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Corbin Hedt, Bradley S. Lambert, Matthew L. Holland, Joshua Daum, Jeremiah Randall, David M. Lintner, and Patrick C. McCulloch

Context: Shoulder rehabilitation can be a difficult task due to the dynamic nature of the joint complex. Various weight training implements, including kettlebells (KB), have been utilized for therapeutic exercise in the rehabilitation setting to improve shoulder girdle strength and motor control. The KBs are unique in that they provide an unstable load and have been purported to promote greater muscle activation versus standard dumbbells. Recent literature has examined the efficacy of KB exercises for global strengthening and aerobic capacity; however, electromyographic data for shoulder-specific activities are lacking. Objective: To examine muscle activation patterns about the rotator cuff and scapular musculature during 5 commonly-utilized KB exercises. Design: Cross-sectional analysis of a single group. Setting: Clinical biomechanics laboratory. Participants: Ten participants performed all exercises in a randomized order. Main Outcome Measures: Mean electromyographic values for each subject were compared between exercises for each target muscle. Results: Significant differences (P < .05) between exercises were observed for all target muscles except for the infraspinatus. Conclusions: The data in this study indicates that certain KB exercises may elicit activation of the shoulder girdle at different capacities. Physical therapy practitioners, athletic trainers, and other clinical professionals who intend to optimize localized strengthening responses may elect to prescribe certain exercises over others due to the inherent difference in muscular utilization. Ultimately, this data may serve to guide or prioritize exercise selection to achieve higher levels of efficacy for shoulder strength and stability gains.

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Julio Zago, Fellipe Amatuzzi, Tatiana Rondinel, and João Paulo Matheus

Context: The effects of an exercise program (EP) for the treatment of patellofemoral pain syndrome (PFPS) are well known. However, the effects of osteopathic manipulative treatment (OMT) are unclear. Objective: To evaluate the effects of OMT versus EP on knee pain, functionality, plantar pressure in middle foot (PPMF), posterior thigh flexibility (PTF), and range of motion of hip extension in runners with PFPS. Design : This is a randomized controlled trial. Setting: Human performance laboratory. Participants: A total of 82 runners with PFPS participated in this study. Interventions: The participants were randomized into 3 groups: OMT, EP, and control group. The OMT group received joint manipulation and myofascial release in the lumbar spine, hip, sacroiliac joint, knee, and ankle regions. The EP group performed specific exercises for lower limbs. The control group received no intervention. Main Outcome Measures: The main evaluations were pain through the visual analog scale, functionality through the Lysholm Knee Scoring Scale, dynamic knee valgus through the step-down test, PPMF through static baropodometry, PTF through the sit and reach test, and range of motion through fleximetry. The evaluations were performed before the interventions, after the 6 interventions, and at 30-day follow-up. Results: There was a significant pain decrease in the OMT and EP groups when compared with the control group. OMT group showed increased functionality, decreased PPMF, and increased PTF. The range of motion for hip extension increased only in the EP group. Conclusion: Both OMT and EP are effective in treating runners with PFPS.

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Chantelle Zimmer and Janice Causgrove Dunn

Teachers can create supportive conditions in physical education to mitigate experiences of stress for children with developmental coordination disorder (DCD); however, most are unfamiliar with DCD and lack adequate training to instruct children with impairments. The purpose of this study was to explore teachers’ perceptions of and interactions in physical education with children thought to demonstrate functional difficulties associated with DCD. A semistructured interview was conducted with 12 teachers across all elementary years with diverse backgrounds and thematically analyzed. Four themes were produced. Teachers (a) had differing views on the etiology of children’s movement difficulties, though (b) all recognized a range of difficulties children demonstrated. They (c) believed it was their role to facilitate positive experiences for these children in physical education but (d) experienced challenges in doing so. Training that increases teachers’ knowledge of and abilities to address the needs of children thought to have DCD is warranted.

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Stamatis Agiovlasitis, Jooyeon Jin, and Joonkoo Yun

The authors examined if body mass index (BMI), weight, and height across age groups differ between adults with Down syndrome (DS) and adults with intellectual disability but without DS. They conducted secondary analyses of cross-sectional data from 45,803 individuals from the United States from 2009 to 2014 of the National Core Indicators Adult Consumer Survey across five age groups: 18–29, 30–39, 40–49, 50–59, and 60+ years. For both men and women with DS, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups and decreased thereafter. For both men and women with intellectual disability, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups, stayed about the same until the 50- to 59-year age group, and decreased thereafter. Height demonstrated a small but significant decrease with older age in all groups. These cross-sectional comparisons indicate that BMI and weight may start decreasing at a younger age in adults with DS than in adults with intellectual disability.

