Dynamic Range Of Motion Research Articles

Longitudinal Study of the Six Degrees of Freedom Cervical Spine Range of Motion During Dynamic Flexion, Extension, and Rotation After Single-level Anterior Arthrodesis.

A longitudinal study using biplane radiography to measure in vivo intervertebral range of motion (ROM) during dynamic flexion/extension, and rotation. To longitudinally compare intervertebral maximal ROM and midrange motion in asymptomatic control subjects and single-level arthrodesis patients. In vitro studies consistently report that adjacent segment maximal ROM increases superior and inferior to cervical arthrodesis. Previous in vivo results have been conflicting, indicating that maximal ROM may or may not increase superior and/or inferior to the arthrodesis. There are no previous reports of midrange motion in arthrodesis patients and similar-aged controls. Eight single-level (C5/C6) anterior arthrodesis patients (tested 7 ± 1 months and 28 ± 6 months postsurgery) and six asymptomatic control subjects (tested twice, 58 ± 6 months apart) performed dynamic full ROM flexion/extension and axial rotation whereas biplane radiographs were collected at 30 images per second. A previously validated tracking process determined three-dimensional vertebral position from each pair of radiographs with submillimeter accuracy. The intervertebral maximal ROM and midrange motion in flexion/extension, rotation, lateral bending, and anterior-posterior translation were compared between test dates and between groups. Adjacent segment maximal ROM did not increase over time during flexion/extension, or rotation movements. Adjacent segment maximal rotational ROM was not significantly greater in arthrodesis patients than in corresponding motion segments of similar-aged controls. C4/C5 adjacent segment rotation during the midrange of head motion and maximal anterior-posterior translation were significantly greater in arthrodesis patients than in the corresponding motion segment in controls on the second test date. C5/C6 arthrodesis appears to significantly affect midrange, but not end-range, adjacent segment motions. The effects of arthrodesis on adjacent segment motion may be best evaluated by longitudinal studies that compare maximal and midrange adjacent segment motion to corresponding motion segments of similar-aged controls to determine if the adjacent segment motion is truly excessive. 3.

Passive hip movement measurements related to dynamic motion during gait in hip osteoarthritis.

Reduced sagittal plane range of motion (ROM) has been reported in individuals with hip osteoarthritis (OA) both during walking and passive testing. The purpose of this study was to determine if a relationship exists between hip extension ROM recorded during gait and passive hip extension ROM in individuals with moderate and severe hip OA, in comparison to an asymptomatic group. Sagittal plane hip ROM was calculated using skin surface marker trajectories captured during treadmill walking at self-selected speed. Passive hip ROM was measured using standardized position and recording procedures with a goniometer. Sagittal plane extension, flexion, and overall ROM were measured dynamically and passively. A two-way mixed model analysis of variance determined significant differences between groups and between passive and dynamic ROM (α = 0.05). Pearson correlations determined relationships between passive and dynamic ROM. Significant group by ROM interactions were found for flexion and extension ROM (p < 0.05). For extension, the severe OA group had less dynamic and passive ROM compared to the other groups and greater passive than dynamic ROM (p < 0.05). For flexion, significant differences in passive ROM existed between all three groups (p < 0.05) whereas no differences were found for dynamic flexion (p < 0.05). Significant correlations between dynamic and passive hip extension were found in the moderate (r = 0.596) and severe OA (r = 0.586) groups, and no correlation was found in the asymptomatic group (r = 0.139). Passive ROM explains variance in dynamic ROM measurements obtained during gait in individuals with moderate and severe hip OA which have implications for the design of treatment strategies targeting walking pathomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1790-1797, 2016.

