Musculoskeletal System Commons^™

Applying Principles Of Motor Learning And Control To Upper Extremity Rehabilitation, Lisa M. Muratori, Eric M. Lamberg, Lori Quinn, Susan V. Duff

Physical Therapy Faculty Articles and Research

The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

Assessment Of Postural Stability Using Inertial Measurement Unit On Inclined Surfaces In Healthy Adults, Chris Frames, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Fatal and nonfatal falls in the construction domain remain a significant issue in today’s workforce. The roofing industry in particular, annually ranks amongst the highest in all industries. Exposure to an inclined surface, such as an inclined roof surface, has been reported to have adverse effects on postural stability. The purpose of this preliminary study was to investigate the intra-individual differences in stability parameters on both inclined and level surfaces. Postural Stability (PS) and Limit of Stability (LOS) were assessed in seven healthy subjects (aged 25-35 years) on inclined and level surfaces using embedded force plates and an Inertial Measurement …

Comparison Of Intra Individual Physiological Sway Complexity From Force Plate And Inertial Measurement Unit, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Center of Pressure (COP) is a clinical measure to investigate the effect of sensory input disturbances on postural stability in healthy, old population as well in people suffering from neuromuscular disease. Increased center of pressure velocity and sway area are interpreted as decreased stability or poor balance and are associated with fall risk. Body mounted inertial sensors have shown great promise as an easily implemented clinical measure of balance. The aim of the present study is to investigate if force plate and accelerometer measurements provide similar physiological information when approximate entropy (ApEn) are valuated from the time series. Seven Young …

Wavelet Based Automated Postural Event Detection And Activity Classification With Single Imu (Tempo), Thurmon E. Lockhart, Rahul Soangra, Jian Zhang, Xuefang Wu

Physical Therapy Faculty Articles and Research

Mobility characteristics associated with activity of daily living such as sitting down, lying down, rising up, and walking are considered to be important in maintaining functional independence and healthy life style especially for the growing elderly population. Characteristics of postural transitions such as sit-to-stand are widely used by clinicians as a physical indicator of health, and walking is used as an important mobility assessment tool. Many tools have been developed to assist in the assessment of functional levels and to detect a person’s activities during daily life. These include questionnaires, observation, diaries, kinetic and kinematic systems, and validated functional tests. …

Extreme Levels Of Noise Constitute A Key Neuromuscular Deficit In The Elderly, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Fluctuations during isometric force production tasks occur due to the inability of musculature to generate purely constant submaximal forces and are considered to be an estimation of neuromuscular noise. The human sensori-motor system regulates complex interactions between multiple afferent and efferent systems, which results in variability during functional task performance. Since muscles are the only active component of the motor system, it therefore seems reasonable that neuromuscular noise plays a key role in governing variability during both standing and walking. Seventy elderly women (including 34 fallers) performed multiple repetitions of isometric force production, quiet standing and walking tasks. No relationship …

Determination Of Stabilogram Diffusion Analysis Coefficients And Invariant Density Analysis Parameters To Understand Postural Stability Associated With Standing On Anti-Fatigue Mats, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Prolonged standing has been associated with loss of balance, onset of low back pain symptoms and development of fatigue in lower extremity muscles in working populations. Although so far, it is unknown how individuals’ postural stability is affected by standing on rigid versus cushioned platform but many industries are opting for anti-fatigue mats at workstations to reduce fall and injury related socio-economic cost. The goal of this study is to test SATECH's anti-fatigue mat for its effects on postural stability. A pilot test with seven healthy subjects (25–35 years old) has been conducted with a force plate to obtain kinetics …

Non-Invasive Fall Risk Assessment In Community Dwelling Elderly With Wireless Inertial Measurement Units, Thurmon E. Lockhart, Han T. Yeoh, Rahul Soangra, Manutchanok Jongprasithporn, Jian Zhang, Xuefang Wu, Arka Ghosh

Physical Therapy Faculty Articles and Research

Falls are among the most serious accidents among the elderly leading to increased injuries, reduced functioning and mortality. In 2009, about 2.2 million nonfatal fall injuries were reported among the elderly population (CDC, 2010). In this study, eleven community dwelling elderly (aged 65-84 years) participated in fall risk assessment camp at sterling senior center organized by Northern Virginia Fall Prevention Coalition (NVFPC). Three custom made wireless inertial measurement units (IMUs) were attached on trunk and both shanks. All participants performed postural and locomotor tasks such as sit-to-stand (STS) and timed up and go (TUG). Temporal and kinematic parameters were obtained. …

Is Pilates An Effective Treatment For Improving Functional Disability And Pain In Patients With Nonspecific Low Back Pain?, Koren V. Fleming

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Pilates an effective treatment for improving functional disability and pain in patients with nonspecific low back pain?”

