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Scott W. Cheatham and Morey J. Kolber

Context: Foam rolling is a popular intervention used by allied health professionals and the general population. Current research suggests that foam rolling may have an effect on the ipsilateral antagonist muscle group and produce a cross-over effect in the muscles of the contralateral limb. The purpose of this study was to examine the acute effects of foam rolling to the left quadriceps on ipsilateral antagonist hamstrings and contralateral quadriceps muscle group pressure pain threshold (PPT). Through this research, we sought to gather data to further develop the methodology for future studies of this intervention. Design: A pretest–posttest exploratory study. Setting: University kinesiology laboratory. Participants: 21 healthy adults (age = 27.52 ± 8.9 y). Intervention: Video-guided foam roll intervention on the left quadriceps musculature. Main Outcome Measures: Ipsilateral hamstring (antagonist) and contralateral quadriceps muscle PPT. Results: A significant difference was found between pretest to posttest measures for the ipsilateral hamstrings (t[20] = −6.2, P < 0.001) and contralateral quadriceps (t[20] = −9.1, P < 0.001) suggesting an increase in PPT. Conclusions: These findings suggest that foam rolling of the quadriceps musculature may have an acute effect on the PPT of the ipsilateral hamstrings and contralateral quadriceps muscles. Clinicians should consider these results to be exploratory and future investigations examining this intervention on PPT is warranted.

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Scott W. Cheatham, Kyle R. Stull and Morey J. Kolber

Background: Roller massage (RM) has become a common intervention among health and fitness professionals. Recently, manufacturers have merged the science of vibration therapy and RM with the development of vibration rollers. Of interest, is the therapeutic effects of such RM devices. Purpose: The purpose of this study was to compare the effects of a vibration roller and nonvibration roller intervention on prone knee-flexion passive range of motion (ROM) and pressure pain threshold (PPT) of the quadriceps musculature. Methods: Forty-five recreationally active adults were randomly allocated to one of 3 groups: vibration roller, nonvibration roller, and control. Each roller intervention lasted a total of 2 minutes. The control group did not roll. Dependent variables included prone knee-flexion ROM and PPT measures. Statistical analysis included parametric and nonparametric tests to measure changes among groups. Results: The vibration roller demonstrated the greatest increase in PPT (180 kPa, P < .001), followed by the nonvibration roller (112 kPa, P < .001) and control (61 kPa, P < .001). For knee flexion ROM, the vibration roller demonstrated the greatest increase in ROM (7°, P < .001), followed by the nonvibration roller (5°, P < .001) and control (2°, P < .001). Between groups, there was a significant difference in PPT between the vibration and nonvibration roller (P = .03) and vibration roller and control (P < .001). There was also a significant difference between the nonvibration roller and control (P < .001). For knee ROM, there was no significant difference between the vibration and nonvibration roller (P = .31). A significant difference was found between the vibration roller and control group (P < .001) and nonvibration roller and control group (P < .001). Conclusion: The results suggest that a vibration roller may increase an individual’s tolerance to pain greater than a nonvibration roller. This investigation should be considered a starting point for future research on this technology.

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Scott W. Cheatham, Morey J. Kolber and Kathryn Kumagai Shimamura

Clinical Scenario:

The differential diagnosis of groin pain can be very challenging due to the many causative pathologies. Osteitis pubis is a pathology that is becoming more recognized in athletes who participate in sports such as soccer, ice hockey, rugby, and football. Conservative nonoperative treatment is often prescribed first before surgical intervention. Of particular interest are the outcomes of nonoperative rehabilitation programs and their effectiveness to return athletes to preinjury levels of participation. The most recent systematic review in 2011 examined the spectrum of treatments for osteitis pubis and found only level 4 (case report or case series) evidence with varying approaches to treatment. Due to the amount of time since the last published review, there is a need to critically appraise the recent literature to see if more high-quality research has been published that measured nonoperative interventions for athletes with osteitis pubis.

Focused Clinical Question:

Is there evidence to suggest that nonoperative rehabilitation programs for osteitis pubis are effective at returning athletes to their preinjury levels of participation?

Summary of Key Findings:

Four studies met the inclusion criteria. Only level 4 evidence was found. All studies reported using a structured nonoperative rehabilitation program with a successful return to preinjury participation between 4 and 14 wk, except for 1 study reporting a successful return at 30 wk. Successful long-term follow-up was reported at 6–48 mo for all patients.

Clinical Bottom Line:

There is weak evidence to support the efficacy of nonoperative rehabilitation programs at returning athletes to their preinjury levels of participation.

Strength of Recommendation:

There is grade D evidence that a nonoperative program for osteitis pubis is effective at helping athletes return to their preinjury level of participation. The Centre of Evidence Based Medicine recommends a grade D for level 4 evidence with consistent findings.

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Scott W. Cheatham, Morey J. Kolber and Michael P. Ernst

Context:

Pulse rate is commonly measured manually or with commercial wrist or belt monitors. More recently, pulse-rate monitoring has become convenient with the use of mobile technology that allows monitoring through a smartphone camera. This optical technology offers many benefits, although the clinimetric properties have not been extensively studied.

Design:

Observational study of reliability.

Setting:

University kinesiology laboratory.

Participants:

30 healthy, recreationally active adults.

Intervention:

Concurrent measurement of pulse rate using 2 smartphone applications (fingertip, face-scan,) with the Polar H7 belt and pulse oximeter.

