements showed marked asymmetry which
favoured the hemiplegic side in that there was less movement of, or
towards this side. There was a significant relationship (at 5% level)
between walking ability and lateral movements (r = 0.6), but not vertical
movements (r= 0.41). No significant differences were found with the
different aids. CONCLUSION: These results give baseline values for trunk
movements during hemiplegic gait and the relationship between the
movements and walking ability. The use of walking aid and the type of
walking aid did not affect the subjects' trunk movements or walking
ability.
<7>
Unique Identifier
99202634
Authors
Eisner WD. Bode SD. Nyland J. Caborn DN.
Institution
Physical Therapy Program, College of Allied Health Professions,
University
of Kentucky, Lexington 40536-0284, USA.
Title
Electromyographic timing analysis of forward and backward cycling.
Source
Medicine & Science in Sports & Exercise. 31(3):449-55, 1999 Mar.
Abbreviated Source
Med Sci Sports Exerc. 31(3):449-55, 1999 Mar.
Local Messages
unidentified
Abstract
PURPOSE: Backward walking to running progressions are becoming a popular,
nontraditional component of functional knee rehabilitation programs. The
purpose of this electromyographic (EMG) and motion analysis study was to
compare the activation duration of the vastus medialis, vastus lateralis,
rectus femoris, medial hamstrings, lateral hamstring, tibialis anterior,
and gastrocnemius muscles during forward and backward cycling. We
hypothesized that the hamstrings would demonstrate greater activation
duration during backward cycling. METHODS: The right lower extremity of
12
healthy subjects (6 male and 6 female) was instrumented with surface EMG
electrodes and retroreflective markers to confirm lower extremity
kinematic consistency between conditions. RESULTS: Statistical analysis
of
hip, knee, and ankle kinematics (200 Hz sampling rate) and gender failed
to reveal significant differences between conditions (P > 0.05). Quadrant
analysis of muscle activation duration with Bonferroni corrections for
multiple comparisons revealed that medial and lateral hamstring
activation
duration was greater during the early recovery phase (quadrant III) of
backward cycling than forward cycling (P < 0.00156). Rectus femoris
activation duration was greater in the early propulsive phase of backward
cycling (quadrant 1) (P < 0.00156) and in the early recovery phase of
forward cycling (quadrant III) (P < 0.00156). CONCLUSIONS: These findings
lend support for the use of backward cycling during the early recovery
phase (quadrant III) to achieve a selective hamstring muscle response of
relatively decreased patellofemoral stress and anterior cruciate ligament
strain.
<8>
Unique Identifier
99221445
Authors
Hesse S. Konrad M. Uhlenbrock D.
Institution
Klinik Berlin, Department of Neurological Rehabilitation, Free
University,
Berlin, Germany.
Title
Treadmill walking with partial body weight support versus floor walking
in
hemiparetic subjects.
Source
Archives of Physical Medicine & Rehabilitation. 80(4):421-7, 1999 Apr.
Abbreviated Source
Arch Phys Med Rehabil. 80(4):421-7, 1999 Apr.
Local Messages
unidentified
Abstract
OBJECTIVE: To compare the gait of hemiparetic subjects walking on a
treadmill with various body weight supports and walking on the floor.
DESIGN: Hemiparetic subjects walked on a treadmill, secured in a harness,
with no body weight support and with 15% and 30% body weight relief, and
walked on a floor. SETTING: Kinematic laboratory of a department of
rehabilitation. SUBJECTS: Eighteen hemiparetic stroke patients. MAIN
OUTCOME MEASURES: Gait cycle parameters and kinesiologic electromyogram
of
six muscles of the affected side and of two muscles of the nonaffected
side. RESULTS: On the treadmill, patients walked more slowly because of a
reduced cadence, with a longer single stance period of the paretic limb,
more symmetrically, and with a larger hip extension (multivariate profile
analysis, p<.05). The mean functional activities of the gastrocnemius
muscle and of the first crest of the erector spinae of the paretic side
were smaller on the treadmill (univariate test, p<.05). Further, the
premature activity of the gastrocnemius muscle, indicating spasticity,
was
less on the treadmill (univariate test, p<.05); correspondingly the
qualitative muscle pattern analysis revealed less co-contraction between
the gastrocnemius and tibialis anterior muscles in 11 of the 18 subjects.
CONCLUSIONS: Treadmill training with partial body weight support in
hemiparetic subjects allows them to practice a favorable gait
characterized by a greater stimulus for balance training because of the
prolonged single stance period of the affected limb, a higher symmetry,
less plantar flexor spasticity, and a more regular activation pattern of
the shank muscles as compared with floor walking.
<9>
Unique Identifier
99180892
Authors
Buschbacher RM. Shay T.
Institution
Department of Physical Medicine and Rehabilitation, Indiana University
Medical Center, Indianapolis, USA.
Title
Martial arts. [Review] [36 refs]
Source
Physical Medicine & Rehabilitation Clinics of North America. 10(1):35-
47,
vi, 1999 Feb.
Abbreviated Source
Phys Med Rehabil Clin N Am. 10(1):35-47, vi, 1999 Feb.
Local Messages
unidentified
Abstract
The martial arts have a reputation for being a high-risk activity, but
are
generally practiced in a safe environment. This article presents the
results of a survey which is used to calculate risk of injury per 1000
hours of practice. The injury rate compares favorably with other
mainstream activities; in fact, the martial arts are generally considered
safer than most. The most common injuries occur to the wrist, hand,
finger, foot, knee, head, and thigh. Special issues of importance for
prevention and treatment of these injuries are discussed. [References:
36]
<10>
Unique Identifier
99186447
Authors
Nadeau S. Arsenault AB. Gravel D. Bourbonnais D.
Institution
School of Rehabilitation, Faculty of Medicine, University of Montreal,
Quebec, Canada.
Title
Analysis of the clinical factors determining natural and maximal gait
speeds in adults with a stroke.
Source
American Journal of Physical Medicine & Rehabilitation. 78(2):123-30,
1999 Mar-Apr.
Abbreviated Source
Am J Phys Med Rehabil. 78(2):123-30, 1999 Mar-Apr.
Local Messages
MED
Abstract
The objective of this study was to identify the most important clinical
variables determining gait speed in persons with stroke. Sixteen chronic
stroke subjects (mean age, 47.9 (+/-15.6) yr; mean time post-stroke, 43.9
(+/-36.5) mo) able to walk independently without a brace participated in
the study. The impairments in motor function, sensation of the paretic
lower limb, and balance were evaluated with the Fugl-Meyer Assessment. A
spasticity index was used to assess the muscle tone of the
plantarflexors.
The maximal strengths in plantarflexion and hip flexion were measured
with
a Biodex dynamometric system. Cinematography and foot-contact data
collected on the paretic side were used to determine the comfortable and
maximal gait speeds. The level of association between gait speeds and the
clinical variables were first examined with Pearson's correlation
coefficients and, then, with multiple linear regression analyses using
the
stepwise method. Results revealed that the motor function of the lower
limb, balance, and hip flexion strength were significantly related to
comfortable and maximal gait speeds (0.5 < r < 0.88; P < 0.05). For the
comfortable gait speed, the regression analysis selected only the hip
flexor strength as a significant variable (R2 = 0.69). For maximal gait
speed, the variables retained were hip flexor strength, sensation at the
lower limb, and plantarflexor strength (R2 = 0.85). The present results
suggest that strength and sensation at the lower limb are important
factors to consider in determining the gait capacity of chronic stroke
subjects.
<11>
Unique Identifier
99124195
Authors
Carpenter DM. Nelson BW.
Institution
Prevention First, Minneapolis, MN 55416, USA.
Title
Low back strengthening for the prevention and treatment of low back pain.
Source
Medicine & Science in Sports & Exercise. 31(1):18-24, 1999 Jan.
Abbreviated Source
Med Sci Sports Exerc. 31(1):18-24, 1999 Jan.
Local Messages
unidentified
Abstract
PURPOSE: Chronic low back pain (CLBP) remains one of the most difficult
and costly medical problems in the industrialized world. A review of
nineteenth and early twentieth century spine rehabilitation shows that
back disorders were commonly treated with aggressive and specific
progressive resistance exercise (PRE). Despite a lack of scientific
evidence to support their efficacy, therapeutic approaches to back
rehabilitation over the past 30 yr have focused primarily upon passive
care for symptom relief. Recent spine rehabilitation programs have
returned to active reconditioning PRE centered around low back
strengthening to restore normal musculoskeletal function. Research has
shown that lumbar extension exercise using PRE significantly increases
strength and decreases pain in CLBP patients. It appears that isolated
lumbar extension exercise with the pelvis stabilized using specialized
equipment elicits the most favorable improvements in low back strength,
muscle cross-sectional area, and vertebral bone mineral density (BMD).
These improvements occur with a low training volume of 1 set of 8 to 15
repetitions performed to volitional fatigue one time per week. CLBP
patients participating in isolated lumbar extension PRE programs
demonstrate significant reductions in pain and symptoms associated with
improved muscle strength, endurance, and joint mobility. Improvements
occur independent of diagnosis, are long-lasting, and appear to result in
less re-utilization of the health care system than other more passive
treatments. Low back strengthening shows promise for the reduction of
industrial back injuries and associated costs.
<12>
Unique Identifier
99378983
Authors
Mitchell JC. Giannoudis PV. Millner PA. Smith RM.
Institution
Department of Trauma and Orthopaedics, St James's University Hospital,
Leeds, United Kingdom.
Title
A rare fracture-dislocation of the hip in a gymnast and review of the
literature. [Review] [12 refs]
Source
British Journal of Sports Medicine. 33(4):283-4, 1999 Aug.
Abbreviated Source
Br J Sports Med. 33(4):283-4, 1999 Aug.
Local Messages
unidentified
Abstract
Posterior fracture-dislocation of the hip is an uncommon injury in
athletics and leisure activities. It is more commonly seen in high energy
motor vehicle accidents and occasionally in high energy sporting
activities. A rare case is reported of posterior fracture-dislocation of
the hip joint that occurred in a young athlete during gymnastics. This
unusual mechanism of injury illustrates the great forces sustained by the
hip joint of gymnasts. Early reduction and operative treatment led to a
congruent and stable hip joint. After rehabilitation, she returned to
light sporting activities after six months. [References: 12]
<13>
Unique Identifier
99153755
Authors
Hesse S. Jahnke MT. Schaffrin A. Lucke D. Reiter F. Konrad M.
Institution
Klinik Berlin, Department of Neurological Rehabilitation, Free
University,
Germany.
Title
Immediate effects of therapeutic facilitation on the gait of hemiparetic
patients as compared with walking with and without a cane.
Source
Electroencephalography & Clinical Neurophysiology. 109(6):515-22, 1998
Dec.
Abbreviated Source
Electroencephalogr Clin Neurophysiol. 109(6):515-22, 1998 Dec.
