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  • Author: Charlie A. Hicks-Little x
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Charlie A. Hicks-Little, Richard D. Peindl, Tricia J. Hubbard-Turner and Mitchell L. Cordova

Context:

Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lowerextremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear.

Objective:

To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures.

Design:

Case control.

Setting:

Sports-medicine research laboratory.

Participants:

18 participants with knee OA and 18 healthy matched controls.

Intervention:

Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN).

Main Outcome Measures:

WOMAC scores, A-P (mm), and ALIGN (°).

Results:

A significant multivariate main effect for group (Wilks’ Λ = 0.30, F 7,26 = 8.58, P < .0001) was found. Knee-OA participants differed in WOMAC scores (P < .0001) but did not differ from healthy controls on ALIGN (P = .49) or total A-P (P = .66). No significant relationships were identified among main outcome measures.

Conclusion:

These data demonstrate that participants with early-stage knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants’ subjective scores, ALIGN, or A-P measures in this study.

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Jacob J. Janicki, Craig L. Switzler, Bradley T. Hayes and Charlie A. Hicks-Little

Context:

Functional movement screening (FMS) has been gaining popularity in the fields of sports medicine and performance. Currently, limited research has examined whether FMS screening that identifies low FMS scores is attributed primarily to limits in range of motion (ROM).

Objective:

To compare scores from the FMS hurdle-step movement with ROM measurements for ankle dorsiflexion and hip flexion (HF).

Design:

Correlational research design.

Setting:

Sports medicine research laboratory.

Participants:

20 healthy active male (age 21.2 ± 2.4 y, weight 77.8 ± 10.2 kg, height 180.8 ± 6.8 cm) and 20 healthy active female (21.3 ± 2.0 y, 67.3 ± 8.9 kg, 167.4 ± 6.6 cm) volunteers.

Intervention:

All 40 participants completed 3 trials of the hurdle-step exercise bilaterally and goniometric ROM measurements for active ankle dorsiflexion and HF.

Main Outcome Measures:

Correlations were determined between ROM and FMS scores for right and left legs. In addition, mean data were compared between FMS scores, gender, and dominant and nondominant limbs.

Results:

There were no significant correlations present when all participants were grouped. However, when separated by gender significant correlations were identified. There was a weak correlation with HF and both hurdle-step (HS) and average hurdle-step (AHS) scores on both left (r = .536, P = .015 and r = .512, P = .012) and right (r = .445, P = .049 and r = .565, P = .009) legs for women. For men, there was a poor negative correlation of HF and both HS and AHS on the left leg (r = –.452, P = .045 and r = .451, P = .046).

Conclusion:

Our findings suggest that although hip and ankle ROMs do not have a strong relationship with FMS hurdle-step scores, they are a contributing factor. More research should be conducted to identify other biomechanical factors that contribute to individual FMS test scores.

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James R. Rosemeyer, Bradley T. Hayes, Craig L. Switzler and Charlie A. Hicks-Little

Context:

Core stability has been shown to affect lower-extremity motion, but activation of the core has also been observed just before movements of the upper extremity. However, there is limited evidence regarding the effects that core musculature has on upper-extremity strength.

Objective:

To determine the effects of core fatigue on maximal shoulder strength.

Design:

Crossover study.

Setting:

Sports-medicine research laboratory.

Participants:

23 participants (15 male and 8 female, age 21.3 ± 2.5 y, height 174.5 ± 10.3 cm, weight 71.3 ± 12.0 kg).

Intervention:

All participants performed maximal voluntary isometric contractions in 3 different planes (sagittal, frontal, transverse) of shoulder-joint motion. A core-fatiguing protocol was conducted, and the same 3 shoulder-strength tests were repeated and compared with the initial measurements.

Main Outcome Measures:

Strength measures were recorded in kilograms with a dynamometer.

Results:

Results showed a significant decrease in strength in the frontal (−0.56 ± 1.06 kg, P = .020) and transverse (−0.89 ± 1.49 kg, P = .012) planes but not in the sagittal plane (−0.20 ± 0.98 kg, P > .05). Furthermore, regardless of the specific strength test measured, results revealed that the 1st (−7.05% ± 11.65%, P = .012) and 2nd (−5.71% ± 12.03%, P = .042) strength-test measurements after the fatiguing protocol were significantly decreased, while the 3rd strength-test measurement (−4.19% ± 12.48%, P = .140) did not show statistical significance.

Conclusion:

These results indicate that decrease in core stability may have an influence on shoulder strength. The literature suggests that the core is designed for endurance, and this study helps validate its recovery properties. Further research is needed to determine the significance of this effect and how injury rates coincide.

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Bradley T. Hayes, Rod A. Harter, Jeffrey J. Widrick, Daniel P. Williams, Mark A. Hoffman and Charlie A. Hicks-Little

Context:

Static stretching is commonly used during the treatment and rehabilitation of orthopedic injuries to increase joint range of motion (ROM) and muscle flexibility. Understanding the physiological adaptations that occur in the neuromuscular system as a result of long-term stretching may provide insight into the mechanisms responsible for changes in flexibility.

Objective:

To examine possible neurological origins and adaptations in the Ia-reflex pathway that allow for increases in flexibility in ankle ROM, by evaluating the reduction in the synaptic transmission of Ia afferents to the motoneuron pool.

Design:

Repeated-measures, case-controlled study.

Setting:

Sports medicine research laboratory.

Participants:

40 healthy volunteers with no history of cognitive impairment, neurological impairment, or lower extremity surgery or injury within the previous 12 mo.

Intervention:

Presynaptic and postsynaptic mechanisms were evaluated with a chronic stretching protocol. Twenty subjects stretched 5 times a wk for 6 wk. All subjects were measured at baseline, 3 wk, and 6 wk.

Main Outcome Measures:

Ankle-dorsiflexion ROM, Hmax:Mmax, presynaptic inhibition, and disynaptic reciprocal inhibition.

Results:

Only ROM had a significant interaction between group and time, whereas the other dependent variables did not show significant differences. The experimental group had significantly improved ROM from baseline to 3 wk (mean 6.2 ± 0.9, P < .001), 3 wk to 6 wk (mean 5.0 ± 0.8, P < .001), and baseline to 6 wk (mean 11.2 ±0.9, P < .001).

Conclusions:

Ankle dorsiflexion increased by 42.25% after 6 wk of static stretching, but no significant neurological changes resulted at any point of the study, contrasting current literature. Significant neuromuscular origins of adaptation do not exist in the Ia-reflex-pathway components after a long-term stretching program as currently understood. Thus, any increases in flexibility are the result of other factors, potentially mechanical changes or stretch tolerance.

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Paul G. Silvestri, Rachel A. Wagstaff and Charlie A. Hicks-Little

Edited by Joe J. Piccininni

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Charlie A. Hicks-Little, Tricia J. Hubbard and Mitchell L. Cordova

Edited by R. Barry Dale

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Jennifer L. Roney, Melissa L. Yamashiro and Charlie A. Hicks-Little

Edited by Joe J. Piccininni