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Roger J. Paxton, Caitlin Feldman-Kothe, Megan K. Trabert, Leah N. Hitchcock, Raoul F. Reiser II and Brian L. Tracy

Introduction:

The purpose was to determine the effect of peripheral neuropathy (PN) on motor output variability for ankle muscles of older adults, and the relation between ankle motor variability and postural stability in PN patients.

Methods:

Older adults with (O-PN) and without PN (O), and young adults (Y) underwent assessment of standing postural stability and ankle muscle force steadiness.

Results:

O-PN displayed impaired ankle muscle force control and postural stability compared with O and Y groups. For O-PN, the amplitude of plantarflexor force fluctuations was moderately correlated with postural stability under no-vision conditions (r = .54, p = .01).

Discussion:

The correlation of variations in ankle force with postural stability in PN suggests a contribution of ankle muscle dyscontrol to the postural instability that impacts physical function for older adults with PN.

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Kanako Shimoura, Yasuaki Nakayama, Yuto Tashiro, Takayuki Hotta, Yusuke Suzuki, Seishiro Tasaka, Tomofumi Matsushita, Keisuke Matsubara, Mirei Kawagoe, Takuya Sonoda, Yuki Yokota and Tomoki Aoyama

frequent injuries. The present results imply that the DS and HS tests would be effective for straightforward assessment of physical function-related injury in basketball players. These 2 tests may be useful in initially assessing general movement dysfunction before a deep screen, because it takes ~5

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Kenneth C. Lam and Jessica G. Markbreiter

PedsQL scores (Table  2 ). Main effects of injury history were reported with the HIS group reporting significantly lower scores than the NO-HIS group for the Pedi-IKDC total score (HIS = 79.2 [21.7], NO-HIS = 95.8 [8.6]) and PedsQL total (HIS = 85.7 [10.9], NO-HIS = 90.9 [7.3]); physical functioning (HIS

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Anna Lina Rahlf, Klaus-Michael Braumann and Astrid Zech

function were measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The questionnaire included 24 questions, divided in 3 subscales: pain, stiffness, and physical function. It was answered by a validated 10 points rating scale. 29 All items were answered retrospectively

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Grant E. Norte, Jay N. Hertel, Susan A. Saliba, David R. Diduch and Joseph M. Hart

-R may contribute to inconsistent reporting of standardized tests or test batteries. 1 , 3 Assessment of physical function and health status for individuals with ACL-R is complex and warrants the use of diverse evaluation strategies. Multimodal assessments of peripheral muscle function (eg

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Dusa Marn-Vukadinovic and Helena Jamnik

Context:

Valid patient-based outcome instruments are necessary for comprehensive patient care that focuses on all aspects of health, from impairments to participation restrictions.

Objective:

To validate the Slovenian translation of Medical Outcome Survey (MOS) Short Form Health Survey (SF-36) and to assess relations among various knee measurements, activity tested with Oxford Knee Score (OKS) and health-related quality of life as estimated with SF-36 domains.

Design:

Descriptive validation study.

Setting:

Isokinetic laboratory in outpatient rehabilitation unit.

Participants:

101 subjects after unilateral sport knee injury.

Interventions:

All subjects completed the SF-36 and OKS, and isokinetic knee-muscle strength output at 60°/s was determined in 78 participants. Within a 3-d period, 43 subjects completed the SF-36 and OKS questionnaires again.

Main Outcome Measures:

Reliability testing included internal consistency and test–retest reliability. Correlations between SF-36 subscales and OKS were calculated to assess construct validity, and correlation between SF-36 subscales and muscle strength was calculated to assess concurrent validity.

Results:

Chronbach α was above .78 for all SF-36 subscales. ICCs ranged from .80 to .93. The correlation between OKS and the physical-functioning subscale, showing convergent construct validity, was higher (r = .83, P < .01) than between OKS and mental health (r = .50, P < .01), showing divergent construct validity. Knee-extensor weakness negatively correlated with physical-functioning (r = −.59, P < .01) and social-functioning (r = −.43, P < .01) subscales.

Conclusions:

The Slovenian translation of the SF-36 is a reliable and valuable tool. The relationships between knee-muscle strength and activity and between knee-muscle strength and SF-36 subscales in patients after sport knee injury were established.

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Alison R. Snyder, Jessica C. Martinez, R. Curtis Bay, John T. Parsons, Eric L. Sauers and Tamara C. Valovich McLeod

Context:

Patient-oriented outcome measures such as the Medical Outcomes Short Form (SF-36) and the Pediatric Outcomes Data Collection Instrument (PODCI) are important tools for determining the impact of events like sport-related injury on health-related quality of life (HRQoL). Unfortunately, there are no published studies using these instruments that compare adolescent athletes with their nonathlete peers, making interpretations of these measures in this population difficult.

Objective:

To compare HRQoL in adolescent athletes and nonathletes using 2 common instruments.

Design:

Cross-sectional.

Setting:

7 high schools.

Participants:

219 athletes and 106 nonathletes.

Intervention:

None.

Main Outcome Measures:

The SF-36 and the PODCI were completed in a counterbalanced manner during 1 session. Dependent variables included the 8 subscale and 2 composite scores of the SF-36 and the 5 subscale scores and 1 global score of the PODCI.

Results:

On the SF-36, athletes reported higher scores on the physical function, general health, social functioning, and mental health subscales and the mental composite score and lower scores on the bodily pain subscale than nonathletes. On the PODCI, athletes reported higher scores on the sport and physical function and happiness subscales and lower scores on the pain/comfort subscale.