STUDY DESIGN: Review of three English language primary studies, two of which were published in 2006 and the other in 2009.

DATA SOURCES: Three single-blind randomized control trials comparing the Pilates method of treatment to a control group that did not receive Pilates intervention were found using PubMed and EBSCOhost databases.

OUTCOMES MEASURED: Each of the studies had patients participate in Pilates sessions for six to seven weeks. …

Investigation Into The Functional Mobility Difference Between Obese And Non-Obese Elderly, Xuefang Wu, Han T. Yeoh, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Obese aging population is increasing in the United States, and obese elderly experience fall twice as frequent as their lean counterparts. However, the mechanisms of older obese adults fall are still not clear. It is not known whether the obese elderly has more functional mobility impairments than their lean counterparts, and consequently have increased risks of falls. It was hypothesized that obese elderly have more functional mobility impairments compared with their healthy weight counterparts. Six lean and six obese community-dwelling elderly participated in the study. “Timed up & go” test was used to quantify the functional mobility for both lean …

A Comparative Study For Performance Evaluation Of Sit-To-Stand Task With Body Worn Sensor And Existing Laboratory Methods, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Human movement such as sit-to-stand (STS) is one of the most fundamental and essential movement among daily living activities. Elderly who are unable to stand are severely limited in daily activities and rely on others for their care. In the coming next two decades about 20% of US population will be above the age of 65 years, and considering ever-increasing elderly population and health care expenses, the rehabilitation of functionally limited elderly is becoming a topic of greater concern. Clinically STS movement is looked upon with great interest, such as its analysis is meaningful in order to evaluate motor 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 …

An Approach For Identifying Gait Events Using Wavelet Denoising Technique And Single Wireless Imu, Rahul Soangra, Thurmon Lockhart, Nathalie Van De Berge

Physical Therapy Faculty Articles and Research

A new approach is proposed to identify gait events in non-laboratory environments with a single inertial measurement unit (IMU) embedded inside shoe. The aim of our work is to develop a useful clinical tool for monitoring individuals walking disability and detect specific pathological gait patterns. Temporal parameters of gait are determined by classification of accelerations and angular velocities. Wavelets denoising of IMU signals allows for an important amount of information that is exploited in different manners for event identification. It was found that wavelet denoising enhanced specific turning points which could effectively identify gait events. The method is verified by …

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

Physical Therapy Faculty Articles and Research

"Over 90% of wrist fractures are caused by falls on the outstretched hands (Palvanen et al., Osteoporos Int, 2000). Along with bone strength, fracture risk depends on the magnitude and distribution of force to soft and hard tissues during impact. In the current study, we examined how pressure distribution over the palm during a fall is affected by impact configuration, body mass index (BMI), palmer soft tissue thickness, and a 5 mm thick foam pad (simulating a protective glove)."

Electromyographic Analysis Of Trunk Muscle Activation During A Throwing Pattern Following Rotator Cuff Mobilization, Aubrey L. Doede

CMC Senior Theses

Correct muscular activation of the body segments during an overhand throw is achieved when movement originates in the larger and more proximal legs and trunk and moves sequentially to the smaller, distal segments of the shoulder and arm. This sequence permits angular velocity to transfer progressively through the throw as part of an open kinetic chain. The athlete can summate angular velocity and segmental forces only if he is able to create a separation between the body segments during the movement pattern, and this separation is thus essential to effective segmental sequencing for activation of the trunk muscles to occur …

Portable, Non-Invasive Fall Risk Assessment In End Stage Renal Disease Patients On Hemodialysis, Thurmon Lockhart, Adam T. Barth, Xiaoyue Zhang, Rahul Soangra, Emaad Abdel-Rahman, John Lach

