Measurement of Ankle Dorsiflexion: A Comparison of Active and Passive Techniques in Multiple Positions

2011 ◽  
Vol 20 (3) ◽  
pp. 333-344 ◽  
Author(s):  
David A. Krause ◽  
Beth A. Cloud ◽  
Lindsey A. Forster ◽  
Jennifer A. Schrank ◽  
John H. Hollman
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Interrater Reliability ◽  
Emg Activity ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intrarater Reliability ◽  
Significant Difference ◽  
Anterior Tibialis ◽  
Passive Techniques

Context:Limited ankle DF (DF) range of motion (ROM) resulting from restricted gastrocnemius and soleus mobility is associated with a variety of lower extremity pathologies. Several techniques are used clinically to measure ankle DF.Objectives:To evaluate the reliability and minimal detectable change of DF ROM measurement, determine whether there is a difference in measured DF between techniques, and quantify the electromyographic (EMG) activity of the soleus and tibialis anterior muscles associated with the techniques.Design:Repeated measures.Setting:Controlled laboratory setting.Participants:39 healthy subjects, age 22–33.Main Outcome Measures:DF measurements using 5 different techniques including active and passive DF with the knee extended and flexed to 90° and a modified lunge. EMG activity of the soleus and anterior tibialis muscles.Results:Intrarater reliability values (ICC3,1) ranged from .68 to .89. Interrater reliability (ICC2,1) ranged from .55 to .82. ICCs were the greatest with the modified lunge. The minimal detectable change (MDC95) ranged from 6° to 8° among the different techniques. A significant difference in DF ROM was found between all methods. Measurements taken with active DF were greater than the same measures taken passively. The lunge position resulted in greater DF ROM than both active and passive techniques. EMG activity of the soleus was greater with active DF and the lunge than with passive DF.Conclusions:The modified lunge, which demonstrated excellent intrarater and interrater reliability, may best represent maximal DF. Active end-range DF was significantly greater than passive end-range DF when measured at either 0° or 90° knee flexion. Greater active DF was not explained by inhibition of the soleus. Finally, using the modified lunge, a difference between 2 measurements over time of 6° or more suggests that a meaningful change has occurred.

scholarly journals Validity and Intrarater Reliability Using a Smartphone Clinometer Application to Measure Active Cervical Range of Motion Including Rotation Measurements in Supine

2020 ◽  
pp. 1-5
Author(s):  
Christanie Monreal ◽  
Lindsay Luinstra ◽  
Lindsay Larkins ◽  
James May
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Pearson Correlation ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intrarater Reliability ◽  
Convenience Sample ◽  
Clinical Measurement ◽  
Cervical Range Of Motion ◽  
Flexion Extension

Context: Technological advances have given smartphones the capabilities of sensitive clinical measurement equipment at lesser cost and higher availability. The Clinometer is a smartphone application that can be used to measure the joint range of motion in a clinical setting, but psychometric properties of the tool’s use measuring cervical range of motion (CROM) are not established. Objectives: The purpose of this study was to examine the validity and intrarater reliability of the Clinometer application for the measurement of CROM (ie, flexion, extension, rotation, lateral flexion) and to determine the minimal detectable change and SEM. Design: A blinded, repeated-measures correlational design was employed. Setting: The study was conducted collaboratively between 2 athletic training clinics. Participants: A convenience sample of healthy adults ages 18–30 years were recruited. Participants with any history in the last 3 months of cervical or thoracic pathology, pain, or any musculoskeletal injury were excluded. Main Outcome Measures: Three repetitions of each motion were measured by a primary researcher with a goniometer. The same researcher then conducted 3 blinded measurements with the Clinometer application following the same procedure. A second researcher, blinded to the goniometer measurements, recorded the results. Thirty minutes later, testing was repeated with the application. The Pearson correlation was calculated to determine validity of the application compared with goniometry. Results: The measurements between devices had moderate to excellent concurrent validity, with the coefficients ranging between 0.544 and 0.888, P < .01. Test–retest reliability of the CROM measurement using the application was moderate to excellent, with intraclass correlation coefficients ranging between .774 and .928. Across all movements, the SEM ranged from 1.17° to 2.01°, and the minimal detectable change ranged from 1.18° to 2.02°. Conclusion: The Clinometer application is a valid and reliable instrument for measuring active CROM. Level of evidence: clinical measurement, level 1b.

scholarly journals The Effect of Pedal Pump Lymphatic Technique Versus Passive Recovery Following Maximal Exercise: A Randomized Cross-Over Trial

