Forearm Position’s Alteration of Radial-Head Impingement on Wrist-Extensor Tendons

2015 ◽  
Vol 24 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Tom A. Ranger ◽  
Wendy M. Braybon ◽  
Craig R. Purdam ◽  
Jill L. Cook

Context:Lateral epicondylalgia, pain at the lateral elbow, is commonly associated with extensor carpi radialis brevis tendinopathy. The radial head, which abuts the extensor tendons and is elliptical in shape, may affect the extensor tendons during pronation of the forearm. Cadaverous studies have shown that the radial head may act as a cam in pronation, to offer a mechanical advantage to the common extensor tendon and to mitigate load on the origin of the extensor carpi radialis brevis tendon.Objective:To determine the effect of radial-head position on the wrist-extensor tendons in vivo.Design:Repeated-measures design.Setting:Laboratory.Participants:22 participants (12 male, 2 left-handed).Main Outcome Measures:Distance (mm) from subcutaneous fascia to radial head measured by ultrasound.Results:The radial head in supination was significantly deeper than either pronation or midprone, indicating a smaller cam effect in supination.Conclusion:The authors recommend that the effect of radial-head position and its relationship to the area of tendon pathology be considered clinically in the rehabilitation of patients suffering from lateral epicondylalgia.

2013 ◽  
Vol 22 (2) ◽  
pp. 108-114 ◽  
Author(s):  
Nahid Tahan ◽  
Amir Massoud Arab ◽  
Bita Vaseghi ◽  
Khosro Khademi

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.


2004 ◽  
Vol 13 (1) ◽  
pp. 54-66 ◽  
Author(s):  
Lauren C. Olmsted ◽  
Jay Hertel

Context:The effects of custom-molded foot orthotics on neuromuscular processes are not clearly understood.Objective:To examine these effects on postural control in subjects with different foot types.Design:Between-groups, repeated-measures design.Setting:Athletic training laboratory.Subjects:30 healthy subjects assigned to groups by foot type: planus (n = 11), rectus (n = 12), or cavus (n = 7).Interventions:Custom-fit semirigid orthotics.Main Outcome Measures:Static postural control was measured on a force plate. Dynamic postural control was measured using the Star Excursion Balance Test. Both measurements were assessed with and without orthotics at baseline and 2 weeks later.Results:For static postural control, a significant condition-by-group interaction was found. Subjects with cavus feet had a decreased center-of-pressure velocity while wearing orthotics. For dynamic postural control, a significant condition-by-direction-by-group interaction was found. Subjects with cavus feet had increased reach distances in 3 of 8 directions while wearing orthotics.Conclusions:Custom orthotics were associated with some improvements in static and dynamic postural control in subjects with cavus feet.


2006 ◽  
Vol 15 (3) ◽  
pp. 215-227
Author(s):  
Brian Campbell ◽  
James Yaggie ◽  
Daniel Cipriani

Context:Functional knee braces (FKB) are used prophylactically and in rehabilitation to aide in the functional stability of the knee.Objective:To determine if alterations in select lower extremity moments persist 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 kinematic and kinetic data were collected at 20-minute increments to assess the effect of the FKB on select lower extremity moments and vertical ground reaction forces.Results:Increase in hip moment and a decrease in knee moment were noted immediately after brace application and appeared to persist throughout a one hour bout of exercise.Conclusions:The FKB and the exercise intervention caused decreases in knee joint moments and increases in hip joint moments.


2013 ◽  
Vol 22 (4) ◽  
pp. 296-300
Author(s):  
Daniel Krasinski ◽  
Ashley B. Thrasher ◽  
Michael G. Miller ◽  
William R. Holcomb

Context:A potential variable that could affect rate of temperature elevation with ultrasound is the pressure (mass) that is applied to the transducer head during application. Added pressure could compress the tissue, affecting density and the transmission of ultrasound energy. Little research has been completed to determine the effects of the amount of pressure applied during therapeutic ultrasound in vivo.Objective:To determine the effects of different applied transducer mass on intramuscular temperature during an ultrasound treatment within the left triceps surae.Design:Crossover clinical trial.Setting:Human performance research laboratory.Participants:Convenience sample of thirteen healthy, college-age students.Interventions:Three separate MHz, 1.0-W/cm2 ultrasound treatments were administered 1.5 cm within the triceps surae. The independent variables were the linear temperature standards (0.5°C, 1.0°C, 1.5°C, and 2.0°C above baseline) and the 3 different applied pressures measured in grams (200 g, 600 g, and 800 g).Main Outcome Measures:A thermocouple probe was used to measure triceps surae temperature, and time to reach the temperature standards was recorded during the ultrasound treatments. A 4 × 3 repeated-measures analysis of variance (RM-ANOVA) was used to analyze the differences for temperature points (0.5°C, 1.0°C, 1.5°C, and 2.0°C) and transducer mass (200 g, 600 g, and 800 g) and with respect to time.Results:The results of the RM-ANOVA showed no temperature-point and transducer-mass interaction (F6,72 = 1.69, P = .137) or main effect for mass (F2,24 = 1.23, P = .309). The time required to raise temperature 2°C was 209.1 ± 68.10 s at 200 g, 181.5 ± 61.50 s at 600 g, and 194.9 ± 75.54 s at 800 g.Conclusions:Under the conditions of this study, the amount of mass applied with the transducer during an ultrasound treatment does not ultimately affect the rate of tissue heating.