EFFECTIVENESS OF ECCENTRIC TRAINING, DYNAMIC RANGE OF MOTION EXERCISES AND STATIC STRETCHING ON FLEXIBILITY OF HAMSTRING MUSCLE AMONG FOOTBALL PLAYERS

Background: Hamstring stretch is an important part of treatment programs aimed at decreasing the likelihood of hamstring injury. Few studies have examine the effect of eccentric training, static stretching and dynamic range of motion(DROM) exercise in improving hamstring flexibility this study compares the effect of eccentric training and static stretching in improving hamstring flexibility. The purpose of this study was to determine the effects of Eccentric training, Static stretching and Dynamic range of motion (DROM) exercise in improving hamstring flexibility and the second objective is find which technique is more effective in improving hamstring flexibility when compared with a control group. Study design is Experimental pre-test post-test design.Methods: 88 male subjects with limited hamstring flexibility were recruited for this study were assigned to four group. Group1 received eccentric training, group2 received dynamic range of motion exercise, group3 received static stretching and group4 was served as control group. Hamstring length was measured pre intervention and post intervention using a self-monitored active knee extension test.Results: Eccentric training, static stretching and dynamic range of motion exercise showed a significant increase in hamstring length between pre and post intervention. Following a between group analysis done by independent t test revealed a significant difference between group1 group2 and group3Conclusion: It is concluded that eccentric training, dynamic range of motion (DROM) exercise and static stretching groups improved hamstring flexibility.

Acute Effects of Different Agonist and Antagonist Stretching Arrangements on Static and Dynamic Range of Motion.

Background:Traditionally, stretching exercises are considered as basic components of warm up aiming to prepare the musculoskeletal system for performance and to prevent injuries.Objectives:The purpose of this study was to examine the effects of different agonist and antagonist stretching arrangements within a pre-exercise warm-up on hip static (SROM) and dynamic range of motion (DROM).Materials and Methods:Sixty trained male subjects (Mean ± SD: height, 177.38 ± 6.92 cm; body mass, 68.4 ± 10.22 kg; age, 21.52 ± 1.17 years) volunteered to participate in this study. SROM was measured by V-sit test and DROM captured by a motion analysis system before and after (i) static stretching for both hip flexor and extensor muscles (SFSE), (ii) dynamic stretching for both hip flexor and extensor muscles (DFDE), (iii) static stretching for the hip flexors and dynamic stretching for hip extensors (SFDE), and (iv) dynamic stretching for the hip flexors and static stretching for hip extensors (DFSE).Results:DFSE showed a significantly higher increase in DROM and SROM than the remainder of the stretching protocols (P < 0.05). There were significant differences between DFDE with SFSE and SFDE (P < 0.05) and SFSE showed significant increase as compared to SFDE (P < 0.05).Conclusions:In conclusion, DFSE is probably the best stretching arrangement due to producing more post activation potentiation on agonist muscles and less muscle stiffness in antagonist muscles.

Acute bouts of upper and lower body static and dynamic stretching increase non-local joint range of motion.

There are conflicts in the literature concerning the crossover or non-local effects of stretching. The objective of this study was to evaluate whether static (SS) and dynamic (DS) stretching of the shoulders would affect hip flexor range of motion (ROM) and performance and reciprocally whether SS and DS of the lower body would affect shoulder extension ROM and performance. A randomized crossover study design examined the acute effects of upper and lower body SS and DS on lower and upper body performance measures, respectively. Experimental sessions included upper and lower body control tests, upper body (shoulder horizontal abduction) SS and lower body (hip abduction) SS, upper body (shoulder horizontal abduction and adduction) DS and lower body DS (hip abduction and adduction). Passive static and dynamic ROM (hip flexion, shoulder extension), leg flexor and elbow flexor maximal voluntary contraction isometric force, fatigue endurance and electromyography were measured. There were significant shoulder ROM increases following lower body SS (P < 0.010, ∆% = 8.2%) and DS (P < 0.019, ∆% = 9%). There was a significant hip flexor ROM (P < 0.016, ∆% = 5.2%) increase following upper body SS. There were no significant main effects or interactions for dynamic ROM or muscle force and activation variables. The lack of stretch-induced force and fatigue changes suggests that rather than a mechanical or neural drive mechanism, an enhanced stretch tolerance was likely the significant factor in the improved ROM.

