There is an increasing emphasis on the use of closed kinetic chain exercises in the testing and rehabilitation of many patients with various pathologies. Because of this increased emphasis, there is a need for critical thinking in rehabilitation. Therefore, the purpose of this article is to provide an overview of the application of critical thinking in the following areas: examination, specific rehabilitation protocols, the need for outcome research, and the rationale and need for the integration of open and closed kinetic chain exercises and their application to testing and rehabilitation.
George J. Davies
Melissa Theige and Shannon David
has been hypothesized that hip instability and poor neuromuscular control can replicate or exacerbate this mechanism of injury. 6 It stands to reason, then, that rehabilitation could address these deficits and improve symptoms, allowing patients to postpone or forgo surgical treatment. Furthermore
Cameron J. Powden, Matthew C. Hoch and Johanna M. Hoch
Context The evaluation of change in patient status throughout and after the cessation of orthopedic rehabilitation is a vital component of health care and is often captured from the patient’s perspective by patient-based outcomes. Patient-based outcomes are used to assess the effect of the health
Christine M. Bonci, Beth Sloane and Karen Middleton
Management of the overhead athlete presenting with anterior instability requires an identification of factors influencing successful therapeutic intervention strategies. The importance of differentiating a diagnosis, of knowing something of the demands of the sport, and of addressing pertinent anatomical and biomechanical considerations of the throwing shoulder prior to implementing rehabilitation programs must be considered. An appreciation of the complexities of the throwing shoulder serves as a basis for the selection of rehabilitation activities aimed at returning the athlete to pretrauma levels of overarm proficiency. The challenge of regaining normal shoulder joint osteokinematics and neuromuscular function at a competitive status is described in terms of the proper selection and sequencing of rehabilitation exercises for the initiation and progression of range of motion, muscle strength, muscle reducation, and sport-specific functional activities. Time frames for progressing the various stages of rehabilitation, indications for exercise selection based on electromyographic studies, and attention to detail with regard to exercise execution are emphasized.
Hooman Minoonejad, Mohammad Karimizadeh Ardakani, Reza Rajabi, Erik A. Wikstrom and Ali Sharifnezhad
basketball players during a single-limb jump landing. This program also results in significant improvements in multiple patient-reported outcomes. These results suggest that the hop stabilization program could be implemented in the overall rehabilitation program for patients with CAI. Acknowledgments The
Mark A. Feger, Luke Donovan, C. Collin Herb, Geoffrey G. Handsfield, Silvia S. Blemker, Joseph M. Hart, Susan A. Saliba, Mark F. Abel, Joseph S. Park and Jay Hertel
to be more neuromuscular, rather than due to muscle size, in nature. Supervised rehabilitation programs 20 – 23 emphasizing neuromuscular and balance training for patients with CAI have been associated with improved patient-reported outcomes and sensorimotor measures, but the effects of such
Todd A. Evans and Kenneth C. Lam
Evidence-based practice is an established guiding principle in most medical and health care disciplines. Central to establishing evidence-based practice is the assessment of clinical outcomes. Clinical outcomes represent a form of evidence on which to base medical decisions, as well as providing the mechanism for assessing the effectiveness of evidence-based interventions. However, clinical outcomes are not routinely assessed in sport rehabilitation. If sport rehabilitation clinicians fail to incorporate clinical outcomes assessment and, as a result, evidence into daily practice, they may be missing an opportunity to improve patient care and putting their professional reputation at risk within the medical community. The purposes of the article are to highlight the emergence of clinical outcomes assessment in the medical community and the current health care system, illustrate the role of clinical outcomes assessment as it pertains to providing the best patient care, and identify challenges that could potentially impede the implementation of outcomes assessment in sport rehabilitation.
Turner A. “Tab” Blackburn Jr.
Rehabilitation procedures for anterior instabilities of the knee were compiled in 1984. Since then these procedures have changed drastically. Immediate weight-bearing, immediate range of motion into full extension, and post-op Day 1 quadricep exercise are only three of the changes that streamline this rehabilitation process. Many of the biomechanical and healing restraints are still the same. But it appears that the human body heals much faster than the animal models used to predict successful treatment of anterior instabilities of the knee. As always, the pendulum swings and puts different emphasis on rehab ideas and techniques that were not used a few years ago. The present paper reflects the latest in this rehabilitation process.
Mark S. De Carlo, Kecia E. Sell, K. Donald Shelbourne and Thomas E. Klootwyk
It is well established that intra-articular anterior cruciate ligament reconstruction with autogenous bone-patellar tendon-bone graft provides satisfactory long-term stability. However, the rehabilitation programs employed following this surgical procedure have been a topic of considerable debate. This paper describes an accelerated rehabilitation protocol that is divided into four phases. The first phase encompasses the preoperative period, during which the patient will work to decrease swelling and restore range of motion and strength. The second phase involves Weeks 1 and 2 following surgery, with the patient emphasizing immediate terminal knee extension and weight bearing. The final two phases involve improving lower extremity strength and full return to daily and athletic activities. This accelerated rehabilitation protocol has resulted in an earlier return of range of motion and strength without compromising ligamentous stability.
Yannis Theodorakis, Anastasia Beneca, Parascevi Malliou and Marios Goudas
The aim of this study was to examine the effectiveness of goal setting on performance and on a number of psychological variables such as self-efficacy, pretesting anxiety, and self-satisfaction during an injury rehabilitation program. An experimental group (n = 20) and a control group (n = 17) of injured physical education students were studied. Both groups underwent a 4-week quadriceps strengthening program on an isokinetic dynamometer, with the experimental group setting specific personal goals in each training session. The experimental group improved in performance significantly more than the control group. Although both groups exhibited an increase in self-efficacy and a decrease in pretesting anxiety, only the experimental group had an increase in self-satisfaction with performance. Results confirm that incorporating goal setting in the rehabilitation process enhances rehabilitation results.