2006 ◽  
Vol 15 (4) ◽  
pp. 299-311 ◽  
Author(s):  
Aimee E. Roth ◽  
Michael G. Miller ◽  
Marc Ricard ◽  
Donna Ritenour ◽  
Brenda L. Chapman

Context:It has been theorized that aquatic balance training differs from land balance training.Objective:To compare the effects of balance training in aquatic and land environments.Design:Between-groups, repeated-measures design.Setting:Biomechanics laboratory and pool.Participants:24 healthy subjects randomly assigned to aquatic (n = 8), land (n = 10), or control (n = 6) groups.Intervention:Four weeks of balance training.Main Outcome Measures:Balance was measured (pre, mid, post, follow-up). COP variables: radial area, y range, x range in single leg (SL), tandem (T), single leg foam (SLF), and tandem form (TF) stance.Results:A significant condition × time interaction for x range was found, with improvements for SL, SLF, and TF. Radial area improved, with post-test 1.01 ± .23 cm2and follow-up 1.06 ± .18 cm2significantly lower than pretest 1.18 ± .23 cm2. Y range significantly improved, with posttest (4.69 ± 1.02 cm2) lower than pretest (5.89 ± 1.26 cm2). The foam conditions (SLF & TF) were significantly different from non-foam conditions (SL & T) for all variables.Conclusions:Results of this study show that balance training can effectively be performed in both land and aquatic environments.


2013 ◽  
Vol 24 (07) ◽  
pp. 600-606 ◽  
Author(s):  
Alexandra C. Huebner ◽  
Susan R. Lytle ◽  
Steven M. Doettl ◽  
Patrick N. Plyler ◽  
James T. Thelin

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults and is a result of otolithic particles or debris that become free floating within a semicircular canal or adhere to the cupula. Characteristics of BPPV include brief episodes of latent onset vertigo that occur with changes in head position, transient rotary nystagmus beating toward the dependent ear, and reversed nystagmus upon sitting up. Both the vertigo and nystagmus fatigue quickly while maintaining the same head position. The BPPV may be classified as objective or subjective. Objective BPPV presents all the aforementioned symptoms whereas subjective BPPV presents all the symptoms without nystagmus. The accepted method of treatment for objective BPPV is canalith repositioning maneuvers (CRM); however, CRM are not traditionally used as the method of treatment for cases of subjective BPPV. Purpose: The purpose of the study was to determine if the subjective report of dizziness using the Dizziness Handicap Inventory (DHI) was different in patients with objective and subjective BPPV and to determine if the two groups showed similar improvements in perceived dizziness handicap following CRM treatment. Research Design: The present study utilized a retrospective, repeated measures design. Study Sample: Sixty-three adults with BPPV that were given the DHI both before and after CRM treatment. Data Collection and Analysis: Pre and post DHI results were analyzed for participants with objective versus subjective BPPV. A five-question DHI subscale was also analyzed between the groups. Results: A significant difference was noted between initial and posttreatment DHI scores for patients in both the subjective and objective groups when using the full-scale and subscale DHI. No significant difference was noted between groups for their initial or posttreatment DHI scores. The two groups also did not differ significantly in their initial or posttreatment DHI subscale scores. Conclusions: The results of the study indicated that individuals with both objective and subjective BPPV demonstrated significant improvement in DHI scores following CRM treatment. Additionally, there was no difference in DHI improvement for the subjective versus objective group suggesting CRM are effective for both subjective BPPV and objective BPPV. This improvement in DHI scores was also noted in the five-question DHI subscale with no significant difference noted between groups. These findings combined with previous studies suggest the presence or absence of nystagmus during Dix-Hallpike maneuvers is not related to the effectiveness of treatment using CRM.