Physical Therapy Faculty Articles and Research

Patients with end stage renal diseases (ESRD) on hemodialysis (HD) have high morbidity and mortality due to multiple causes, one of which is dramatically higher fall rates than the general population. The mobility mechanisms that contribute to falls in this population must be understood if adequate interventions for fall prevention are to be achieved. This study utilizes emerging noninvasive, portable gait, posture, strength, and stability assessment technologies to extract various mobility parameters that research has shown to be predictive of fall risk in the general population. As part of an ongoing human subjects study, mobility measures such as postural and …

The Impact Of Left Hemisphere Stroke On Force Control With Familiar And Novel Objects: Neuroanatomic Substrates And Relationship To Apraxia, Amanda M. Dawson, Laura J. Buxbaum, Susan V. Duff

Physical Therapy Faculty Articles and Research

Fingertip force scaling for lifting objects frequently occurs in anticipation of finger contact. An ongoing question concerns the types of memories that are used to inform predictive control. Object-specific information such as weight may be stored and retrieved when previously encountered objects are lifted again. Alternatively, visual size and shape cues may provide estimates of object density each time objects are encountered. We reasoned that differences in performance with familiar versus novel objects would provide support for the former possibility. Anticipatory force production with both familiar and novel objects was assessed in six left hemisphere stroke patients, two of whom …

Performance Of A Hip Protector Depends On Its Position During A Fall, Woochol J. Choi, Joaquin A. Hoffer, Stephen N. Robinovitch

Physical Therapy Faculty Articles and Research

"Hip protectors are designed to attenuate and redistribute the force applied to the hip region during a fall, and thereby reduce risk for hip fracture [1]. However, little information exists on the effectiveness of hip protectors in achieving these goals, and how this is altered by displacement of the hip protector relative to the greater trochanter (GT). In the current study, we tested these issues."

Gastrocnemius-Soleus Muscle Tendon Unit Changes Over The First 12 Weeks Of Adjusted Age In Infants Born Preterm, Marybeth Grant-Beuttler, Robert J. Palisano, Debra P. Miller, Barbara Reddien Wagner, Carolyn B. Heriza, Patricia A. Shewokis

Physical Therapy Faculty Articles and Research

Background and Purpose: Differences in the gastrocnemius-soleus muscle and tendon have been documented shortly after birth in infants born preterm compared with infants born at term. Knowledge of muscle tendon unit lengths at term age to 12 weeks of age in infants born preterm may be useful in understanding motor development.

Participants and Method: Gastrocnemius-soleus muscle tendon unit lengths were compared at term age, at 6 weeks of age, and at 12 weeks of age (preterm adjusted age) in 20 infants born full term and 22 infants born preterm.

Results: Significant differences were found between the 2 groups on taut …

Author Response To Invited Commentary By Heathcock [Commentary For: Gastrocnemius/Soleus Muscle Tendon Unit Changes Over The First 12 Weeks Of Adjusted Age In Infants Born Preterm], Marybeth Grant-Beuttler, Robert J. Palisano, Debra P. Miller, Barbara Reddien Wagner, Carolyn B. Heriza, Patricia A. Shewokis

Physical Therapy Faculty Articles and Research

"We thank Heathcock for taking the time to write her commentaryregarding our study. Her comments are interesting, and our subsequent investigation into these ideas has led us to uncover some enlightening evidence in relation to the topics raised in the commentary. We will attempt to review each of the topics raised and the evidence associated with these topics."

Influence Of A Functional Knee Brace And Exercise On Lower Extremity Kinematics During Jogging, Brian M. Campbell, Daniel Cipriani, James A. Yaggie

Physical Therapy Faculty Articles and Research

ABSTRACT Context: Functional knee braces (FKB) are used prophylactically and in rehabilitation to aide in the functional stability of the knee joint. Objective: To determine if alterations in sagittal plane lower extremity kinematics remain evident throughout a one hour period in healthy individuals. Design: 2X5 repeated measures design. Setting: Biomechanics Laboratory. Subjects: Twenty subjects (14 male and 6 female, mean age 26.5±7 yrs; height 172.4±13 cm; weight 78.6±9 kg), separated into braced (B) and no brace (NB) groups. Intervention: A one-hour exercise program divided into three 20 minute increments. Main Outcome Measures: Synchronized three-dimensional …