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Joanne DiFrancisco-Donoghue ◽  
Thomas Chan ◽  
Alexandra S. Jensen ◽  
James E. B. Docherty ◽  
Rebecca Grohman ◽  
...  
Keyword(s):  
Blood Lactate ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Maximal Exercise ◽  
Lactate Concentration ◽  
The Body ◽  
Intense Exercise ◽  
Passive Recovery ◽  
Significant Difference ◽  
Recovery Protocols

Abstract Context Muscle damage and delayed onset muscle soreness (DOMS) can occur following intense exercise. Various modalities have been studied to improve blood lactate accumulation, which is a primary reason for DOMS. It has been well established that active recovery facilitates blood lactate removal more rapidly that passive recovery due to the pumping action of the muscle. The pedal pump is a manual lymphatic technique used in osteopathic manipulative medicine to increase lymphatic drainage throughout the body. Pedal pump has been shown to increase lymphatic flow and improve immunity. This may improve circulation and improve clearance of metabolites post-exercise. Objective This study compared the use of pedal pump lymphatic technique to passive supine recovery following maximal exercise. Methods 17 subjects (male n = 10, age 23 ± 3.01; female n = 7, age 24 ± 1.8), performed a maximal volume O2 test (VO2 max) using a Bruce protocol, followed by a recovery protocol using either pedal pump technique or supine passive rest for 10 min, followed by sitting for 10 min. Outcome measures included blood lactate concentration (BL), heart rate (HR), systolic blood pressure (SBP) and VO2. Subjects returned on another day to repeat the VO2 max test to perform the other recovery protocol. All outcomes were measured at rest, within 1- minute post-peak exercise, and at minutes 4, 7, 10 and 20 of the recovery protocols. A 2 × 6 repeated measures ANOVA was used to compare outcome measures (p ≤ 0.05). Results No significant differences were found in VO2, HR, or SBP between any of the recovery protocols. There was no significant difference in BL concentrations for recovery at minutes 4, 7, or 10 (p > 0.05). However, the pedal pump recovery displayed significantly lower BL concentrations at minute 20 of recovery (p = 0.04). Conclusion The pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20. The use of manual lymphatic techniques in exercise recovery should be investigated further.

The Reliability of Strength Tests Performed In Elevated Shoulder Positions Using a Handheld Dynamometer

2016 ◽  
Vol 25 (2) ◽  
Author(s):  
Sally J. McLaine ◽  
Karen A. Ginn ◽  
Cecilia M. Kitic ◽  
James W. Fell ◽  
Marie-Louise Bird
Keyword(s):  
Repeated Measures ◽  
External Rotation ◽  
Body Position ◽  
Movement Control ◽  
Minimal Detectable Change ◽  
Intrarater Reliability ◽  
Strength Change ◽  
Flexion Extension ◽  
Strength Tests ◽  
Shoulder Strength

Context: The reliable measurement of shoulder strength is important when assessing athletes involved in overhead activities. Swimmers' shoulders are subject to repetitive humeral elevation and consequently have a high risk of developing movement-control issues and pain. Shoulder-strength tests performed in positions of elevation assist with the detection of strength deficits that may affect injury and performance. The reliability of isometric strength tests performed in positions of humeral elevation without manual stabilization, which is a typical clinical scenario, has not been established. Objective: To establish the relative and absolute intrarater reliability of shoulder-strength tests functional to swimming in 3 body positions commonly used in the clinical setting. Design: Repeated-measures reliability study. Setting: Research laboratory. Subjects: 15 university students and staff (mean ± SD age 24 ± 8.2 y).Intervention: Isometric shoulder-strength tests were performed in positions of humeral elevation (flexion and extension in 140° abduction in the scapular plane, internal and external rotation in 90° abduction) on subjects without shoulder pain in supine, prone, and sitting. Subjects were tested by 1 examiner with a handheld dynamometer and retested after 48 h. Main Outcome Measures: Relative reliability (ICC3,1) values with 95% CI. Absolute reliability was reported by minimal detectable change (MDC). Results: Good to excellent intrarater reliability was found for all shoulder-strength tests (ICC .87-.99). Intrarater reliability was not affected by body position. MDC% was <16% for every test and ≤11% for tests performed in supine. Conclusions: Shoulder flexion, extension, and internal- and external-rotation strength tests performed in humeral elevation demonstrated excellent to good intrarater reliability regardless of body position. A strength change of more than 15% in any position can be considered meaningful.