Acute changes in glenohumeral range-of-motion following in-season minor league pitching starts

Background. Asymmetric glenohumeral range-of-motion (ROM) between the throwing and non-throwing arms of overhead athletes has been well described in the literature. Thresholds of internal rotation (IR) loss have been associated with throwing arm injury in baseball players. Acute changes in shoulder ROM following an individual pitching appearance remain poorly understood. Objectives: To determine the acute change of external rotation (ER), IR, and total arc-of-motion (TAM) in minor league starting pitchers immediately following an in-season starting pitching appearance. Methods. Nine minor league starting pitchers participated in the study with data collected for 22 individual starts. IR, ER and TAM were measured in the throwing shoulder and non-throwing shoulder at three time points for each appearance: before, immediately following, and at 24 hours following the pitching appearance. Results. In the throwing arm, IR significantly decreased (49.4 vs 46.0, p = 0.037) immediately after pitching, and ER significantly increased immediately following an appearance (150.7 vs 153.6, p = 0.030) and at 24 hours (150.7 vs 154.0, p = 0.028). No difference was detected in throwing arm TAM and IR at 24 hours, or TAM immediately following an appearance. Conclusions. Minor league pitchers demonstrate the dynamic glenohumeral ROM changes after starting appearances of increased ER and diminished IR with maintenance of TAM. At 24 hours, the observed loss of IR had resolved, whereas the gains in ER remained present. Our study supports the need to further assess the acute changes of glenohumeral ROM in pitchers, and the association of acute glenohumeral ROM change with the development of pathologic ROM profiles and injury.

Preoperative factors associated with postoperative gait kinematics and kinetics after total hip arthroplasty

To determine how patient factors: age, sex, body mass index (BMI), clinical scores and physical exam findings, are associated with gait recovery after total hip arthroplasty (THA). 145 subjects, who were evaluated with standard gait analysis, the Harris Hip Score (HHS), and a physical exam including passive range of motion (ROM), hip abductor strength assessment, before and after primary unilateral THA, were identified from an IRB-approved repository. Sagittal plane dynamic ROM and 3D peak external moments were averaged from operated-side normal-speed trials at each visit. We used linear regression analysis to evaluate the association among preoperative clinical factors and postoperative gait, with and without controlling for the influence of preoperative gait variables. Sagittal and transverse plane moments, and the peak abduction moment seen in early stance, significantly improved after THA (p < 0.001, effect size d = 0.22-1.04). The peak adduction moment did not change significantly (p = 0.646), although the change ranged from -2.7 to + 4.0 %Body weight × height (-80% to +315%). Preoperative gait, clinical factors and patient characteristics predicted up to 33% of the variability in postoperative gait. Notably, greater preoperative abductor strength was associated with higher postoperative adduction and external rotation moments (R = 0.197-0.266, p < 0.05) after adjusting for age, sex, BMI and preoperative gait. Preoperative clinical factors predicted several specific aspects of objectively-characterized postoperative gait function. Physical exam findings can augment the predictive ability of clinical outcome measures, and potentially help guide rehabilitation plans.

Effects of compression at myofascial trigger points in patients with acute low back pain: A randomized controlled trial.

Although there is some evidence that massage therapy, especially compression at myofascial trigger points (MTrPs), is effective for sub-acute and chronic low back pain, the effectiveness of massage therapy with compression at MTrPs for acute low back pain has not been studied. To evaluate the effectiveness of compression at MTrPs for acute low back pain, 63 patients with acute low back pain were randomly assigned to one of three groups: the MTrP group who received compression at MTrPs (N=23), the non-MTrP group who received compression at non-trigger points (N=21), and the effleurage massage group who received superficial massage (N=19). The patients received the assigned treatment 3 times/week for 2weeks. The subjective pain intensity in static and dynamic conditions and disability caused by low back pain were measured by the visual analogue scale (VAS) and Roland-Morris questionnaire (RMQ), respectively; along with the range of motion (ROM) at the lumbar region and pressure pain threshold (PPT) at trigger points before treatment (baseline), 1week after the start of treatment, and 1month after the end of treatment (follow-up). Static and dynamic VAS score, PPT and ROM were significantly improved in the MTrP group compared with those in the non-MTrP and effleurage groups. These results indicate that compression at MTrPs is effective to treat acute low back pain compared with compression at non-MTrPs and superficial massage. For this article, a commentary is available at the Wiley Online Library.

