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Hoffmann GO, Borba E, Casarotto EH, Devetak GF, Jaber R, Buckley JG, Rodacki ALF. Smartphone Assessment of the Sitting Heel-Rise Test. SENSORS (BASEL, SWITZERLAND) 2024; 24:6036. [PMID: 39338781 PMCID: PMC11436003 DOI: 10.3390/s24186036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 09/09/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024]
Abstract
The study presents a new approach for assessing plantarflexor muscles' function using a smartphone. The test involves performing repeated heel raises for 60 s while seated. The seated heel-rise test offers a simple method for assessing plantarflexor muscles' function in those with severe balance impairment who are unable to complete tests performed while standing. The study aimed to showcase how gyroscopic data from a smartphone placed on the lower limb can be used to assess the test. Eight participants performed the seated heel-rise test with each limb. Gyroscope and 2D video analysis data (60 Hz) of limb motion were used to determine the number of cycles, the average rise (T-rise), lowering (T-lower), and cycle (T-total) times. The number of cycles detected matched exactly when the gyroscope and kinematic data were compared. There was good time domain agreement between gyroscopic and video data (T-rise = 0.0005 s, T-lower = 0.0013 s, and T-total = 0.0017 s). The 95% CI limits of agreement were small (T-total -0.1118, 0.1127 s, T-lower -0.1152, 0.1179 s, and T-total -0.0763, 0.0797 s). Results indicate that a smartphone placed on the thigh can successfully assess the seated heel-rise test. The seated heel-rise test offers an attractive alternative to test plantarflexor muscles' functionality in those unable to perform tests in standing positions.
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Affiliation(s)
- Gustavo O. Hoffmann
- Centro de Estudos do Comportamento Motor, Departamento de Educação Física, Setor de Ciências Biológicas, Universidade Federal do Paraná, Rua Coronel Heráclito dos Santos, 100, Centro Politécnico, Jardim das Américas, Curitiba 19011, Paraná, Brazil; (G.O.H.); (E.B.); (E.H.C.); (G.F.D.)
| | - Edilson Borba
- Centro de Estudos do Comportamento Motor, Departamento de Educação Física, Setor de Ciências Biológicas, Universidade Federal do Paraná, Rua Coronel Heráclito dos Santos, 100, Centro Politécnico, Jardim das Américas, Curitiba 19011, Paraná, Brazil; (G.O.H.); (E.B.); (E.H.C.); (G.F.D.)
| | - Eduardo H. Casarotto
- Centro de Estudos do Comportamento Motor, Departamento de Educação Física, Setor de Ciências Biológicas, Universidade Federal do Paraná, Rua Coronel Heráclito dos Santos, 100, Centro Politécnico, Jardim das Américas, Curitiba 19011, Paraná, Brazil; (G.O.H.); (E.B.); (E.H.C.); (G.F.D.)
| | - Gisele Francine Devetak
- Centro de Estudos do Comportamento Motor, Departamento de Educação Física, Setor de Ciências Biológicas, Universidade Federal do Paraná, Rua Coronel Heráclito dos Santos, 100, Centro Politécnico, Jardim das Américas, Curitiba 19011, Paraná, Brazil; (G.O.H.); (E.B.); (E.H.C.); (G.F.D.)
| | - Ramzi Jaber
- Faculty of Engineering & Informatics, University of Bradford, Bradford BD7 1DP, UK; (R.J.); (J.G.B.)
| | - John G. Buckley
- Faculty of Engineering & Informatics, University of Bradford, Bradford BD7 1DP, UK; (R.J.); (J.G.B.)
| | - André L. F. Rodacki
- Centro de Estudos do Comportamento Motor, Departamento de Educação Física, Setor de Ciências Biológicas, Universidade Federal do Paraná, Rua Coronel Heráclito dos Santos, 100, Centro Politécnico, Jardim das Américas, Curitiba 19011, Paraná, Brazil; (G.O.H.); (E.B.); (E.H.C.); (G.F.D.)
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Fernandez MR, Athens J, Balsalobre-Fernandez C, Kubo M, Hébert-Losier K. Concurrent validity and reliability of a mobile iOS application used to assess calf raise test kinematics. Musculoskelet Sci Pract 2023; 63:102711. [PMID: 36604270 DOI: 10.1016/j.msksp.2022.102711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/04/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. The Calf Raise application (CRapp) uses computer-vision algorithms to objectively measure CRT outcomes and replicate laboratory-based metrics that are difficult to measure clinically. OBJECTIVE To validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment, and its intra- and inter-rater reliability. DESIGN Observational cross-sectional validation study. METHODS CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen individuals (6 males, 7 females) on three occasions on both legs using the CRapp, 3D motion capture, and force plate simultaneously. Data were extracted from two markers: below lateral malleolus (n = 77) and on the heel (n = 77). Concurrent validity and agreement were determined from 154 data files using intraclass correlation coefficients (ICC3,k), typical errors expressed as coefficient of variations (CV), and Bland-Altman plots to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. RESULTS Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were on average better for the lateral malleolus marker. Inter- and intra-rater reliability were excellent (ICC≥0.949, CV ≤ 5.6%). CONCLUSION CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.