Functional Effects of Inertial Training of the Upper Extremity

2003 ◽  
Vol 12 (3) ◽  
pp. 229-239 ◽  
Author(s):  
Todd A. McLoda ◽  
Kate M. Murphy ◽  
Steve Davison
Keyword(s):  
Upper Extremity ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Biceps Brachii ◽  
Exercise Group ◽  
Emg Activity ◽  
Control Group ◽  
Significant Group ◽  
Time Interaction ◽  
Size Groups

Context:Inertial training of the shoulder.Objective:To determine the differences of functional and EMG measures between a control group and an exercise group of overhead throwers.Design:Repeated measures.Setting:Research laboratory.Participants:17 intercollegiate baseball players and 19 intercollegiate softball players divided into 2 equal-size groups, control and exercise.Main Outcome Measures:Preliminary data were recorded, including throwing velocity, throwing accuracy, and EMG activity of the biceps brachii, upper pectorals, and posterior deltoid. The exercise group completed a 4-week training regimen on the Impulse Inertial Trainer. All participants returned for follow-up measures.Results:No significant group-by-time interaction occurred relative to ball velocity, accuracy, or EMG activity.Conclusion:For experienced throwers, functional measures and muscle activity during throwing were not affected by inertial training of the upper extremity.

Electromyographic Evaluation of Abdominal-Muscle Function With and Without Concomitant Pelvic-Floor-Muscle Contraction

2013 ◽  
Vol 22 (2) ◽  
pp. 108-114 ◽  
Author(s):  
Nahid Tahan ◽  
Amir Massoud Arab ◽  
Bita Vaseghi ◽  
Khosro Khademi
Keyword(s):  
Pelvic Floor ◽  
Muscle Contraction ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Pelvic Floor Muscle ◽  
Abdominal Muscle ◽  
Emg Activity ◽  
Abdominal Muscles ◽  
Repeated Measures Design ◽  
Emg Signal

Context:Coactivation of abdominal and pelvic-floor muscles (PFM) is an issue considered by researchers recently. Electromyography (EMG) studies have shown that the abdominal-muscle activity is a normal response to PFM activity, and increase in EMG activity of the PFM concomitant with abdominal-muscle contraction was also reported.Objective:The purpose of this study was to compare the changes in EMG activity of the deep abdominal muscles during abdominal-muscle contraction (abdominal hollowing and bracing) with and without concomitant PFM contraction in healthy and low-back-pain (LBP) subjects.Design:A 2 × 2 repeated-measures design.Setting:Laboratory.Participants:30 subjects (15 with LBP, 15 without LBP).Main Outcome Measures:Peak rectified EMG of abdominal muscles.Results:No difference in EMG of abdominal muscles with and without concomitant PFM contraction in abdominal hollowing (P = .84) and abdominal bracing (P = .53). No difference in EMG signal of abdominal muscles with and without PFM contraction between LBP and healthy subjects in both abdominal hollowing (P = .88) and abdominal bracing (P = .98) maneuvers.Conclusion:Adding PFM contraction had no significant effect on abdominal-muscle contraction in subjects with and without LBP.

Comparing the Effects of Peroneal Muscle Fatigue and Cyclic Loading on Ankle Neuromuscular Control During Lateral-Hop Landing

2015 ◽  
Vol 24 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Kazem Malmir ◽  
Gholam Reza Olyaei ◽  
Saeed Talebian ◽  
Ali Ashraf Jamshidi
Keyword(s):  
Reaction Time ◽  
Muscle Fatigue ◽  
Energy Absorption ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Neuromuscular Control ◽  
Median Frequency ◽  
Peroneus Longus ◽  
Significant Difference ◽  
Main Effect

Context:Cyclic movements and muscle fatigue may result in musculoskeletal injuries by inducing changes in neuromuscular control. Ankle frontal-plane neuromuscular control has rarely been studied in spite of its importance.Objective:To compare the effects of peroneal muscle fatigue and a cyclic passive-inversion (CPI) protocol on ankle neuromuscular control during a lateral hop.Design:Quasi-experimental, repeated measures.Setting:University laboratory.Participants:22 recreationally active, healthy men with no history of ankle sprain or giving way.Interventions:Participants performed a lateral hop before and after 2 interventions on a Biodex dynamometer. They were randomly assigned to intervention order and interventions were 1 wk apart. A passive intervention included 40 CPIs at 5°/s through 80% of maximum range of motion, and a fatigue intervention involved an isometric eversion at 40% of the maximal voluntary isometric contraction until the torque decreased to 50% of its initial value.Main Outcome Measures:Median frequency of the peroneus longus during the fatigue protocol, energy absorption by the viscoelastic tissues during the CPI protocol, and feedforward onset and reaction time of the peroneus longus during landing.Results:A significant fall in median frequency (P < .05) and a significant decrease in energy absorption (P < .05) confirmed fatigue and a change in viscoelastic behavior, respectively. There was a significant main effect of condition on feedforward onset and reaction time (P < .05). No significant main effect of intervention or intervention × condition interaction was noted (P > .05). There was a significant difference between pre- and postintervention measures (P < .0125), but no significant difference was found between postintervention measures (P > .0125).Conclusions:Both fatigue and the CPI may similarly impair ankle neuromuscular control. Thus, in prolonged sports competitions and exercises, the ankle may be injured due to either fatigue or changes in the biomechanical properties of the viscoelastic tissues.