Local Messages
MED (-1988)
Abstract
OBJECTIVES: Although the neurodevelopmental technique (Bobath) is the
most
widely used approach in the gait rehabilitation of hemiparetic subjects
in
Europe, there is little neurophysiological evidence for its presumed
effects on gait symmetry and facilitation of paretic muscles during the
therapeutic intervention. The study, therefore, investigated the
immediate
effects of gait entrainment by a physical therapist on the gait of
hemiparetic subjects. METHODS: Cycle parameters, gait symmetry, hip joint
movement and the electromyographic activity of several lower limb muscles
were assessed in 22 patients during a classic intervention by five Bobath
therapists and while walking with and without a cane. RESULTS:
Multivariate statistics revealed that, while being assisted by the
therapist, patients walked faster (P = 0.022), with a longer relative
stance period of the affected leg (P = 0.005), a higher symmetry (P =
0.002), larger hip extension (P = 0.001) and more activation (P = 0.026)
of the Mm. triceps surae, vastus lateralis, biceps femoris and gluteus
medius as compared to walking with and without a cane. Extensor
spasticity
of the plantar-flexor tended to increase (n.s.). In five subjects, no
after-effect could be documented 1 h after a gait training of 30 min.
CONCLUSIONS: The study confirmed a more balanced walking pattern in
conjunction with facilitation of various weight bearing muscles during
the
therapeutic intervention. A prolonged single stance period of the
affected
leg, an unobstructed hip movement, enhanced weight acceptance and a
faster
gait seemed to be responsible for the observed immediate effects of the
therapeutic intervention.
<14>
Unique Identifier
99127428
Authors
Mares SC.
Institution
Williamsburg Medical Arts-Greensprings Medical Center, VA 23185, USA.
Title
Hip, pelvic, and thigh injuries and disorders in the adolescent athlete.
[Review] [24 refs]
Source
Adolescent Medicine. 9(3):551-68, vii, 1998 Oct.
Abbreviated Source
Adolesc Med. 9(3):551-68, vii, 1998 Oct.
Local Messages
unidentified
Abstract
The common injuries and disorders that affect the hip joint, pelvis, and
thigh and its surrounding tissues are discussed in this chapter. The
clinician's challenge is to determine the severity of the injury and
select the correct treatment and rehabilitation. Careful observation,
diagnostic tests, and a thorough medical history aids this selection. The
characteristics of several sports injuries are highlighted with the
essential components of effective treatment and physical rehabilitation.
[References: 24]
<15>
Unique Identifier
99006276
Authors
DeVita P. Hortobagyi T. Barrier J.
Institution
Department of Exercise and Sport Science, East Carolina University,
Greenville, NC 27858, USA. DeVitaP@MAIL.ECU.EDU
Title
Gait biomechanics are not normal after anterior cruciate ligament
reconstruction and accelerated rehabilitation.
Source
Medicine & Science in Sports & Exercise. 30(10):1481-8, 1998 Oct.
Abbreviated Source
Med Sci Sports Exerc. 30(10):1481-8, 1998 Oct.
Local Messages
unidentified
Abstract
PURPOSE: Accelerated rehabilitation for anterior cruciate ligament (ACL)
injury and reconstruction surgery is designed to return injured people to
athletic activities in approximately 6 months. The small amount of
empirical data on this population suggests, however, that the torque at
the knee joint may not return until 22 months after surgery during
walking
and even longer during running. Although the rehabilitation has ended and
individuals have returned to preinjury activities, gait mechanics appear
to be abnormal at the end of accelerated programs. The purpose of this
study was to compare lower extremity joint kinematics, kinetics, and
energetics between individuals having undergone ACL reconstruction and
accelerated rehabilitation and healthy individuals. METHODS: Eight
ACL-injured and 22 healthy subjects were tested. Injured subjects were
tested 3 wk and 6 months (the end of rehabilitation) after surgery.
Ground
reaction force and kinematic data were combined with inverse dynamics to
predict sagittal plane joint torques and powers from which angular
impulse
and work were derived. RESULTS: The difference in all kinematic variables
between the two tests for the ACL group averaged 38% (all P < 0.05). The
kinematics were not different between the ACL group after rehabilitation
and healthy subjects. Angular impulses and work averaged 100% difference
for all joints (all P < 0.05) between tests for the ACL group. After
rehabilitation, the differences between injured and healthy groups in
angular impulse and work at both the hip and knee remained large and
averaged 52% (all P < 0.05). CONCLUSIONS: Results indicated that after
reconstruction surgery and accelerated rehabilitation for ACL injury,
humans walk with normal kinematic patterns but continue to use altered
joint torque and power patterns.
<16>
Unique Identifier
98340292
Authors
Saini M. Kerrigan DC. Thirunarayan MA. Duff-Raffaele M.
Institution
Spaulding Rehabilitation Hospital, Boston, MA 02114, USA.
Title
The vertical displacement of the center of mass during walking: a
comparison of four measurement methods.
Source
Journal of Biomechanical Engineering. 120(1):133-9, 1998 Feb.
Abbreviated Source
J Biomech Eng. 120(1):133-9, 1998 Feb.
Local Messages
unidentified
Abstract
Measuring the vertical displacement of the center of mass (COM) of the
body during walking may provide useful information about the energy
required to walk. Four methods of varying complexity to estimate the
vertical displacement of the COM were compared in 25 able-bodied, female
subjects. The first method, the sacral marker method, utilized an
external
marker on the sacrum as representative of the COM of the body. The second
method, the reconstructed pelvis method, which also utilized a marker
over
the sacrum, theoretically controlled for pelvic tilt motion. The third
method, the segmental analysis method, involved measuring motion of the
trunk and limb segments. The fourth method, the forceplate method,
involved estimating the COM displacement from ground reaction force
measurements. A two-tailed paired t-test within an ANOVA showed no
statistically significant difference between the sacral marker and the
reconstructed pelvis methods (p = 0.839). There was also no statistically
significant difference between the sacral marker and the segmental
analysis method (p = 0.119) or between the reconstructed pelvis and the
segmental analysis method (p = 0.174). It follows that the first method,
which is the most simple, can provide essentially the same estimate of
the
vertical displacement of the COM as the more complicated second and third
measures. The forceplate method produced data with a lower range and a
different distribution than the other three methods. There was a
statistically significant difference between the forceplate method and
the
other methods (p < 0.01 for each of the three comparisons). The
forceplate
method provides information that is statistically significantly different
from the results of the kinematic methods. The magnitude of the
difference
is large enough to be physiologically significant and further studies to
define the sources of the differences and the relative validity of the
two
approaches are warranted.
<17>
Unique Identifier
98161466
Authors
Juker D. McGill S. Kropf P. Steffen T.
Institution
Institute of Sports Science, Federal School of Sports, Magglingen,
Switzerland.
Title
Quantitative intramuscular myoelectric activity of lumbar portions of
psoas and the abdominal wall during a wide variety of tasks.
Source
Medicine & Science in Sports & Exercise. 30(2):301-10, 1998 Feb.
Abbreviated Source
Med Sci Sports Exerc. 30(2):301-10, 1998 Feb.
Local Messages
unidentified
Abstract
PURPOSE: Since most previous reports of EMG activation profiles from
psoas
and the abdominal wall have been qualitative, the objective of this work
was to document myoelectric activity from these deep muscles. This
knowledge is required to assist in choosing specific training exercises
and for making rehabilitation decisions that require knowledge of
normalized and calibrated muscle activation levels in different tasks.
METHODS: Intramuscular EMG was collected from five men and three women,
in
whom amplitudes were normalized to maximum contraction efforts and
reported over a wide variety of clinical and rehabilitation tasks.
Electrodes were inserted into vertebral portions of psoas and the three
layers of the abdominal wall. Normalized signal amplitudes were reported
as peak levels and time histories. RESULTS: All forms of sit-ups
activated
psoas (15-35% MVC) more than the curl-up (<10%); psoas was not highly
activated during barbell lifting of loads up to 100 kg (< 16% MVC); psoas
was most active during maximal hip flexion efforts; push-ups activated
psoas up to 25% MVC. Several isometric abdominal exercises were evaluated
using the criteria of maximizing abdominal activation while minimizing
psoas activity: the side (bridge) support exercise proved the best
training method for the abdominal wall. CONCLUSIONS: Consideration of
deep
muscle activity, provided in this report, is important for choosing the
most appropriate rehabilitation and training program for an individual.
Specific guidance is provided for choosing the best abdominal exercise,
together with activation profiles during lifting, during twisting, and
during hip rotation.
<18>
Unique Identifier
98141477
Authors
Kerrigan DC. Todd MK. Della Croce U.
Institution
Harvard Medical School, Department of Physical Medicine and
Rehabilitation, and Spaulding Rehabilitation Hospital, Boston,
Massachusetts 02114, USA.
Title
Gender differences in joint biomechanics during walking: normative study
in young adults.
Source
American Journal of Physical Medicine & Rehabilitation. 77(1):2-7, 1998
Jan-Feb.
Abbreviated Source
Am J Phys Med Rehabil. 77(1):2-7, 1998 Jan-Feb.
Local Messages
MED
Abstract
The effect of gender on specific joint biomechanics during gait has been
largely unexplored. Given the perceived, subjective, and temporal
differences in walking between genders, we hypothesized that quantitative
analysis would reveal specific gender differences in joint biomechanics
as
well. Sagittal kinematic (joint motion) and kinetic (joint torque and
power) data from the lower limbs during walking were collected and
analyzed in 99 young adult subjects (49 females), aged 20 to 40 years,
using an optoelectronic motion analysis and force platform system.
Kinetic
data were normalized for both height and weight. Female and male data
were
compared graphically and statistically to assess differences in all major
peak joint kinematic and kinetic values. Females had significantly
greater
hip flexion and less knee extension before initial contact, greater knee
flexion moment in pre-swing, and greater peak mechanical joint power
absorption at the knee in pre-swing (P < 0.0019 for each parameter).
Other
differences were noted (P < 0.05) that were not statistically significant
when accounting for multiple comparisons. These gender differences may
provide new insights into walking dynamics and may be important for both
clinical and research studies in motivating the development of separate
biomechanical reference databases for males and females.
<19>
Unique Identifier
97480879
Authors
Boyd KT. Peirce NS. Batt ME.
Institution
Department of Orthopaedic and Accident Surgery, University of Nottingham,
England.
Title
Common hip injuries in sport. [Review] [115 refs]
Source
Sports Medicine. 24(4):273-88, 1997 Oct.
Abbreviated Source
Sports Med. 24(4):273-88, 1997 Oct.
Local Messages
unidentified
Abstract
As a major weight-bearing joint, normal hip function is fundamental to
successful sporting participation. Not only is it important in running-,
jumping- and kicking-based activities, it also contributes to the
generation and transference of forces in upper limb-dominated activities.