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Affiliation(s)
- Ma Roxanne Fernandez
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, New Zealand; Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Philippines.
| | - Josie Athens
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | | | - Masayoshi Kubo
- Department of Physical Therapy, Niigata University of Health and Welfare, Japan.
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, New Zealand.
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Vinti M, Saikia MJ, Donoghue J, Mankodiya K, Kerman KL. A modified surface EMG biomarker for gait assessment in spastic cerebral palsy. Hum Mov Sci 2021; 80:102875. [PMID: 34736019 DOI: 10.1016/j.humov.2021.102875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Muscle clinical metrics are crucial for spastic cocontraction management in children with Cerebral Palsy (CP). We investigated whether the ankle plantar flexors cocontraction index (CCI) normalized with respect to the bipedal heel rise (BHR) approach provides more robust spastic cocontraction estimates during gait than those obtained through the widely accepted standard maximal isometric plantar flexion (IPF). METHODS Ten control and 10 CP children with equinus gait pattern performed the BHR and IPF testing and walked barefoot 10-m distance. We compared agonist medial gastrocnemius EMG during both testing and CCIs obtained as the ratios of antagonist EMG during swing phase of gait and either BHR or IPF agonist EMG. RESULTS Agonist EMG values from the BHR were: (i) internally reliable (Cronbach's α = 0.993), (ii) ~50 ± 0.4% larger than IPF, (iii) and positively correlated. Derived CCIs were significantly smaller (p < 0.05) in both populations. CONCLUSION The bipedal heel rise approach may be accurate enough to reveal greater agonist activity of plantar flexors than the maximal isometric plantar flexion and seems to be more appropriate to obtain cocontraction estimates during swing of gait. SIGNIFICANCE This modified biomarker may represent a step forward towards improved accuracy of spastic gait management in pediatric.
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Affiliation(s)
- Maria Vinti
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI 02905, USA.
| | - Manob Jyoti Saikia
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA 02155, USA
| | - John Donoghue
- Department of Neuroscience, Brown University, Providence, RI 02906, USA
| | - Kunal Mankodiya
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, RI 02881, USA
| | - Karen L Kerman
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI 02905, USA
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Mazzarino M, Morris ME, Kerr D. Pilates for low risk pregnant women: Study protocol for a randomized controlled trial. J Bodyw Mov Ther 2020; 25:240-247. [PMID: 33714503 DOI: 10.1016/j.jbmt.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 10/25/2020] [Accepted: 12/11/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pilates has growing appeal to pregnant women, as a form of exercise and relaxation. It is purported to benefit lumbo-pelvic stability, as well as motor control, strength and endurance. Some suggest that modified Pilates exercises may assist low risk pregnant women to enjoy a healthier pregnancy and prepare for the physical demands of labour and birth. The feasibility and safety of Pilates during pregnancy is poorly understood. We describe the protocol for a feasibility study designed to compare a midwife-led 6-week community-based Pilates intervention with standard antenatal care. METHODS A convenience sample of 30 low-risk pregnant women will be recruited from private obstetric clinics in Melbourne, Australia. Participants shall be randomly allocated to a six-week, 1-h weekly Pilates exercises group session or to usual care. The Pilates exercise class will have a warm-up phase, Pilates exercises, breathing exercises, and a cool down phase. Exercises have been designed to prepare for active birth. The primary outcome will be feasibility of implementation, determined by recruitment, retention, adherence and safety. Secondary outcomes include women's health (quality of life, pain, mobility for daily activities, lower extremity performance, abdominal separation, continence) and labour and birth outcomes (duration of first stage and second stage labour, analgesia used, mode of birth). Validated questionnaires will include the Quality of life 12-item short form survey; Pregnancy Mobility Index, and International Consultation on Incontinence Questionnaire. Lower extremity performance and abdominal separation will also be measured. DISCUSSION This trial will provide preliminary data regarding the feasibility and safety of Pilates exercise in healthy pregnant women. It will also provide preliminary outcome data used to inform the design of a future large scale, multi-centre RCT. TRIAL REGISTRATION This clinical trial has been registered with the Australian and New Zealand Clinical Trials Registry 2016 (ACTRN12616000809437).
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Affiliation(s)
- Melissa Mazzarino
- La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.
| | - Meg E Morris
- Healthscope ARCH, Victorian Rehabilitation Centre, Glen Waverly, VIC, 3150, Australia.
| | - Debra Kerr
- Deakin University, School of Nursing and Midwifery, Geelong, VIC, 3220, Australia.