1C3-5 Identifying human property measurements for user-centered design based on user scenarios

User-centered design (UCD) gives extensive attention to human's physical, cognitive, and psychological characteristics at every stage of the product and service design process. Most of human property measurements currently available in UCD are limited to the physical body dimensions such as length or girth of a particular body part. This study aims to derive new concepts of human property measurements such as perceptional and cognitive characteristics from user scenarios. User scenarios were generated by combining factor levels, each belong to three factors such as user profile, user state, and environment. A total of 60 user scenarios were created and analyzed to derive relevant human property measurements, for example, sensory ability (visual/auditory/tactile), dynamic range of motion, and emotional/mental state, etc. The results demonstrated that various human property measurements could be efficiently derived from the user scenarios, without resorting to cost/time-consuming methods such as an observation and interview. The list of human property measurements derived in this study would be systematically measured and disseminated to be used for designing user-centered products and services in the further research.

Foam Rolling as a Recovery Tool after an Intense Bout of Physical Activity

The objective of this study is to understand the effectiveness of foam rolling (FR) as a recovery tool after exercise-induced muscle damage, analyzing thigh girth, muscle soreness, range of motion (ROM), evoked and voluntary contractile properties, vertical jump, perceived pain while FR, and force placed on the foam roller. Twenty male subjects (≥3 yr of strength training experience) were randomly assigned into the control (n = 10) or FR (n = 10) group. All the subjects followed the same testing protocol. The subjects participated in five testing sessions: 1) orientation and one-repetition maximum back squat, 2) pretest measurements, 10 × 10 squat protocol, and POST-0 (posttest 0) measurements, along with measurements at 3) POST-24, 4) POST-48, and 5) POST-72. The only between-group difference was that the FR group performed a 20-min FR exercise protocol at the end of each testing session (POST-0, POST-24, and POST-48). FR substantially reduced muscle soreness at all time points while substantially improving ROM. FR negatively affected evoked contractile properties with the exception of half relaxation time and electromechanical delay (EMD), with FR substantially improving EMD. Voluntary contractile properties showed no substantial between-group differences for all measurements besides voluntary muscle activation and vertical jump, with FR substantially improving muscle activation at all time points and vertical jump at POST-48. When performing the five FR exercises, measurements of the subjects' force placed on the foam roller and perceived pain while FR ranged between 26 and 46 kg (32%-55% body weight) and 2.5 and 7.5 points, respectively. The most important findings of the present study were that FR was beneficial in attenuating muscle soreness while improving vertical jump height, muscle activation, and passive and dynamic ROM in comparison with control. FR negatively affected several evoked contractile properties of the muscle, except for half relaxation time and EMD, indicating that FR benefits are primarily accrued through neural responses and connective tissue.

Cervical arthroplasty for moderate to severe disc degeneration: clinical and radiological assessments after a minimum follow-up of 18 months--Pfirrmann grade and cervical arthroplasty.

PurposeClinical outcomes and radiologic results after cervical arthroplasty have been reported in many articles, yet relatively few studies after cervical arthroplasty have been conducted in severe degenerative cervical disc disease.Materials and MethodsSixty patients who underwent cervical arthroplasty (Mobi-C®) between April 2006 and November 2011 with a minimum follow-up of 18 months were enrolled in this study. Patients were divided into two groups according to Pfirrmann classification on preoperative cervical MR images: group A (Pfirrmann disc grade III, n=38) and group B (Pfirrmann disc grades IV or V, n=22). Visual analogue scale (VAS) scores of neck and arm pain, modified Oswestry Disability Index (mODI) score, and radiological results including cervical range of motion (ROM) were assessed before and after surgery.ResultsVAS and mean mODI scores decreased after surgery from 5.1 and 57.6 to 2.7 and 31.5 in group A and from 6.1 and 59.9 to 3.7 and 38.4 in group B, respectively. In both groups, VAS and mODI scores significantly improved postoperatively (p<0.001), although no significant intergroup differences were found. Also, cervical dynamic ROM was preserved or gradually improved up to 18 months after cervical arthroplasty in both groups. Global, segmental and adjacent ROM was similar for both groups during follow-up. No cases of device subsidence or extrusion were recorded.ConclusionClinical and radiological results following cervical arthroplasty in patients with severe degenerative cervical disc disease were no different from those in patients with mild degenerative cervical disc disease after 18 months of follow-up.