scholarly journals Influence of Body Position on Shoulder and Trunk Muscle Activation During Resisted Isometric Shoulder External Rotation

2018 ◽  
Vol 10 (4) ◽  
pp. 355-360 ◽  
Author(s):  
David A. Krause ◽  
Lucas G. Dueffert ◽  
Jaclyn L. Postma ◽  
Eric T. Vogler ◽  
Amy J. Walsh ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Muscle Activation ◽  
External Rotation ◽  
Body Position ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Emg Activity ◽  
Convenience Sample ◽  
Overhead Athletes ◽  
Significant Difference

Background: External rotation (ER) strengthening of the shoulder is an integral component of rehabilitative and preventative programs for overhead athletes. A variety of shoulder ER strengthening exercises are reported, including those intended to integrate the core musculature. The purpose of this study was to examine ER torque and electromyographic (EMG) activation of shoulder and trunk muscles while performing resisted isometric shoulder ER in 3 positions (standing, side lying, and side plank). Hypothesis: Significantly greater force and shoulder muscle activation would be generated while side lying given the inherent stability of the position, and greater trunk muscle activation would be generated in the less stable plank position. Study Design: Quasi-experimental repeated-measures study. Level of Evidence: Level 5. Methods: A convenience sample of 25 healthy overhead recreational athletes (9 men, 16 women) participated in this study. EMG electrodes were placed on the infraspinatus, posterior deltoid, middle trapezius, multifidi, internal obliques, and external obliques. EMG signals were normalized to a maximal isometric contraction. Participants performed resisted isometric ER in standing, side-lying, and side plank positions. Results were analyzed using a repeated-measures analysis of variance with post hoc Bonferroni corrections (α = 0.05). Results: There was no significant difference in ER torque between positions (α = 0.05). A significant difference in EMG activity of shoulder and trunk musculature between positions was found in 7 of the 8 muscles monitored. Significantly greater EMG activity in the infraspinatus, middle trapezius, and the nondominant external and internal obliques was found in the side plank position as compared with standing and side lying. Conclusion: While there was no difference in ER torque between the 3 exercise positions, EMG activity of the shoulder and trunk muscles was dependent on body position. Clinical Relevance: If a clinician is seeking to integrate trunk muscle activation while performing shoulder ER strengthening, the side plank position is preferred as compared with standing or side lying.

scholarly journals Preseason to Postseason Changes on the BTrackS Force Plate in a Sample of College Athletes

2020 ◽  
Vol 29 (1) ◽  
pp. 134-136
Author(s):  
Ryan Morrison ◽  
Kyle M. Petit ◽  
Chris Kuenze ◽  
Ryan N. Moran ◽  
Tracey Covassin
Keyword(s):  
Athletic Training ◽  
Path Length ◽  
College Athletes ◽  
Center Of Pressure ◽  
Low Cost ◽  
Force Plate ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Competitive Season ◽  
Significant Difference

Context: Balance testing is a vital component in the evaluation and management of sport-related concussion. Few studies have examined the use of objective, low-cost, force-plate balance systems and changes in balance after a competitive season. Objective: To examine the extent of preseason versus postseason static balance changes using the Balance Tracking System (BTrackS) force plate in college athletes. Design: Pretest, posttest design. Setting: Athletic training facility. Participants: A total of 47 healthy, Division-I student-athletes (33 males and 14 females; age 18.4 [0.5] y, height 71.8 [10.8] cm, weight 85.6 [21.7] kg) participated in this study. Main Outcome Measures: Total center of pressure path length was measured preseason and postseason using the BTrackS force plate. A Wilcoxon signed-rank test was conducted to examine preseason and postseason changes. SEM and minimal detectable change were also calculated. Results: There was a significant difference in center of pressure path length differed between preseason (24.6 [6.8] cm) and postseason (22.7 [5.4] cm) intervals (P = .03), with an SEM of 3.8 cm and minimal detectable change of 10.5 cm. Conclusions: Significant improvements occurred for center of pressure path length after a competitive season, when assessed using the BTrackS in a sample of college athletes. Further research is warranted to determine the effectiveness of the BTrackS as a reliable, low-cost alternative to force-plate balance systems. In addition, clinicians may need to update baseline balance assessments more frequently to account for improvements.