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Ferracuti F, Fioretti S, Frontoni E, Iarlori S, Mengarelli A, Riccio M, Romeo L, Verdini F. Functional evaluation of triceps surae during heel rise test: from EMG frequency analysis to machine learning approach. Med Biol Eng Comput 2020; 59:41-56. [PMID: 33191440 DOI: 10.1007/s11517-020-02286-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/31/2020] [Indexed: 11/28/2022]
Abstract
Soleus muscle flap as coverage tissue is a possible surgical solution adopted to cover the wounds due to open fractures. Despite this procedure presents many clinical advantages, relatively poor information is available about the loss of functionality of triceps surae of the treated leg. In this study, a group of patients who underwent a soleus muscle flap surgical procedure has been analyzed through the heel rise test (HRT), in order to explore the triceps surae residual functionalities. A frequency band analysis was performed in order to assess whether the residual heads of triceps surae exhibit different characteristics with respect to both the non-treated lower limb and an age-matched control group. Then, an in-depth analysis based on a machine learning approach was proposed for discriminating between groups by generalizing across new unseen subjects. Experimental results showed the reliability of the proposed analyses for discriminating between-group at a specific time epoch and the high interpretability of the proposed machine learning algorithm allowed the temporal localization of the most discriminative frequency bands. Findings of this study highlighted that significant differences can be recognized in the myoelectric spectral characteristics between the treated and contralateral leg in patients who underwent soleus flap surgery. These experimental results may support the clinical decision-making for assessing triceps surae performance and for supporting the choice of treatment in plastic and reconstructive surgery. Graphical Abstract The Graphical abstract presents the scope of the proposed analysis of myoelectric signals of soleus and gastrocnemius muscles of patiens groups during Hell Rise Test, highlighting the applied methods and the obtained results.
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Affiliation(s)
- Francesco Ferracuti
- Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy
| | - Sandro Fioretti
- Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy
| | - Emanuele Frontoni
- Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy
| | - Sabrina Iarlori
- Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy.
| | | | - Michele Riccio
- Department of Plastic and Reconstructive Hand Surgery, Università Politecnica delle Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - Luca Romeo
- Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy
| | - Federica Verdini
- Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy
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Stokes MJ, Witchalls J, Waddington G, Adams R. Can musculoskeletal screening test findings guide interventions for injury prevention and return from injury in field hockey? Phys Ther Sport 2020; 46:204-213. [PMID: 32979818 DOI: 10.1016/j.ptsp.2020.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study is to identify if intrinsic factors tested in the preseason screening (PSS) can identify an elevated risk of injury. This aim has two aspects; to assess whether previous injury is associated with ongoing deficits in performance, and to assess if the PSS can identify differences in intrinsic factors that profile risk of future injury. DESIGN A cohort of state level field hockey players were tested on a screening test battery including proprioception, postural stability, muscular strength and range of motion, to establish if these intrinsic factors were useful in identifying elevated risk of injury. Retrospective injury data was collated to determine association with previous injury and prospective injury data was collated to determine association with future injury. PARTICIPANTS A total of 130 field hockey players were included in this study, from state level squads (age ± SD = 20.96 (3.75); height = 176.09 cm). Groups for prescreening and post screening injury status (injured/not injured) were established for comparison to screening test results. RESULTS Right Active Movement Extent Discrimination Assessment (AMEDA), left AMEDA and right Y-balance test (YBT) anterior direction (Ant) were significantly associated (p < 0.05) with injury prior to screening. Right YBTAnt and right and left hip internal rotation (IR) were significantly associated (p < 0.05) with injury post screening. The YBTAnt and YBT posteromedial (PMed) reach directions and Hip IR are associated with previous hamstring injury and show a difference between post screening injured and non-injured groups. CONCLUSIONS AMEDA, R YBTAnt, Hip IR tests should be a focus for recovery after previous injury and during season preparation. Full recovery may improve readiness to return to play and reduce risk of primary injury or re-injury. YBTAnt and YBTPmed and Hip IR show a performance deficit link between previous injury and subsequent re-injury of hamstrings. Since these are the most common re-injury types in this cohort, these tests are clinically useful in informing return to play decisions for hockey players.
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Affiliation(s)
- Mark J Stokes
- Research Institute for Sport and Exercise, University of Canberra, 11 Kirinari Street, Bruce, ACT, 2617, Australia; Centre of Excellence Queensland Academy of Sport, 400 Kessels Road, Nathan, Qld, 4111, Australia.