Protective effects of preserving the posterior complex on the development of adjacent-segment degeneration after lumbar fusion

During the past decades, lumbar fusion has increasingly become a standard treatment for degenerative spinal disorders. However, it has also been associated with an increased incidence of adjacent-segment degeneration (ASD). Previous studies have reported less ASD in anterior fusion surgeries; thus, the authors hypothesized that the integrity of the posterior complex plays an important role in ASD. This study was designed to investigate the effect of the posterior complex on adjacent instability after lumbar instrumentation and the development of ASD. To evaluate different surgical interventions, 120 patients were randomly allocated into 3 groups of 40 patients each who were statistically similar with respect to demographic and clinical data. Patients in Group A were allocated for facet joint resection and L4-5 fusion, Group B for semilaminectomy and fusion, and Group C for complete laminectomy and fusion. All of the patients were followed up for 5-7 years (mean 5.9 years). The disc height, intervertebral disc angle, dynamic intervertebral angular range of motion (ROM), L3-4 slip, and the total lordosis angle were each measured before the operation and at the final follow-up. The Japanese Orthopaedic Association (JOA) score was determined before surgery and at the final follow-up to evaluate the clinical results. Among the 3 groups, no significant differences were detected in all clinical and demographic assessments before surgery. At 3 months after surgery, the JOA score of all groups improved significantly and showed no significant differences among the groups. At the final follow-up, Group C had a significantly (p < 0.05) lower JOA score than the other 2 groups. Moreover, the disc height and total lumbar lordosis in patients of Group C were significantly decreased compared with disc height and total lumbar lordosis in the other 2 groups. In contrast, disc angle, dynamic angular ROM, and listhesis were significantly higher in Group C than in the other 2 groups. Twenty-four patients showed signs of ASD after the operation (3 patients in Group A, 4 in B, and 17 in C). The number of patients in Group C showing ASD was significantly different from that in Groups A and B. During follow-up for 6 years, a significantly higher number of patients with ASD were noted in the complete-laminectomy group. The number of reoperations for treating ASD was much higher in this patient group than in the patients undergoing facet joint resection and L4-5 fusion or semilaminectomy and fusion. Therefore, preserving the posterior complex as much as possible during surgery plays an important role in preventing ASD and in reducing the reoperation rate.

Kinematics Analysis: The Acute Effect of Different Stretching Methods on Dynamic Range of Motion of Lower Extremity Joints during Soccer Instep Kicking

The purpose of this study was to examine the effects of static and dynamic stretching within a pre-exercise warm-up on angular displacement identified as dynamic range of motion (DROM) of hip, knee, and ankle joints during instep kicking in less and more experienced soccer players. The kicking motions of dominant legs were captured from fifteen professional adult male soccer players using 6 infrared cameras at 200 Hz. Lower extremity joints DROM at instep kicking phases after different warm-ups protocols consisting of static, dynamic stretching, and no stretching, captured to analysing. Less experienced players showed significant differences in DROM after the dynamic stretching compared with the static stretching relative to the no stretching method in hip and knee joints. More experienced players showed significant difference in DROM after the dynamic stretching compared with the static stretching relative to the no stretching method in hip, knee, and ankle joints. There was no significant difference in DROM between less and more experienced after the dynamic stretching and also after with the static stretching relative to the no stretching method. We concluded that dynamic stretching during warm-ups, as compared to static stretching, is probably most effective as preparation for the DROM required in soccer.