Main Outcome Measure:

Average resting pulse rate for 5 min in 3 positions (supine, sitting, and prone).

Results:

Concurrent validity in supine and standing was good between the 2 applications and the Polar H7 (intraclass correlation coefficient [ICC] .80–.98) and pulse oximeter (ICC .82–98). For sitting, the validity was good between the fingertip application, Polar H7 (ICC .97), and pulse oximeter (ICC .97). The face-scan application had moderate validity with the Polar H7 (ICC .74) and pulse oximeter (ICC .69). The minimal detectable change (MDC90) between the fingertip application and Polar H7 ranged from 1.38 to 4.36 beats/min (BPM) and from 0.69 to 2.97 BPM for the pulse oximeter with both positions. The MDC90 between the face-scan application and Polar H7 ranged from 11.88 to 12.83 BPM and from 0.59 to 17.72 BPM for the pulse oximeter. The 95% limits of agreement suggest that the fingertip application may vary between 2.40 and 3.59 BPM with the Polar H7 and between 3.40 and 3.42 BPM with the pulse oximeter. The face-scan application may vary between 3.46 and 3.52 BPM with the Polar H7 and between 2.54 and 3.46 BPM with the pulse oximeter.

Conclusion:

Pulse-rate measurements may be effective using a fingertip application, belt monitor, and pulse oximeter. The fingertip scanner showed superior results compared with the face scanner, which only demonstrated modest validity compared with the Polar H7 and pulse oximeter.

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Scott W. Cheatham, Keelan R. Enseki and Morey J. Kolber

Context:

Hip arthroscopy has become an increasingly popular option for active individuals with recalcitrant hip pain. Conditions that may be addressed through hip arthroscopy include labral pathology, femoral acetabular impingement, capsular hyperlaxity, ligamentum teres tears, and the presence of intra-articular bodies. Although the body of literature examining operative procedures has grown, there is a paucity of evidence specifically on the efficacy of postoperative rehabilitation programs. To date, there are no systematic reviews that have evaluated the available evidence on postoperative rehabilitation.

Objective:

To evaluate the available evidence on postoperative rehabilitation programs after arthroscopy of the hip joint.

Evidence Acquisition:

A search of the PubMed, CINAHL, SPORTDiscus, ProQuest, and Google Scholar databases was conducted in January 2014 according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews.

Evidence Synthesis:

Six studies met the inclusion criteria and were either case series or case reports (level 4 evidence) that described a 4- or 5-phase postoperative rehabilitation program. The available evidence supports a postoperative period of restricted weight bearing and mobility; however, the specific interventions in the postoperative phases are variable with no comparison trials.

Conclusion:

This review identified a paucity of evidence on postoperative rehabilitation after hip arthroscopy. Existing reports are descriptive in nature, so the superiority of a particular approach cannot be determined. One can surmise from existing studies that a 4- to 5-stage program with an initial period of weight-bearing and mobility precautions is efficacious in regard to function, patient satisfaction, and return to competitive-level athletics. Clinicians may consider such a program as a general guideline but should individualize treatment according to the surgical procedure and surgeon guidelines. Future research should focus on comparative trials to determine the effect of specific postoperative rehabilitation designs.

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Scott W. Cheatham, Keelan R. Enseki and Morey J. Kolber

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Scott Cheatham, Morey J. Kolber and Michael P. Ernst

Context:

Pulse oximetry has become mobile with the use of smartphone and Bluetooth wireless technology. This technology offers many benefits but has not been extensively studied. There is a need to further validate its clinimetric properties for health professionals to provide proper guidance to patients.

Objective:

This investigation assessed the concurrent validity of the iSpO2 pulse oximeter against a traditional pulse oximeter in measuring short-term resting blood oxygen saturation (SpO2) and pulse rate.

Design:

Observational study of reliability.

Setting:

University kinesiology laboratory.

Participants:

Thirty healthy, recre-ationally active adults (18 men, 12 women; mean age = 25.7 ± 5.46 years, mean height = 170.3cm ± 9.51, mean body mass = 76.4 kg ± 19.33).

Intervention:

Resting measurement of SpO2 and pulse rate using the iSpO2 pulse oximeter with the iPad Mini and a traditional pulse oximeter with Bluetooth.

Main Outcome Measure:

Resting SpO2 and pulse rate were concurrently measured over 5 min.

Results:

The concurrent validity between the iSpO2 and traditional pulse oximeter was moderate for measuring SpO2, intraclass correlation coeffcient (ICC)(3, 1) = .73, SEM = 0.70%, and good for pulse rate, ICC(3, 1) = .97, SEM = 1.74 beats per minute (bpm). The minimal detectable change at the 95% confidence interval for both instruments suggests that there may be 1.94% disagreement for SpO2 and 4.82 bpm disagreement between pulse oximetry methods. The 95% limits of agreement (LoA) for measuring SpO2 suggests that the iSpO2 and traditional pulse oximeters may vary -0.28 ± 1.98%, or approximately 2%. The 95% LoA for measuring pulse rate suggests that the iSpO2 and traditional pulse oximeter may vary 1.74 ± 4.98 bpm, potentially upward of 6 bpm. On the basis of the results of the LoA, it appears that there may be a slight systematic bias between the two devices, with the traditional pulse oximeter producing higher pulse rates than the iSpO2.

Conclusion:

The findings suggest that both instruments may be beneficial for indirect short-term measurements of resting SpO2 and pulse rate.