Rehabilitation and Therapy 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 …

Highly-Individualized Physical Therapy Instruction Beyond The Clinic Using Wearable Inertial Sensors, Samir A. Rawashdeh, Ella Reimann, Timothy L. Uhl

Physical Therapy Faculty Publications

Musculoskeletal conditions, often requiring rehabilitation, affect one-third of the U.S. population annually. This paper presents rehabilitation assistive technology that includes body-worn motion sensors and a mobile application that extends the reach of a physical rehabilitation specialist beyond the clinic to ensure that home exercises are performed with the same precision as under clinical supervision. Assisted by a specialist in the clinic, the wearable sensors and user interface developed allow the capture of individualized exercises unique to the patient’s physical abilities. Beyond the clinical setting, the system can assist patients by providing real-time corrective feedback to repeat these exercises through a …

Maximal Strength In Relation To Force And Velocity Patterns During Countermovement Jumps, Michael H. Haischer, John Krzyszkowski, Stuart Roche, Kristof Kipp

Exercise Science Faculty Research and Publications

Maximal strength is important for the performance of dynamic athletic activities, such as countermovement jumps (CMJ). Although measures of maximal strength appear related to discrete CMJ variables, such as peak ground reaction forces (GRF) and center-of-mass (COM) velocity, knowledge about the association between strength and the time series patterns during CMJ will help characterize changes that can be expected in dynamic movement with changes in maximal strength. Purpose: To investigate the associations between maximal strength and GRF and COM velocity patterns during CMJ. Methods: Nineteen female college lacrosse players performed 3 maximal-effort CMJs and isometric midthigh pull. GRF …

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 …

Hip And Knee Joint Angle Patterns And Kicking Velocity In Female And Male Professional Soccer Players: A Principal Component Analysis Of Waveforms Approach, Archit Navandar, Kristof Kipp, Enrique Navarro

Exercise Science Faculty Research and Publications

This study used principal component analysis (PCA) of waveforms to extract movement patterns from hip and knee angle time-series data; and determined if the extracted movement patterns were predictors of ball velocity during a soccer kick. Twenty-three female and nineteen male professional soccer players performed maximal effort instep kicks while motion capture and post-impact ball velocities data were recorded. Three-dimensional hip and knee joint angle time-series data were calculated from the beginning of the kicking leg’s backswing phase until the end of the follow-through phase and entered into separate PCAs for females and males. Three principal components (PC) (i.e., movement …

Head Impact Exposure In Youth And Collegiate American Football, Grace B. Choi, Eric P. Smith, Stefan M. Duma, Steven Rowson, Eamon Campolettano, Mireille E. Kelley, Derek A. Jones, Joel D. Stitzel, Jillian E. Urban, Amaris Genemaras, Jonathan G. Beckwith, Richard M. Greenwald, Arthur C. Maerlender, Joseph J. Crisco

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9–14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs …

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 …

Influence Of The Bar Position On Joint-Level Biomechanics During Isometric Pulling Exercises, Nayun Ahn, Hoon Kim, John Krzyszkowski, Stuart Roche, Kristof Kipp

Exercise Science Faculty Research and Publications

The purpose of this study was to investigate the influence of the bar position on ankle, knee, and hip net joint moments (NJMs), relative muscular effort (RME), and vertical ground reaction forces (GRFs) during isometric pulling exercises, such as the isometric midthigh pull. Eight female lacrosse athletes performed maximal effort isometric pulls at 3 different bar positions (low: above patella, mid: midthigh, and high: crease of hip) while motion capture and GRF data were recorded. Net joint moments were calculated with inverse dynamics. Relative muscle effort was defined as the ratio between the inverse dynamics NJMs and the maximum theoretical …

Etherapy: The Next Generation Of Physical And Occupational Therapy, Colin Elliott

Summer Scholarship, Creative Arts and Research Projects (SCARP)

The purpose of the research is to create software capable of revolutionizing the way physical and occupational therapy is done by utilizing wireless inertia sensors. The inertia sensors themselves can accurately identify their exact position in space. Hence, when they are attached correctly to a patient requiring therapy, they can provide precise data on the patient’s real-time motions. It is the goal of the software to leverage the power of the sensors to provide real-time feedback to the patient and to the therapist to ensure patients are performing prescribed exercises correctly and are restoring their range(s) of motion. For ease …

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 …

Gait Rehabilitation Using Functional Electrical Stimulation Induces Changes In Ankle Muscle Coordination In Stroke Survivors: A Preliminary Study, Jessica L. Allen, Lena H. Ting, Trisha M. Kesar

Faculty & Staff Scholarship

No abstract provided.

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 …

The Biomechanics Of Music Performance, Rachel F. Bellisle, Jessika Decker

Senior Honors Projects

When first learning to play a wind instrument, beginner musicians are taught how to hold their instrument and correctly position their body. They are taught how to sit, where to put their hands and fingers on the keys, and how to hold their arms. This initial lesson on posture and hand positioning is often short, as one quickly moves on to learn the embouchure and breathing techniques that allow sound to be produced. As a musician progresses in skill, positioning is emphasized more, and they learn that it can affect their risk of strain or injury and improve their sound …

Superhero Robotics, Frank Sup, Brian Umberger, Nick Sawyer

Science and Engineering Saturday Seminars

No abstract provided.