Effect of body position and type of stretching on hamstring flexibility

Background and objective: Stretching exercise protocols, as part of outpatient treatment or home exercise programs, are used to improve muscle flexibility. So, the aim of the study was to examine the body position effect (standing and supine) and dynamic range of motion (DROM) stretching technique on hamstring flexibility. Material and Methods: Seventy five subjects with decreased flexibility of hamstring (defined as ≥30° loss of active knee extension, from 90°hip flexion position), participants were randomly assigned to one of three equal groups. The first group performed static stretch from standing for 30 sec. The second group performed static stretch from supine for 30 sec. The third group performed DROM stretch. The stretching procedure conducted three times per week for four weeks. Results: There was a significant increase in the knee extension range of motion for standing, supine and DROM stretch (p 0.05). Conclusion: Both standing and supine stretches displayed improvement in the hamstring flexibility, and both of them produced higher improvement than DROM stretch during hamstring flexibility training

Effects of a 4-Week Dynamic-Balance-Training Program Supplemented With Graston Instrument-Assisted Soft-Tissue Mobilization for Chronic Ankle Instability

A dynamic-balance-training (DBT) program supplemented with the Graston instrument-assisted soft-tissue mobilization (GISTM) technique has not been evaluated collectively as a treatment in subjects with chronic ankle instability (CAI). To examine the effects of GISTM in conjunction with a DBT program on outcomes associated with CAI, including pain and disability, range of motion (ROM), and dynamic postural control. Pretest/posttest, repeated measures. High school and a Division I mid-Atlantic university. Thirty-six healthy, physically active individuals (5 female, 31 male; age 17.7 ± 1.9 y; height 175.3 ± 14.6 cm) with a history of CAI as determined by an ankle-instability questionnaire volunteered to be in this study. Subjects were randomly assigned to 1 of 3 intervention groups: both treatments (DBT/GISTM, n = 13), DBT and a sham GISTM treatment (DBT/GISTM-S, n = 12), or DBT and control-no GISTM (DBT/C, n = 11). All groups participated in a 4-wk DBT program consisting of low-impact and dynamic activities that was progressed from week to week. The DBT/GISTM and DBT/GISTM-S groups received the GISTM treatment or sham treatment twice a week for 8 min before performing the DBT program. Pretest and posttest measurements included the Foot and Ankle Ability Measure (FAAM), FAAM Sport, the visual analog scale (VAS), ankle ROM in 4 directions, and the Star Excursion Balance Test (SEBT) in 3 directions. FAAM and FAAM-Sport scores, VAS, goniometric ROM (plantar flexion, dorsiflexion, inversion, eversion), and SEBT (anterior, posteromedial, posterolateral). Subjects in all groups posttest demonstrated an increase in FAAM, FAAM Sport, ROM, and SEBT in all directions but not in VAS, which decreased. No other results were significant. For subjects with CAI, dynamic postural control, ROM, pain and disability improved pretest to posttest regardless of group membership, with the largest effects found in most measures in the DBT/GISTM group.

Determination of the dynamic knee joint range of motion during leg extension exercise using an EMG-driven model

In this study, we proposed a new approach for determining the dynamic knee joint range of motion according to the external load applied during leg extension exercise. One elderly participant volunteered. The dynamometer task was performed to develop a subject-specific model using maximum voluntary contractions. EMG signals were also measured simultaneously. After the dynamometer task, 3D motion data were captured during leg extension exercise. The data obtained from the dynamometer task were used to develop the subject-specific model using an EMG-driven model, and then the developed model was used to estimate joint moment during leg extension exercise. Adjusting the model parameters positively affected the correlation and RMS error. The correlation between the model prediction and the measured joint moment increased with decreasing RMS error. The predicted knee joint moments during the leg extension exercise showed the usual inverse parabolic shapes in terms of time. These results implied that the dynamic range of motion should vary according to the external load applied to the joint. In this paper, we proposed a novel method to determine the dynamic knee joint range of motion using an EMG-driven model. We expect that the proposed approach will be employed to design exercise/rehabilitation protocols for the elderly.

