Medicine and Health Sciences Commons^™

Sex-Related Differences In Gait Characteristics And Their Associations With Symptoms In Individuals With Patellofemoral Osteoarthritis, Harvi Hart Dr.

Physical Therapy Publications

Background

Patellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown.

Research question

Compare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations.

Methods

Mixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Muscle-Specific Contributions To Lower Extremity Net Joint Moments While Squatting With Different External Loads, Kristof Kipp, Hoon Kim, William I. Wolf

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to lower extremity net joint moments (NJMs) during squats with different external loads. Nine healthy subjects performed sets of the back squat exercise with 0, 25, 50, and 75% of body mass as an added external load. Motion capture and force plate data were used to calculate NJMs and to estimate individual muscle forces via static optimization. Individual muscle forces were multiplied by their respective moment arms to calculate the resulting muscle-specific joint moment. Statistical parametric mapping (α = 0.05) was used to determine load-dependent changes in the time series …

Knee Cartilage T2 Relaxation Times 3 Months After Acl Reconstruction Are Associated With Knee Gait Variables Linked To Knee Osteoarthritis, Jack R. Williams, Kelsey Neal, Abdulmajeed Alfayyadh, Kendra Lennon, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Hollis G. Potter, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Osteoarthritis development after ACL reconstruction (ACLR) is not well understood. Investigators have examined associations between knee biomechanical alterations and quantitative MRI (qMRI) variables, reflective of cartilage health, 12–60 months following ACLR; however, none have done so early after surgery. As part of an exploratory study, 45 individuals (age, 23 ± 7 years) underwent motion analysis during walking and qMRI 3 months after ACLR. For each limb, peak knee adduction moment (pKAM) and peak knee flexion moment (pKFM) were determined using inverse dynamics and peak medial compartment force was calculated using a neuromusculoskeletal model. T₂ relaxation times in the medial …

Asymmetries In Dynamic Valgus Index After Anterior Cruciate Ligament Reconstruction: A Proof-Of-Concept Study, Kai Yu Ho, Andrew Murata

Physical Therapy Faculty Publications

Individuals with anterior cruciate ligament reconstruction (ACLR) are at a higher risk for subsequent anterior cruciate ligament (ACL) tears. Risk factors for ACL injuries likely involve a combination of anatomical, biomechanical, and neuromuscular factors. Dynamic knee valgus has been indicated as a possible biomechanical factor for future ACL injuries. Given that knee valgus is often accompanied by contralateral pelvic drop during single-leg activities, a dynamic valgus index (DVI) that quantifies combined kinematics of the knee and hip in the frontal plane has recently been developed. As the premise of asymmetrical DVI between limbs in the ACLR population has not been …

Lower Extremity Kinetics And Muscle Activation During Gait Are Significantly Different During And After Pregnancy Compared To Nulliparous Females, Jennifer J. Bagwell, Nicholas Reynolds, Michelle Walaszek, Hannah Runez, Kristina Lam, Jo Armour Smith, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

Low back, pelvic, and lower extremity pain are common during and after pregnancy. Understanding differences in mechanics between pregnant and non-pregnant females is a first step toward identifying potential pathological mechanisms. The primary purpose of this study was to compare joint kinetics and muscle activation during gait between females during and after pregnancy to nulliparous females.

Methods

Twenty pregnant females completed testing on three occasions (second trimester, third trimester, and post-partum), while 20 matched, nulliparous controls were tested once. Motion capture, force data, and surface electromyography were averaged across seven trials during gait. Lower extremity kinematics, lower extremity moments …

Improvement In Overground Walking After Treadmill-Based Gait Training In A Child With Agenesis Of The Corpus Callosum, Gena Henderson, Matthew Beerse, Huaqing Liang, Diego Ferreira, Jianhua Wu

Physical Therapy Faculty Research

Background: Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC.

Objective: The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC.

Design: A single-participant design with 2 phases was used.

Methods: The settings were …

Risk Factors Associated With Low Back Pain In Golfers: A Systematic Review And Meta-Analysis, Jo Armour Smith, Andrew Hawkins, Marybeth Grant-Beuttler, Richard Beuttler, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Context:

Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing.

Objective:

The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers.

Data Sources:

A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017.