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, 11 Kirinari Street, Bruce, ACT, 2617, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, 11 Kirinari Street, Bruce, ACT, 2617, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, 11 Kirinari Street, Bruce, ACT, 2617, Australia
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Abstract
Strokes are a constant concern for people and pose a major health concern. Tests that allow detection and the rehabilitation of patients have started to become more important and essential. There are several tests used by physiotherapists to speed up the recovery process of patients. This article presents a systematic review of existing studies using the Heel-Rise Test and sensors (i.e., accelerometers, gyroscopes, pressure and tilt sensors) to estimate the different levels and health statuses of individuals. It was found that the most measured parameter was related to the number of repetitions, and the maximum number of repetitions for a healthy adult is 25 repetitions. As for future work, the implementation of these methods with a simple mobile device will facilitate the different measurements on this subject.
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Zellers JA, Brorsson A, Silbernagel KG. Impact of seated and standing positions on triceps surae muscle activation in unilateral Achilles tendon rupture. TRANSLATIONAL SPORTS MEDICINE 2020; 3:3-8. [PMID: 32432214 DOI: 10.1002/tsm2.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Heel-rises are commonly used in the rehabilitation of individuals following Achilles tendon rupture, however, the impact of tendon elongation on triceps surae activation in seated versus standing positions has not been investigated. The purpose of this study was to investigate changes in triceps surae activation during seated compared to standing heel-rises in individuals with Achilles tendon rupture and its relationship to tendon elongation. Ten individuals with a history of Achilles tendon rupture were included in this study. Muscle activity using electromyography was examined during a heel-rise task in seated (unilateral) and standing (bilateral) positions. Soleus activity was not significantly different between sitting and standing on both the ruptured and uninjured side. On the ruptured, side there were no differences in medial or lateral gastrocnemius activity between sitting and standing; however, on the uninjured side medial and lateral gastrocnemius activity was lower in sitting compared to standing. The results of this study suggest that neuromuscular changes in triceps surae activation occur following Achilles tendon rupture. The seated heel-rise position can be used to strengthen all muscles of the triceps surae and is useful when the patient is unable to perform a standing heel-rise.
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Affiliation(s)
- Jennifer A Zellers
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, St. Louis, MO 63108, USA
| | - Annelie Brorsson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Obst S, Heales L, Hrelja Z, Ishri P, Wesche J, Barber L. The effect of deloading tape on medial gastrocnemius muscle fascicle behaviour during dynamic exercise. J Sports Sci 2019; 37:1874-1883. [PMID: 30935296 DOI: 10.1080/02640414.2019.1600225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the effect of diamond deloading tape on medial gastrocnemius (MG) muscle behaviour during exercise in healthy adults (n = 27). A randomised cross-over trial assessed the effect of tape (no-tape, sham-tape and deload-tape) on ankle and MG fascicle kinematics during three heel raise-lower exercises [double leg (DL), single leg (SL) and loaded single leg (LSL)]. There was no effect of tape on standing fascicle length (FL) or pennation angle (PA), or ankle or knee joint angle. There was a significant effect of tape on ankle kinematics for all exercises. Both the deload-tape and sham-tape resulted in less ankle plantar flexion but had no effect on dorsiflexion. There was a significant effect of tape on FL change for the SL and LSL exercise. Compared to no-tape, the deload-tape resulted in less fascicle shortening during ankle plantar flexion, and more fascicle lengthening during ankle dorsiflexion. For the LSL exercise, deload-tape caused MG fascicles to operate at longer lengths, for a given joint angle. Diamond taping, with or without added tension, has only a small effect on ankle and MG fascicle kinematics during the heel raise-lower exercise. With the exception of the LSL exercise, both tape conditions resulted in similar changes in the FL-angle relations.
