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Knee-Extension Exercise’s Lack of Immediate Effect on Maximal Voluntary Quadriceps Torque and Activation in Individuals With Anterior Knee Pain

Jihong Park, Terry L. Grindstaff, Joe M. Hart, Jay N. Hertel, and Christopher D. Ingersoll

Context:

Weight-bearing (WB) and non-weight-bearing (NWB) exercises are commonly used in rehabilitation programs for patients with anterior knee pain (AKP).

Objective:

To determine the immediate effects of isolated WB or NWB knee-extension exercises on quadriceps torque output and activation in individuals with AKP.

Design:

A single-blind randomized controlled trial.

Setting:

Laboratory.

Participants:

30 subjects with self-reported AKP.

Interventions:

Subjects performed a maximal voluntary isometric contraction (MVIC) of the quadriceps (knee at 90°). Maximal voluntary quadriceps activation was quantified using the central activation ratio (CAR): CAR = MVIC/(MVIC + superimposed burst torque). After baseline testing, subjects were randomized to 1 of 3 intervention groups: WB knee extension, NWB knee extension, or control. WB knee-extension exercise was performed as a sling-based exercise, and NWB knee-extension exercise was performed on the Biodex dynamometer. Exercises were performed in 3 sets of 5 repetitions at approximately 55% MVIC. Measurements were obtained at 4 times: baseline and immediately and 15 and 30 min postexercise.

Main Outcome Measures:

Quadriceps torque output (MVIC: N·m/Kg) and quadriceps activation (CAR).

Results:

No significant differences in the maximal voluntary quadriceps torque output (F 2,27 = 0.592, P = .56) or activation (F 2,27 = 0.069, P = .93) were observed among the 3 treatment groups.

Conclusions:

WB and NWB knee-extension exercises did not acutely change quadriceps torque output or activation. It may be necessary to perform exercises over a number of sessions and incorporate other disinhibitory interventions (eg, cryotherapy) to observe acute changes in quadriceps torque and activation.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 21 (2012): Issue 2 (Jan 2012)

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The Effect of Traditional Bridging or Suspension-Exercise Bridging on Lateral Abdominal Thickness in Individuals With Low Back Pain

Rebecca J. Guthrie, Terry L. Grindstaff, Theodore Croy, Christopher D. Ingersoll, and Susan A. Saliba

Context:

Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature.

Objective:

To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP.

Design:

Randomized control trial.

Setting:

University research laboratory.

Participants:

51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification.

Interventions:

Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria.

Main Outcome Measures:

Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness.

Results:

There was not a significant increase in EO (F 1,47 = 0.44, P = .51) or IO (F 1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F 1,47 = 4.05, P = .05) group-by-time interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28).

Conclusion:

A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 21 (2012): Issue 2 (Jan 2012)

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Center-of-Pressure Parameters Used in the Assessment of Postural Control

Riann M. Palmieri, Christopher D. Ingersoll, Marcus B. Stone, and B. Andrew Krause

Objective:

To define the numerous center-of-pressure derivatives used in the assessment of postural control and discuss what value each might provide in the assessment of balance.

Data Sources:

MEDLINE and SPORTDiscus were searched with the terms balance, postural control, postural sway, and center of pressure. The remaining citations were collected from references of similar papers. A total of 67 references were studied.

Conclusions:

Understanding what is represented by each parameter used to assess postural control is crucial. At the present time the literature has failed to demonstrate how the variables reflect changes made by the postural-control system. Until it can be shown that the center of pressure and its derivatives actually reveal changes in the postural-control system, the value of using these measures to assess deficits in postural control is minimized.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 11 (2002): Issue 1 (Jan 2002)

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Effects of Altering Intensity during 1-MHz Ultrasound Treatment on Increasing Triceps Surae Temperature

Phillip O. Burr, Timothy J. Demchak, Mitchell L. Cordova, Christopher D. Ingersoll, and Marcus B. Stone

Context:

It has been suggested that to obtain optimal physiological effects of heating, musculoskeletal temperature (TEMP) should be elevated 3 °C above baseline and maintained for at least 5 min.

Objective:

To identify a multi-intensity ultrasound protocol that will achieve optimal heating.

Design:

1 × 2 between-subjects.

Setting:

Sports-injury research laboratory.

Participants:

20 healthy volunteers.

Interventions:

A 2.5-min treatment at 2.4 W/cm2 immediately followed by a 7.5-min treatment at 1.0 W/cm2 (T1) and a 10-min treatment at 1.5 W/cm2 (T2).

Outcome Measures:

TEMP change during the first 2.5 min of ultrasound treatment (°C), time the TEMP was ≥3 °C above baseline during and after the treatment.

Results:

T1 increased TEMP during the first 2.5 min of the ultrasound treatment (3.22 ± 1.25 °C) more than T2 did (1.68 ± 0.72 °C). No difference was found for the remaining measures.

Conclusions:

The multi-intensity protocol (2.4 W/cm2 and 1.0 W/cm2) did not result in optimal heating.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 13 (2004): Issue 4 (Jan 2004)

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Cryotherapy Does Not Affect Peroneal Reaction Following Sudden Inversion

Christine L. Berg, Joseph M. Hart, Riann Palmieri-Smith, Kevin M. Cross, and 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.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 16 (2007): Issue 4 (Jan 2007)

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The Effect of Textured Insoles on Postural Control in Double and Single Limb Stance

Dawn M. Corbin, Joseph M. Hart, Patrick O. McKeon, Christopher D. Ingersoll, and Jay Hertel

Context:

Increased plantar cutaneous afferent information may improve postural control.

