Physical Therapy Commons^™

Can The Forward-Step-Down Test Be Used Reliably In The Clinical Setting To Assess Movement Changes Resulting From Maximal Exertion? A Pilot Study, Erin Mccallister, Daniel W. Flowers

Internet Journal of Allied Health Sciences and Practice

Introduction: Visual assessment of lower extremity mechanics is used frequently in clinical practice, and objective scoring of the visual assessment is beneficial to improve objectivity of patient evaluation. In addition, lower extremity mechanics change with fatigue and these changes may increase the risk of lower extremity injury. The Forward-Step-Down Test (FSDT) is one such objective tool, but its ability to detect changes in movement quality in response to exertion are not known. Methods: This study utilized a repeated-measures design, where the participants were scored on the FSDT before performing the Bruce protocol for an exertion stimulus. The participants were re-scored …

The Effects Of A 6-Week Controlled Whole-Body Vibration Training Program In Reducing Falls Risk Among Healthy Older Adults, Fabricio Saucedo Jr.

Open Access Theses & Dissertations

Falling is the second leading cause of accidental or injury-related death in the aging population worldwide and a leading cause of serious injury. Whole-body vibration (WBV) training has been implemented as a way to improve functional performance among the elderly and reduce the falls risk. The purposes of this study were: 1) examine to what extent a six-week course of WBV training reduced falls risk and improved fall outcomes in response to slips, and 2) examine whether the benefits of WBV training could be retained at least 2 months after the completion of the entire training session. A total of …

Connecting The Pieces: How Low Back Pain Alters Lower Extremity Biomechanics And Shock Attenuation In Active Individuals, Alexa Johnson

Theses and Dissertations--Rehabilitation Sciences

Low back pain in collegiate athletes has been reported at a rate of 37% from a wide array of sports including soccer, volleyball, football, swimming, and baseball. Whereas, in a military population the prevalence of low back pain is 70% higher than the general population. Compensatory movement strategies are often used as an attempt to reduce pain. Though compensatory movement strategies may effectively reduce pain, they are often associated with altered lower extremity loading patterns. Those who suffer from chronic low back pain tend to walk and run slower and with less trunk and pelvis coordination and variability. Individuals with …

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 …

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 …

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 …

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 …

Longitudinal Adaptations In Muscle Strength, Functional Performance, Gait Biomechanics, And Patient-Reported Function After Unilateral Total Knee Arthroplasty, Paul W. Kline

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to impairments after total knee arthroplasty (TKA) (Aim 1) and define recovery between 3 and 6 months after TKA across four domains: 1) hip and knee muscle performance, 2) functional performance, 3) patient-reported function, and 4) biomechanics of walking and stair descent (Aim 2). Additionally, this project sought to explore the relationships between each domain (Aim 3) and establish predictive models to allow clinicians to use clinical measures to predict future gait biomechanics in patients after TKA (Aim 4). Ultimately, the results of this research would …

Multi-Digit Coordination In Absence Of Cutaneous Sensory Feedback During Grasping Tasks, Christina Gioeli, Kerry Mcpartlan, Emily Reid, Matthew Turturro

Dissertations, Theses, and Capstone Projects

Motor learning and adaptation to object properties and task requirements requires integration of cutaneous sensory feedback with motor commands. Joint mechanics constantly change, with individual joints or muscles compensation so performance output is the same per task. Effects of mixed cutaneous sensory feedback on multi-digit coordination is not well understood. Investigators sought to determine the influence absent cutaneous sensory feedback has on motor learning and adaptation, and how the CNS coordinates multi-digit mechanical output to adapt to manual tasks, with partially intact digital sensory feedback. 19 participants were randomly assigned for three-digit anesthesia administration (TIM- thumb, index, middle; TRL- thumb, …

Mobility Of Individuals With Multiple Sclerosis And The Influence Of Physical Therapy, Brenda L. Davies

Theses & Dissertations

One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investi­gation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with …

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 …

Use Of Audio Biofeedback To Reduce Tibial Impact Accelerations During Running, Claire M. Wood, Kristof Kipp