Acute Effect of Static and Dynamic Stretching on Hip Dynamic Range of Motion During Instep Kicking in Professional Soccer Players

The purpose of this study was to examine the effects of static and dynamic stretching within a pre-exercise warm-up on hip dynamic range of motion (DROM) during instep kicking in professional soccer players. The kicking motions of dominant legs were captured from 18 professional adult male soccer players (height: 180.38 ± 7.34 cm; mass: 69.77 ± 9.73 kg; age: 19.22 ± 1.83 years) using 4 3-dimensional digital video cameras at 50 Hz. Hip DROM at backward, forward, and follow-through phases (instep kick phases) after different warm-up protocols consisting of static, dynamic, and no-stretching on 3 nonconsecutive test days were captured for analysis. During the backswing phase, there was no difference in DROM after the dynamic stretching compared with the static stretching relative to the no-stretching method. There was a significant difference in DROM after the dynamic stretching compared with the static stretching relative to the no-stretching method during (a) the forward phase with p < 0.03, (b) the follow-through phase with p < 0.01, and (c) all phases with p < 0.01. We concluded that professional soccer players can perform a higher DROM of the hip joint during the instep kick after dynamic stretching incorporated in warm-ups, hence increasing the chances of scoring and injury prevention during soccer games.

Effects of a 4-Week Dynamic Balance-Training Program Supplemented with Graston Instrumented-Assisted Soft Tissue Mobilization for Chronic Ankle Instability

A dynamic balance training program (DPT) and Graston Instrumented-Assisted Soft Tissue Mobilization (GISTM) technique are interventions that have been implemented as treatment options for chronic ankle instability (CAI). Although both have been evaluated individually, there are no published reports with the two treatments combined in a population with CAI. PURPOSE: To investigate the effects of a dynamic balance training program with GISTM technique on improving dynamic postural control, range of motion, pain and disability in subjects with CAI. METHODS: Thirty-six healthy, physically active individuals (5 female, 31 male; age= 17.7±1.9 yrs; ht=175.3±14.6 cm) with a history of CAI as determined by an Instability Questionnaire and orthopedic special tests volunteered to be in this study. Subjects were randomly assigned to three groups: both treatments (DBT/GISTM, n=13), DBT and a sham GISTM treatment (DBT/GISTM-S, n=12), or DBT and control- no GISTM (DBT/C, n=11). All groups participated in a 4-week DBT program consisting of low impact and dynamic activities that was progressed from week to week. The DBT/GISTM and DBT/GISTM-S groups received the GISTM treatment or sham treatment twice a week for 8 minutes before performing the DBT program. Pre- and Post-test measurements included the Foot and Ankle Ability Measures (FAAM), FAAM Sport, the Visual Analog Scale (VAS), ankle range of motion (ROM) in four movements, and the Star Excursion Balance Test (SEBT) in three directions. RESULTS: Subjects in all groups demonstrated differences between pre to post-test with post-test results showing improvement for disability (FAAM, P<0.001 and FAAM Sport, P<0.001) and pain (VAS, P<0.001). ROM improvements were noted for plantarflexion (P=0.001), inversion (P<0.001) and eversion (P<0.001) and SEBT in the direction of anterior (P<0.001), posteromedial (P<0.001) and posterolateral (P<0.001) pre to post-test as well. The ranges with percent change scores for groups were disability (10.4%-30.6%), pain (87.2%-100%), ROM (0% to 44.9%), and SEBT (5.7% to 17.4%). No other results were significant, especially differences between groups. CONCLUSIONS: Dynamic postural control, ROM, pain and disability improved pre to post-test for subjects with CAI following a 4-week dynamic balance-training program with GISTM.

The Influence of Ankle Taping on Selected Lower Extremity Kinematics During Treadmill Running