Injuries to the hip do not account for a large proportion of the sports
physician's workload, but may result in significant morbidity. The wide
variety of acute, subacute and chronic injuries, affecting both the joint
and surrounding soft tissues, can prove a diagnostic dilemma. The
predisposition and the types of injuries around the hip vary with the age
of the athlete. The young child rarely sustains a significant injury but
one should be aware of orthopaedic conditions common in this age group
that may manifest themselves through exercise. The immature skeleton of
the adolescent is relatively injury prone and the demands of sport often
exceed the capacity of the growing musculoskeletal system. In adults and
older athletes, a further spectrum of injury exists, along with the
effects of aging tissues and the concerns of degenerative joint disease.
Rational treatment is based on a clear diagnosis developed through sound
knowledge and a thorough history and examination. For the sports
physician, treatments are typically early physical therapy and
structured,
progressive rehabilitation programmes which are individualised to the
needs of the athlete. The spectrum of hip injuries is reviewed with
current recommended diagnoses and management. [References: 115]
<20>
Unique Identifier
97308167
Authors
Raasch CC. Zajac FE. Ma B. Levine WS.
Institution
Rehabilitation R&D Center (153), Veterans Affairs Palo Alto Health Care
System, CA 94304-1200, USA.
Title
Muscle coordination of maximum-speed pedaling.
Source
Journal of Biomechanics. 30(6):595-602, 1997 Jun.
Abbreviated Source
J Biomech. 30(6):595-602, 1997 Jun.
Local Messages
unidentified
Abstract
A simulation based on a forward dynamical musculoskeletal model was
computed from an optimal control algorithm to understand uni- and
bi-articular muscle coordination of maximum-speed startup pedaling. The
muscle excitations, pedal reaction forces, and crank and pedal kinematics
of the simulation agreed with measurements from subjects. Over the crank
cycle, uniarticular hip and knee extensor muscles provide 55% of the
propulsive energy, even though 27% of the amount they produce in the
downstroke is absorbed in the upstroke. Only 44% of the energy produced
by
these muscles during downstroke is delivered to the crank directly. The
other 56% is delivered to the limb segments, and then transferred to the
crank by the ankle plantarflexors. The plantarflexors, especially soleus,
also prevent knee hyperextension, by slowing the knee extension being
produced during downstroke by the other muscles, including hamstrings.
Hamstrings and rectus femoris make smooth pedaling possible by propelling
the crank through the stroke transitions. Other simulations showed that
pedaling can be performed well by partitioning all the muscles in a leg
into two pairs of phase-controlled alternating functional groups, with
each group also alternating with its contralateral counterpart. In this
scheme, the uniarticular hip/knee extensor muscles (one group) are
excited
during downstroke, and the uniarticular hip/knee flexor muscles (the
alternating group) during upstroke. The ankle dorsiflexor and rectus
femoris muscles (one group of the other pair) are excited near the
transition from upstroke to downstroke, and the ankle plantarflexors and
hamstrings muscles (the alternating group) during the downstroke to
upstroke transition. We conclude that these alternating functional muscle
groups might represent a centrally generated primitive for not only
pedaling but also other locomotor tasks as well.
<21>
Unique Identifier
97177703
Authors
Mohr T. Andersen JL. Biering-Sorensen F. Galbo H. Bangsbo J. Wagner
A. Kjaer M.
Institution
Copenhangen Muscle Research Centre, National University Hospital,
Denmark.
Title
Long-term adaptation to electrically induced cycle training in severe
spinal cord injured individuals [published erratum appears in Spinal Cord
1997 Apr;35(4):262].
Source
Spinal Cord. 35(1):1-16, 1997 Jan.
Abbreviated Source
Spinal Cord. 35(1):1-16, 1997 Jan.
Local Messages
unidentified
Abstract
Spinal cord injured (SCI) individuals most often contract their injury at
a young age and are deemed to a life of more or less physical inactivity.
In addition to the primary implications of the SCI, severe SCI
individuals
are stigmatized by conditions related to their physically inactive
lifestyle. It is unknown if these inactivity related conditions are
potentially reversible and the aim of the present study was, therefore,
to
examine the effect of exercise on SCI individuals. Ten such individuals
(six with tetraplegia and four with paraplegia; age 27-45 years; time
since injury 3-23 years) were exercise trained for 1 year using an
electrically induced computerized feedback controlled cycle ergometer.
They trained for up to three times a week (mean 2.3 times), 30 min on
each
occasion. The gluteal, hamstring and quadriceps muscles were stimulated
via electrodes placed on the skin over their motor points. During the
first training bouts, a substantial variation in performance was seen
between the subjects. A majority of them were capable of performing 30
min
of exercise in the first bout; however, two individuals were only able to
perform a few minutes of exercise. After training for 1 year all of the
subjects were able to perform 30 min of continuous training and the work
output had increased from 4 +/- 1 (mean +/- SE) to 17 +/- 2 Kilo Joules
per training bout (P < 0.05). The maximal oxygen uptake during
electrically induced exercise increased from 1.20 +/- 0.08 litres per
minute measured after a few weeks habituation to the exercise to 1.43 +/-
0.09 litres per minute after training for 1 year (P < 0.05). Magnetic
resonance cross sectional images of the thigh were performed to estimate
muscle mass and an increase of 12% (mean, P < 0.05) was seen in response
to 1 year of training. In biopsies taken before exercise various degrees
of atrophy were observed in the individual muscle fibres, a phenomenon
that was partially normalized in all subjects after training. The fibre
type distribution in skeletal muscles is known to shift towards type IIB
fibres (fast twitch, fast fatiguable, glycolytic fibres) within the first
2 years after the spinal cord injury. The muscle in the present
investigation contained of 63% myosin heavy chain (MHC) isoform IIB, 33%
MHC isoform IIA (fast twitch, fatigue resistant) and less than 5% MHC
isoform I (slow twitch) before training. A shift towards more fatigue
resistant contractile proteins was found after 1 year of training. The
percentage of MHC isoform IIA increased to 61% of all contractile protein
and a corresponding decrease to 32% was seen in the fast fatiguable MHC
isoform IIB, whereas MHC isoform I only comprised 7% of the total amount
of MHC. This shift was accompanied by a doubling of the enzymatic
activity
of citrate synthase, as an indicator of mitochondrial oxidative capacity.
It is concluded that inactivity-associated changes in exercise
performance
capacity and skeletal muscle occurring in SCI individuals after injury
are
reversible, even up to over 20 years after the injury. It follows that
electrically induced exercise training of the paralysed limbs is an
effective rehabilitation tool that should be offered to SCI individuals
in
the future.
<22>
Unique Identifier
97170332
Authors
Tucker AM.
Institution
Primary Care Sports Medicine, University of Maryland Medical Center,
Baltimore, USA.
Title
Common soccer injuries. Diagnosis, treatment and rehabilitation. [Review]
[41 refs]
Source
Sports Medicine. 23(1):21-32, 1997 Jan.
Abbreviated Source
Sports Med. 23(1):21-32, 1997 Jan.
Local Messages
unidentified
Abstract
Soccer is a game with worldwide appeal. Increasing numbers of
participants
are members of all age groups and skill levels. The game presents to the
sports medicine practitioner a wide variety of musculoskeletal and
medical
problems. Soccer injuries increase in frequency as the age of participant
increases, with a low incidence of injury in preadolescent players.
Musculoskeletal injuries most commonly affect the lower extremities and
include contusions, acute and chronic musculotendinous strains, and
ligamentous injuries to the knee and ankle. Most injuries are minor and
respond to analgesics, therapy modalities and exercise therapy. Groin
pain
is a common problem and particularly prevalent among soccer players owing
to the game's specific stresses. Other less common but important injuries
include facial trauma, mild brain injury (concussion) and heat-related
injury. Team physicians, athletic trainers and physical therapists need
to
possess a basic understanding of the most common injuries and problems in
order to maximise safe participation for their athletes. [References: 41]
<23>
Unique Identifier
97133775
Authors
Sparto PJ. Parnianpour M. Reinsel TE. Simon S.
Institution
Biomedical Engineering Center, Ohio State University, Columbus 43210,
USA.
Title
The effect of fatigue on multijoint kinematics, coordination, and
postural
stability during a repetitive lifting test.
Source
Journal of Orthopaedic & Sports Physical Therapy. 25(1):3-12, 1997 Jan.
Abbreviated Source
J Orthop Sports Phys Ther. 25(1):3-12, 1997 Jan.
Local Messages
unidentified
Abstract
Because of the inability of strength tests to accurately discriminate
between low back pain patients and healthy subjects, a multifactorial
evaluation of low back pain patients is warranted. It is postulated that
measurements of endurance, kinematics, postural stability, and
coordination, in addition to strength, are necessary to fully document
the
patients' functional capabilities. This research study was conducted in
order to understand the effects of fatigue on the above factors. Twelve
healthy male subjects performed a repetitive lifting test in which a
submaximal load was lifted at a maximal rate. Knee, hip, and trunk motion
was measured using videography and electrogoniometry, postural stability
was measured using a forceplate, and coordination parameters were
determined using phase-plane analysis. Fatigue was documented by a 31%
reduction in lifting power. At the end of the endurance test, there was
less knee and hip range of motion and greater spine peak flexion, while
the coordination measures demonstrated that there was greater hip and
lumbar spine extension earlier in the lifting phase. The postural
stability declined as the test endured. Utilization of these measures may
guide physical therapists in their rehabilitation of low back pain
patients.
Date: 27-Feb-2001
Name: rehabill
Database: Medline <1993 to 1996>
Set Search Results

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003 1 and 2 2
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007 3 or 6 5
008 2 and 5 379
010 8 and 9 37
011 7 or 10 41
013 from 12 keep 1-2,4-7,10-17,20,22-24,26,28,30,33-34,37 24
014 13 24
<1>
Unique Identifier
97013639
Authors
Czerniecki JM. Gitter AJ. Beck JC.
Institution
Department of Rehabilitation Medicine, University of Washington, Seattle,
USA.
Title
Energy transfer mechanisms as a compensatory strategy in below knee
amputee runners.
Source
Journal of Biomechanics. 29(6):717-22, 1996 Jun.
Abbreviated Source
J Biomech. 29(6):717-22, 1996 Jun.
Local Messages
unidentified
Abstract
Below knee amputee runners exhibit abnormalities in the mechanical work
characteristics of the lower extremity musculature during stance phase.
The most significant abnormality is a marked reduction in the mechanical
work done in the stance phase prosthetic limb. Energy transfer across the
hip joint to the trunk during deceleration of the swing phase leg may be
an important energy distribution mechanism to compensate for the reduced
work done during prosthetic stance phase. Five unilateral below knee
amputee runners wearing the SACH prosthetic foot and 5 normal subjects
were studied. All subjects ran at a controlled velocity of 2.8 ms(-1)
while kinematic and ground reaction force data were collected. Using a
four segment linked segment model and an inverse dynamics approach joint
moments, muscle power outputs, mechanical work values and energy
transfers
across the hip were calculated. The total amount of energy transferred
during swing phase and the energy transferred out of the swing phase leg
into the trunk were both significantly greater than normal. Energy
transfer mechanisms are important in influencing the lower extremity
energetics during swing phase. In addition, the 74 percent increase in
energy transfer out of the intact swing phase limb combined with the
temporal characteristics of this energy flow suggests that energy
transfer
may be an adaptive mechanism that allows energy redistribution to the
trunk which may partially compensate for the reduced power output of the
stance phase prosthetic limb.
