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Casper de Boer, Johannes van der Steen, Francesco Mattace-Raso, Agnita J.W. Boon and Johan J.M. Pel

The early stages of neurodegenerative disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD) involve deterioration of specific (visuo)motor functions. The aim of the current study was to investigate differences in visuomotor behavior between age-matched groups of 17 patients with AD, 17 patients with PD, and 20 healthy control subjects across three eye-hand-coordination tasks of different cognitive complexity. In two of three tasks, timing and execution parameters of eyes and hand significantly differed between groups. Timing and execution parameters of the eyes and hands could potentially give a quantitative description of disease specific deficits in the spatial and temporal domains and may serve as a tool to monitor disease progression in AD and PD populations.

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Lori A. Bolgla, Scott W. Shaffer and Terry R. Malone

Context:

Knee extension exercise is an important part of knee rehabilitation. Clinicians prescribe non-weight bearing exercise initially and progress patients to weight bearing exercise once they can perform a straight leg raise (SLR).

Objective:

Compare VM activation during a SLR and weight bearing exercises.

Design:

One-way repeated measures design.

Setting:

University Laboratory.

Subjects:

Fifteen healthy subjects.

Intervention:

One SLR exercise and 6 weight-bearing knee extension exercises.

Main Outcome Measures:

Electromyographic amplitudes for the VM expressed as a percent maximum voluntary isometric contraction.

Results:

The SLR had greater activation than the single leg stance and bilateral squat exercises. The step-up and unilateral leg press exercises had the greatest activation.

Conclusions:

SLR performance can be an important indicator for exercise progression. These results provide foundational knowledge to assist clinicians with exercise prescription.

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Marc J. Philippon, Jesse C. Christensen and Michael S. Wahoff

Objective:

To report the 4-phase rehabilitation progression of a professional athlete who underwent arthroscopic intra-articular repair of the hip after injury during the 2006–07 season.

Design:

Case study; level of evidence, 4.

Main Outcome Measures:

Objective values were obtained by standard goniometric measurements, handheld dynamometer, dynamic sports testing, and clinical testing for intra-articular pathology.

Results:

This case report illustrates improvements in hip mobility, muscle-force output, elimination of clinical signs of intra-articular involvement, and ability to perform high-level sport-specific training at 9 wk postsurgery. At 16 wk postsurgery, the patient was able to return to full preparation for sport for the following season.

Conclusion:

After the 4-phase rehabilitation program, the patient demonstrated improvement in all areas of high-level function after an arthroscopic intra-articular repair of the hip. The preoperative management to return to sport is outlined, with clinical outcomes and criteria for return to competition.

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Michael L. Voight and Gray Cook

Enhancing the ability to function within one's environment and to perform activities of daily living is a common goal in rehabilitation. The entire rehabilitation process should be focused on improving the patient's functional status. A functional progression for return to activity can be developed by breaking specific activities down into a hierarchy and then performing them in a sequence that allows for acquisition or reacquisition of skill. Rehabilitation following injury has focused upon restoring muscular strength, endurance, and joint flexibility without any consideration of the role of the neuromuscular mechanism. A common error in rehabilitation is assuming that clinical programs alone using traditional methods will safely return the athlete to function. Limiting athletic rehabilitation to these traditional programs often results in an incomplete restoration of athletic ability and quite possibly an increased risk of reinjury. Reactive neuromuscular training fills the gap left by traditional rehabilitation in order to return the athlete to activity.

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Jeff Konin, Michael J. Axe and Ron Courson

The implementation of interval throwing programs during rehabilitation has been suggested in the literature to allow for a quicker and safer return of the throwing athlete to competition. Many programs have clearly focused on baseball players. This program is specifically designed for the football quarterback. The program encompasses a sound flexibility and strength training regime and provides for a supervised step-by-step progression of throwing. Although the authors have found success with early results, practitioners should apply this program with caution, as it may need to be modified for each athlete. The purpose of this paper is to establish a foundation for future work in the area of the throwing shoulder for the football quarterback.

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Tania Pizzari, Helen McBurney, Nicholas F. Taylor and Julian A. Feller

Objective:

To investigate the subjective experience of anterior cruciate ligament (ACL) rehabilitation and identify variables that influence adherence as perceived by ACL-reconstructed patients.