Conclusions:

Athletes reported higher scores on a number of SF-36 and PODCI subscales related to mental, emotional, and physical well-being than nonathletes. Our findings suggest that athletic involvement may be a benefit to the overall health status of adolescents and imply that athletes may be a distinct adolescent group requiring their own normative values when using the SF-36 and PODCI.

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George J. Salem, Sean P. Flanagan, Man-Ying Wang, Joo-Eun Song, Stanley P. Azen and Gail A. Greendale

Stepping activities when wearing a weighted vest may enhance physical function in older persons. Using 3 weighted-vest resistance dosages, this study characterized the lower-extremity joint biomechanics associated with stepping activities in elders. Twenty healthy community-dwelling older adults, ages 74.5 ± 4.5 yrs, performed 3 trials of forward step-up and lateral step-up exercises while wearing a weighted vest which added 0% body weight (BW), 5% BW, or 10% BW. They performed these activities on a force platform while instrumented for biomechanical analysis. Repeated-measures ANOVA was used to evaluate the differences in ankle, knee, and hip maximum joint angles, peak net joint moments, joint powers, and impulses among both steping activities and the 3 loading conditions. Findings indicated that the 5% BW vest increased the kinetic output associated with the exercise activities at all three lower-extremity joints. These increases ranged from 5.9% for peak hip power to 12.5% for knee extensor impulse. The application of an additional 5% BW resistance did not affect peak joint moments or powers, but it did increase the joint impulses by 4–11%. Comparisons between exercise activities, across the 3 loading conditions, indicated that forward stepping preferentially targeted the hip extensors while lateral stepping targeted the plantar flexors; both activities equally targeted the knee extensors. Weighted-vest loads of 5% and 10% BW substantially increased the mechanical demand on the knee extensors, hip extensors (forward stepping), and ankle plantar flexors (lateral stepping).

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Ozgur Surenkok, Aydan Aytar and Gul Baltaci

Objective:

The aim of this study was to evaluate the initial effects of scapular mobilization (SM) on shoulder range of motion (ROM), scapular upward rotation, pain, and function.

Design:

Pretest–posttest for 3 groups (SM, sham, and control).

Setting:

A double-blinded, randomized, placebo-controlled trial was conducted to evaluate the initial effect of the SM at a sports physiotherapy clinic.

Participants:

39 subjects (22 women, 17 men; mean age 54.30 ± 14.16 y, age range 20-77 y).

Interventions:

A visual analog scale, ROM, scapular upward rotation, and function were assessed before and just after SM. SM (n = 13) consisted of the application of superoinferior gliding, rotations, and distraction to the scapula. The sham (n = 13) condition replicated the treatment condition except for the hand positioning. The control group (n = 13) did not undergo any physiotherapy and rehabilitation program.

Main Outcome Measures:

Pain severity was assessed with a visual analog scale. Scapular upward rotation was measured with a baseline digital inclinometer. Constant Shoulder Score (CSS) was used to measure shoulder function.

Results:

After SM, we found significant improvements for shoulder ROM, scapular upward rotation, and CSS between pretreatment and posttreatment compared with the sham and control groups. In the sham group, shoulder-ROM values increased or decreased for the shoulder and scapular upward rotation was not changed. Pain, ROM, and physical function of the shoulder were not significantly different in the sham group than in controls (P > .05).

Conclusions:

SM may be a useful manual therapy technique to apply to participants with a painful limitation of the shoulder. SM increases ROM and decreases pain intensity.

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Johanna M. Hoch, Jamie L. Legner, Christina Lorete and Matthew C. Hoch

Context: Documented barriers to implementation of patient-reported outcome instruments (PROs) in practice include administration and scoring time. The Quick Foot and Ankle Ability Measure (Quick-FAAM) was developed to decrease these barriers; however, the clinometric properties in an acute population are unknown. Purpose: To determine the internal consistency, validity, and the floor and ceiling effects of the Quick-FAAM in patients seeking treatment for an acute or subacute ankle or foot health condition. Study Design: Cross-Sectional. Setting: Healthcare facilities.Patients: 50 patients (20.3 ± 2.2 y, 177.9 ± 10.7 cm, 80 ± 19.4 kg) seeking treatment for an acute or subacute ankle or foot condition. Main Outcome Measures: Each patient completed a demographic and health-history questionnaire followed by 5 PROs: the Quick-FAAM, the FAAM-Activities of Daily Living (ADL), FAAM-Sport, the modified Disablement in the Physically Active Scale (mDPA), the Short-Form 12 (SF-12) and the PROMISv1.2 Physical Function (PROMIS-PF). Cronbach alpha was used to determine internal consistency and Spearman’s rank correlations were performed to examine the relationship between the Quick-FAAM and all other outcomes. Results: The Quick-FAAM was very strongly correlated with the FAAM-Total (r = .91, r 2 = .83, P < .001), FAAM-ADL (r = .83, r 2 = .69, P < .001), FAAM-Sport (r = .89, r 2 = .79, P < .001), SF12-Physical Component Score (PCS, r = .74, r 2 = .55, P < .001), mDPA-PCS (r = -.83, r 2 = .69, P < .001) and PROMIS PF (r = .85, r 2 = .72, P < .001). There was a weak or no relationship with the SF12-Mental Component Score (MCS, r = .04, r 2 = .00, P < .001) and the mDPA-MCS (r = -.35, r 2 = .12, P < .001). A total of 8% (n = 4) of the patients scored a 0, and 2% (n = 1) patients scored a 48. Conclusion: The Quick-FAAM demonstrated good convergent and divergent validity along with good internal consistency. There was no evidence of a floor or ceiling effect. Therefore, the Quick-FAAM should be considered for use in practice when determining treatment effectiveness for patients with acute or subacute ankle or foot health conditions. Future research should determine the test-retest reliability and the minimal detectable change of this instrument.