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Teri A. Todd, Keely Ahrold, Danielle N. Jarvis, and Melissa A. Mache

Children with autism spectrum disorder (ASD) typically demonstrate deficits in gross motor skills such as the overhand throw. It has not been determined whether such deficits persist into adulthood. Therefore, the purpose of this study was to examine the kinematics and developmental level of overhand throws among young adults with and without ASD. Three-dimensional motion-capture data were collected during overhand throwing trials performed by 20 college students (10 students with ASD). Individuals with ASD demonstrated similar throw duration, stride length, and step width but a longer acceleration phase and slower ball velocity than individuals without ASD. Young adults with ASD also performed the overhand throw with less developmental proficiency than those without ASD. Specifically, individuals with ASD exhibited developmental deficits in the backswing and composite throwing score. Motor skill interventions for individuals with ASD should address throwing skills, with a particular focus on the preparatory phase of the overhand throw.

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Kerri L. Staples, E. Andrew Pitchford, and Dale A. Ulrich

The Test of Gross Motor Development is among the most commonly used measures of gross motor competency in children. An important attribute of any developmental assessment is its sensitivity to detect change. The purpose of this study was to examine the instructional sensitivity of the Test of Gross Motor Development—third edition (TGMD-3) performance criteria to changes in performance for 48 children (age 4–7 years) with and without Down syndrome following 10 weeks of physical education. Paired t tests identified significant improvements for all children on locomotor (p < .01) and ball skills (p < .01). These significant differences were associated with moderate to large effect sizes. SEM was low relative to the maximum raw score for each subtest, indicating high confidence in the scores. These findings provide evidence that the TGMD-3 is sensitive to change in performance for children with and without Down syndrome.

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Marte Bentzen, Danielle Alexander, Gordon A. Bloom, and Göran Kenttä

The purpose of this scoping review was to provide a broad overview of the literature pertaining to parasport coaches, including information regarding the size and scope of research, the populations and perspectives obtained, and the type of methods used to conduct the research. Data were collected and analyzed using a six-stage framework for conducting scoping reviews. The results revealed that the majority of articles were based on interviews, and an overwhelming majority of the participants were men coaching at the high-performance level in North America. Three of the most frequent topics were becoming a parasport coach, being a parasport coach, and having general parasport coaching knowledge. Articles ranged in date from 1991 to 2018, with 70% of empirical articles published from 2014 onward, indicating an emerging interest in this field of research. This review has the potential to advance the science and practice of parasport coaching at all levels.

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Alex Brun and Michelle A. Sandrey

Context: Joint mobilizations have been studied extensively in the literature for the glenohumeral joint and talocrural joint (ankle). Consequently, joint mobilizations have been established as an effective means of improving range of motion (ROM) within these joints. However, there is a lack of extant research to suggest these effects may apply within another critical joint in the body, the hip. Objective: To examine the immediate effects of hip joint mobilizations on hip ROM and functional outcomes. Secondarily, this study sought to examine the efficacy of a novel hip mobilization protocol. Design: A prospective exploratory study. Setting: Two research labs. Patients or Other Participants: The study included 19 active male (n = 8) and female (n = 11) college students (20.56 [1.5] y, 171.70 [8.6] cm, 72.23 [12.9] kg). Interventions: Bilateral hip mobilizations were administered with the use of a mobilization belt. Each participant received hip joint mobilization treatments once during 3 weekly sessions followed immediately by preintervention and postintervention testing/measurements. Testing for each participant occurred once per week, at the same time of day, for 3 consecutive weeks. Hip ROM was the first week, followed by modified Star Excursion Balance Test the second week and agility T test during the third week. Main Outcomes Measures: Pretest and posttest measurements included hip ROM for hip flexion, extension, abduction, adduction, internal and external rotation, as well as scores on the modified Star Excursion Balance Test (anterior, posterolateral, and posteromedial directions) and agility T test. Results: A significant effect for time was found for hip adduction, internal and external rotation ROM, as well as the posterolateral and posteromedial directions of the modified Star Excursion Balance Test. A separate main effect for both limbs was found for adduction and internal rotation ROM. Conclusion: Isolated immediate changes in ROM and functional outcomes were evident. Further evaluation is needed.

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Saša Krstulović, Andrea De Giorgio, Óscar DelCastillo Andrés, Emerson Franchini, and Goran Kuvačić

The main aim of this investigation was to determine the effect of high contextual interference (HCI) and low contextual interference (LCI) on motor learning of falling techniques. Thirty-five kinesiology students (21 males and 14 females; mean ± SD, age = 19.4 ± 0.69 years) were randomly assigned to the HCI or LCI practice group. The participants’ task was to learn two judo falling techniques on both sides over 3 weeks. The two-way analysis of variance found no difference between LCI and HCI in the performance at the pretest, posttest, retention, and transfer. Both groups improved posttest and retention performance. Finally, differences were found for both groups between the falling performance in the posttest and the application test (except for the right yoko ukemi fall in the HCI). Lower application test scores led to the conclusion that the 3-week treatment was insufficient to reach the application level of the falling techniques.

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Stefanie N. Foster, Michael D. Harris, Mary K. Hastings, Michael J. Mueller, Gretchen B. Salsich, and Marcie Harris-Hayes

Context: The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. Objective: To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Design: Cross-sectional Setting: Academic medical center. Patients: A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated. Intervention: None. Main Outcome Measures: Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Results: Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Conclusions: Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.