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Affiliation(s)
- Steven Obst
- a School of Health, Medical and Applied Sciences , Central Queensland University , Bundaberg , Australia
| | - Luke Heales
- b School of Health, Medical and Applied Sciences , Central Queensland University , Rockhampton , Australia
| | - Zachary Hrelja
- a School of Health, Medical and Applied Sciences , Central Queensland University , Bundaberg , Australia
| | - Prashneveet Ishri
- a School of Health, Medical and Applied Sciences , Central Queensland University , Bundaberg , Australia
| | - Johanna Wesche
- a School of Health, Medical and Applied Sciences , Central Queensland University , Bundaberg , Australia
| | - Lee Barber
- a School of Health, Medical and Applied Sciences , Central Queensland University , Bundaberg , Australia
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Buchholtz KA, Lambert MI, Bosch A, Burgess TL. Calf muscle architecture and function in ultra runners and low physical activity individuals: A comparative review. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kim A. Buchholtz
- Division of Physiotherapy; Department of Health and Rehabilitation Sciences; University of Cape Town; Cape Town South Africa
| | - Michael I. Lambert
- Division of Exercise Science and Sports Medicine; Department of Human Biology; University of Cape Town; Cape Town South Africa
| | - Andrew Bosch
- Division of Exercise Science and Sports Medicine; Department of Human Biology; University of Cape Town; Cape Town South Africa
| | - Theresa L. Burgess
- Division of Physiotherapy; Department of Health and Rehabilitation Sciences; University of Cape Town; Cape Town South Africa
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André HI, Carnide F, Moço A, Valamatos MJ, Ramalho F, Santos-Rocha R, Veloso A. Can the calf-raise senior test predict functional fitness in elderly people? A validation study using electromyography, kinematics and strength tests. Phys Ther Sport 2018; 32:252-259. [DOI: 10.1016/j.ptsp.2018.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 04/06/2018] [Accepted: 05/11/2018] [Indexed: 12/15/2022]
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Björklund G, Alricsson M, Svantesson U. Using Bilateral Functional and Anthropometric Tests to Define Symmetry in Cross-Country Skiers. J Hum Kinet 2018; 60:9-18. [PMID: 29339981 PMCID: PMC5765781 DOI: 10.1515/hukin-2017-0107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate the symmetry of anthropometry and muscle function in cross-country skiers and their association to vertical jumping power. Twenty cross-country skiers were recruited (21.7 ± 3.8 yrs, 180.6 ± 7.6 cm, 73.2 ± 7.6 kg). Anthropometric data was obtained using an iDXA scan. VO2max was determined using the diagonal stride technique on a ski treadmill. Bilateral functional tests for the upper and lower body were the handgrip and standing heel-rise tests. Vertical jump height and power were assessed with a counter movement jump. Percent asymmetry was calculated using a symmetry index and four absolute symmetry index levels. At a group level the upper body was more asymmetrical with regard to lean muscle mass (p = 0.022, d = 0.17) and functional strength (p = 0.019, d = 0.51) than the lower body. At an individual level the expected frequencies for absolute symmetry level indexes showed the largest deviation from zero for the heel-rise test (χ2 = 16.97, p = 0.001), while the leg lean mass deviated the least (χ2 = 0.42, p = 0.517). No relationships were observed between absolute symmetry level indexes of the lower body and counter movement jump performance (p > 0.05). As a group the skiers display a more asymmetrical upper body than lower body regarding muscle mass and strength. Interestingly at the individual level, despite symmetrical lean leg muscle mass the heel-rise test showed the largest asymmetry. This finding indicates a mismatch in muscle function for the lower body.
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Affiliation(s)
- Glenn Björklund
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid-Sweden University, Östersund, Sweden.,The Swedish Sports Confederation, Stockholm, Sweden
| | - Marie Alricsson
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid-Sweden University, Östersund, Sweden.,Department of Sports Science, Linnaeus University, Kalmar, Sweden
| | - Ulla Svantesson
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid-Sweden University, Östersund, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Miaskowski C, Mastick J, Paul SM, Topp K, Smoot B, Abrams G, Chen LM, Kober KM, Conley YP, Chesney M, Bolla K, Mausisa G, Mazor M, Wong M, Schumacher M, Levine JD. Chemotherapy-Induced Neuropathy in Cancer Survivors. J Pain Symptom Manage 2017; 54:204-218.e2. [PMID: 28063866 PMCID: PMC5496793 DOI: 10.1016/j.jpainsymman.2016.12.342] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 12/11/2016] [Accepted: 12/27/2016] [Indexed: 12/21/2022]
Abstract
CONTEXT Evidence suggests that chemotherapy-induced neuropathy (CIN) is a significant problem for cancer survivors. However, a detailed phenotypic characterization of CIN in cancer survivors is not available. OBJECTIVES To evaluate between-group differences in demographic and clinical characteristics, as well as in measures of sensation, function, and postural control, in a sample of cancer survivors who received a platinum and/or a taxane-based CTX regimen and did (n = 426) and did not (n = 197) develop CIN. METHODS Survivors completed self-report questionnaires and underwent objective testing (i.e., light touch, pain sensation, cold sensation, vibration, muscle strength, grip strength, Purdue Pegboard test, Timed Get Up and Go test, Fullerton Advanced Balance test). Parametric and nonparametric statistics were used to compare between-group differences in study outcomes. RESULTS Of the 426 survivors with CIN, 4.9% had CIN only in their upper extremities, 27.0% only in their lower extremities, and 68.1% in both their upper and lower extremities. Demographic and clinical characteristics associated with CIN included the following: older age, lower annual income, higher body mass index, a higher level of comorbidity, being born prematurely, receipt of a higher cumulative dose of chemotherapy, and a poorer functional status. Survivors with CIN had worse outcomes for all of the following objective measures: light touch, pain, temperature, vibration, upper and lower extremity function, and balance. CONCLUSIONS This study is the first to provide a detailed phenotypic characterization of CIN in cancer survivors who received a platinum and/or a taxane compound. These data can serve as a benchmark for future studies of CIN in cancer survivors.