Objective:

To compare postural control measures between balance conditions with and without textured insoles.

Design:

crossover trial.

Setting:

Research Laboratory.

Patients or Other Participants:

33 healthy subjects (27.4 ± 9.1yrs, 172.6 ± 10.3 cm, 75.4 ± 16.4 kg).

Intervention(s):

Subjects performed 24, 10-second bipedal and unilateral stance balance trials with eyes opened and eyes closed, with and without a textured insole in subjects’ shoes.

Main Outcome Measures:

Average velocity and area of center of pressure (COP) excursions.

Results:

We observed an interaction among balance conditions during bilateral stance, but not during unilateral stance. On average, subjects exhibited greater area and velocity of COP excursions with eyes closed compared to eyes opened. Significant differences in area and velocity of COP excursions were observed during bilateral stance only when subjects were not wearing textured insoles. There were no significant differences while subjects balanced in bilateral stance with textured insoles.

Conclusions:

Increased afferent information from textured insoles improves postural control in bilateral stance.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 16 (2007): Issue 4 (Jan 2007)

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Anterior Shoulder Laxity Is Not Correlated with Medial Elbow Laxity in High School Baseball Players

Brian A. Friscia, Robert R. Hammill, Brian A. McGuire, Jay N. Hertel, and Christopher D. Ingersoll

Context:

Uninjured baseball players have been shown to have increased anterior glenohumeral joint laxity, which may result in adaptive changes at the medial elbow.

Objective:

To determine the relationship between anterior shoulder laxity and medial elbow laxity in both arms of baseball and nonbaseball high school athletes and compare the laxity of dominant and nondominant shoulders and elbows of high school baseball and nonbaseball players.

Design:

Cohort design.

Setting:

Local high schools.

Participants:

Thirty healthy high school male athletes.

Outcome Measures:

Anterior shoulder and medial elbow laxity measurements were taken bilaterally with the Ligmaster™.

Results:

Dominant and nondominant shoulder laxity was significantly greater in the nonbaseball players than the baseball players. No other significant relationships existed.

Conclusions:

High school baseball players exhibit less anterior shoulder laxity than do nonbaseball players. No relationship exists between anterior shoulder and medial elbow laxity in high school baseball players.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 17 (2008): Issue 2 (Jan 2008)

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Altered Ankle Kinematics and Shank-Rear-Foot Coupling in Those with Chronic Ankle Instability

Lindsay K. Drewes, Patrick O. McKeon, Gabriele Paolini, Patrick Riley, D. Casey Kerrigan, Christopher D. Ingersoll, and Jay Hertel

Context:

Kinematic patterns during gait have not been extensively studied in relation to chronic ankle instability (CAI).

Objective:

To determine whether individuals with CAI demonstrate altered ankle kinematics and shank-rear-foot coupling compared with controls during walking and jogging.

Design:

Case control.

Setting:

Motion-analysis laboratory.

Participants:

7 participants (3 men, 4 women) suffering from CAI (age 24.6 ± 4.2 y, height 172.6 ± 9.4 cm, mass 70.9 ± 8.1 kg) and 7 (3 men, 4 women) healthy, matched controls (age 24.7 ± 4.5 y, height 168.2 ± 5.9 cm, mass 66.5 ± 9.8 kg).

Interventions:

Subjects walked and jogged on a treadmill while 3-dimensional kinematics of the lower extremities were captured.

Main Outcome Measures:

The positions of rear-foot inversion–eversion and shank rotation were calculated throughout the gait cycle. Continuous relative-phase angles between these segments were calculated to assess coupling.

Results:

The CAI group demonstrated more rear-foot inversion and shank external rotation during walking and jogging. There were differences between groups in shank-rear-foot coupling during terminal swing at both speeds.

Conclusions:

Altered ankle kinematics and joint coupling during the terminal-swing phase of gait may predispose a population with CAI to ankle-inversion injuries. Less coordinated movement during gait may be an indication of altered neuromuscular recruitment of the musculature surrounding the ankle as the foot is being positioned for initial contact.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 18 (2009): Issue 3 (Jan 2009)

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Fibular Reposition Taping Does Not Change Lower Extremity Biomechanics During Gait in Active Adults With Chronic Ankle Instability

John McCleve, Luke Donovan, Christopher D. Ingersoll, Charles Armstrong, and Neal R. Glaviano

Altered arthrokinematics are present in individuals with chronic ankle instability, which may influence their walking biomechanics. The objective of this study was to determine if fibular reposition tape (FRT) has any effect on lower extremity kinematics, kinetics, and vertical ground reaction forces (vGRFs) during gait in individuals with chronic ankle instability (CAI). Twenty active individuals with bilateral CAI received three conditions: FRT, sham FRT, and no tape. Ten trials of walking were collected for each condition to evaluate lower extremity kinematics, kinetics, and vGRF. Curve analyses were used to compare conditions by plotting group means and 90% confidence intervals. There were no significant differences in lower extremity biomechanics between any tape conditions. Application of FRT did not have any effect on triplanar kinematics, kinetics, or vGRF during gait in individuals with CAI.

Cover International Journal of Athletic Therapy and Training

In International Journal of Athletic Therapy and Training Volume 24 (2019): Issue 3 (May 2019)

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The Role of Disinhibitory Modalities in Joint Injury Rehabilitation

Michael G. Dolan, Brian G. Pietrosimone, J. Ty Hopkins, and Christopher D. Ingersoll

Cover International Journal of Athletic Therapy and Training

In International Journal of Athletic Therapy and Training Volume 13 (2008): Issue 6 (Nov 2008)