2012 ◽  
Vol 37 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Leanne Sawle ◽  
Jennifer Freeman ◽  
Jonathan Marsden ◽  
Martin John Matthews

Background: Lumbopelvic injuries are often refractory to treatment and can limit return to sport. Research shows that 50 Newtons (N) of force applied transversely to the pelvis improves lumbopelvic stability and pain. This study applies transverse and diagonal forces to the pelvis in athletes with lumbopelvic pain, and investigates effects on pain and function. Objective: To investigate the effects of transverse and diagonal compressive forces applied to the pelvis of athletes with lumbopelvic pain Study Design: A randomized, repeated measures design using 20 athletes with lumbopelvic pain. Methods: No belt and four pelvic belt configurations (50 N force) were tested. Outcome measures were: resting pain, pain on active straight leg raise (ASLR), resisted hip adduction force and pain on 1-metre broad jump. Force on the adduction test was determined via load cell. Results: Data were analyzed using repeated measures ANOVA. Squeeze test showed significant effect of condition F (4, 76) = 2.7, P < 0.05. On ASLR ipsilateral to the side of pain, pain decreased across conditions ( F (4, 76) = 2.5 P = 0.05). Conclusion: Results suggest application of diagonal forces towards the site of pain may have additional benefits in improving pain and function. Such information may inform the development of an orthosis. Clinical relevance The results may be used clinically to determine the effectiveness of different belt placements (with belts or straps) in managing athletic lumbopelvic pain. The results offer an alternative to the application of transverse belts, and may inform new approaches in the development of orthotics.


2009 ◽  
Vol 18 (4) ◽  
pp. 564-571 ◽  
Author(s):  
Carolyn Jimenez ◽  
Mayra Santiago ◽  
Michael Sitler ◽  
Guenther Boden ◽  
Carol Homko

Context:Little is known about the acute effects of resistance exercise on insulin sensitivity in people with type 1 diabetes.Design:Repeated-measures design with 2 independent variables: group (exercise and nonexercise control) and time (preexercise and 12 and 36 h postexercise).Setting:General Clinical Research Center, Temple University Hospital, Philadelphia, PA.Patients:14 physically active subjects (11 men and 3 women) with type 1 diabetes.Intervention:The exercise group completed 5 sets of 6 repetitions of strenuous (80% 1-RM) quadriceps and hamstring exercises while the control group performed only activities of daily Living.Main Outcome Measures:Insulin sensitivity was assessed with the euglycemic-hyperinsulinemic-clamp technique preexercise and 12 and 36 h postexercise.Results:Insulin-sensitivity values were not significantly different between the exercise and control groups (P = .92) or over time (P = .67).Conclusions:A single bout of strenuous resistance exercise does not alter insulin sensitivity in people with type 1 diabetes.


2017 ◽  
Vol 26 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Ui-jae Hwang ◽  
Oh-yun Kwon ◽  
In-cheol Jeon ◽  
Si-hyun Kim ◽  
Jong-hyuck Weon

Context:The push-up-plus (PP) exercise has been recommended for strengthening of the serratus anterior (SA). Previous studies have investigated the effect of different stability properties of the base of support to adjust the difficulty level of SA muscle-strengthening exercises in the PP position. However, the optimal humeral-elevation angle (HEA) for selective activation and maximum contraction of the SA during PP has not been investigated.Objectives:To assess the effects of HEA during PP on electromyographic (EMG) activity in the SA, upper trapezius (UT), and pectoralis major (PM) and on the UT:SA and PM:SA activity ratios.Design:Comparative, repeated-measures design.Setting:University research laboratory.Participants:29 healthy men.Main Outcome Measures:The subjects performed PP at 3 different HEAs (60°, 90°, and 120°); EMG activity in the SA, UT, and PM was measured, and the UT:SA and PM:SA activity ratios were calculated. Differences in muscle activity and ratios between the 60°, 90°, and 120° HEAs were assessed using 1-way repeated-measures analysis of variance; the Bonferroni correction was applied.Results:SA muscle activity was significantly increased, in order of magnitude, at the 120°, 90°, and 60° HEAs. UT:SA and PM:SA activity ratios were significantly greater during performance of the PP at an HEA of 60° than at HEAs of 120° and 90°.Conclusion:The results suggest that an HEA of 120° should be used during performance of the PP because it produces greater SA activation than HEAs of 60° and 90°.


2007 ◽  
Vol 16 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Christine L. Berg ◽  
Joseph M. Hart ◽  
Riann Palmieri-Smith ◽  
Kevin M. Cross ◽  
Christopher D. Ingersoll

Context:If ankle joint cryotherapy impairs the ability of the ankle musculature to counteract potentially injurious forces, the ankle is left vulnerable to injury.Objective:To compare peroneal reaction to sudden inversion following ankle joint cryotherapy.Design:Repeated measures design with independent variables, treatment (cryotherapy and control), and time (baseline, immediately post treatment, 15 minutes post treatment, and 30 minutes post treatment).Setting:University research laboratory.Patients or Other Participants:Twenty-seven healthy volunteers.Intervention(s):An ice bag was secured to the lateral ankle joint for 20 minutes.Main Outcome Measures:The onset and average root mean square amplitude of EMG activity in the peroneal muscles was calculated following the release of a trap door mechanism causing inversion.Results:There was no statistically significant change from baseline for peroneal reaction time or average peroneal muscle activity at any post treatment time.Conclusions:Cryotherapy does not affect peroneal muscle reaction following sudden inversion perturbation.


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