Exercise Science Faculty Research and Publications

Visual biofeedback of tibial peak positive acceleration (PPA) during running has been used successfully as a method of gait retraining to reduce PPAs. Audio biofeedback generated from PPA may present a novel, portable alternative. The purpose of this study was to investigate the feasibility of using PPA-generated audio biofeedback to reduce PPAs while running. Nine runners were fitted with a wireless accelerometer on their left tibia. PPAs were recorded and a custom LabVIEW program was used to emit a single beep once the PPA reached a preset threshold. The numerical difference between this threshold and peak PPA during running was …

In Vitro Manual Therapy And Biorobotic Simulation Of Glenohumeral Joint Mobilization Techniques, Hunter Johnson Smith

Theses and Dissertations (ETD)

Physical therapists (PT) employ mobilization techniques for restoring range of motion to joints. Few studies have attempted to quantify the biomechanics of manual therapy on the glenohumeral (GH) joint. The objectives of this study were to develop an in vitro protocol to determine the biomechanical effects of joint mobilization on the GH joint, and to then simulate these mobilizations in the University of Tennessee Health Science Center (UTHSC) Joint Implant Biomechanics Laboratory’s Robotic Testing Platform (RTP).

The GH joint is an incredibly shallow socket joint. This gives the joint an unusually large range of motion (ROM) compared to other ball …

Effects Of Footstrike Pattern On Low Back Posture, Shock Attenuation, And Comfort During Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Barefoot running (BF) is popular in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). In addition, changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain (LBP). However it is not known how changing from RFS to FFS affects lumbar lordosis or LBP. Thus, the purpose of this study was to determine if a change from RFS to FFS would change lumbar lordosis, and/or decrease shock attenuation, and/or change comfort levels in healthy recreational/experienced runners.

Methods: …

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 …

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 …

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 …

Biomechanical Analysis Of The Upper Extremity During Multiple Softball Pitches, Amy Bookkless, Katelyn Bottelberghe, Tara Petersen

Physical Therapy Scholarly Projects

Purpose: There are a large number of fast pitch softball participants including high school, college, Olympic, professional and recreational leagues. While a large number of studies describe the baseball pitch, there is a shortage of studies describing the windmill softball pitch. Therefore, the purpose of this study is to utilize electromyography (EMG) and motion analysis to determine the biomechanical factors of muscle recruitment, shoulder and elbow range of motion and joint velocities during the windmill softball pitch.

Subjects: Five Division II women's fast pitch softball pitchers, mean age 19 years, were included in the study. The player's pitching experience averaged …

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 …

Motion Analysis Of A Back Handspring, Sarah Knoll, Jaclyn Minar, Melissa Moos

Physical Therapy Scholarly Projects

Purpose: The purpose of this study was to analyze the joint angles and segmental motion of gymnasts during a back handspring in a tumbling series. The difference in lower extremity motion of the individual gymnasts with different levels of experience was compared.

Subjects: 13 gymnasts were recruited by gymnastics coaches at Red River Valley Gymnastics. Only subjects with qualifications of being competitive in USA Gymnastics program, varying in levels 5-10, were included. Subjects were required to be able to perform a tumbling series consisting of a round off, a back handspring, and a back tuck-salto on a floor exercise mat …

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 …

Walker-Assisted Gait In Rehabilitation: A Study Of Biomechanics And Instrumentation, Rebecca Ann Bachschmidt, Gerald F. Harris, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

While walkers are commonly prescribed to improve patient stability and ambulatory ability, quantitative study of the biomechanical and functional requirements for effective walker use is limited. To date no one has addressed the changes in upper extremity kinetics that occur with the use of a standard walker, which was the objective of this study. A strain gauge-based walker instrumentation system was developed for the six degree-of-freedom measurement of resultant subject hand loads. The walker dynamometer was integrated with an upper extremity biomechanical model. Preliminary system data were collected for seven healthy, right-handed young adults following informed consent. Bilateral upper extremity …