<2>
Unique Identifier
97101127
Authors
Fregly BJ. Zajac FE. Dairaghi CA.
Institution
Rehabilitation R&D Center, Veterans Affairs Palo Alto Health Care System,
California 94304-1200, USA.
Title
Crank inertial load has little effect on steady-state pedaling
coordination.
Source
Journal of Biomechanics. 29(12):1559-67, 1996 Dec.
Abbreviated Source
J Biomech. 29(12):1559-67, 1996 Dec.
Local Messages
unidentified
Abstract
Inertial load can affect the control of a dynamic system whenever parts
of
the system are accelerated or decelerated. During steady-state pedaling,
because within-cycle variations in crank angular acceleration still
exist,
the amount of crank inertia present (which varies widely with road-riding
gear ratio) may affect the within-cycle coordination of muscles. However,
the effect of inertial load on steady-state pedaling coordination is
almost always assumed to be negligible, since the net mechanical energy
per cycle developed by muscles only depends on the constant cadence and
workload. This study test the hypothesis that under steady-state
conditions, the net joint torques produced by muscles at the hip, knee,
and ankle are unaffected by crank inertial load. To perform the
investigation, we constructed a pedaling apparatus which could emulate
the
low inertial load of a standard ergometer or the high inertial load of a
road bicycle in high gear. Crank angle and bilateral pedal force and
angle
data were collected from ten subjects instructed to pedal steadily (i.e.,
constant speed across cycles) and smoothly (i.e., constant speed within a
cycle) against both inertias at a constant workload. Virtually no
statistically significant changes were found in the net hip and knee
muscle joint torques calculated from an inverse dynamics analysis. Though
the net ankle muscle joint torque, as well as the one- and two-legged
crank torque, showed statistically significant increases at the higher
inertia, the changes were small. In contrast, large statistically
significant reductions were found in crank kinematic variability both
within a cycle and between cycles (i.e., cadence), primarily because a
larger inertial load means a slower crank dynamic response. Nonetheless,
the reduction in cadence variability was somewhat attenuated by a large
statistically significant increase in one-legged crank torque
variability.
We suggest, therefore, that muscle coordination during steady-state
pedaling is largely unaffected, though less well regulated, when crank
inertial load is increased.
<3>
Unique Identifier
97038899
Authors
Brown DA. Kautz SA. Dairaghi CA.
Institution
VA Palo Alto Health Care System, Rehabilitation Research and Development
Center, Palo Alto, CA 94304-1200, USA.
Title
Muscle activity patterns altered during pedaling at different body
orientations.
Source
Journal of Biomechanics. 29(10):1349-56, 1996 Oct.
Abbreviated Source
J Biomech. 29(10):1349-56, 1996 Oct.
Local Messages
unidentified
Abstract
Gravity is a contributing force that is believed to influence strongly
the
control of limb movements since it affects sensory input and also
contributes to task mechanics. By altering the relative contribution of
gravitational force to the overall forces used to control pedaling at
different body orientations, we tested the hypothesis that joint torque
and muscle activation patterns would be modified to generate steady-state
pedaling at altered body orientations. Eleven healthy subjects pedaled a
modified ergometer at different body orientations (from horizontal to
vertical), maintaining the same workload (80 J), cadence (60 rpm), and
hip
and knee kinematics. Pedal reaction forces and crank and pedal kinematics
were measured and used to calculate joint torques and angles. EMG was
recorded from four muscles (tibialis anterior, triceps surae, rectus
femoris, biceps femoris). Measures of muscle activation (joint torque and
EMG activity) showed strong dependence on body orientation, indicating
that muscle activity is not fixed and is modified in response to altered
body orientation. Simulations confirmed that, while joint torque changes
were not necessary to pedal at different body orientations, observed
changes were necessary to maintain consistent crank angular velocity
profiles. Dependence of muscle activity on body orientation may be due to
neural integration of sensory information with an internal model that
includes characteristics of the endpoint, to produce consistent pedaling
trajectories. Thus, both sensory consequences and mechanical aspects of
gravitational forces are important determinants of locomotor tasks such
as
pedaling.
<4>
Unique Identifier
96371313
Authors
Gomez JE.
Institution
Department of Pediatrics, University of Texas Health Science Center at
San
Antonio 78284-7808, USA.
Title
Bilateral anterior inferior iliac spine avulsion fractures.
Source
Medicine & Science in Sports & Exercise. 28(2):161-4, 1996 Feb.
Abbreviated Source
Med Sci Sports Exerc. 28(2):161-4, 1996 Feb.
Local Messages
unidentified
Abstract
A case of bilateral groin pain of sudden onset in a 14-yr-old boy is
presented. The patient reported sudden onset of pain in both inguinal
regions during a 100-m dash. He presented a week later to the clinic
where
physical examination revealed a shuffling gait, bilateral hip flexion
contractures, limited active and passive hip extension, and bilateral
weakness of hip flexion and knee extension. Plain radiographs of the
pelvis revealed avulsion fragments minimally displaced from both anterior
inferior iliac spines (AIIS). Pain relief in the acute phase was achieved
by limiting ambulation until weight bearing was painless. The patient was
treated conservatively and returned to full speed running in 10 wk. Only
one case of bilateral AIIS avulsion fractures has previously been
reported. AIIS avulsion fractures that are not widely displaced may be
treated conservatively. Following a careful program of rehabilitation,
full functional recovery following AIIS avulsion fractures may be
achieved
in 4-6 wk.
<5>
Unique Identifier
96368164
Authors
Steele MK 3rd.
Institution
Maryland Knee and Hip Center, USA.
Title
Caring for athletes in youth sports.
Source
Maryland Medical Journal. 45(8):689-91, 1996 Aug.
Abbreviated Source
Md Med J. 45(8):689-91, 1996 Aug.
Local Messages
unidentified
<6>
Unique Identifier
96294966
Authors
Lange GW. Hintermeister RA. Schlegel T. Dillman CJ. Steadman JR.
Institution
Rehabilitation and Human Performance Laboratory, Steadman Hawkins Sports
Medicine Foundation, Vail, CO 81657, USA.
Title
Electromyographic and kinematic analysis of graded treadmill walking and
the implications for knee rehabilitation.
Source
Journal of Orthopaedic & Sports Physical Therapy. 23(5):294-301, 1996
May.
Abbreviated Source
J Orthop Sports Phys Ther. 23(5):294-301, 1996 May.
Local Messages
unidentified
Abstract
Muscle activity, joints, angles, and heart rate during uphill walking
were
compared for application in knee rehabilitation. The objectives of this
study were to quantify muscle activation levels at different treadmill
grades and to determine the grade(s) at which knee range of motion would
not further compromise the joint. Average and peak electromyographic
activity of the quadriceps (vastus medialis oblique and vastus lateralis)
and hamstrings (biceps femoris and medial hamstrings
(semimembranosus/semitendinosus)] was recorded during walking at 0, 12,
and 24% grade. Six subjects (age = 28.5 +/- 3.7 years, stature = 1.79 +/-
.05 m, and mass = 74.7 +/- 7.9 kg) walked at self-selected speeds at each
grade while ankle, knee and hip angles, heart rate, and electromyographic
activity (surface electrodes) were recorded. Maximum voluntary
contractions provided a relative reference for the electromyographic
activity during walking. Average and peak electromyographic activity
increased significantly across grades for the vastus medialis oblique
(125
and 154%), vastus lateralis (109 and 139%), and biceps femoris (53 and
46%), but remained similar for the medial hamstrings. Maximum knee
flexion
at heel strike increased significantly with grade. Despite decreased
self-selected speeds with increasing grade, there were significant
increases in heart rate across grades. The results of this study provide
a
basic understanding of the quadriceps and hamstrings activity levels,
lower extremity joint range of motion, and cardiovascular requirements of
graded treadmill walking in normal subjects. The results also suggest
that
a grade just greater than 12% may be most beneficial for knee
rehabilitation to minimize patellofemoral discomfort or potential strain
on the anterior cruciate ligament. The benefits achieved through this
functional activity encourage its implementation in rehabilitation and
provide a basis for comparison with injured patients.
<7>
Unique Identifier
96254992
Authors
DeVita P. Torry M. Glover KL. Speroni DL.
Institution
Department of Exercise and Sport Science, East Carolina University,
Greenville, NC 27858, USA.
Title
A functional knee brace alters joint torque and power patterns during
walking and running.
Source
Journal of Biomechanics. 29(5):583-8, 1996 May.
Abbreviated Source
J Biomech. 29(5):583-8, 1996 May.
Local Messages
unidentified
Abstract
Individuals with anterior cruciate ligament (ACL) injury use greater
extensor torques at the hip and ankle and lower extensor torques and
joint
power at the knee during gait compared to healthy subjects. These
adaptations may be mediated by (1) altered neuromuscular strategies due
to
the injury, (2) training effects produced by rehabilitation protocols,
and
(3) training effects due to the functional knee brace (FKB) used during
rehabilitation. The purpose of the study was to test the hypothesis that
a
FKB can cause individuals to walk and run with the torque and power
patterns observed in rehabilitated ACL-injured individuals. Ten healthy
subjects were tested walking and running with and without a FKB.
Kinematic
and ground reaction data were collected and combined with inverse
dynamics
to estimate the joint torques and powers. Data were analyzed with a
two-way repeated measures ANOVA (gait vs knee condition). In walking, the
hip and ankle extensor torques were 14.3% (p < 0.038) and 5.1% (p <
0.003)
greater with FKB. In running, the hip extensor torque was 17.0% greater
with FKB (p < 0.023). Knee torque was not different between conditions.
In
walking, the work performed at the hip and knee were 11.6% greater (p <
0.013) and 17.7% lower with FKB (p < 0.025), respectively. Results
supported the hypothesis and it was concluded that a FKB may be one
causative factor in the development of the unique joint torque and power
patterns seen in ACL-injured gait.
<8>
Unique Identifier
96281872
Authors
Howell SM. Taylor MA.
Institution
Clinical Investigation Facility, David Grant Medical Center, Travis Air
Force Base, California 94535-5300, USA.
Title
Brace-free rehabilitation, with early return to activity, for knees
reconstructed with a double-looped semitendinosus and gracilis graft.
Source
Journal of Bone & Joint Surgery - American Volume. 78(6):814-25, 1996
Jun.
Abbreviated Source
J Bone Joint Surg Am. 78(6):814-25, 1996 Jun.