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Affiliation(s)
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Kimberly Topp
- School of Medicine, University of California, San Francisco, California, USA
| | - Betty Smoot
- School of Medicine, University of California, San Francisco, California, USA
| | - Gary Abrams
- School of Medicine, University of California, San Francisco, California, USA
| | - Lee-May Chen
- School of Medicine, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margaret Chesney
- School of Medicine, University of California, San Francisco, California, USA
| | - Kay Bolla
- School of Nursing, University of California, San Francisco, California, USA
| | - Grace Mausisa
- School of Nursing, University of California, San Francisco, California, USA
| | - Melissa Mazor
- School of Nursing, University of California, San Francisco, California, USA
| | - Melisa Wong
- School of Medicine, University of California, San Francisco, California, USA
| | - Mark Schumacher
- School of Medicine, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
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Byrne C, Keene DJ, Lamb SE, Willett K. Intrarater reliability and agreement of linear encoder derived heel-rise endurance test outcome measures in healthy adults. J Electromyogr Kinesiol 2017; 36:34-39. [PMID: 28719820 DOI: 10.1016/j.jelekin.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 11/16/2022] Open
Abstract
A linear encoder measuring vertical displacement during the heel-rise endurance test (HRET) enables the assessment of work and maximum height in addition to the traditional repetitions measure. We aimed to compare the test-retest reliability and agreement of these three outcome measures. Thirty-eight healthy participants (20 females, 18 males) performed the HRET on two occasions separated by a minimum of seven days. Reliability was assessed by the intraclass correlation coefficient (ICC) and agreement by a range of measures including the standard error of measurement (SEM), coefficient of variation (CV), and 95% limits of agreement (LoA). Reliability for repetitions (ICC=0.77 (0.66, 0.85)) was equivalent to work (ICC=0.84 (95% CI 0.76, 0.89)) and maximum height (ICC=0.85 (0.77, 0.90)). Agreement for repetitions (SEM=6.7 (5.8, 7.9); CV=13.9% (11.9, 16.8%); LoA=-1.9±37.2%) was equivalent to work (SEM=419J (361, 499J); CV=13.1% (11.2, 15.8%); LoA=0.1±34.8%) with maximum height superior (SEM=0.8cm (0.6, 1.0cm); CV=6.6% (5.7, 7.9%); LoA=1.3±17.1%). Work and maximum height demonstrated acceptable reliability and agreement that was at least equivalent to the traditional repetitions measure.
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Affiliation(s)
- Christopher Byrne
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK; School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, UK.
| | - David J Keene
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK
| | - Sarah E Lamb
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK
| | - Keith Willett
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK
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15
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André HI, Carnide F, Borja E, Ramalho F, Santos-Rocha R, Veloso AP. Calf-raise senior: a new test for assessment of plantar flexor muscle strength in older adults: protocol, validity, and reliability. Clin Interv Aging 2016; 11:1661-1674. [PMID: 27895473 PMCID: PMC5117878 DOI: 10.2147/cia.s115304] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to develop a new field test protocol with a standardized measurement of strength and power in plantar flexor muscles targeted to functionally independent older adults, the calf-raise senior (CRS) test, and also evaluate its reliability and validity. Patients and methods Forty-one subjects aged 65 years and older of both sexes participated in five different cross-sectional studies: 1) pilot (n=12); 2) inter- and intrarater agreement (n=12); 3) construct (n=41); 4) criterion validity (n=33); and 5) test–retest reliability (n=41). Different motion parameters were compared in order to define a specifically designed protocol for seniors. Two raters evaluated each participant twice, and the results of the same individual were compared between raters and participants to assess the interrater and intrarater agreement. The validity and reliability studies involved three testing sessions that lasted 2 weeks, including a battery of functional fitness tests, CRS test in two occasions, accelerometry, and strength assessments in an isokinetic dynamometer. Results The CRS test presented an excellent test–retest reliability (intraclass correlation coefficient [ICC] =0.90, standard error of measurement =2.0) and interrater reliability (ICC =0.93–0.96), as well as a good intrarater agreement (ICC =0.79–0.84). Participants with better results in the CRS test were younger and presented higher levels of physical activity and functional fitness. A significant association between test results and all strength parameters (isometric, r=0.87, r2=0.75; isokinetic, r=0.86, r2=0.74; and rate of force development, r=0.77, r2=0.59) was shown. Conclusion This study was successful in demonstrating that the CRS test can meet the scientific criteria of validity and reliability. The test can be a good indicator of ankle strength in older adults and proved to discriminate significantly between individuals with improved functionality and levels of physical activity.