Study Selection:

Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related …

Changes In Reach To Eat Movement Control After Intensive Training For Children With Unilateral Cerebral Palsy, Yaching Hung, Aryeh D. Spingarn

Publications and Research

Ya Ching Hung EdD. and Aryeh Spingarn EP-C, CSCS, EIM-Level 2 Queens College, City University of New York Department of Family, Nutrition, and Exercise Sciences, Changes in Reach to Eat Movement Control After Intensive Training for Children with Unilateral Cerebral Palsy. Purpose: The current study compares the effects of an intervention on children with Congenital Hemiplegia during a simple eating task using kinematic analyses. Previous studies looked at simple bimanual tasks such as opening a drawer; no studies examined the effects of intensive training on unimanual reach, grasp, and eat movement control. Methods: 20 children with Unilateral Spastic Cerebral Palsy …

Midfoot Power During Walking And Stair Ascent In Healthy Adults, Frank Diliberto, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Intrinsic foot muscles have the capacity to attenuate and reverse arch deformation under loaded conditions. This function is proposed to be an important component in generating the midfoot power and stability requisite for gastroc-soleus muscle action at the ankle during forward propulsion. Synergistic activation of intrinsic foot muscles is proposed to function as a ‘foot core’ during weightbearing activity that is analogous to the function of the smaller muscles at the spine. If this theory were sound, midfoot power would be expected to increase, potentially in proportion to ankle power, as the muscular demand of a task increases. The …

Reliability And Validity Of A Biomechanically Based Analysis Method For The Tennis Serve, Natalie L. Myers, W. Ben Kibler, Leah Lamborn, Belinda J. Smith, Tony English, Cale A. Jacobs, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: An observational tennis serve analysis (OTSA) tool was developed using previously established body positions from three-dimensional kinematic motion analysis studies. These positions, defined as nodes, have been associated with efficient force production and minimal joint loading. However, the tool has yet to be examined scientifically.

Purpose: The primary purpose of this investigation was to determine the inter-observer reliability for each node between two health care professionals (HCPs) that developed the OTSA, and secondarily to investigate the validity of the OTSA.

Methods: Two separate studies were performed to meet these objectives. An inter-observer reliability study preceded the …

Male And Female Runners Demonstrate Different Sagittal Plane Mechanics As A Function Of Static Hamstring Flexibility, D. S. Blaise Williams Iii, Lee M. Welch

Physical Therapy Publications

Background:

Injuries to runners are common. However, there are many potential contributing factors to injury. While lack of flexibility alone is commonly related to injury, there are clear differences in hamstring flexibility between males and females.

Objective:

To compare the effect of static hamstring length on sagittal plane mechanics between male and female runners.

Method:

Forty subjects (30.0±6.4 years) participated and were placed in one of 4 groups: flexible males (n=10), inflexible males (n=10), flexible females (n=10), and inflexible females (n=10). All subjects were free of injury at the time of data collection. Three-dimensional kinematics and kinetics were collected while …

Influence Of Knee Flexion Angle And Age On Triceps Surae Muscle Fatigue During Heel Raises, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S. John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

Hébert-Losier, K, Schneiders, AG, García, JA, Sullivan, SJ, and Simoneau, GG. Influence of knee flexion angle and age on triceps surae muscle fatigue during heel raises. J Strength Cond Res 26(11): 3134–3147, 2012—The triceps surae (TS) muscle-tendon unit is 1 of the most commonly injured in elite and recreational athletes, with a high prevalence in middle-aged adults. The performance of maximal numbers of unilateral heel raises is used to assess, train, and rehabilitate TS endurance and conventionally prescribed in 0° knee flexion (KF) for the gastrocnemius and 45° for the soleus (SOL). However, the extent of muscle selectivity conferred through …

Influence Of Upper Extremity Assistance On Lower Extremity Force Application Symmetry In Individuals Post–Hip Fracture During The Sit-To-Stand Task, Janet A. Kneiss, Jeff R. Houck, Susan A. Bukata, J. Edward Puzas

Faculty Publications - College of Physical Therapy

STUDY DESIGN: Controlled laboratory study using a cross-sectional design.

OBJECTIVES: To compare lower extremity force applications during a sit-to-stand (STS) task with and without upper extremity assistance in older individuals post–hip fracture to those of age matched controls.

BACKGROUND: A recent study documented the dependence on upper extremity assistance and the uninvolved lower limb during an STS task in individuals post–hip fracture. This study extends this work by examining the effect of upper extremity assistance on symmetry of lower extremity force applications.

