Successful rehabilitation of a recreational endurance runner: initial validation for the Bunkie test

Clinical Commentary: A Criteria-Based Testing Protocol for Return to Sport Post Hip Arthroscopy for Impingement

Overall, 84%-87% of athletes will return to sport following hip arthroscopy; however, some literature suggests that only 57% of athletes return to their preinjury level, and only 16.9% report optimal performance. This discrepancy may be due to a lack of consistency within the definition of return to sport as well as a lack of consistency within rehabilitation programs when determining return to sport readiness. Athletes who are returning to sport must demonstrate adequate range of motion, strength, and the ability to perform multi-directional movements without the risk of reinjury. There has yet to be a comprehensive, criteria-based, return to sport testing protocol that utilizes objective measures to ensure athletes are ready for return to sport. The goal of the authors was to create a criteria-based testing protocol for return to sport following hip arthroscopy utilizing components best supported in the literature. The following parameters were identified as key areas to assess for within a return to sport testing protocol: range of motion, strength, functional testing, self-reported outcomes including psychological readiness and time. The purpose of this clinical commentary is to propose a criteria-based testing protocol to be used following hip arthroscopy for impingement from early rehabilitation through return to previous level of sport. Criteria are presented clearly to promote objective progression through rehabilitation while still being mindful of the biological healing time required for safe and efficient progression. It is the authors' hope that in identifying and establishing a criteria-based testing protocol a higher percentage of athletes will be able to return to sport.

Level of Evidence

5.

Assessment and application of the Bunkie test in college students

INTRODUCTION

The 'Bunkie test' is a functional performance test consisting of five different plank positions held bilaterally. No current literature has established appropriate rest intervals for in-between plank positions nor termination criteria.

PURPOSE

The current study examined rest interval duration and test termination criteria for the Bunkie test.

METHODS

Forty college students participated in the study, completing three Bunkie test sessions separated by at least 48 h. Positions included the anterior power line (APL), lateral stabilizing line (LSL), posterior power line (PPL), posterior stabilizing line (PSL), and medial stabilizing line (MSL). Positions were held for as long as possible with proper form. Each session utilized a different rest interval of either 30s, 1min, or 2min between each of the plank positions.

RESULTS

A repeated measures ANOVA revealed significant differences bilaterally among rest intervals for APL (p = .009; p = .001) whereas, no significant differences (p < .05) were observed for PPL. LSL and MSL and PSL had significant differences among rest intervals on one side (LSL left, p = .002; MSL right, p = .006; PSL right p=.005)). Post hoc analysis with a Bonferroni adjustment revealed less variability among times between the 1min and 2min rest intervals between plank positions.

CONCLUSIONS

The current study revealed that utilizing a shorter rest interval time frame (30s) appears to create greater variability in performance outcomes. Since no differences were found between using a 1min or 2min rest interval for both the final hold times and tension times, a rest interval of at least 1min will allow for more dependable data.

The bunkie test: descriptive data for a novel test of core muscular endurance

The Bunkie test, a functional performance test consisting of 5 test positions (performed bilaterally), has been used to assess aspects of muscular function. Current performance measures are based on clinical recommendations. The purpose of this study was to report normative data for a healthy population. One hundred and twelve subjects (mean age 25.9 ± 4.5 years) were recruited from a university setting. Subjects completed a demographic questionnaire prior to testing. Hold times for each position was measured in seconds. Subjects were able to hold many of the positions for a mean score of approximately 40 seconds. There were no side-to-side differences in test position hold times per gender. Males were able to hold some positions significantly longer than their female counterparts. Males with a lower BMI were able to hold 8 of the 10 positions significantly longer than those with a higher BMI. Bunkie test scores in subjects with a prior history of musculoskeletal injury were similar to those with no history of injury. The normative data presented in this study may be used by rehabilitation professionals when assessing and rehabilitating their patients.

Core stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain

Context

Therapeutic exercises are frequently prescribed to patients with low back pain. Numerous exercise programs for patients with low back pain have been described. Many of these treatment programs are based on 1 of 2 popular rehabilitation strategies: a motor control exercise approach or a general exercise approach.

Data Sources

PubMed clinical queries from 1966 to March 2013 for keyword combinations including motor control exercise, core stability exercise, therapeutic exercise, general exercise, global exercise, local exercise, transversus abdominis, segmental stabilization, and low back pain.

Study Selection

Randomized controlled trials that assessed the effects of a motor control exercise approach, a general exercise approach, or both for patients with low back pain that were published in scientific peer-reviewed journals.

Data Extraction

Included studies underwent appraisal for exercise intervention and outcomes.

Results

Fifteen studies were identified (8, motor control exercise approach without general exercise comparison; 7, general exercise approach with or without motor control exercise approach comparison). Current evidence suggests that exercise interventions may be effective at reducing pain or disability in patients with low back pain.

Conclusion:

Stabilization exercises for patients with low back pain may help to decrease pain and disability. It may not be necessary to prescribe exercises purported to restore motor control of specific muscles.