Returning an athlete to functional activity is the primary goal of the sports medicine practitioner. Eccentric exercise may be used throughout the rehabilitation program to improve muscle performance and restore normal function. The selection and progression of eccentric exercise are contingent on treatment goals and the individual's tolerance to activity. Basic concepts of eccentric muscle performance are discussed, and general treatment guidelines with an emphasis on specificity and intensity are presented, to enable the clinician to organize and implement relevant, prudent eccentric exercise within the restrictions of the clinical setting. The use of eccentric exercise in the management of tendinitis is briefly discussed.
Douglas R. Keskula
Douglas R. Keskula and Jason Lott
To define, identify, and briefly describe functional outcome measures for assessing functional limitations and disability in athletes with shoulder conditions.
The MEDLINE and CINAHL databases were searched for English-language articles published from 1982 to 2000, using the terms functional outcomes, shoulder, questionnaires, disability, and functional limitations, among others.
The authors identified disease-specific self-report questionnaires that assess functional limitations and disability in patients with shoulder dysfunction.
When describing outcome measures, the authors considered the items to be assessed, the measurement properties, and the practicality of the test. They categorized the available measures designed to assess patients with shoulder instability or general shoulder conditions.
The ability to define and measure function is a fundamental consideration in managing athletes with shoulder dysfunction. The measures described might be useful in assessing functional limitations and disability in such athletes.
Lori A. Bolgla and Douglas R. Keskula
To provide information on research investigating the relationship between a knee effusion and quadriceps inhibition
Peer-reviewed publications from 1965 to 1997 that investigated the effect of a knee effusion on quadriceps strength.
The studies reviewed involved human subjects. Researchers have used active motion, electromyographic equipment, and isokinetics to measure changes in quadriceps strength after a knee effusion.
Most studies reported that a knee effusion resulted in quadriceps inhibition and inferred that quadriceps inhibition would impair knee function.
The authors believe that additional research is needed to better understand the effect of a knee effusion on knee function. Although a knee effusion might lead to quadriceps inhibition, other factors contribute to normal knee function and might allow enough compensation so that knee function is not affected significantly in the presence of certain effusions.
Lori A. Bolgla, Douglas R. Keskula and Jewell B. Duncan
Researchers have suggested that quadriceps inhibition resulting from a simulated knee effusion would lead to decreased lower extremity performance.
To investigate the relationship between a simulated knee effusion and lower extremity performance.
9 college students.
Subjects performed 3 functional-performance tests before and after a simulated knee effusion. Measurement was the average distance hopped for a single hop and crossover hop for distance and time for completion on a timed hop test.
An analysis of variance revealed significant change in average test scores after injection only for the timed hop in subjects receiving a 60-ml injection.
Nonsignificant differences might have resulted from compensation from other muscle groups, fluid movement within the knee joint, and absence of an inflammatory process. Further research on the relationship between simulated knee effusion and lower extremity performance is needed.