Disaggregating The Relative Influence Of Genetic, Environmental And Individual Factors On Ldl And Hdl Cholesterols And Bmi For A Sample Of African American (Aa) Mothers And Daughters, C. Jayne Brahler, Jewel Harden, Michelle Mchone, Matthew Soules, Eric Evans, Ann Alyanak, Fred Diakpieng, Paul M. Vanderburgh

Health and Sport Science Faculty Publications

There are many reports about the associations between blood lipids, body mass index (BMI) and dietary cholesterol intakes both within the individual and between related individuals. The purpose of this descriptive research project was to investigate the relationships between LDL and HDL cholesterols, body mass index and dietary cholesterol intakes for a sample of African American (AA) mothers and their daughters and to attempt to separate the contribution of genetic versus environmental factors. Mother and daughter participants (n =42 and 66, respectively) were 12-14-hours fasted when blood samples were drawn, heights and weights measured, and 24 hour food recalls completed.

The Role Of Lower Leg Muscle Activity In Blood Pressure Maintenance Of Older Adults, Michelle M. Masterson, Amy L. Morgan, Christine E. Multer, Daniel Cipriani

Physical Therapy Faculty Articles and Research

Purpose. Age-associated muscle weakness, postural instability, and orthostatic hypotension have been identified as contributing factors to falls , but the relationships among them are not clear. Therefore, the purpose of this study, a two-way factorial design, was to investigate the differences in lower extremity (LE) muscle activity, blood pressure (BP), and heart rate (HR) between young and older individuals in an upright position. Methods. Ten young males (20-24 yrs.) and 10 older males (65-82 yrs.) stood for 15 minutes while BP, HR, and LE electromyography (EMG) were recorded at one minute intervals . A two-way ANOVA was used …

Central Somatosensory Changes And Altered Muscle Synergies In Subjects With Anterior Cruciate Ligament Deficiency, Carol Courtney, Rose Marie Rine, Penny G. Kroll

Physical Therapy Faculty Research

To clarify the mechanisms of compensation in subjects with anterior cruciate ligament deficiency (ACL-D), we examined proprioception, quadriceps strength, somatosensory evoked potentials (SEPs) and muscle responses during gait in varied combinations of speed and incline. Seventeen subjects with ACL-D were grouped by functional level and report of giving way. Seven subjects without ACL-D served as a control sample for muscle response measures. ACL-D subjects with quadriceps weakness experienced giving way and could not resume sport activities. Those without weakness fell into one of two groups: (1) copers, who had full return to previous activity and no giving way despite proprioceptive …

Qtc Is Associated With Obesity And Physical Activity Level For African American Females, C. Jayne Brahler

Health and Sport Science Faculty Publications

Long QT syndrome (LQTS) is an independent risk factor for cardiovascular or ischemic disease mortality. Obesity as a cause for acquired LQTS in otherwise healthy individuals is rapidly gaining the attention of the scientific community. African American people have a higher incidence of obesity compared to Caucasians, yet race-specific information is not available for their prevalence of LQTS. Chronic physical activity can help reduce the incidence of obesity, yet little is known about the effects of chronic physical activity on acquired LQTS. Subjects in this study were a volunteer sample of African American mothers (21-53 yr, n = 44) and …

Effects Of Ibuprofen And Vicoprofen (R) On Physical Performance After Exercise-Induced Muscle Damage, Jaci L. Van Heest, Jim Stoppani, Tim P. Scheett, Valerie Wherley

All PTHMS Faculty Publications

Objective: To determine the effects of Vicoprofen® and ibuprofen on aerobic performance, agility, and pain after exercise-induced muscle damage. Design: Double-blind randomized, placebo-controlled, repeated-dose clinical trial. Setting: Human-performance and sports-medicine laboratory. Participants: 36 healthy men. Methods and Measures: Baseline testing was performed, 72 hours after which subjects performed eccentric exercise to induce muscle damage. They were evaluated for pain 24 hours postdamage and placed randomly into 3 groups: Vicoprofen (VIC), ibuprofen, or placebo (P). Postdamage testing was performed every day for 5 days. Subjects performed an economy run and a t-agility test to determine exercise performance. Results: The drugs had …

Safe At The Shoulder, Daniel Cipriani

Physical Therapy Faculty Articles and Research

The key to preventing shoulder injuries is understanding the anatomy of the shoulder complex and how the body's other muscles affect the throwing motion