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Jihong Park, W. Matt Denning, Jordan D. Pitt, Devin Francom, J. Ty Hopkins and Matthew K. Seeley

Context:

Although knee pain is common, some facets of this pain are unclear. The independent effects (ie, independent from other knee injury or pathology) of knee pain on neural activation of lower-extremity muscles during landing and jumping have not been observed.

Objective:

To investigate the independent effects of knee pain on lower-extremity muscle (gastrocnemius, vastus medialis, medial hamstrings, gluteus medius, and gluteus maximus) activation amplitude during landing and jumping, performed at 2 different intensities.

Design:

Laboratory-based, pretest, posttest, repeated-measures design, where all subjects performed both data-collection sessions.

Methods:

Thirteen able-bodied subjects performed 2 different land and jump tasks (forward and lateral) under 2 different conditions (control and pain), at 2 different intensities (high and low). For the pain condition, experimental knee pain was induced via a hypertonic saline injection into the right infrapatellar fat pad. Functional linear models were used to evaluate the influence of experimental knee pain on muscle-activation amplitude throughout the 2 land and jump tasks.

Results:

Experimental knee pain independently altered activation for all of the observed muscles during various parts of the 2 different land and jump tasks. These activation alterations were not consistently influenced by task intensity.

Conclusion:

Experimental knee pain alters activation amplitude of various lower-extremity muscles during landing and jumping. The nature of the alteration varies between muscles, intensities, and phases of the movement (ie, landing and jumping). Generally, experimental knee pain inhibits the gastrocnemius, medial hamstring, and gluteus medius during landing while independently increasing activation of the same muscles during jumping.

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Ítalo Ribeiro Lemes, Xuemei Sui, Stacy L. Fritz, Paul F. Beattie, Carl J. Lavie, Bruna Camilo Turi-Lynch and Steven N. Blair

self-reported from the medical history questionnaire that asked participants whether they had ever experienced joint pain, low back pain, stiff joints, arthritis, osteoporosis, or gout. If participants responded “yes” to any of the above questions, they were defined as having musculoskeletal conditions

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Lee Herrington

Context:

A valgus position of the knee on functional loading tasks has been reported to be associated with patellofemoral-joint pain. Training programs to reduce knee valgus have been shown to be effective but take time. It would appear logical to use a brace or strap to help control this knee motion to reduce symptoms.

Objective:

To assess the impact of the SERF strap on knee valgus and patellofemoral-joint pain.

Design:

Repeated measures.

Setting:

University human performance laboratory.

Participants:

12 women with patellofemoral pain (mean age 24 ± 3.2 y).

Intervention:

Application of SERF strap.

Main Outcome Measures:

Knee-valgus angle on single-leg squat and step landing and visual analog scale pain score.

Results:

The application of the SERF brace significantly reduced the pain (P < .04) and knee valgus (P < .034) during both tasks.

Conclusion:

The SERF brace brings about a significant reduction in pain during functional tasks. Although the brace brought about a significant reduction in knee valgus, this failed to exceed the smallest-detectable-difference value, so the difference is likely to be related to measurement error. The mechanism as to why this the reduction in pain occurs therefore remains unclear, as this study in line with many others failed to demonstrate meaningful changes in kinematics that could provide an obvious explanation.

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Hiroshige Tateuchi, Noriaki Ichihashi, Masahiro Shinya and Shingo Oda

Patients with hip osteoarthritis (OA) have difficulty with mediolateral postural control. Since the symptom of hip OA includes joint pain, which mostly occurs upon initial movement, patients with hip OA might have disabling problems with movement initiation. This study aimed to identify the movement strategy during the anticipatory postural adjustments in the lateral step motion in patients with hip OA. We studied 18 female subjects with unilateral hip OA and 10 healthy subjects, and measured temporal, kinetic, and kinematic variables. Patients with hip OA required a longer duration of anticipation phase than the control subjects, the total duration of lateral stepping was not different between the groups. Displacement of the center of mass to the supporting (affected) side during the anticipation phase was not different between the two groups. These findings suggest that, in patients with hip OA, the center of mass slowly moved to the affected side. Furthermore, patients with hip OA showed greater shift of the trunk to the supporting side than did the control subjects. These movement characteristics might contribute to the achievement of both protection of the affected hip joint and quickness in the subsequent lateral step in patients with hip OA.

