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  • Author: Jennifer M. McKeon x
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Jennifer M. Medina McKeon and Kathleen E. Yancosek

Context:

There are discrepancies regarding the efficacy of neural gliding exercises for the management of carpal tunnel syndrome (CTS).

Objective:

To conduct a systematic review assessing the efficacy of neural gliding in comparison to alternative nonsurgical treatment for the management of CTS.

Evidence Acquisition:

A computerized search was performed in April 2008. Criteria for inclusion required that studies (1) were written in English, (2) examined the efficacy of neural gliding techniques for treatment of CTS, and (3) included at least one of the selected patient-oriented outcomes. Effect sizes, relative risk, and 95% confidence intervals were calculated to compare neural gliding to alternative treatment.

Evidence Synthesis:

Six studies met inclusion criteria. For all variables, none were consistently favorable toward neural gliding over alternative treatment. However, comparisons across studies revealed a possible trend toward improved outcomes with the use neural gliding.

Conclusions:

The efficacy of neural gliding is not clear. More research is necessary to determine the population that may respond optimally to this treatment.

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Jennifer M. Medina McKeon, Craig R. Denegar and Jay Hertel

The purpose of this study was to formulate a predictive equation to discriminate males from females using static and dynamic lower extremity (LE) alignments. Twenty-four healthy adults volunteered to participate. Three-dimensional motion analysis was used to assess the kinematics of the right hip and knee during two functional tasks. Six measures of static LE alignment were also performed. Statistical comparisons were made between males and females for all variables. Static and dynamic variables that were significantly different by sex were entered into separate discriminant analyses for each task. The resulting equations were each able to correctly predict 87% of the subjects by sex. Fifty-eight percent and 55% of the variance was explained by sex for the vertical jump and plant & jump, respectively. The frontal plane hip angle was the best predictor of sex for both tasks. While there were statistically significant differences between the sexes for static measures of LE alignment, kinematic measures were better at discriminating between sexes.

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Carrie S. Baker, Jennifer M. Medina McKeon and Ellen L. Usher

Self-efficacy of balance, a psychological characteristic, may provide information regarding psychological risk factors for lower-extremity injury. Validated instruments to assess self-efficacy of balance do not currently exist. The objective of this study was to determine the face and content validity of the Self-Efficacy of Balance Scale (SEBS) for an adolescent population, as well as content validity, construct and convergent validity of the overall instrument. A series of panelists (n = 11) assessed proposed items for face and content validity for self-efficacy of balance. Construct and convergent validity were assessed with active college individuals (n = 74) and female high school basketball athletes (n = 57). Original items were revised to 21 items. Panelists validated both face and content validity of the SEBS. All items were assessed to have the construct of self-efficacy. Evidence of convergent validity supported the proposed construct of self-efficacy, and was found to be relevant to the physical functioning of a young, active population.

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Nathan Oakes and Jennifer M. Medina McKeon

Since its inception, surgical management of the ulnar collateral ligament (UCL) is fairly standard; however, the invasive, costly, and time-intensive nature of UCL surgery may be restrictive to some athletes. Electronic databases were searched starting from the year 2013 to September 2018. Extracted data included frequencies of (a) return to play (RTP); (b) return to same level of play (RTSP); (c) athlete’s position; (d) complete reconstitution of the UCL; and (e) the location of ligament rupture (proximal or distal). Proportions of success/failure for selected outcomes were calculated. Additionally, an odds ratio (OR) (95% confidence interval [CI]) determined the association between tear location (proximal vs. distal) and nonsurgical success. A total of 169 athletes underwent nonsurgical management of UCL injury in the seven included studies. Sports included baseball, gymnastics, softball, hockey, volleyball, and tennis. Overall, 83% (n = 140) were able to RTP and 72% (n = 121) were able to RTSP. Those with proximal UCL tears had a RTSP rate of 82% (n = 56) compared to 42% (n = 13) of those with a distal tear. Proximal tears were associated with higher rates of successful outcomes in RTP and RTSP (OR = 6.5 [2.5,16.7], p < .001). In baseball, 76% (n = 38) of pitchers were able to RTSP compared to 90% (n = 9) of position players. When visualized using MRI, 96% (n = 22) of athletes had full UCL reconstitution following nonsurgical management. Based on the pooled outcomes of included studies, nonsurgical management of a UCL injury was reasonably successful for RTP and RTSP rates in professional athletes, with a better chance of success for proximal tears compared to distal and incomplete tears compared to complete. The exploratory nature of utilizing nonsurgical management for UCL sprains in athletes, by way of the case series, appears to be fairly well established, but an upgrade in study design is warranted.

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Jennifer M. Medina McKeon and Patrick O. McKeon

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Patrick O. McKeon and Jennifer M. McKeon

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Jennifer M. Medina McKeon and Patrick O. McKeon

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Jennifer M. Medina McKeon and Patrick O. McKeon

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Patrick O. McKeon and Jennifer M. Medina McKeon

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Jennifer M. Medina McKeon and Patrick O. McKeon