Local Messages
unidentified
Abstract
Forty-one patients in whom operative reconstruction of a torn anterior
cruciate ligament had been performed by one surgeon with use of a
double-looped semitendinosus and gracilis hamstring graft were studied to
determine (1) if a brace-free rehabilitation program compromised the
early
stability of the knee; (2) if the stability of the knee deteriorated
between four months, when the patient returned to unrestricted
activities,
and two years; and (3) if the function of the treated knee was completely
restored by four months after the operation. The graft was placed
arthroscopically, without impingement by the intercondylar roof, and was
fixed within the tibial tunnel to conserve the length of the graft. The
stability and function of thirty-seven of the knees were assessed at four
months as part of a larger prospective study. Four patients chose not to
return for the four-month evaluation. The patients returned to
unrestricted sports and work activities after the four-month evaluation.
At two years, all forty-one patients were evaluated. At four months,
after
completion of the brace-free rehabilitation program, thirty-three (82 per
cent) of the thirty-seven patients had an absent pivot shift and a normal
Lachman test. Twenty-eight (88 per cent) of thirty-four knees had less
than three millimeters of difference in laxity compared with the
contralateral knee, as determined by testing at the maximum manual force
with use of a KT-1000 arthrometer. Stability remained unchanged at two
years, justifying the early return to vigorous activities at four months.
The girth of the thigh, the extension of the knee, and the Lysholm and
Gillquist score were the same at four months as at two years, verifying
the success of the brace-free intensive rehabilitation program in the
restoration of early function to the treated knee. However, some
continued
improvement was observed in the performance of the one-leg-hop for
distance test between four months and two years.
<9>
Unique Identifier
96258310
Authors
Saitoh E. Suzuki T. Sonoda S. Fujitani J. Tomita Y. Chino N.
Institution
Department of Rehabilitation Medicine, School of Medicine, Fujita Health
University, 1-98 Kustukake, Toyoake, Aichi, Japan.
Title
Clinical experience with a new hip-knee-ankle-foot orthotic system using
a
medial single hip joint for paraplegic standing and walking.
Source
1996 May-Jun.
Abbreviated Source
Am J Phys Med Rehabil. 75(3):198-203, 1996 May-Jun.
Local Messages
MED
Abstract
The Walkabout is a new hip-knee-ankle-foot orthotic (HKAFO) system with a
medial single hip joint (MSH-KAFO) invented by S. McKay in 1992. Compared
with other HKAFO systems, the hip joint part is compact and removable, so
it has distinguishable, real merits: ease in donning and doffing the
device, compatibility with a wheelchair, and cosmesis. We clinically
tested five patients, paraplegic because of spinal cord injury, using the
MSH-KAFO system. All were males, aged 26-36 yr old. Their functional
levels were L-1 (2 cases), T-10 (2 cases), and T-5 (1 case). All patients
could stand stably without crutches and walk in parallel bars immediately
the first time they wore the braces. After a few hours of crutch-walking
exercises, all could walk independently with Lofstrand crutches. Their
walking velocities ranged from 10 to 37.5 (mean, 19.9) m/min at the
follow-up points (mean, 7.1 mo). With four cases, we measured oxygen
uptake for predictions of energy consumption. At comfortable walking,
predicted energy consumptions were from 1.31 to 3.89 (mean, 2.75) METs.
Compared with the data in literature, these seemed to be at the same
level
with normal walking and lower than the KAFOs walking level. Our results
suggest that MSH-KAFO is a very convenient standing and walking device
for
paraplegics and is compatible with wheelchair use.
<10>
Unique Identifier
96264740
Authors
BeDell KK. Scremin AME. Perell KL. Kunkel CF.
Institution
Physical Medicine and Rehabilitation Service, West Los Angeles Department
of Veterans Affairs Medical Center, CA 90073, USA.
Title
Effects of functional electrical stimulation-induced lower extremity
cycling on bone density of spinal cord-injured patients.
Source
1996
Jan-Feb.
Abbreviated Source
Am J Phys Med Rehabil. 75(1):29-34, 1996 Jan-Feb.
Local Messages
MED
Abstract
Spinal cord-injured (SCI) patients are at increased risk for fractures
secondary to neurogenic osteoporosis. Earlier research claimed physical
conditioning resulted in a decreased incidence or reversal of neurogenic
osteoporosis. This study evaluated the effects of functional electrical
stimulation-induced lower extremity cycling (FESILEC) on the bone
densities of SCI patients using dual-energy x/ray absorptiometry (DEXA).
The study consisted of 12 healthy male SCI patients, aged 23 to 46 (x +/-
SD, 34 +/- 6) yr. The patients were post-traumatic, complete, spastic
SCI;
time postinjury ranged from 2 to 19 (9.7 +/- 5.1) yr. Patients
participated in a three-phase training program. Phase 1 consisted of
quadriceps strengthening. Phase 2 consisted of progressive sequential
stimulation of quadriceps, hamstrings, and gluteal muscles, achieving a
rhythmical pedaling motion on the REGYS I ergometer. Phase 3a consisted
of
30-min FESILEC sessions. DEXAs were done at baseline and at completion of
Phase 3a and Phase 3b. Bone densities were done of the lumbar spine
levels
2-4 (L2-4), bilateral trochanters (T), Ward's triangles (WT) and femoral
necks (FN). Baseline bone density indicated no difference between L2-4 of
ambulatory males and SCI males. Baseline values obtained for T, WT, and
FN
were, respectively, 71, 82, and 79% of ambulatory values. Results after
completion of the Phase 3a training program indicated no statistically
significant difference compared with baseline values. There was, however,
a positive trend in the lumbar spine post-Phase 3a (L2-4, P=0.056). Eight
patients continued the exercise program, using a combination of upper and
lower extremity cycling (Phase 3b) for a longer period of time (25 +/- 9
wk). DEXAs done after Phase 3b indicated no change relative to baseline
data or data post-Phase 3a. In conclusion, although FESILEC did not
significantly increase bone density in the hip parameters of chronic SCI
patients, a positive trend was observed in the lumbar spine. Further
research with acute intervention, such as FESILEC during the first few
months post-SCI, is warranted to further evaluate a treatment regimen to
prevent or reduce neurogenic osteopenia.
<11>
Unique Identifier
96115959
Authors
Tashman S. Zajac FE. Perkash I.
Institution
Rehabilitation Research and Development Center, Veterans Affairs Medical
Center, Palo Alto, CA, USA.
Title
Modeling and simulation of paraplegic ambulation in a reciprocating gait
orthosis.
Source
Journal of Biomechanical Engineering. 117(3):300-8, 1995 Aug.
Abbreviated Source
J Biomech Eng. 117(3):300-8, 1995 Aug.
Local Messages
unidentified
Abstract
We developed a three dimensional, four segment, eight-degree-of-freedom
model for the analysis of paraplegic ambulation in a reciprocating gait
orthosis (RGO). Model development was guided by experimental analysis of
a
spinal cord injured individual walking in an RGO with the additional
assistance of arm crutches. Body forces and torques required to produce a
dynamic simulation of the RGO gait swing phase were found by solving an
optimal control problem to track the recorded kinematics and ground
reaction forces. We found that high upper body forces are required, not
only during swing but probably also during double support to compensate
for the deceleration of the body during swing, which is due to the pelvic
thrust necessary to swing the leg forward. Other stimulations showed that
upper body forces and body deceleration during swing can be reduced
substantially by producing a ballistic swing. Functional neuromuscular
stimulation of the hip musculature during double support would then be
required, however, to establish the initial conditions needed in a
ballistic swing.
<12>
Unique Identifier
96193262
Authors
Short JW. Pedowitz RA. Strong JA. Speer KP.
Institution
Primary Care Sports Medicine Section, Duke University Medical Center,
Durham, North Carolina, USA.
Title
The evaluation of pelvic injury in the female athlete.
Source
Sports Medicine. 20(6):422-8, 1995 Dec.
Abbreviated Source
Sports Med. 20(6):422-8, 1995 Dec.
Local Messages
unidentified
Abstract
The differential diagnosis of pelvic pain and possible injury in the
female athlete is quite broad and must include gastrointestinal and
genitourinary aetiologies, as well as musculoskeletal injuries. These
considerations reflect the anatomical complexity of the female pelvis.
The
pelvic bones house the lower gastrointestinal and genitourinary viscera
and transmit stress from the lower extremities to the upper body. The
innervation of the pelvic structures also complicates evaluation and
diagnosis when somatic and visceral afferent information affects the
athlete's interpretation of pain. An algorithmic approach can facilitate
evaluation and rehabilitation of pelvic injuries in the female athlete in
the contest of previously described mechanisms of musculoskeletal injury.
<13>
Unique Identifier
96129688
Authors
Welch CM. Banks SA. Cook FF. Draovitch P.
Institution
Human Performance Technologies, Inc., Jupiter, FL 33477, USA.
Title
Hitting a baseball: a biomechanical description.
Source
Nov.
Abbreviated Source
J Orthop Sports Phys Ther. 22(5):193-201, 1995 Nov.
Local Messages
unidentified
Abstract
A tremendous amount of time and energy has been dedicated to the
development of conditioning programs, mechanics drills, and
rehabilitation
protocols for the throwing athlete. In comparison, a significantly
smaller
amount has been spent on the needs of the hitting athlete. Before these
needs can be addressed, an understanding of mechanics and the demands
placed on the body during the swing must be developed. This study uses
three-dimensional kinematic and kinetic data to define and quantify
biomechanics during the baseball swing. The results show that a hitter
starts the swing with a weight shift toward the rear foot and the
generation of trunk coil. As the hitter strides forward, force applied by
the front foot equal to 123% of body weight promotes segment acceleration
around the axis of the trunk. The hip segment rotates to a maximum speed
of 714 degrees/sec followed by a maximum shoulder segment velocity of 937
degrees/sec. The product of this kinetic link is a maximum linear bat
velocity of 31 m/sec. By quantifying the hitting motion, a more educated
approach can be made in developing rehabilitation, strength, and
conditioning programs for the hitting athlete.
<14>
Unique Identifier
96043993
Authors
Cipriani DJ. Armstrong CW. Gaul S.
Institution
Medical College of Ohio, School of Allied Health, Department of Physical
Therapy, Toledo 43699-0008, USA.
Title
Backward walking at three levels of treadmill inclination: an
electromyographic and kinematic analysis.
Source
Sep.
Abbreviated Source
J Orthop Sports Phys Ther. 22(3):95-102, 1995 Sep.