Extensive research addressing prophylactic ankle taping has been conducted related to static ankle ROM before and after exercise sessions and frontal plane kinematics of the ankle (i.e. inversion and eversion). It has been noted that static and to a certain extent dynamic ankle range of motion (ROM) have been altered when the ankle was taped. However, the effect of a prophylactic ankle taping application on lower extremity (LE) kinematics, specifically the hip and the knee, has not been investigated thoroughly. PURPOSE: The primary purpose of this study was to examine LE kinematics while ankle ROM has been restricted by a basic prophylactic ankle taping application. The secondary purpose was to examine static ROM measures before and after the run in a subset of the sample. METHODS: Twelve recreational runners, 3 males and 9 females, (mean age = 31.3 ± 8.0 yrs; mass = 61.8 ± 9.4 kg; height = 158.0 ± 28.3 cm; BMI = 22.2 ± 2.7 kg/m2) volunteered to complete two 20 min treadmill running sessions (tape and no tape) at their own pace. The order of the trials was counter-balanced. Prior to the run, seven reflective markers were placed along bony prominences on the right side of the body (5th metatarsal, heel, lateral malleolus, lateral condyle of the femur, greater trochantar, and acromion process). Two-dimensional kinematic data (60 Hz) from the sagittal plane were analyzed for three gait cycles that were captured at 2:30, 9:30, 17:30, and 20 min into the run. The variables analyzed were stride rate (SR), stride length (SL), ground contact time (GC), LE joint ROM and angles at heel-strike (HS) and toe-off (TO). Static ankle ROM measures were obtained on four subjects before and after each run. The data were analyzed using an ANOVA with repeated measures. RESULTS: There was a significant condition-by-time interaction for the hip angle at TO (p = .01); however, the interactions for the ankle and hip at TO were not significant. The interactions for SR, SL, GC, LE joint angles at HS and ROM were not significant. There was a trend for hip ROM to decrease over time during the taped condition (p = .08) and the ankle angle tended to decrease during TO when it was taped. There was not a statistical interaction for static ROM measurements. There was a significant effect for condition (p = .04) and static ROM of the ankle was significantly reduced during the taped trial. CONCLUSION: At push-off the hip angle continued to decrease during the taped condition, which resulted in a trend for less ROM at the hip. LE joint angles at HS, SR, SL, and GC were not affected by taping. Taping the ankle did significantly decrease static ROM of the ankle. Further qualitative kinematic examination of each subject's data suggested that certain individuals expressed changes in the LE (i.e. joint angles and ROM) when the ankle was taped compared to when the ankle was not taped. It is not clear as to why the taping application had this effect on certain subjects. PRACTICAL APPLICATION: Since prophylactic taping applications are widely used within sporting events it is important to consider the effects on the rest of the kinetic chain as well as its protective integrity. The dynamic ROM of the ankle was within the functional mid-range of the static ROM even when the ankle was taped. Thus, there was no significant impact on the kinetic chain by limiting the end ROM of the ankle through a prophylactic taping application.

Videoradiographic analysis of the range of motion in unilateral experimental knee joint arthritis in rats

IntroductionThe translational and predictive value of animal models highly depends on the validity of respective readout parameters. In arthritis research, there has been a shift from sole threshold testing for pain-related behavior, as well as from swelling and histology assessment for inflammation, toward an analysis of joint function as indicated, for instance, by an increasing number of studies on gait abnormalities. Clinically, the range of motion (ROM) of the affected joint plays a major role in diagnosis and the assessment of treatment benefits. This parameter, however, is only insufficiently detected by currently used analytic systems in animals.MethodsHere we used high-resolution videoradiographic analysis to assess ROM in experimental knee joint arthritis in rats. This parameter is described during the 21-day course of antigen-induced arthritis in rats. Furthermore, the therapeutic effects of antinociceptive (morphine) and anti-inflammatory (dexamethasone) treatment on ROM are documented. To obtain additional information on the implications of ROM in animal models, correlations were performed to measure pain-related behavior and inflammation.ResultsThe study animals showed a significant reduction in ROM of the inflamed knee joint in the acute phase of arthritis. This was accompanied by an increase in knee joint movement on the contralateral side, indicating a compensational mechanism. Both morphine and dexamethasone treatment increased and thus normalized ROM. Changes in ROM were further stage-dependently correlated with weight bearing and joint swelling, that is, with both pain-related behavior and signs of inflammation.ConclusionsThe dynamic ROM observed in freely moving rats in our model of knee joint arthritis might serve as a parameter for global disease activity and might thus represent a promising readout parameter for preclinical assessment regarding the overall efficacy not only of antiarthritic but also of antinociceptive compounds.