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Mark Kluemper, Tim Uhl and Heath Hazelrigg

Context:

Imbalanced shoulder muscles might cause poor posture in swimmers, which has been implicated as potential cause of injury.

Objective:

To determine whether a training program can reduce forward shoulder posture.

Design:

Prospective pseudorandomized.

Setting:

College swimming pool.

Participants:

39 competitive swimmers (age 16 ± 2 years) divided into an exercise group (n = 24) and a control group (n = 15).

Intervention:

The experimental group performed a partner-stretching program on the anterior shoulder muscles and a strengthening regimen focusing on the posterior shoulder muscles for 6 weeks. The control group participated in normal swim-training activities.

Main Outcome Measures:

Shoulder posture was measured as the distance from the anterior acromion to a wall using a double-square method.

Results:

The experimental group significantly reduced the distance of the acromion from the wall in a resting posture (–9.6 ± 7.3 mm) as compared with the control group (–2.0 ± 6.9 mm).

Conclusions:

A training routine might reduce the forward shoulder posture present in most competitive swimmers.

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Valerie Gladwell, Samantha Head, Martin Haggar and Ralph Beneke

Objective:

To evaluate the effect of a program of modified Pilates for active individuals with chronic non-specific low back pain.

Design:

A single blind randomized controlled trial.

Participants:

49 individuals with chronic low back pain were randomly allocated to control (n = 24) or Pilates group (n = 25). Thirty-four individuals completed the study (14 and 20 individuals for control and Pilates group, respectively).

Intervention:

The Pilates group undertook a six week program of Pilates. Both groups continued with normal activity.

Main Outcome Measures:

An assessor blinded to group allocation conducted functional and questionnaire-based assessments pre- and post- intervention.

Results:

Improvements were seen in the Pilates group post- intervention period with increases (P < 0.05) in general health, sports functioning, flexibility, proprioception, and a decrease in pain. The control group showed no significant differences in the same measures post- intervention.

Conclusions:

These data suggest that Pilates used as a specific core stability exercise incorporating functional movements can improve non-specific chronic low back pain in an active population compared to no intervention. Additionally, Pilates can improve general health, pain level, sports functioning, flexibility, and proprioception in individuals with chronic low back pain.

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Gal Ziv and Ronnie Lidor

The purpose of this study was to review a series of studies (n = 20) examining the effects of adding music to exercise programs in clinical populations and in the elderly. We found that the addition of music can (a) improve exercise capacity and increase patients’ motivation to participate in cardiac and pulmonary exercise rehabilitation programs; (b) lead to improved balance, greater ability to perform activities of daily living, and improved life satisfaction in elderly individuals; (c) enhance adherence and function of individuals suffering from neurological diseases such as Alzheimer’s and Parkinson’s; and (d) sustain these benefits if continued on a long-term basis. Based on the reviewed studies, a number of methodological concerns were presented, among them the choice of music style. One of the practical implications suggested for clinicians and practitioners was that the type of music should be individualized based on each patient’s musical preferences.

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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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Damien Moore, Adam I. Semciw, Jodie McClelland, Henry Wajswelner and Tania Pizzari

Context: The gluteus minimus (GMin) muscle consists of 2 uniquely oriented segments that have potential for independent function and have different responses to pathology and aging. For healthy young adults, it is unknown that which rehabilitation exercises specifically target the individual segments. Objective: To quantify segmental GMin activity for 6 common lower-limb rehabilitation exercises in healthy young adults and determine if significant differences exist in segmental activity levels between the exercises. Method: Six common lower-limb rehabilitation exercises were performed by 10 healthy young adults with fine-wire electromyography (EMG) electrodes inserted into the anterior and posterior segments of the GMin muscle. Main Outcome Measures: Electromyography signals were recorded, and median normalized exercise activity levels were reported and compared for each GMin segment across the 6 exercises. Results: High activity levels were generated in the anterior segment by the resisted hip abduction–extension exercise (51% maximum voluntary isometric contraction [MVIC]), whereas for the posterior segment, high activity levels were produced by the single-leg bridge (49% MVIC), the side-lie hip abduction (43% MVIC), the resisted hip abduction–extension exercise (43% MVIC), and the single-leg squat (40% MVIC). There were significant differences (P < .05) in the median electromyography activity levels for the anterior GMin segment but not for the posterior GMin segment across some of the exercises with large effect sizes. Conclusion: Targeted rehabilitation exercises graded by exercise intensity can be prescribed specifically for the anterior and posterior GMin segments to aid in restoration of hip function following injury or aging.

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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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Anners Lerdal, Elin Hannevig Celius and Gunn Pedersen

Background:

Participants who completed a 3-month prescribed individualized exercise program in groups were followed-up prospectively. The aims were to describe the characteristics of the participants, their health-related quality of life (HRQoL) and physical fitness at baseline, at completion and at 12-month follow-up, and to identify predictors of HRQoL and physical fitness at completion and at 12-month follow-up.

Methods:

A 1-group follow-up design was used. Data were collected from records of 163 attendees at a municipality-sponsored health center in Norway. HRQoL was measured by self-report using the COOP/WONCA questionnaire. Physical fitness was estimated from the results of a 2-km walk test.

Results:

Of the 163 participants referred to the clinic, 130 (79.8%) were women and 33 were (20.2%) men. Participants who completed were older than those who dropped out. The participants showed clinical improvement in physical fitness and all health-related quality life domains (d > 0.53) at the completion of the program and in physical functioning, mental health, performance of daily activities, overall health, and perceived improved health after 12 months (d > 0.36).

Conclusions:

Participation in group-based prescribed exercise program for 3 months may improve physical fitness and HRQoL significantly in short and long terms.

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Damien Moore, Tania Pizzari, Jodie McClelland and Adam I. Semciw

Context: Many different rehabilitation exercises have been recommended in the literature to target the gluteus medius (GMed) muscle based mainly on single-electrode, surface electromyography (EMG) measures. With the GMed consisting of 3 structurally and functionally independent segments, there is uncertainty on whether these exercises will target the individual segments effectively. Objective: To measure individual GMed segmental activity during 6 common, lower-limb rehabilitation exercises in healthy young adults, and determine if there are significant differences between the exercises for each segment. Method: With fine-wire EMG electrodes inserted into the anterior, middle, and posterior segments of the GMed muscle, 10 healthy young adults performed 6 common, lower-limb rehabilitation exercises. Main Outcome Measures: Recorded EMG activity was normalized, then reported and compared with median activity for each of the GMed segments across the 6 exercises. Results: For the anterior GMed segment, high activity was recorded for the single-leg squat (48% maximum voluntary isometric contraction [MVIC]), the single-leg bridge (44% MVIC), and the resisted hip abduction–extension exercise (41% MVIC). No exercises recorded high activity for the middle GMed segment, but for the posterior GMed segment very high activity was recorded by the resisted hip abduction–extension exercise (69% MVIC), and high activity was generated by the single-leg squat (48% MVIC) and side-lie hip abduction (43% MVIC). For each of the GMed segments, there were significant differences (P < .05) in the median EMG activity levels between some of the exercises and the side-lie clam with large effect sizes favoring these exercises over the side-lie clam. Conclusions: Open-chain hip abduction and single-limb support exercises appear to be effective options for recruiting the individual GMed segments with selection dependent on individual requirements. However, the side-lie clam does not appear to be effective at recruiting the GMed segments, particularly the anterior and middle segments.