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Nina Sperber, Katherine S. Hall, Kelli Allen, Brenda M. DeVellis, Megan Lewis and Leigh F. Callahan

Background:

Physical and psychological symptoms limit physical activity for people with arthritis. This study examined if self-efficacy mediated a relationship between symptom and physical activity (PA) frequency change.

Methods:

This was a secondary analysis of older adults with arthritis and joint pain in a trial of a lifestyle PA program (n = 339). Measures were depressive symptoms, pain, fatigue, arthritis self-efficacy, PA self-efficacy, and PA frequency. A panel model was used to analyze relationships at baseline and changes at 20 weeks.

Results:

The mean age was 68.8 years. At baseline, depression and fatigue were associated with arthritis self-efficacy (β = –.34 and –.24) and, in turn, PA self-efficacy (β = .63); PA self-efficacy was associated with PA (β = .15). Pain and depression changes were associated with arthritis self-efficacy change (β = –.20 and –.21) and, in turn, PA self-efficacy (β = .32) change; PA self-efficacy change was associated with PA change (β = .36).

Conclusion:

Change in symptom severity affected change in PA frequency. These relationships appeared to operate through self-efficacy. Over time, pain appeared to have a stronger relationship than fatigue with self-efficacy and PA. These findings support strategies to help people with arthritis strengthen their confidence for symptom coping and PA participation.

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Pablo Fanlo-Mazas, Elena Bueno-Gracia, Alazne Ruiz de Escudero-Zapico, José Miguel Tricás-Moreno and María Orosia Lucha-López

Context: Tightness or lack of flexibility of several muscles of the thigh has been associated with patellofemoral joint pain. A tight iliotibial band can lead to laterally located patella and an abnormal patellar tracking pattern. Diacutaneous fibrolysis (DF) is commonly used to reduce muscle tightness, but no studies have evaluated the effects of this technique in the treatment of patients with patellofemoral pain syndrome. Objective: To assess the effect of DF on patellar position in patients with patellofemoral pain syndrome. Design: A single-group, pretest–posttest clinical trial. Setting: University of Zaragoza. Participants: A total of 46 subjects with patellofemoral pain (20 males, 26 females; age: 27.8 [6.9] y). Intervention: Three sessions of DF. Main Outcome Measures: Patellar position measurement using real-time ultrasound scanning; pain intensity measured with visual analog scale and function measured with the Anterior Knee Pain Scale. Results: The application of 3 sessions of DF significantly increased the patellar position at posttreatment evaluation (P < .001) and at 1-week follow-up (P < .001). There was not a significant difference on patellar position between posttreatment and follow-up measurements (P = .28). There were also a statistically significant decrease in pain and increase in function at posttreatment and at 1-week follow-up measurements (P < .001). Conclusion: This study found that patellar position, pain intensity, and function were significantly improved after 3 sessions of DF and at 1-week follow-up.

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Dimitrios-Sokratis Komaris, Cheral Govind, Andrew Murphy, Alistair Ewen and Philip Riches