METHODS: Twenty-eight community-dwelling elderly subjects, 14 who had recovered from a hip fracture and 14 controls, participated in …

Analysis Of Vertical Ground Reaction Force Variables During A Sit To Stand Task In Participants Recovering From A Hip Fracture, Jeff R. Houck, Janet Kneiss, Susan V. Bukata, J. Edward Puzas

Faculty Publications - College of Physical Therapy

Background: A Sit to Stand task following a hip fracture may be achieved through compensations (e.g. bilateral arms and uninvolved lower extremity), not restoration of movement strategies of the involved lower extremity. The primary purpose was to compare upper and lower extremity movement strategies using the vertical ground reaction force during a Sit to Stand task in participants recovering from a hip fracture to control participants. The secondary purpose was to evaluate the correlation between vertical ground reaction force variables and validated functional measures.

Methods: Twenty eight community dwelling older adults, 14 who had a hip fracture and 14 control …

Pressure Distribution Over The Palm Region During Forward Falls On The Outstretched Hands, Woochol J. Choi, Stephen N. Robinovitch

Physical Therapy Faculty Articles and Research

Falls on the outstretched hands are the cause of over 90% of wrist fractures, yet little is known about bone loading during this event. We tested how the magnitude and distribution of pressure over the palm region during a forward fall is affected by foam padding (simulating a glove) and arm configuration, and by the faller’s body mass index (BMI) and thickness of soft tissues over the palm region.

Thirteen young women with high (n=7) or low (n=6) BMI participated in a “torso release experiment” that simulated falling on both outstretched hands with the arm inclined either at 20° or …

Deep Posterior Compartment Strength And Foot Kinematics In Subjects With Stage Ii Posterior Tibial Tendon Dysfunction, Christopher Neville, Adolph S. Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Tibialis posterior muscle weakness has been documented in subjects with Stage II posterior tibial tendon dysfunction (PTTD) but the effect of weakness on foot structure remains unclear. The association between strength and flatfoot kinematics may guide treatment such as the use of strengthening programs targeting the tibialis posterior muscle.

Materials and Methods: Thirty Stage II PTTD subjects (age; 58.1 ± 10.5 years, BMI 30.6 ± 5.4) and 15 matched controls (age; 56.5 ± 7.7 years, BMI 30.6 ± 3.6) volunteered for this study. Deep Posterior Compartment strength was measured from both legs of each subject and the strength ratio …

Effects Of The Airlift Pttd Brace On Foot Kinematics In Subjects With Stage Ii Posterior Tibial Tendon Dysfunction, Christopher Neville, A. Samuel Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

Study Design: Experimental laboratory study.

Objectives: To investigate the effect of inflation of the air bladder component of the AirLift PTTD brace on relative foot kinematics in subjects with stage II posterior tibial tendon dysfunction (PTTD).

Background: Orthotic devices are commonly recommended in the conservative management of stage II PTTD to improve foot kinematics.

Methods and Measures: Ten female subjects with stage II PTTD walked in the laboratory wearing the AirLift PTTD brace during 3 testing conditions (air bladder inflation to 0, 4, and 7 PSI [SI equivalent: 0, 27 579, and 48 263 Pa]). Kinematics were recorded from the …

Choosing Among 3 Ankle-Foot Orthoses For A Patient With Stage Ii Posterior Tibial Tendon Dysfunction, Christopher Neville, Jeff Houck

Faculty Publications - College of Physical Therapy

No head-to-head comparisons of different orthoses for patients with stage II posterior tibial tendon dysfunction (PTTD) have been performed to date. Additionally, the cost of orthoses varies considerably, thus choosing an effective orthosis that is affordable to the patient is largely a trial-and-error process. Case Description: A 77-year-old woman was seen with complaints of abnormal foot posture (“my foot is out”), minimal medial foot and ankle pain, and a 3-year history of conservatively managed stage II PTTD. The patient was not able to complete 1 single-limb heel rise on the involved side, while she could complete 3 on the uninvolved …

Comparison Of Frontal Plane Trunk Kinematics And Hip And Knee Moments During Anticipated And Unanticipated Walking And Side Step Cutting Tasks, Jeff R. Houck, Andrew Duncan, Kenneth E. De Haven

Faculty Publications - College of Physical Therapy

Background: Frontal plane trunk and lower extremity adjustments during unanticipated tasks are hypothesized to influence hip and knee neuromuscular control, and therefore, contribute to anterior cruciate ligament (ACL) injury risk. The aims of this study were to examine frontal plane trunk/hip kinematics and hip and knee moments (measures of neuromuscular control) during unanticipated straight and side step cut tasks.

