-LBP, such as the treatment-based classification system, do not necessarily translate to chronic pain and notably do not take psychosocial factors into consideration. 9 Therapeutic exercise is a low-risk and effective treatment option for chronic pain, which can be utilized by all rehabilitation clinicians
Kaitlyn C. Jones, Evelyn C. Tocco, Ashley N. Marshall, Tamara C. Valovich McLeod and Cailee E. Welch Bacon
Cameron Bolton, Sheri Hale and Todd Telemeco
is lack of literature examining the effects of the addition of TJM to a therapeutic exercise regimen on functional performance. Therefore, the purpose of our study is to examine the effects of TJM directed at the talocrural joint and the proximal and distal tibiofibular joints in conjunction with an
Carl R. Cramer
Rebecca J. Guthrie, Terry L. Grindstaff, Theodore Croy, Christopher D. Ingersoll and Susan A. Saliba
Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature.
To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP.
Randomized control trial.
University research laboratory.
51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification.
Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria.
Main Outcome Measures:
Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness.
There was not a significant increase in EO (F 1,47 = 0.44, P = .51) or IO (F 1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F 1,47 = 4.05, P = .05) group-by-time interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28).
A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant.
Jason S. Scibek and Christopher R. Carcia
The efficacy of a variety of noninvasive, conservative management techniques for calcific tendinopathy has been investigated and established for improving pain and function and/or facilitating a decrease in the size or presence of calcium deposits. Surprisingly, few have reported on the use of traditional therapeutic exercise and rehabilitation alone in the management of this condition, given the often spontaneous resorptive nature of calcium deposits. The purpose of this case is to present the results of a conservative approach, including therapeutic exercise, for the management of calcific tendinopathy of the supraspinatus, with an emphasis on patient outcomes.
The patient was a self-referred 41-y-old man with complaints of acute right-shoulder pain and difficulty sleeping. Imaging studies revealed liquefied calcium deposits in the right supraspinatus. The patient reported constant pain at rest (9/10) and tenderness in the area of the greater tuberosity. He exhibited a decrease in all shoulder motions and had reduced strength. The simple shoulder test (SST) revealed limited function (0/12). Conservative management included superficial modalities and medication for pain and a regimen of scapulothoracic and glenohumeral range-of-motion (ROM) and strengthening exercises.
At discharge, pain levels decreased to 0/10 and SST scores increased to 12/12. ROM was full in all planes, and resisted motion was strong and pain free. The patient was able to engage in endurance activities and continue practicing as a health care provider.
The outcomes with respect to pain, function, and patient satisfaction provide evidence to support the use of conservative therapeutic interventions when managing patients with acute cases of calcific tendinopathy. Successful management of calcific tendinopathy requires attention to outcomes and an understanding of the pathophysiology, prognostic factors, and physical interventions based on the current stage of the calcium deposits and the patient’s status in the healing continuum.
Mark A. Feger, Luke Donovan, C. Collin Herb, Geoffrey G. Handsfield, Silvia S. Blemker, Joseph M. Hart, Susan A. Saliba, Mark F. Abel, Joseph S. Park and Jay Hertel
related to muscle hypertrophy. Determining if hypertrophy occurs after rehabilitation and if it may be responsible for increases in measured force will allow for more informed decisions regarding the prescription of therapeutic exercise for the treatment of LAS and CAI. Analyzing muscle morphological