Tibiofemoral Joint-Surface Motions in Weight-Bearing and Non-Weight-Bearing Movement

2003 ◽  
Vol 12 (2) ◽  
pp. 143-161 ◽  
Author(s):  
John H. Hollman ◽  
Robert H. Deusinger ◽  
Linda R. Van Dillen ◽  
Dequan Zou ◽  
Scott D. Minor ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Weight Bearing ◽  
Knee Extension ◽  
Thigh Muscle ◽  
Joint Surface ◽  
Emg Activity ◽  
Sliding Motion ◽  
Type Design

Context:Analyses of the path of instant center of rotation (PICR) can be used to infer joint-surface rolling and sliding motion (arthrokinematics). Previous PICR research has not quantified arthrokinematics during weight-bearing (WB) movement conditions or studied the association of muscle activity with arthrokinematics.Objective:To examine tibiofemoral arthrokinematics and thigh-muscle EMG during WB and non-weight-bearing (NWB) movement.Design:2 x 9 repeated-measures experiment.Setting:Laboratory.Participants:11 healthy adults (mean age 24 years).Main Outcome Measures:Tibiofemoral percentage rolling arthrokinematics and quadriceps: hamstring EMG activity.Results:WB percentage rolling (76.0% ± 4.7%) exceeded that of NWB (57.5% ± 1.8%) through terminal knee extension (F8,80= 8.99,P< .001). Quadriceps:hamstring EMG ratios accounted for 45.1% and 34.7% of the variance in arthrokinematics throughout the WB and NWB movement conditions, respectively (P< .001).Conclusions:More joint-surface rolling occurs through terminal knee extension during WB movement and is associated with an increase in hamstring activity.

Reliability of Hip Rotation Range of Motion in Supine and Seated Positions

2018 ◽  
Vol 27 (4) ◽  
Author(s):  
Marissa C. Gradoz ◽  
Lauren E. Bauer ◽  
Terry L. Grindstaff ◽  
Jennifer J. Bagwell
Keyword(s):  
Range Of Motion ◽  
Outcome Measures ◽  
External Rotation ◽  
Intraclass Correlation ◽  
Minimal Detectable Change ◽  
Low Back ◽  
Detectable Change ◽  
Significance Level ◽  
Spine Pathology ◽  
Hip Rotation

Context: Hip rotation range of motion (ROM) is commonly assessed in individuals with lower extremity or spine pathology. It remains unknown which hip rotation ROM testing position is most reliable. Objective: To compare interrater and intrarater reliabilities between hip internal rotation (IR) and external rotation (ER) ROM in supine and seated positions. Study Design: Controlled laboratory study. Setting: University research laboratory. Participants: A total of 19 participants (11 females and 8 males; age = 23.5 [1.2] y; height = 173.2 [8.6] cm; and mass = 69.2 [13.4] kg) without hip, knee, low back, or sacroiliac pain within the preceding 3 months or history of hip or low back surgery were recruited. Interventions: Three testers obtained measures during 2 testing sessions. Passive supine and seated hip IR and ER ROM were performed with the hip and knee flexed to 90°. Main Outcome Measures: The primary outcome measures were hip IR and ER ROM in supine and seated positions (in degrees). Interrater and intrarater reliabilities were calculated using intraclass correlation coefficients (ICCs). Minimal detectable change was calculated. Differences between supine and seated hip IR and ER ROM values were assessed using paired t tests (significance level was .05). Results: Supine hip IR and ER ROM interrater and intrarater reliabilities were excellent (ICC = .75–.91). Seated hip IR ROM interrater and intrarater reliabilities were good (ICC = .64–.71). Seated hip ER ROM interrater reliability was good (ICC = .65), and intrarater reliabilities were good to excellent (ICC = .65–.82). Minimal detectable change values for supine and seated hip IR and ER ROM ranged from 6.1° to 8.6°. There were significant differences between supine and seated positions for hip IR and ER ROM (41.6° vs 44.5°; P < .01 and 53.0° vs 44.2°; P < .01, respectively). Conclusion: Supine hip rotation had higher interrater and intrarater reliabilities. Hip IR and ER ROM values differed significantly between supine and seated positions and should not be used interchangeably.

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