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Miguel A. Sanchez-Lastra, Antonio J. Molina, Vicente Martin, Tania Fernández-Villa, Jose M. Cancela and Carlos Ayan

population, intervention, comparison, and outcome strategy was formulated as follows: adults aged 60 years and older (population), stretching exercise (intervention), other exercise therapies (comparison), and physical fitness and function (outcome). Based on this strategy and following the recommendations

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Damla Karabay, Yusuf Emük and Derya Özer Kaya

: 15189015 doi:10.2519/jospt.2004.34.5.235 15189015 10.2519/jospt.2004.34.5.235 Appendix 1: Search Strategy PubMed Search Strategy 1. Trapezius (Text Word) 2. Serratus Anterior (Text Word) 3. 1 OR 2 4. Exercise Therapy (MeSH Terms) 5. Exercise (MeSH Terms) 6. Resistance Training (MeSH Terms) 7. Exercise

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Brian C. Focht, Wendy M. Sanders, Peter H. Brubaker and W. Jack Rejeski

The authors examined the validity of the Computer Science and Application (CSA) activity monitor during a bout of rehabilitative exercise among older adults with chronic disease. In order to determine convergent validity, 50 participants were monitored during a 30-min walk in Study 1. In order to assess concurrent validity, 10 volunteers wore both a CSA accelerometer and a Cosmed K4 b2 portable gas-analysis unit during 30 min of rehabilitative exercise in Study 2. Study 1 results revealed significant (p < .01) positive relationships between mean CSA activity counts and estimated METs (r = .60), pedometer readings (r = .47), 6-min walk (r = .62), and self-efficacy (r = .45). Study 2 results demonstrated a significant (p < .01) positive correlation between CSA activity counts and oxygen uptake (r = .72). The findings suggest that the CSA activity monitor is an effective objective measure of physical activity during a structured, moderate-intensity bout of exercise among older adults with chronic disease.

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Justin W.L. Keogh, Steve Morrison and Rod Barrett

The current study investigated the effect of 2 different types of unilateral resistance training on the postural tremor output of 19 neurologically healthy men age 70–80 yr. The strength- (n = 7) and coordination-training (n = 7) groups trained twice a week for 6 wk, performing dumbbell biceps curls, wrist flexions, and wrist extensions, while the control group (n = 5) maintained their normal activities. Changes in index-finger tremor (RMS amplitude, peak, and proportional power) and upper limb muscle coactivation were assessed during 4 postural conditions that were performed separately with the trained and untrained limbs. The 2 training groups experienced significantly greater reductions in mean RMS tremor amplitude, peak, and proportional tremor power 8–12 Hz and upper limb muscle coactivation, as well as greater increases in strength, than the control group. These results further demonstrate the benefits of resistance training for improving function in older adults.

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Wolfram Haslinger, Lisa Müller, Nejc Sarabon, Christian Raschner, Helmut Kern and Stefan Löfler

Objective:

To determine the effectiveness of exercise in improving sensorimotor function and functional performance, crucial parts of activities of daily living in healthy older adults.

Design:

RCT.

Setting:

Laboratory.

Participants:

39 subjects (M = 71.8 years, range: 61–89 years).

Intervention:

Task-oriented visual feedback balance training.

Primary outcome measure:

Timed Up & Go (TUG).

Secondary outcome measures:

Chair stand test (CST), self-paced walk test, maximum isometric torque, quiet stand posturography, and dynamic balance (DB).

Results:

Postintervention comparison of the treatment group (TG) and control group (CG) showed better TUG (p < .01), CST (p < .001), and DB (p < .025) for the TG. Pre–post intervention comparison of the TG showed better clinically-relevant outcomes in TUG (p < .001), CST (p < .001), and DB (p < .001).

Conclusion:

Active driven visual feedback balance training is effective in improving functional performance and dynamic balance in older adults.

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Timothy L. Uhl, Thomas Rice, Brianna Papotto and Timothy A. Butterfield

Context:

The role of the rotator cuff is to provide dynamic stability to the glenohumeral joint. Human and animal studies have identified sarcomerogenesis as an outcome of eccentric training indicated by more torque generation with the muscle in a lengthened position.

Objective:

The authors hypothesized that a home-based eccentric-exercise program could increase the shoulder external rotators’ eccentric strength at terminal internal rotation (IR).

Design:

Prospective case series.

Setting:

Clinical laboratory and home exercising.

Participants:

10 healthy subjects (age 30 ± 10 y).

Intervention:

All participants performed 2 eccentric exercises targeting the posterior shoulder for 6 wk using a home-based intervention program using side-lying external rotation (ER) and horizontal abduction.

Main Outcome Measures:

Dynamic eccentric shoulder strength measured at 60°/s through a 100° arc divided into 4 equal 25° arcs (ER 50–25°, ER 25–0°, IR 0–25°, IR 25–50°) to measure angular impulse to represent the work performed. In addition, isometric shoulder ER was measured at 5 points throughout the arc of motion (45° IR, 30° IR, 15° IR, 0°, and 15° ER). Comparison of isometric and dynamic strength from pre- to posttesting was evaluated with a repeated-measure ANOVA using time and arc or positions as within factors.

Results:

The isometric force measures revealed no significant differences between the 5 positions (P = .56). Analysis of the dynamic eccentric data revealed a significant difference between arcs (P = .02). The percentage-change score of the arc of IR 25–50° was found to be significantly greater than that of the arc of IR 0–25° (P = .007).