Patients with osteoarthritis of the knee commonly alter their movement to compensate for lower limb weakness and alleviate joint pain. Movement alterations may lead to weight-bearing asymmetries, and potentially to the progression of the disease. This study presents a novel numerical procedure for the identification of sit-to-walk strategies and differences in movement habits between control adults and persons with knee osteoarthritis. Ten control and 12 participants with osteoarthritis performed the sit-to-walk task in a motion capture laboratory. Participants sat on a stool with the height adjusted to 100% of their knee height, then stood and walked to pick up an object from a table in front of them. Different movement strategies were identified by means of hierarchical clustering. Trials were also classified as to whether the left and right extremities used a bilateral or an asymmetrical strategy. Participants with osteoarthritis used significantly more asymmetrical arm strategies (P = .03) while adopting the pushing through the chair strategy more often than the control subjects (P = .02). The results demonstrated that the 2 groups favor different sit-to-walk strategies. Asymmetrical arm behavior possibly indicates a compensation for the weakness of the affected leg. The proposed procedure may be useful to rapidly assess postoperative outcomes and developing rehabilitation strategies.

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Ana Anton-Solanas, Barry V. O’Neill, Tessa E. Morris and Joe Dunbar

Purpose:

To assess changes in body composition and monitor cognitive function, subjective well-being, and physiological stress, as measured by salivary hormones and markers of mucosal immunity, during an Antarctic expedition.

Methods:

A 36-y-old man (188.2 cm height, 94.5 kg body mass) took part in a world-record attempt. A total-body dual-energy X-ray absorptiometry scan and measurement of 8 skinfolds and 5 girths were performed before and after the expedition. In addition, daily subjective data were recorded (sleep quality, total hours of sleep, energy levels, perceived exertion, mood, muscle soreness, and muscle/joint pain) along with distance covered and hours of physical activity per day. As a measure of cognitive function, the athlete completed a computerized battery of tasks (Axon Sports Cognitive Priming Application) every third morning. Saliva samples were collected before, during, and after the expedition to determine salivary cortisol (sCort), testosterone (sT), alpha amylase (sAA), and secretory immunoglobulin A (sIgA).

Results:

The athlete lost 5.3 kg body mass and sum of 8 skinfolds decreased from 73 mm to 59 mm from preexpedition to postexpedition. Psychomotor speed declined over the course of the expedition. sT increased and sCort decreased throughout, and sAA and sIgA peaked toward the end of the expedition.

Conclusions:

This case study provides novel data about the physiological and cognitive impact of an Antarctic expedition. The findings may inform strategies for future expeditions, allowing individuals undertaking expeditions of this nature to better prepare for success.

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Sean M. Burfeind and Nicole Chimera

Context:

Athletes participating in upper-extremity-dominant sports such as softball and volleyball are at increased risk for glenohumeral-joint pain and injury. For these athletes, an integral part of many injuryprevention and -rehabilitation programs includes improving joint proprioception. One way to measure joint proprioception is through the reproduction of joint angles, or joint-reposition sense (JRS). Kinesiology tape is purported to enhance neuromuscular feedback; therefore, it may influence JRS. However, conflicting findings and the lack of research in the upper extremity warrant further investigation.

Objective:

To determine the effects of kinesiology tape on shoulder-joint proprioception by actively reproducing joint angles, or measurement of JRS.

Design:

Randomized controlled trial.

Setting:

College laboratory.

Participants:

9 men and 7 women 24 ± 3 y old.

Intervention:

SpiderTech kinesiology tape precut Shoulder Spider was applied to the shoulder of participants block randomized to the experimental group, following product-specific instructions, to measure its influence on JRS compared with a control group.

Main Outcome Measurement:

JRS-error scores in shoulder flexion, extension, internal rotation, and external rotation (ER).

Results:

There was a significant interaction between groups pre- to postintervention resulting in decreased JRS errors in flexion (P = .04) and ER (P = .03) in the experimental compared with the control group. The 95% confidence intervals suggest a clinically relevant difference in the variability of JRS errors between postintervention movements for the experimental group in flexion and ER, such that the control group demonstrated much more variability in JRS errors than the experimental group.

Conclusions:

After the application of kinesiology tape the JRS errors were smaller in flexion and ER. This may be of clinical significance in improving proprioception and thus improving joint stability. Additional research should determine the effectiveness of kinesiology tape in reducing joint injury.