Local Messages
unidentified
Abstract
Backward walking on a treadmill is a common tool for lower extremity
rehabilitation in the clinical setting. The purpose of this study was to
evaluate the adaptations in the gait cycle produced by walking backward
on
a treadmill at 0, 5, and 10% inclination. Sixteen healthy adult subjects
(14 females, two males), mean age of 23.19 +/- 3.02, participated. Joint
positions for hip, knee, and ankle were measured during a complete gait
cycle. Values were time matched with average electromyographic (EMG)
activity (surface electrode) of the rectus femoris, hamstrings,
gastrocnemius, and anterior tibialis during each subphase of gait
(initial
contact, midstance, heel-off, and midswing). Values of joint position and
average EMG were compared over the three treadmill conditions. Subjects
walked for approximately 1 minute at 4.0 km/h. A simple repeated measures
analysis of variance (p < .05) with a Duncan post hoc test was used to
analyze for changes. Significant changes occurred in the joint positions
of the knee and ankle at initial contact (ankle increased from 9.81 +/-
5.06 degrees to 13.08 +/- 3.68 degrees; knee increased from 30.94 +/-
5.25
degrees to 42.42 +/- 4.08 degrees) as the treadmill was raised from 0 to
10%. Significant changes occurred for average EMG activity for each
muscle
studied over the three treadmill conditions. The greatest changes
occurred
in the gastrocnemius at initial contact (increase from 189.76 +/- 44.29%
to 293.09 +/- 79.16%) between the 0 and 10% conditions. The results of
this investigation confirm that backward walking up an incline may place
additional muscular demands on an individual.(ABSTRACT TRUNCATED AT 250
WORDS)
<15>
Unique Identifier
96015567
Authors
Wolfe MW. Brinker MR. Cary GR. Cook SD.
Institution
Department of Orthopaedic Surgery, Tulane University Medical Center, New
Orleans, La 70112, USA.
Title
Posterior fracture-dislocation of the hip in a jogger.
Source
Journal of the Southern Orthopaedic Association. 4(2):91-5, 1995 Summer.
Abbreviated Source
J South Orthop Assoc. 4(2):91-5, 1995 Summer.
Local Messages
unidentified
Abstract
Posterior fracture-dislocation of the hip is an uncommon athletic injury,
occasionally seen in contact and high-energy sports. The mechanism of
injury in this case highlights the high hip joint forces possible during
running. The key treatment principle is early reduction of the hip joint,
since the incidence of osteonecrosis of the femoral head and degenerative
arthrosis increases with delay. Operative treatment will frequently be
required to achieve a stable, congruent reduction of articular surfaces,
essential for good long-term results. Partial weight-bearing exercise
such
as swimming and bicycling may aid rehabilitation. Long-term follow-up,
with serial radiographs, is important to detect late complications.
<16>
Unique Identifier
95311696
Authors
Karpos PA. Spindler KP. Pierce MA. Shull HJ Jr.
Institution
Department of Orthopaedics and Rehabilitation, and Internal Medicine,
Vanderbilt University Medicine Center, Nashville, TN 37232, USA.
Title
Osteomyelitis of the pubic symphysis in athletes: a case report and
literature review. [Review] [29 refs]
Source
Medicine & Science in Sports & Exercise. 27(4):473-9, 1995 Apr.
Abbreviated Source
Med Sci Sports Exerc. 27(4):473-9, 1995 Apr.
Local Messages
unidentified
Abstract
Groin pain is a common problem in athletes. Osteitis pubis, a chronic
inflammatory condition involving the pubic symphysis, is a rare cause,
and
pyogenic osteomyelitis of the pubis is seen even more rarely in healthy
athletes. We report one of four cases of pyogenic osteomyelitis of the
pubis seen at our institution, review our experience with all four cases,
and present a review of the literature (7 cases). The diagnosis is
established by the presence of extreme pain, point tenderness at the
pubic
symphysis, fever, and either a positive culture of blood, needle
aspiration, or open biopsy of the pubis. White blood cell count,
erythrocyte sedimentation rate, and the results of bone scan and
computerized tomography may initially be normal and therefore cannot
exclude the diagnosis. Prompt treatment with intravenous (i.v.)
antibiotics effective against Staphylococcus aureus (causative organism
in
all documented cases-9/11) should initially be administered and then
guided by culture and sensitivity information. Oral antibiotics should be
given if the infection is responsive to i.v. antibiotic treatment. Prompt
recognition and treatment with antibiotics may obviate the need for
surgical debridement. All athletes who returned to sports activity did so
by 6 months after diagnosis. [References: 29]
<17>
Unique Identifier
95192592
Authors
Gibbs N.
Institution
South Sydney Orthopaedic and Sports Medicine Centre, Maroubra, New South
Wales, Australia.
Title
Common rugby league injuries. Recommendations for treatment and
preventative measures. [Review] [63 refs]
Source
Abbreviated Source
Sports Med. 18(6):438-50, 1994 Dec.
Local Messages
unidentified
Abstract
Rugby league is the main professional team sport played in Eastern
Australia. It is also very popular at a junior and amateur level.
However,
injuries are common because of the amount of body contact that occurs and
the amount of running that is required to participate in the game.
Injuries to the lower limbs account for over 50% of all injuries. The
most
common specific injuries are ankle lateral ligament tears, knee medial
collateral and anterior cruciate ligament tears, groin musculotendinous
tears, hamstring and calf muscle tears, and quadriceps muscle contusions.
Head injuries are common and consist of varying degrees of concussion as
well as lacerations and facial fractures. Serious head injury is rare.
Some of the more common upper limb injuries are to the acromioclavicular
and glenohumeral joints. Accurate diagnosis of these common injuries
using
appropriate history, examination and investigations is critical in
organising a treatment and rehabilitation plan that will return the
player
to competition as soon as possible. An understanding of the mechanism of
injury is also important in order to develop preventative strategies.
[References: 63]
<18>
Unique Identifier
95078906
Authors
Crosbie J.
Title
Comparative kinematics of two walking frame gaits.
Source
Oct.
Abbreviated Source
J Orthop Sports Phys Ther. 20(4):186-92, 1994 Oct.
Local Messages
unidentified
Abstract
Walking frames are commonly used as part of the gait rehabilitation
process for a variety of clinical conditions. There has been little
investigation of the characteristics of gait with such frames or of the
advantages of one gait style compared with others. The kinematics of two
simulated gait patterns with walking frames were investigated using
conventional video analysis techniques. The purpose of the study was to
compare the two gaits with respect to patterns of joint motion and
temporospatial parameters. It was found that simultaneous motion of the
protected limb and the frame during stepping (gait S) permitted a faster
walking speed than a gait in which the frame and the protected limb were
moved separately (gait D). Although the patterns of hip motion in both
aided gaits differed markedly from that found in free gait, gait S
encouraged more hip extension on the protected side than gait D. Since
this is seen as a desirable feature in gait retraining, patients using
walking frames, particularly after hip trauma, should be assessed
carefully and encouraged to use gait pattern S when possible.
<19>
Unique Identifier
94225105
Authors
Karlsson J. Sward L. Kalebo P. Thomee R.
Institution
Department of Orthopaedics, East Hospital, University of Goteborg,
Sweden.
Title
Chronic groin injuries in athletes. Recommendations for treatment and
rehabilitation.
Source
Sports Medicine. 17(2):141-8, 1994 Feb.
Abbreviated Source
Sports Med. 17(2):141-8, 1994 Feb.
Local Messages
unidentified
Abstract
Chronic muscle and tendon injuries to the groin are common sports
injuries. The symptoms of groin injuries are often uncharacteristic which
can result in a delay in the correct and specific diagnosis being
reached.
The most common injury is the overuse strain resulting in chronic
tendinitis of the adductor muscle/tendon units, especially the adductor
longus. The rectus femoris and rectus abdominous muscles and tendons are
also commonly affected. Computed tomography, magnetic resonance imaging
and ultrasonography have been widely adopted to diagnose muscle/tendon
injuries to the groin. Ultrasonography has been shown to be accurate and
sensitive in diagnosing tendon injuries in the groin region, especially
small partial ruptures of the muscle/tendon unit. Ultrasonography has the
advantage of being fast, inexpensive and widely available. Normal
findings
are readily distinguished from pathological findings providing valuable
pre-operative information, such as location and extent of the injury. The
differential diagnoses are many and often difficult to reach. The most
commonly overlooked differential diagnoses are chronic prostatitis and
hernias. A multidisciplinary approach is valuable in many cases. The
recommended treatment is well planned and gradually increased
rehabilitation programme during the first stages. Surgery for acute
injuries is rarely indicated. Surgery, for example tenotomy of the
adductor longus, has given satisfactory results in many athletes when
nonsurgical treatment has failed.
<20>
Unique Identifier
94248636
Authors
Hutchinson MR. Ireland ML.
Institution
University of Illinois, Department of Orthopaedic Surgery, Chicago.
Title
Common compartment syndromes in athletes. Treatment and rehabilitation.
[Review] [30 refs]
Source
Sports Medicine. 17(3):200-8, 1994 Mar.
Abbreviated Source
Sports Med. 17(3):200-8, 1994 Mar.
Local Messages
unidentified
Abstract
Compartment syndromes in athletes are rare, but they can also be
limb-threatening events. Chronic exertional compartment syndrome (CECS)
is
a less emergent form where symptoms recur with repetitive loading or
exertional activities. CECS is the most common form of compartment
syndrome seen in athletes. Acute compartment syndromes may also occur in
athletes secondary to direct trauma or may develop from pre-existing
CECS.
The leg is by far the most common site of compartment syndrome in
athletes. The thigh, forearm, and foot are the next most common sites,
although any fascially limited compartment can be affected. Awareness of
the clinical presentation and pathophysiology of compartment syndromes
can
help the examiner make a prompt and accurate diagnosis. The treatment of
acute compartment syndrome is emergent while the treatment of CECS is
not.
Conservative treatment and rehabilitation can be successful in treating
CECS. Acute compartment syndromes must be treated immediately with
surgical decompression. With CECS, if conservative treatment fails,
surgical decompression is also indicated. Some authors have suggested
that
the results of surgical fasciotomy and rate of return to sport for
athletes with CECS has not been uniform. If the diagnosis is accurate and
carefully documented, a high degree of success with athletes returning to
sport can be expected. [References: 30]
<21>
Unique Identifier
94057195
Authors
Lephart SM. Kocher MS. Harner CD. Fu FH.
Institution
Department of Orthopaedic Surgery, University of Pittsburgh, PA 15261.
Title
Quadriceps strength and functional capacity after anterior cruciate
ligament reconstruction. Patellar tendon autograft versus allograft.
Source
American Journal of Sports Medicine. 21(5):738-43, 1993 Sep-Oct.
Abbreviated Source
Am J Sports Med. 21(5):738-43, 1993 Sep-Oct.
Local Messages
MED
Abstract
Harvesting the central third of the patellar tendon for autograft
anterior
cruciate ligament reconstruction is thought to compromise quadriceps
strength and functional capacity. We compared objective measurements of
quadriceps strength and functional capacity in athletes after patellar
tendon autograft or allograft anterior cruciate ligament reconstruction.