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Affiliation(s)
- Helô-Isa André
- Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Study Centre for Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, Portugal
| | - Filomena Carnide
- Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Study Centre for Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, Portugal
| | - Edgar Borja
- Sports Science School of Rio Maior (ESDRM), Polytechnic Institute of Santarém, Portugal
| | - Fátima Ramalho
- Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Study Centre for Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, Portugal; Sports Science School of Rio Maior (ESDRM), Polytechnic Institute of Santarém, Portugal
| | - Rita Santos-Rocha
- Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Study Centre for Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, Portugal; Sports Science School of Rio Maior (ESDRM), Polytechnic Institute of Santarém, Portugal
| | - António P Veloso
- Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Study Centre for Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, Portugal
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16
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De la Fuente C, Peña y Lillo R, Carreño G, Marambio H. Prospective randomized clinical trial of aggressive rehabilitation after acute Achilles tendon ruptures repaired with Dresden technique. Foot (Edinb) 2016; 26:15-22. [PMID: 26802945 DOI: 10.1016/j.foot.2015.10.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/04/2015] [Accepted: 10/07/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Rupture of the Achilles tendon is a common injury during working years. Aggressive rehabilitation may provide better outcomes, but also a greater chance of re-rupture. OBJECTIVE To determine if aggressive rehabilitation has better clinical outcomes for Achilles tendon function, Triceps surae function, one-leg heel rise capacity and lower complication rate during twelve weeks after percutaneous Achilles tendon repair compared to conventional rehabilitation. DESIGN Randomized controlled trial. METHOD Thirty-nine patients were prospectively randomized. The aggressive group (n=20, 41.4 ± 8.3 years) received rehabilitation from the first day after surgery. The conventional group (n=19, 41.7 ± 10.7 years) rested for 28 days, before rehabilitation started. The statistical parameters were the Achilles tendon rupture score (ATRS), verbal pain scale, time to return to work, pain medication consumption, Achilles tendon strength, dorsiflexion range of motion (RoM), injured-leg calf circumference, calf circumference difference, one-leg heel rise repetition and difference, re-rupture rate, strength deficit rate, and other complication rates. Mixed-ANOVA and Bonferroni's post hoc test were performed for multiple comparisons. Student's t-test was performed for parameters measured on the 12th week. RESULTS The aggressive group with respect to the conventional group had a higher ATRS; lower verbal pain score; lower pain medication consumption; early return to work; higher Achilles tendon strength; higher one-leg heel rise repetitions; and lower one-leg heel rise difference. The re-rupture rate was 5% and 5%, the strength deficit rate was 42% and 5%, and other complications rate was 11% and 15% in the conventional and aggressive group, respectively. CONCLUSION Patients with Dresden repair and aggressive rehabilitation have better clinical outcomes, Achilles tendon function and one-leg heel rise capacity without increasing the postoperative complications rate after 12 weeks compared to rehabilitation with immobilization and non-weight-bearing during the first 28 days after surgery.
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Affiliation(s)
- Carlos De la Fuente
- Biomechanics Unit, Centro de Investigaciones Médicas del Instituto Traumatológico "Teodoro Gebauer Weisser", Santiago 8340220, Chile; Carrera de Kinesiología, UDA Cs Salud, Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; Mechanics Department, Engineer Faculty, USACH, Santiago 717835, Chile; Kinesiology and Clinical Biomechanics Program, UMCE, Santiago 7780450, Chile.
| | - Roberto Peña y Lillo
- Foot and Ankle Unit, Instituto Traumatológico "Teodoro Gebauer Weisser", Santiago 8340220, Chile; Servicio de Kinesiterapia y Terapia Ocupacional, Instituto Traumatológico "Teodoro Gebauer Weisser", Santiago 8340220, Chile.
| | - Gabriel Carreño
- Laboratorio de Movimiento Humano, Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago 8370109, Chile; Facultad de Ciencias de la Salud, Universidad Iberoamericana de Ciencias y Tecnología, Santiago 8330440, Chile.
| | - Hugo Marambio
- Trauma Service, Clínica Santa María, Santiago 7520378, Chile; Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago 7501015, Chile.
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Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations. J Orthop Sports Phys Ther 2015; 45:887-98. [PMID: 26390269 DOI: 10.2519/jospt.2015.5987] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should focus on progressively developing load tolerance of the tendon, the musculoskeletal unit, and the kinetic chain, as well as addressing key biomechanical and other risk factors. Rehabilitation can be slow and sometimes frustrating. This review aims to assist clinicians with key concepts related to examination, diagnosis, and management of patellar tendinopathy. Difficult clinical presentations (eg, highly irritable tendon, systemic comorbidities) as well as common pitfalls, such as unrealistic rehabilitation time frames and overreliance on passive treatments, are also discussed. J Orthop Sports Phys Ther 2015;45(11):887-898. Epub 21 Sep 2015. doi:10.2519/jospt.2015.5987.