Do Scapular Kinematics Alter During The Performance Of The Scapular Assistance Test And Scapular Retraction Test: A Pilot Study, W. Ben Kibler, Thomas J. Cunningham, Natalie L. Myers, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To describe to what degree and in what plane biomechanical alterations occur during the performance of the Scapular Retraction test (SRT) and Scapular Assistance Test (SAT).

Design: Laboratory Pilot Study

Participants: Eight symptomatic and 7 asymptomatic subjects were instrumented with electromagnetic sensors.

Main Outcome Measures: The SRT and SAT were performed with the scapula stabilized and unstabilized. The scapular kinematic variables of posterior tilt, internal rotation, upward rotation, protraction, and elevation were measured during both tests.

Results: Descriptive analysis of scapular kinematics suggested that posterior tilt was primarily increased during both clinical tests in both groups. Both groups decreased …

Muscle-Specific Effective Mechanical Advantage And Joint Impulse In Weightlifting, Kristof Kipp, Chad Harris

Exercise Science Faculty Research and Publications

Lifting greater loads during weightlifting exercises may theoretically be achieved through increasing the magnitudes of net joint impulses or manipulating the joints’ effective mechanical advantage (EMA). The purpose of this study was to investigate muscle-specific EMA and joint impulse as well as impulse-momentum characteristics of the lifter-barbell system across a range of external loads during the execution of the clean. Collegiate-level weightlifters performed submaximal cleans at 65, 75, and 85% of their 1-repetition maximum (1-RM) while data from a motion analysis system and a force plate were used to calculate lifter-barbell system impulse and velocity, as well as net extensor …

Mechanical Demands Of The Hang Power Clean And Jump Shrug: A Joint-Level Perspective, Kristof Kipp, Philip Malloy, Jordan Smith, Matthew D. Giordanelli, Michael T. Kiely, Christopher Geiser, Timothy J. Suchomel

Exercise Science Faculty Research and Publications

The purpose of this study was to investigate the joint- and load-dependent changes in the mechanical demands of the lower extremity joints during the hang power clean (HPC) and the jump shrug (JS). Fifteen male lacrosse players were recruited from an NCAA DI team, and completed three sets of the HPC and JS at 30%, 50%, and 70% of their HPC 1-Repetition Maximum (1-RM HPC) in a counterbalanced and randomized order. Motion analysis and force plate technology were used to calculate the positive work, propulsive phase duration, and peak concentric power at the hip, knee, and ankle joints. Separate three-way …

Hip External Rotator Strength Is Associated With Better Dynamic Control Of The Lower Extremity During Landing Tasks, Philip Malloy, Alexander Morgan, Carolyn M. Meinerz, Christopher Geiser, Kristof Kipp

Exercise Science Faculty Research and Publications

Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res 30(1): 282–291, 2016—The purpose of this study was to determine the association between hip strength and lower extremity kinematics and kinetics during unanticipated single-leg landing and cutting tasks in collegiate female soccer players. Twenty-three National Collegiate Athletic Association division I female soccer players were recruited for strength testing and biomechanical analysis. Maximal isometric hip abduction and external rotation strength were measured using a hand-held dynamometer and expressed as muscle torque (force × femoral length) and normalized to body weight. …

Reliability Of 3-Dimensional Measures Of Single-Leg Cross Drop Landing Across 3 Different Institutions: Implications For Multicenter Biomechanical And Epidemiological Research On Acl Injury Prevention, Christopher A. Dicesare, Nathaniel A. Bates, Kim D. Barber Foss, Staci M. Thomas, Samuel C. Wordeman, Dai Sugimoto, Benjamin D. Roewer, Jennifer M. Medina Mckeon, Stephanie Di Stasi, Brian W. Noehren, Kevin R. Ford, Adam W. Kiefer, Timothy E. Hewett, Gregory D. Myer

Physical Therapy Faculty Publications

Background: Anterior cruciate ligament (ACL) injuries are physically and financially devastating but affect a relatively small percentage of the population. Prospective identification of risk factors for ACL injury necessitates a large sample size; therefore, study of this injury would benefit from a multicenter approach.

Purpose: To determine the reliability of kinematic and kinetic measures of a single-leg cross drop task across 3 institutions.

Study Design: Controlled laboratory study.

Methods: Twenty-five female high school volleyball players participated in this study. Three-dimensional motion data of each participant performing the single-leg cross drop were collected at 3 institutions over a period of 4 …

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 …

Weightlifting Performance Is Related To Kinematic And Kinetic Patterns Of The Hip And Knee Joints, Kristof Kipp, Josh Redden, Michelle B. Sabick, Chad Harris

Exercise Science Faculty Research and Publications

The purpose of this study was to investigate the correlations between biomechanical outcome measures and weightlifting performance. Joint kinematics and kinetics of the hip, knee, and ankle were calculated while 10 subjects performed a clean at 85% of 1 repetition maximum (1RM). Kinematic and kinetic time-series patterns were extracted with principal components analysis. Discrete scores for each time-series pattern were calculated and used to determine how each pattern was related to body mass–normalized 1RM. Two hip kinematic and 2 knee kinetic patterns were significantly correlated with relative 1RM. The kinematic patterns captured hip and trunk motions during the first pull …

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 …