We looked at 33 active male patients (mean age, 24.3 years) who had
anterior cruciate ligament reconstructions 12 to 24 months earlier using
patellar tendon autograft (N = 15) or allograft (N = 18) techniques. All
patients underwent an intensive rehabilitation program. Quadriceps
strength and power were assessed by measuring peak torque at 60 and 240
deg/sec, torque acceleration energy at 240 deg/sec, and the quadriceps
index using a Cybex II isokinetic testing device. Functional capacity was
evaluated based on the results of 3 specially designed functional
performance tests and the hop test. Results revealed no significant
difference between autograft and allograft groups with respect to any of
these parameters. These findings indicate that harvesting the central
third of the patellar tendon for autograft anterior cruciate ligament
reconstruction does not diminish quadriceps strength or functional
capacity in highly active patients who have intensive rehabilitation.
Thus, the recommendation to avoid patellar tendon autograft anterior
cruciate ligament reconstruction to preserve quadriceps strength and
functional capacity may be unnecessary.
<22>
Unique Identifier
93256738
Authors
Gooch JL. Geiringer SR. Akau CK.
Institution
University of Utah Health Sciences Center, Salt Lake City 84132.
Title
Sports medicine. 3. Lower extremity injuries. [Review] [29 refs]
Source
Archives of Physical Medicine & Rehabilitation. 74(5-S):S438-42, 1993
May.
Abbreviated Source
Arch Phys Med Rehabil. 74(5-S):S438-42, 1993 May.
Local Messages
unidentified
Abstract
This self-directed learning module highlights new advances in
sports-related injuries of the lower extremity. It is part of the chapter
on sports medicine in the Self-Directed Medical Knowledge Program for
practitioners and trainees in physical medicine and rehabilitation. This
article contains sections on injuries of the hip and thigh, knee and leg,
and ankle and foot. The most common injuries are primarily addressed,
while less common injuries are more briefly discussed. New advances that
are covered in this section include closed kinetic chain strengthening
exercises and recent advances in rehabilitation after anterior cruciate
ligament reconstruction. [References: 29]
<23>
Unique Identifier
93222887
Authors
Cibulka MT. Delitto A.
Institution
Jefferson County Rehabilitation & Sports Clinic, Crystal City, MO 63019.
Title
A comparison of two different methods to treat hip pain in runners.
Source
Journal of Orthopaedic & Sports Physical Therapy. 17(4):172-6, 1993 Apr.
Abbreviated Source
J Orthop Sports Phys Ther. 17(4):172-6, 1993 Apr.
Local Messages
unidentified
Abstract
Little or no research has been performed on the physical therapy
treatment
of hip pain. The purpose of this study was to compare two different
treatments for hip pain. Twenty runners who had primary hip pain and
sacroiliac joint dysfunction, without evidence of arthritic changes, were
randomly assigned to two groups. One group received a mobilization
technique to the involved hip, while the other was treated with a
manipulative technique known to affect sacroiliac joint dysfunction. The
subjects were evaluated by using a pain questionnaire and the Faber test
to determine the response of the hip joint to treatment. Data were
analyzed with the Mann-Whitney U statistic for perceived pain response
and
with the Chi-square statistic with Yates correction for the Faber test.
Results showed a significant difference in perceived pain response, as
well as reproduction of pain with the Faber test, between the two groups.
The results suggest that a manipulative technique designed to reduce
sacroiliac joint dysfunction is an effective method to reduce hip pain.
Physical therapists should evaluate the sacroiliac joint in patients with
hip pain.
<24>
Unique Identifier
93176013
Authors
Bhambhani YN. Holland LJ. Steadward RD.
Institution
Faculty of Rehabilitation Medicine, University of Alberta, Edmonton,
Canada.
Title
Anaerobic threshold in wheelchair athletes with cerebral palsy: validity
and reliability.
Source
Archives of Physical Medicine & Rehabilitation. 74(3):305-11, 1993 Mar.
Abbreviated Source
Arch Phys Med Rehabil. 74(3):305-11, 1993 Mar.
Local Messages
unidentified
Abstract
This study examined the validity and reliability of the anaerobic
threshold (AT) using blood lactate (ATLa) and respiratory gas exchange
(ATg) criteria during cycle ergometry (CE) and wheelchair ergometry (WE)
in athletes with spastic cerebral palsy (CP). Eleven subjects attempted a
discontinuous incremental test protocol, two minutes work interspersed
with one minute rest, twice each on the CE and WE. Only five out of the
11
subjects were able to complete the CE tests, whereas all the subjects
were
able to complete the WE test. Inadequate hip flexion due to muscle
spasticity was the primary limiting factor during the CE tests. Although
the maximal aerobic power using this protocol was reliable during WE (r =
0.89, p < .05), the validity and reliability of the AT identified by two
independent evaluators using these two techniques was questionable.
Evaluator 1 was able to identify ATLa and ATg in seven out of the 11
cases, whereas evaluator 2 was successful in five and seven cases,
respectively. It is unclear from these results whether the poor validity
and reliability of the AT was due to the discontinuous test protocol
used,
or whether it was due to inconsistencies in the rate of lactate diffusion
from the muscle into the blood due to variations in muscle spasticity
during the test.
Date: 27-Feb-2001
Name: rehabill
Database: Medline <1987 to 1992>
Set Search Results

---------------------------------------------------------------------------
003 1 and 2 3
006 4 and 5 6
007 3 or 6 8
008 2 and 5 347
010 8 and 9 13
011 7 or 10 20
013 from 12 keep 1,4-7,9-14,16-17 13
014 13 13
<1>
Unique Identifier
93117626
Authors
Fried T. Lloyd GJ.
Institution
Medical Science Committee, Canadian Soccer Association, Toronto, Ontario.
Title
An overview of common soccer injuries. Management and prevention.
[Review]
[17 refs]
Source
Sports Medicine. 14(4):269-75, 1992 Oct.
Abbreviated Source
Sports Med. 14(4):269-75, 1992 Oct.
Local Messages
unidentified
Abstract
The most common injuries in soccer involve the ankle and knee joints, and
the muscles and ligaments of the thigh and calf. Rehabilitation to
restore
strength and endurance after healing is extremely important to prevent a
recurrence of the injury, which is much more severe and disabling than
the
initial injury. Sprains and strains of the hamstring and quadriceps, and
injuries to the external and internal structures of the knee joints are
frequent and relatively more disabling. Recent progress in the technical
aspect of investigative medicine, such as magnetic resonance (MRI)
imaging/quantitative only computer tomography (CT) scanning, ultrasonic
imaging of soft tissues and isokinetic measurement of muscle
characteristics, lead to better diagnosis and management of soccer
injuries. Appropriate nutritional and physiological preparation,
maintaining fluid and electrolytes during the game and restoration of the
reserves following completion of exhaustive activities will help to
minimise injuries. [References: 17]
<2>
Unique Identifier
92270667
Authors
Delitto RS. Rose SJ.
Institution
Department of Physical Therapy, School of Health and Rehabilitation
Sciences, University of Pittsburgh Medical Center, PA 15261.
Title
An electromyographic analysis of two techniques for squat lifting and
lowering.
Source
Physical Therapy. 72(6):438-48, 1992 Jun.
Abbreviated Source
Phys Ther. 72(6):438-48, 1992 Jun.
Local Messages
unidentified
Abstract
The purpose of this study was to examine the effects of two different
alignments of the pelvis and three different loads on electromyographic
(EMG) activity of the erector spinae and oblique abdominal muscles during
squat lifting and lowering. Each of 15 healthy subjects lifted and
lowered
loads with the pelvis aligned both in an anterior tilt and in a posterior
tilt. Based on total duration, both the lift and the lower were divided
into two equal phases. The EMG activity of each muscle was quantified for
each half of both the lift and the lower and was normalized to the total
EMG produced by the muscle during a maximal voluntary isometric
contraction. The results indicate (1) that the EMG activity of the
erector
spinae muscles was greater when subjects maintained an anterior tilt than
when they maintained a posterior tilt; (2) that the EMG activity of the
oblique abdominal muscles was greater in the first half of the lift than
in the second half for both lifting styles, although the opposite was
true
for both lowering styles; and (3) that the EMG activity increased with
increasing loads. The results suggest that the greater trunk muscle
activity occurring with the anterior tilt position may ensure optimal
muscular support for the spine while handling loads, thereby reducing the
risk for low back injury.
<3>
Unique Identifier
92205464
Authors
Noe DA. Mostardi RA. Jackson ME. Porterfield JA. Askew MJ.
Institution
Musculoskeletal Research Laboratory, Akron City Hospital, Ohio.
Title
Myoelectric activity and sequencing of selected trunk muscles during
isokinetic lifting.
Source
Spine. 17(2):225-9, 1992 Feb.
Abbreviated Source
Spine. 17(2):225-9, 1992 Feb.
Local Messages
unidentified
Abstract
Trained weight lifters lift heavy loads without a concomitant degree of
acute low-back injuries. To study the process by which large loads are
lifted with minimal injury, integrated electromyographic signals were
recorded from four large muscle groups: gluteus maximus, quadriceps,
latissimus dorsi, and erector spinae in 4 weight lifters and 11
asymptomatic control subjects. These signals were recorded during a
floor-to-knuckle-height isokinetic lift (dead lift) at 30.5 and 45.7
cm/sec. The signals were normalized for the height of the lift and the
maximal isokinetic integrated electromyographic activity. The weight
lifters achieved maximal force at 50% of maximal lift height, whereas the
control subjects achieved it at 67%. Although not statistically
significant, the weight lifters used the gluteus maximus more during the
early stages of the lift, perhaps contributing to earlier development of
force. This process would stabilize the pelvis and permit the erector
spinae to extend the trunk more efficiently. The weight lifter then
completed the lift with prolonged and increasing activity in the
quadriceps. This technique may minimize the required force in the erector
spinae and the forces on the low-back structures. Clinical implications
include more effective strength training of lifting muscle groups other
than spinal extensors and the teaching of lifting strategies employed by
weight lifters in low-back rehabilitation and work-hardening programs.
<4>
Unique Identifier
92180782
Authors
Fields KB. Rasco T. Kramer JS. Cates R.
Institution
Moses H. Cone Memorial Hospital, Greensboro, North Carolina.
Title
Rehabilitation exercises for common sports injuries. [Review] [21 refs]
Source
American Family Physician. 45(3):1233-43, 1992 Mar.
Abbreviated Source
Am Fam Physician. 45(3):1233-43, 1992 Mar.
Local Messages
MED; KAL
Abstract
Residual weakness after joint injury is a risk factor for recurrent
injury. A rehabilitation program helps patients recover strength and
helps
prevent further injuries. Orthopedic injuries account for 10 percent of
visits to family physicians, yet many primary care physicians do not
routinely prescribe rehabilitation exercises for injured patients.
Illustrations of exercises for the hip, knee, ankle and shoulder are
included as a reference for family physicians to use when prescribing
rehabilitation exercises. [References: 21]
<5>
Unique Identifier
92074561
Authors
Marder RA. Raskind JR. Carroll M.
Institution
Department of Orthopaedic Surgery, University of California, Davis,
School
of Medicine, Sacramento 95817.