Design:

A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings.

Setting:

Participants were interviewed at home or in their workplace.

Participants:

Eleven patients were interviewed at an average of 4.8 months (SD = 0.8) after ACL reconstruction.

Results:

Using thematic coding of the interview data, 3 categories of variables influencing adherence emerged: environmental factors, physical factors, and psychological factors. Variables specifically affecting adherence to home exercise were perceived lack of time and a lack of self-motivation. Fear of reinjury emerged as a significant consideration for those who were nonadherent. Factors such as therapist support, the rehabilitation clinic, and the progression of exercises were identified as being important for attendance at physiotherapy appointments and adherence during appointments.

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William C. Whiting, Robert J. Gregor and Marie Halushka

Eight male javelin throwers were filmed while throwing new-rules javelins during competition at five meets over a 2-year period. Body segment kinematics and javelin release parameters were assessed relative to their contribution to throwing performance. The data suggest that successful throws, as judged by distance thrown, are characterized by higher release speeds, longer last-step lengths, less flexion of the front-leg knee during the final plant phase, and an orderly progression of peak speeds at the hip, shoulder, and elbow from the onset of double leg support until release. Individual variability in performance was associated with differences measured between several throwing variables. Limitations inherent to two-dimensional analysis were identified that highlighted the need for three-dimensional investigation of the javelin throw.

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Todd G. Goldbeck and George J. Davies

Context:

Functional testing of patients is essential to clinicians because it provides objective data for documentation that can be used for serial reassessment and progression through a rehabilitation program. Furthermore, new tests should require minimal time, space, and money to implement.

Purpose:

To determine the test-retest reliability of the Closed Kinetic Chain (CKC) Upper Extremity Stability Test.

Participants:

Twenty-four male college students.

Methods:

Each subject was tested initially and again 7 days later. Each subject performed 1 submaximal test followed by 3 maximal efforts. A 45-second rest was given after each 15-second test. The 2 maximal-test scores were averaged and compared with those from the retest.

Results:

The intraclass correlation coefficient was .922 for test-retest reliability. A paired-samples t test (.927) was conducted, and the coefficient of stability was .859. The results indicate that the CKC Upper Extremity Stability Test is a reliable evaluation tool.

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Reint H. Geuze

The functional integrity of the bimanual neuromotor system of Parkinson's disease (PD) subjects (stage II) compared to controls (2 × n = 16) was evaluated by measures of coordination stability of tapping in in-phase. anti-phase. and 90°-phase. Recently, intentional influence was modeled as an additive attractor function on the intrinsic dynamics, resulting in predictions tested by Scholz and Kelso (1990). In this study, the intentional influence was modulated by attaching cognitive meaning to the rhythmical pattern, which was expected to enhance the stability of coordination and, if effective, might be profitable to PD patients. Half of the PD subjects significantly lacked stability. They were less stable than controls, lost coordination at lower frequencies, and needed more time to switch between phase patterns. The reduction of stability was reflected in the progression of the disease. Cognitive meaning reduced variability of the single hands but not of relative phase, and no effect on switching time was found. The results suggest a weaker coupling strength between the limbs in PD patients lacking stability.

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Alexandra Milligan, Chris Mills and Joanna Scurr

More and more studies are emerging reporting breast kinematics. These studies rarely present effect sizes, power, and variance in the data. Important inferences are drawn from these data, including applications to product design, breast pain assessment, sports performance effects, and more. The aim of the study was to explore the within-participant variance in breast kinematic data during a 5 km run. Multiplanar breast kinematics and within-participant variance, defined by the coefficient of variation, for 10 female participants wearing a low and high level breast support were calculated during a 5 km run. Greater within-participant variance was reported in the high level (mean = 15%) breast support compared with the low level (mean = 12%). Within-participant variance in breast kinematics did not change over the 5 km run. Differences in the magnitude of within-participant variance in breast kinematics were reported between directions of breast movement, with greater levels in the anteroposterior direction compared with mediolateral and vertical. It is important for the progression of this research area that the presence and sources of within-participant variance in breast kinematics are quantified and acknowledged, ensuring that the margin for meaningful differences can be reported.