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Brorsson A, Olsson N, Nilsson-Helander K, Karlsson J, Eriksson BI, Silbernagel KG. Recovery of calf muscle endurance 3 months after an Achilles tendon rupture. Scand J Med Sci Sports 2015; 26:844-53. [DOI: 10.1111/sms.12533] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2015] [Indexed: 01/26/2023]
Affiliation(s)
- A. Brorsson
- Department of Orthopaedics; Institute of Clinical Sciences at Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- IFK Kliniken Rehab; Gothenburg Sweden
| | - N. Olsson
- Department of Orthopaedics; Institute of Clinical Sciences at Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Orthocenter IFK-Kliniken; Gothenburg Sweden
- Sahlgrenska University Hospital; Mölndal Sweden
| | - K. Nilsson-Helander
- Department of Orthopaedics; Institute of Clinical Sciences at Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Hallands sjukhus; Kungsbacka Sweden
| | - J. Karlsson
- Department of Orthopaedics; Institute of Clinical Sciences at Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Sahlgrenska University Hospital; Mölndal Sweden
| | - B. I. Eriksson
- Department of Orthopaedics; Institute of Clinical Sciences at Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Sahlgrenska University Hospital; Mölndal Sweden
| | - K. G. Silbernagel
- Department of Orthopaedics; Institute of Clinical Sciences at Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Department of Physical Therapy; University of Delaware; Newark Delaware USA
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Design and reliability of a novel heel rise test measuring device for plantarflexion endurance. BIOMED RESEARCH INTERNATIONAL 2014; 2014:391646. [PMID: 24877089 PMCID: PMC4022004 DOI: 10.1155/2014/391646] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Plantarflexion results from the combined action of the soleus and gastrocnemius muscles in the calf. The heel rise test is commonly used to test calf muscle endurance, function, and performance by a wide variety of professionals; however, no uniform description of the test is available. This paper aims to document the construction and reliability of a novel heel rise test device and measurement protocol that is suitable for the needs of most individuals. METHODS This device was constructed from compact and lightweight materials and is fully adjustable, enabling the testing of a wide variety of individuals. It is easy to assemble and disassemble, ensuring that it is portable for use in different settings. FINDINGS We tested reliability on 40 participants, finding excellent interrater reliability (ICC2,1 0.97, 95% CI: 0.94 to 0.98). Limits of agreement were less than two repetitions in 90% of cases and the Bland-Altman plot showed no bias. INTERPRETATION We have designed a novel, standardized, simple, and reliable device and measurement protocol for the heel rise test which can be used by researchers and clinicians in a variety of settings.
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Early prognostic factors in patients with whiplash. J Orthop Sports Phys Ther 2011; 41:983; author reply 983-4. [PMID: 22146590 DOI: 10.2519/jospt.2011.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Analysis of knee flexion angles during 2 clinical versions of the heel raise test to assess soleus and gastrocnemius function. J Orthop Sports Phys Ther 2011; 41:505-13. [PMID: 21335928 DOI: 10.2519/jospt.2011.3489] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Controlled laboratory study, using a repeated-measures, counterbalanced design. OBJECTIVES To provide estimates on the average knee angle maintained, absolute knee angle error, and total repetitions performed during 2 versions of the heel raise test. BACKGROUND The heel raise test is performed in knee extension (EHRT) to assess gastrocnemius and knee flexion (FHRT) for soleus. However, it has not yet been determined whether select knee angles are maintained or whether total repetitions differ between the clinical versions of the heel raise test. METHODS Seventeen healthy males and females performed maximal heel raise repetitions in 0° (EHRT) and 30° (FHRT) of desired knee flexion. The average angle maintained and absolute error at the knee during the 2 versions, and total heel raise repetitions, were measured using motion analysis. Participants' kinematic measures were fitted into a generalized estimation equation model to provide estimates on EHRT and FHRT performance applicable to the general population. RESULTS The model estimates that average angles of 2.2° and 30.7° will be maintained at the knee by the general population during the EHRT and the FHRT, with an absolute angle error of 3.4° and 2.5°, respectively. In both versions, 40 repetitions should be completed. However, the average angles maintained by participants ranged from -6.3° to 21.6° during the EHRT and from 22.0° to 43.0° during the FHRT, with the highest absolute errors in knee position being 25.9° and 33.5°, respectively. CONCLUSION On average, select knee angles will be maintained by the general population during the select heel raise test versions, but individualized performance is variable and total repetitions do not distinguish between versions. Clinicians should, therefore, interpret select heel raise test outcomes with caution when used to respectively assess and rehabilitate soleus and gastrocnemius function.
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Sole CC, Milosavljevic S, Sole G, John Sullivan S. Exploring a model of asymmetric shoe wear on lower limb performance. Phys Ther Sport 2010; 11:60-5. [DOI: 10.1016/j.ptsp.2010.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 02/10/2010] [Accepted: 02/10/2010] [Indexed: 12/26/2022]
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