Methods: Kinematic and kinetic variables were collected while subjects performed two anticipated tasks, including walking straight (ST) and side step cutting (SS), and two unanticipated tasks (STU and SSU). Foot placement, thorax–pelvis–hip kinematic variables and hip and knee moments were calculated …

Knee And Hip Angle And Moment Adaptations During Cutting Tasks In Subjects With Anterior Cruciate Ligament Deficiency Classified As Noncopers, Jeff R. Houck, Andrew Duncan, Kenneth E. De Haven

Faculty Publications - College of Physical Therapy

Study Design: Two-factor mixed-design study, with factors including group (control and noncoper) and task (sidestep, crossover, and straight).

Objectives: To compare the knee and hip joint angles and moments of control subjects and subjects with an anterior cruciate ligament (ACL) deficient knee classified as noncopers, during a sidestep, crossover, and straight-ahead task.

Background: Subjects with ACL deficiency primarily note difficulty with cutting tasks as opposed to straight-ahead tasks. Yet, previous studies have primarily focused on straight-ahead tasks.

Methods and Measures: Fifteen subjects with ACL deficiency classified as noncopers, based on the number of giving-way episodes (1) and global question of …

In-Season Functional Shoulder Training For High School Baseball Pitchers, Jason Brumitt, Erik Meira, Greg Davidson

Faculty Publications - College of Physical Therapy

The overhead throwing motion is used in numerous sports including track, football, and baseball. Among these sports, the baseball pitch is unique in the demands placed upon the shoulder. The forces created in the shoulder can potentially lead to pathology affecting the athlete's career. To enhance performance and decrease the risk of injury, it is important that the athlete participate in a year-round periodized program. Inappropriate or deficient training combined with the stress that the shoulder experiences during a season can lead to strains, impingement, tendon or labral tears, and instabilities.

Rabbit Knee Joint Biomechanics: Motion Analysis And Modeling Of Forces During Hopping, David L. Gushue, Jeff Houck, Amy L. Lerner

Faculty Publications - College of Physical Therapy

Although the rabbit hindlimb has been commonly used as an experimental animal model for studies of osteoarthritis, bone growth and fracture healing, the in vivo biomechanics of the rabbit knee joint have not been quantified. The purpose of this study was to investigate the kinematic and kinetic patterns during hopping of the adult rabbit, and to develop a model to estimate the joint contact force distribution between the tibial plateaus. Force platform data and three-dimensional motion analysis using infrared markers mounted on intracortical bone pins were combined to calculate the knee and ankle joint intersegmental forces and moments. A statically …

Associations Of Knee Angles, Moments And Function Among Subjects That Are Healthy And Anterior Cruciate Ligament Deficient (Acld) During Straight Ahead And Crossover Cutting Activities, Jeff Houck, H. John Yack

Faculty Publications - College of Physical Therapy

The objective of this study was to compare knee angles and moments of healthy subjects (n/20) and subjects that were anterior cruciate ligament deficient (ACLD) (n/16) during stepping and crossover cutting activities. Subjects that were ACLD were separated into high (n/7) and low (n/9) functioning groups based on knee functioning ratings. Knee angles and moments were estimated using three dimensional motion tracking and force plate data. The results suggest that knee angle and moment data were associated with level of functioning of ACLD subjects. Primarily knee frontal and transverse plane moments distinguished the stepping and crossover cut activities. Only some …

Self-Reported Giving-Way Episode During A Stepping-Down Task: Case Report Of A Subject With An Acl-Deficient Knee, Jeff Houck, Amy Lerner, David Gushue, H. John Yack

Faculty Publications - College of Physical Therapy

Study Design: Case report.

Objective: To describe the knee kinematics and moments of a giving-way trial of a subject with an anterior-cruciate-ligament– (ACL) deficient knee relative to his non–giving-way trials and to healthy subjects during a step-down task.

Background: Episodes of giving way are believed to damage joint structures, therefore treatments aim to prevent giving-way episodes, yet few studies document giving-way events.

Methods: The giving-way trial experienced by a 32-year-old male subject with ACL deficiency during a step-down task was compared to his non–giving-way trials (n = 5) and data from healthy subjects (n = 20). Position data collected at …