Title
Prospective evaluation of arthroscopically assisted anterior cruciate
ligament reconstruction. Patellar tendon versus semitendinosus and
gracilis tendons.
Source
American Journal of Sports Medicine. 19(5):478-84, 1991 Sep-Oct.
Abbreviated Source
Am J Sports Med. 19(5):478-84, 1991 Sep-Oct.
Local Messages
MED
Abstract
Eighty consecutive patients with chronic laxity due to a torn ACL
underwent arthroscopically assisted reconstruction with either autogenous
patellar tendon or doubled semitendinosus and gracilis tendons.
Reconstructions were performed on a one-to-one alternating basis.
Preoperatively, no significant differences between the two groups were
noted with respect to age, sex, level of activity, and degree of laxity
(chi square analysis). A standard rehabilitation regimen was used for all
patients after surgery including immediate passive knee extension, early
stationary cycling, protected weightbearing for 6 weeks, avoidance of
resisted terminal knee extension until 6 months, and return to activity
at
10 to 12 months postoperatively. Seventy-two patients were evaluated at a
minimum of 24 months postoperatively (range, 24 to 40 months). No
significant differences were noted between groups with respect to
subjective complaints, functional level, or objective laxity evaluation,
including KT-1000 measurements. Seventeen of 72 patients (24%)
experienced
anterior knee pain after ACL reconstruction. Overall, 46 of 72 patients
(64%) returned to their preinjury level of activity. Mean KT-1000 scores
were 1.6 +/- 1.4 mm for the patellar tendon group and 1.9 +/- 1.3 mm for
the semitendinosus and gracilis tendons group. This study did find a
statistically significant weakness in peak hamstrings torque at 60
deg/sec
when reconstruction was performed with double-looped semitendinosus and
gracilis tendons.
<6>
Unique Identifier
90275405
Authors
Yde J. Nielsen AB.
Institution
Division of Sports Traumatology, Accident Analysis Centre, Aarhus County
Hospital, Denmark.
Title
Sports injuries in adolescents' ball games: soccer, handball and
basketball.
Source
British Journal of Sports Medicine. 24(1):51-4, 1990 Mar.
Abbreviated Source
Br J Sports Med. 24(1):51-4, 1990 Mar.
Local Messages
unidentified
Abstract
In a prospective study of 302 adolescent players in three ball games
(soccer, handball and basketball), 119 incurred injuries. The injury
incidence (number of injuries per 1000 playing hours) was 5.6 in soccer,
4.1 in handball and 3.0 in basketball. Ankle sprains accounted for 25 per
cent of the injuries, finger sprains 32 per cent, strains in the thigh
and
leg 10 per cent, and tendinitis/apophysitis 12 per cent. The most serious
injuries were four fractures, one anterior cruciate ligament rupture, and
two meniscus lesions. The most serious injuries, with the longest
rehabilitation period, occurred in soccer. In soccer, many injuries
occurred during tackling and contact with an opposing player, while the
injuries in handball and basketball were often caused by ball contact and
running.
<7>
Unique Identifier
90140052
Authors
Renstrom P. Johnson RJ.
Institution
Department of Orthopaedics and Rehabilitation, University of Vermont
College of Medicine, Burlington.
Title
Cross-country skiing injuries and biomechanics. [Review] [54 refs]
Source
Abbreviated Source
Sports Med. 8(6):346-70, 1989 Dec.
Local Messages
unidentified
Abstract
Cross-country skiing exercises most of the joints, muscles and tendons in
the body giving the skier an all around workout. This, in combination
with
a low incidence of injury, makes cross-country skiing an ideal
recreational and competitive sport. The new skating techniques developed
during the last decade have resulted in greater velocity. The maximum
speed during the diagonal stride technique is 6 m/sec compared to 8 to 9
m/sec when skating and double poling. Top-level skiers today use strong
and ultra light skis of fiberglass and graphite. The ski weight is less
than 500g. Today's skating technique does not require any waxing and only
the cambered portion of the ski is waxed when performing the diagonal
stride. The preparation of the ski course has improved with the
development of special track machines. This allows top-level skiers to
reach 60 to 80 km/h on downhill slopes, which has resulted in an
increased
risk of injury. Because cross-country skiing takes place wherever snow is
available, it is difficult to establish accurate injury rates in
comparison to alpine skiing which is performed on very specialised
terrain
at ski areas. Studies estimate the cross-country ski injury rate in
Sweden
to be around 0.2 to 0.5 per thousand skier days. A prospective study of
cross-country ski injuries conducted in Vermont revealed an injury rate
of
0.72 per thousand skier days. 75% of the injuries sustained by members of
the Swedish national cross-country ski team during 1983 and 1984 were
overuse injuries while 25% resulted from trauma. The most common overuse
injuries included medial-tibial stress syndrome, Achilles tendon problems
and lower back pain. Most common among traumatic injuries were ankle
ligament sprains and fractures, muscle ruptures, and knee ligament
sprains. Shoulder dislocation, acromioclavicular separation and rotator
cuff tears are not infrequent in cross-country skiing. Injuries to the
ulnar collateral ligament of the metacarpal phalangeal joint of the thumb
(Stener's lesion) is the most common ski injury involving the upper
extremity. Cross-country skiers 16 to 21 years of age complained more
frequently of mild lower back pain than similarly aged non-skiers. This
may result from repetitive hyperextension motions during the kick phase
and the recurring spinal flexion and extension during the double poling
phase. Repeated slipping on hard and icy tracks infrequently produce
partial tears or microtrauma in the muscle tendinous units of the
groin.(ABSTRACT TRUNCATED AT 400 WORDS) [References: 54]
<8>
Unique Identifier
90090664
Authors
Cibulka MT.
Institution
Jefferson County Rehabilitation and Sports Clinic, Crystal City,
Missouri.
Title
Rehabilitation of the pelvis, hip, and thigh. [Review] [78 refs]
Source
Clinics in Sports Medicine. 8(4):777-803, 1989 Oct.
Abbreviated Source
Clin Sports Med. 8(4):777-803, 1989 Oct.
Local Messages
unidentified
Abstract
Low back pain, hip pain, and muscle strain of the thigh are common in
athletes. Proper rehabilitation requires proper identification. Once
identified, rehabilitation must include restoration of function as well
as
prevention of recurrence. This article discusses methods of identifying,
rehabilitating, and preventing injuries to the pelvis, hip, and thigh.
[References: 78]
<9>
Unique Identifier
89193052
Authors
Steinweg J.
Title
Hamstring injuries.
Source
Australian Family Physician. 17(12):1036-7, 1988 Dec.
Abbreviated Source
Aust Fam Physician. 17(12):1036-7, 1988 Dec.
Local Messages
MED
<10>
Unique Identifier
88270560
Authors
Balduini FC.
Institution
University of Pennsylvania Sports Medicine Center, Philadelphia.
Title
Abdominal and groin injuries in tennis.
Source
Clinics in Sports Medicine. 7(2):349-57, 1988 Apr.
Abbreviated Source
Clin Sports Med. 7(2):349-57, 1988 Apr.
Local Messages
unidentified
Abstract
Although abdominal and groin injuries are not unique to the game of
tennis, the very mechanics of the ground stroke and overhead volley
predispose participants in this sport to the chronic pain and frustration
of these injuries. Careful consideration must be given not only to the
muscular anatomy of the region but also to the visceral and neurologic
anatomy. A patient, controlled program of rehabilitation, emphasizing
flexibility and subsequent strengthening, must be stressed if recurrence
is to be avoided.
<11>
Unique Identifier
88148195
Authors
Antao NA.
Title
Myositis of the hip in a professional soccer player. A case report.
Source
American Journal of Sports Medicine. 16(1):82-3, 1988 Jan-Feb.
Abbreviated Source
Am J Sports Med. 16(1):82-3, 1988 Jan-Feb.
Local Messages
MED
Abstract
Myositis in the hip joint is a rare entity in sportsmen. Repeated trauma
or massage can be detrimental. Successful outcome depends upon the
recognition of mature, well-organized new bone, and full excision. Best
results can be obtained by performing surgery on a biologically sound
joint which contains no trace of active or latent inflammation. The joint
should be immobilized till the soft tissue trauma has completely healed.
Rehabilitation must be in stages.
<12>
Unique Identifier
88021473
Authors
Fowler PJ. Regan WD.
Institution
University Hospital, London, Ontario, Canada.
Title
The patient with symptomatic chronic anterior cruciate ligament
insufficiency. Results of minimal arthroscopic surgery and
rehabilitation.
Source
American Journal of Sports Medicine. 15(4):321-5, 1987 Jul-Aug.
Abbreviated Source
Am J Sports Med. 15(4):321-5, 1987 Jul-Aug.
Local Messages
MED
Abstract
Forty-nine patients with 51 chronic symptomatic anterior cruciate
deficient knees were studied retrospectively by chart review and follow-
up
examination an average of 5.8 years postinjury and 1.5 years from
arthroscopic evaluation, with or without arthroscopic surgery, and the
institution of a conservative rehabilitation program. Subjective
evaluation of function was obtained by questionnaire. At arthroscopy,
meniscal lesions were seen in 37 of 51 knees, and degenerative changes
were noted in 24 knees. The ACL was absent in 43 knees. Partial
meniscectomy or suturing was performed on 20 patients. All patients had
an
average of 3 weeks of supervised physical therapy stressing hamstring
strengthening. At followup, thigh girth measurements of injured and
normal
legs found thigh wasting in 40 patients. Seven of 33 patients
radiographed
showed evidence of degenerative changes. About two-thirds of the patients
returned to some level of athletics and had no problems with activities
of
daily living. Twenty were able to return to pivoting sports, but only
five
could return to their preinjury levels of competition. Of the 18 patients
who did not return to athletics, only 8 were considering or had had a
ligament reconstruction. Those patients who chose to continue
rehabilitation beyond the prescribed period and who modified their
activities had a better functional outcome.
<13>
Unique Identifier
87135319
Authors
Nicholas JA. Marino M.
Title
The relationship of injuries of the leg, foot, and ankle to proximal
thigh
strength in athletes.
Source
Foot & Ankle. 7(4):218-28, 1987 Feb.
Abbreviated Source
FOOT ANKLE. 7(4):218-28, 1987 Feb.
Local Messages
unidentified
Abstract
Rehabilitation programs designed to restore leg, ankle, and foot function
following injury frequently ignore the proximal muscles. During
athletics,
these knee, hip, and trunk muscles derive much of their functional power
from the foot and ankle. They also serve to integrate distal segment
motions into a total movement pattern such as jumping, running, or
kicking. The linkage system, which is a theoretical concept, describes
the
normal biomechanical and physiological interactions between proximal and
distal musculoskeletal structures. Immobilization or injury of distal
segments interrupts the normal generation, summation, and transmission of
muscular forces across joints. Adequate measures must be taken to
properly
assess proximal structures for weakness and tightness and to prescribe
specific exercises to prevent the migration of the effects of injury away
from the involved segment.

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