Conclusion:

After eccentric training the only arc of motion that had a positive improvement in the capacity to absorb eccentric loads was the arc of motion that represented eccentric contractions at the longest muscle length.

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Annina B. Schmid, Linda Dyer, Thomas Böni, Ulrike Held and Florian Brunner

Context:

Various studies report decreased muscle activation in the concavity of the curve in patients with scoliosis. Such decreased muscle-performance capacity could lead to sustained postural deficits.

Objective:

To investigate whether specific asymmetrical sports therapy exercises rather than symmetrical back strengthening can increase EMG amplitudes of paraspinal muscles in the concavity of the curve.

Design:

Cross-sectional.

Setting:

Laboratory.

Participants:

16 patients with idiopathic scoliosis.

Interventions:

Patients performed 4 back-strengthening exercises (front press, lat pull-down, roman chair, bent-over barbell row) during 1 test session. Each exercise was performed in a symmetrical and asymmetrical variant and repeated 3 times.

Main Outcome Measure:

EMG amplitudes of the paraspinal muscles were recorded in the thoracic and lumbar apexes of the scoliotic curve during each exercise. Ratios of convex- to concave-side EMG activity were calculated.

Results:

Statistical analysis revealed that the asymmetrical variants of front press at the lumbar level (P = .002) and roman chair and bent-over barbell row at the thoracic level (P < .0001, .001 respectively) were superior in increasing EMG amplitudes in the concavity of the scoliotic curve.

Conclusions:

Specific asymmetrical exercises increase EMG amplitudes of paraspinal muscles in the concavity. If confirmed in longitudinal studies measuring improvements of postural deficits, these exercises may advance care of patients with scoliosis.

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James W. Youdas, Hannah E. Baartman, Brian J. Gahlon, Tyler J. Kohnen, Robert J. Sparling and John H. Hollman

Context: Suspension training devices use body weight resistance and unstable support surfaces that may facilitate muscle recruitment during push-up exercises. Objective: The authors examined muscle recruitment with surface electromyography on 4 shoulder and 4 torso muscles during (1) standard push-ups, (2) feet-suspended push-ups, (3) hands-suspended push-ups, and (4) dual-instability push-ups in which feet were suspended and hands were on unstable surfaces. Design: Cross-sectional design with repeated measures. Setting: Biomechanics laboratory. Participants: Thirty-two healthy men and women (mean age, 24.3 y; mean body mass index, 24.6 kg·m−2) participated. Intervention: Participants were tested while performing 2 repetitions each of 4 variations of push-ups. Main Outcome Measures: Muscle recruitment, normalized to maximum voluntary isometric contraction, was measured in 4 prime movers (anterior deltoid, pectoralis major, serratus anterior, and triceps brachii) and 4 torso stabilizers (external oblique, internal oblique, rectus abdominis, and upper erector spinae). Results: Muscle recruitment in the anterior deltoid, pectoralis major, and serratus anterior during suspended exercises was no greater than during standard push-ups. In contrast, torso stabilizer recruitment was significantly greater in the external oblique, internal oblique, and rectus abdominis during all 3 suspended exercises compared with standard push-ups. Suspended exercises under a dual-instability condition did not generate greater levels of muscle activation compared with conditions of single instability. Conclusions: Push-ups performed with suspension training systems may provide benefit if one’s goal is to enhance torso muscle training. One unstable surface may be sufficiently challenging for the client or athlete when performing push-up exercises with a suspension training device.

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Marie A. Johanson, Megan Armstrong, Chris Hopkins, Meghan L. Keen, Michael Robinson and Scott Stephenson

Context:

Stretching exercises are commonly prescribed for patients and healthy individuals with limited extensibility of the gastrocnemius muscle.

Objective:

To determine if individuals demonstrate more dorsiflexion at the ankle/rear foot and less at the midfoot after a gastrocnemius-stretching program with the subtalar joint (STJ) positioned in supination compared with pronation.

Design:

Randomized controlled trial.

Setting:

Biomechanical laboratory.

Participants:

22 volunteers with current or recent history of lower-extremity cumulative trauma and gastrocnemius tightness (10 women and 4 men, mean age 28 y) randomly assigned to stretching groups with the STJ positioned in either pronation (n = 11) or supination (n = 11).

Intervention:

3-wk home gastrocnemius-stretching program using a template to place the subtalar joint in either a pronated or a supinated position.

Main Outcome Measures:

A 7-camera Vicon motion-analysis system measured ankle/rear-foot dorsiflexion and midfoot dorsiflexion of all participants during stretching with the STJ positioned in both pronation and supination before and after the 3-wk gastrocnemius-stretching program.

Results:

A 2-way mixed-model ANOVA revealed a significant interaction (P = .019). At posttest, the group who performed the 3-week stretching program with the STJ positioned in pronation demonstrated more increased ankle/rear-foot dorsiflexion when measured with the STJ in pronation than the group who performed the 3-wk stretching program with the STJ positioned in supination. No significant main effect of stretching group or interaction for dorsiflexion at the midfoot was detected (P = .755 and P = .820, respectively).

Conclusion:

After a 3-wk gastrocnemius-stretching program, when measuring dorsiflexion with the STJ positioned in supination, the participants who completed a 3-wk gastrocnemius stretching program with the STJ positioned in pronation showed more increased dorsiflexion at the ankle/rear foot than participants who completed the stretching program with the STJ positioned in supination.