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George J. Holland, Kiyoji Tanaka, Ryosuke Shigematsu and Masaki Nakagaichi

This review examines the influences of physiological aging processes on connective tissue, joint integrity, flexibility (range of motion [ROM]), and physical functions of older adults. Studies that attempted to improve older adults' ROM are also critiqued. Multiple mechanisms of musculoskeletal and soft-tissue degeneration, as well as disease processes (osteoporosis, arthritis, atherosclerosis), contribute to significant decreases in neuromuscular function and ROM in older adults, all of which can be exacerbated by disuse influences. No delineation of disuse effects on the rate of aging-related decrements in ROM can be provided, however, because long-term investigations (with physical activity controls) have not been conducted. Research efforts have documented both upper and lower extremity decrements in ROM with development of physical impairments, reductions in basic and instrumental activities of daily living, and progression of disability. There is limited research evidence that either specialized stretch-training or general-exercise intervention protocols moderately improve ROM in older adults and the frail elderly.

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Nathan F. Johnson, Chloe Hutchinson, Kaitlyn Hargett, Kyle Kosik and Phillip Gribble

, health care providers should focus on identifying and improving specific musculoskeletal impairments that contribute to falls. Health care professionals have an important and growing role in the reduction of falls and preservation of autonomy. A variety of functional outcome tools exist to aid clinicians

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Theresa M. Spitznagle and Shirley Sahrmann

Context:

Transient abdominal pain commonly occurs during running. There is limited information to guide the physical examination and treatment of individuals with this transient pain with running (TAPR). The purposes of this report are to describe the movement-system examination, diagnosis, and treatment of 2 female adolescent athletes with TAPR and highlight the differences in their treatment based on specific movement impairments.

Study Design:

Case series.

Diagnosis:

The movement diagnosis determined for both patients was thoracic flexion with rotation. The key signs and symptoms that supported this diagnosis included (1) alignment impairments of thoracic flexion and posterior sway and ribcage asymmetry; (2) movement impairments during testing and running of asymmetrical range of motion for trunk rotation, side bending, and flexion of the thoracic spine; and (3) reproduction of TAPR.

Discussion:

Musculoskeletal impairments related to the trunk muscles combined with the mechanical stresses of running could contribute to TAPR. Treatment in each of the patients was focused on patient education regarding correction of alignment, muscle, and movement impairments of the extremities, thoracic spine, and ribcage. A strategy was determined for correcting motion during running to reduce or abolish the TAPR. Outcomes were positive in both patients. Differences in specific impairments in each patient demonstrate the need for specificity of treatment. These 2 patients illustrate how developing a movement diagnosis and identifying the contributing factors based on a systematic examination can be used in individuals with TAPR.

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Elena J. Caruthers, Julie A. Thompson, Ajit M.W. Chaudhari, Laura C. Schmitt, Thomas M. Best, Katherine R. Saul and Robert A. Siston

Sit-to-stand transfer is a common task that is challenging for older adults and others with musculoskeletal impairments. Associated joint torques and muscle activations have been analyzed two-dimensionally, neglecting possible three-dimensional (3D) compensatory movements in those who struggle with sit-to-stand transfer. Furthermore, how muscles accelerate an individual up and off the chair remains unclear; such knowledge could inform rehabilitation strategies. We examined muscle forces, muscleinduced accelerations, and interlimb muscle force differences during sit-to-stand transfer in young, healthy adults. Dynamic simulations were created using a custom 3D musculoskeletal model; static optimization and induced acceleration analysis were used to determine muscle forces and their induced accelerations, respectively. The gluteus maximus generated the largest force (2009.07 ± 277.31 N) and was a main contributor to forward acceleration of the center of mass (COM) (0.62 ± 0.18 m/s2), while the quadriceps opposed it. The soleus was a main contributor to upward (2.56 ± 0.74 m/s2) and forward acceleration of the COM (0.62 ± 0.33 m/s2). Interlimb muscle force differences were observed, demonstrating lower limb symmetry cannot be assumed during this task, even in healthy adults. These findings establish a baseline from which deficits and compensatory strategies in relevant populations (eg, elderly, osteoarthritis) can be identified.

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Margaret A. Finley, Elizabeth Euiler, Shivayogi V. Hiremath and Joseph Sarver

shoulder girdle kinematics during overhead reaching. Analysis of this task is critical, as alterations have been shown to be sensitive to various chronic musculoskeletal impairments such as subacromial impingement, 10 , 11 rotator cuff tendinopathy, 12 , 13 and adhesive capsulitis, 14 , 15 as well as

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

of shoulder injury; musculoskeletal impairment that prevented participation in typical physical activities for more than 2 days in the 6 months before enrollment; and any neuromuscular pain or sensory impairment in the upper-extremity, lower-extremity, or back. This study was approved by the Mayo

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José Machado Filho, Carlos Leonardo Figueiredo Machado, Hirofumi Tanaka and Rodrigo Ferrari

. Uncontrolled hypertension and a diagnosis of diabetes mellitus, as well as clinical depression, neurological disease, and musculoskeletal impairment that limited the performance of physical exercises were adopted as the exclusion criteria for participation in the study. All participants were instructed to

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Rebekah Lynn, Rebekah Pfitzer, Rebecca R. Rogers, Christopher G. Ballmann, Tyler D. Williams and Mallory R. Marshall

musculoskeletal impairment. Additionally, individuals had to be able to perform various walking and jogging tasks at the speeds (3.0 mph [4.8 km/hr] and 6.5 mph [10.5 km/h], respectively) chosen for this study. This study was approved by the Samford University Institutional Review Board. All participants provided

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Gulcan Harput, Volga B. Tunay and Matthew P. Ithurburn

subsequent physical activity, several musculoskeletal impairments are observed during rehabilitation, including deficits in knee range of motion, 3 knee joint laxity, 4 and, most commonly, quadriceps and hamstring muscle weakness. 5 – 8 Often, strength recovery of the involved limb quadriceps and

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Courtney L. Pollock, Michael A. Hunt, Taian M. Vieira, Alessio Gallina, Tanya D. Ivanova and S. Jayne Garland

conditions that impacted mobility (e.g., severe osteoarthritis). Controls were free from neurological or musculoskeletal impairment, which resulted in mobility restrictions and/or balance deficits. The study conformed to the standards set by the latest revision of the Declaration of Helsinki and was approved