Lower Extremity Range Of Motion Research Articles

Correlation Between Functional Ability and Great Toe Flexor Strength in Young Adults

Background: Functional ability refers to the capacity to perform daily tasks efficiently, which relies on maintaining balance and stability. Balance is essential for keeping the body’s center of gravity aligned over a stable base and is supported by the coordination of the vestibular, visual, proprioceptive, and musculoskeletal systems. Factors such as proprioception, muscle strength, and lower extremity range of motion significantly impact functional ability. Toe flexor muscles play a vital role in providing the necessary force for anterior-posterior stability, especially when leaning forward, and contribute to the proprioceptive feedback loop that is essential for maintaining balance. Objective: To find correlation between functional ability and great toe flexor strength in young adults. Methodology: 12 male and female young adults with normal BMI were selected for the study. functional ability was measured using Functional Reach Test, great toe flexor strength was assessed using Pinch Guage Dynamometer. Karl Pearson’s Correlation Coefficient was used for statistical analysis, with a p value < 0.05 considered as significant. Result: Statistically significant strong correlation was found between Functional Reach Test score and great toe flexor strength ( r = 0.887, p=0.035) suggesting that higher the great toe flexion strength higher the functional ability score. Conclusion: This study conluded that an increase in great toe flexor strength is associated With Improved Functional Ability In Young Adults.

The relationship between lower extremity range of motion and dynamic balance

<p>目的：本研究欲探討，青少年運動員下肢關節活動度與動態平衡表現的相關性，以及兩者在測量表現上的差異。方法：招募 20 名國高中男性運動員，測量下肢髖關節及踝關節活動度、改良版星狀偏移平衡測試 (modified star excursion balance test, mSEBT) 和 Y 字平衡測試 (Y balance test, YBT)。以皮爾森積差相關係數，比較慣用腳 mSEBT、YBT 與下肢關節活動度之相關性。透過多元迴歸分析，分析下肢關節活動度對 mSEBT 和 YBT 的預測性，以成對樣本 t 檢定比較 mSEBT 和 YBT 之差異。結果：mSEBT 與踝背屈、髖外展和髖外轉活動度呈顯著正相關，前側以踝背屈活動度解釋力最大 (R2 ＝ .506)，後內側 (R2 ＝ .544) 和後外側 (R2 ＝ .399) 以髖外轉活動度解釋力最大。YBT 前側與踝背屈活動度 (r ＝ .519，p < .05)；YBT後外側與髖外轉活動度 (r ＝ .561，p < .05)；YBT後內側與髖外展活動度 (r ＝ .558，p < .05) 呈顯著正相關。mSEBT 和 YBT 在 3 個方向上皆有中至高度相關 (r = .473 - .736，p < .05)，測量距離在前側、後外側和總分達顯著差異。結論：mSEBT 受多關節活動度影響，而 YBT 僅和單一關節活動度有關。mSEBT 和 YBT 雖有中至高度相關，但測量距離表現上並不相同。日後實驗設計及臨床應用上，應考量測試之差異，針對受試者的動態平衡能力，選擇適合的評估方法。</p> <p> </p><p>Purpose: To examine the relationships of lower extremity range of motion (ROM), modified star excursion balance test (mSEBT) and Y balance test (YBT) and to compare the differences between mSEBT and YBT. Methods: Twenty adolescent high school male athletes were recruited to measure hip ROM, ankle ROM, mSEBT, and YBT. Pearson’s product-moment correlation coefficient were used to analyze the relationship between lower extremity ROM and dynamic balance. Multiple regression analysis were used to determine the predictors in explaining the variance to dynamic balance outcomes. Paired t test was used to compare the differences between mSEBT and YBT. Results: mSEBT was significantly correlated with ankle dorsiflexion, hip abduction and hip external rotation ROM. Ankle dorsiflexion ROM was the strongest predictor for anterior direction (R2 ＝ .506). Hip external rotation ROM was the strongest predictor for posteromedial direction (R2 ＝ .544) and posterolateral direction (R2 ＝ .399). Anterior YBT was correlated with ankle dorsiflexion ROM (r ＝ .519, p < .05). Posterolateral YBT was correlated with hip external rotation ROM (r ＝ .561, p < .05), and posteromedial YBT was correlated with hip abduction ROM (r ＝ .558, p < .05). There were significant correlations in all three directions between mSEBT and YBT (r = .473 - .736, p < .05). Conclusion: There were significant differences in anterior, posterolateral and composite performance between YBT and mSEBT. mSEBT performance was affected by multi-joint ROM and YBT performance was affected by single-joint ROM. Even though mSEBT and YBT were highly correlated, the absolutely reach distances are different. Future works should consider the differences between two dynamic balance measures and select the proper tool while examining dynamic balance in different sports.</p> <p> </p>

Gait Performance and Brain Activity Are Improved by Gait Automatization during Robot-Assisted Gait Training in Patients with Burns: A Prospective, Randomized, Single-Blinded Study.

Background: Patients with lower extremity burn injuries have decreased gait function. Gait dysfunctions are compensated by activation of executive areas such as the prefrontal cortex (PFC). Although robot-assisted gait training (RAGT) can improve gait function, the training mechanisms of RAGT are unknown. We aimed to determine the clinical effects of RAGT in patients with burns and investigate their underlying mechanisms. Methods: This single-blind, randomized controlled trial involved 54 patients with lower extremity burns. The RAGT group underwent RAGT using SUBAR® and conventional training. The control (CON) group underwent only conventional training. The primary outcome was cortical activity measured using a functional near-infrared spectroscopy device before and after 8 weeks of training to confirm the compensatory effect of gait dysfunction. The secondary outcomes were the functional ambulation category (FAC) to evaluate gait performance, 6-min walking test (6 MWT) distance to measure gait speed, isometric force and range of motion (ROM) of lower extremities to evaluate physical function, and the visual analog scale (VAS) score to evaluate subjective pain during gait. Results: PFC activation during the gait phase in the RAGT group decreased significantly compared with that of the CON. The VAS score decreased and FAC score improved after 8 weeks of training in both groups. The 6 MWT scores, isometric strengths (the left knee flexor and bilateral ankle plantar flexors), and the ROMs (the extensions of bilateral hip and bilateral knee) of the RAGT group were significantly improved compared with those of the CON. RAGT improved gait speed, lower extremity ROMs, and lower extremity muscles strengths in patients with burns. Conclusions: The improvement in gait speed and cerebral blood flow evaluation results suggests that the automatization of gait is related to the treatment mechanism during RAGT.

Comparison of the Conjunct Effects of Electrical Stimulation and Whole-Body Vibration Therapy with Transcranial Direct Current Stimulation and Whole-body Vibration Therapy on Balance and Function in Children With Spastic Cerebral Palsy.

Cerebral palsy is a neurodevelopmental condition that results in impaired movement and posture, often accompanied by disturbances in balance and functional abilities. Recent advances in neurorehabilitation, including whole-body vibration therapy (WBVT), functional electrical stimulation, and transcranial direct current stimulation, show promise in enhancing traditional interventions and fostering neuroplasticity. However, the efficacy of their conjunct effects remains largely uncharted territory and warrants further exploration. The objective of the study was to compare the conjunct effects of functional electrical stimulation (FES) and WBVT with transcranial direct current stimulation (tDCS) and WBVT on lower extremity range of motion (ROM), dynamic balance, functional mobility, isometric muscle strength and hand grip strength in children with spastic cerebral palsy. A randomized clinical trial was carried out on 42 children of both genders with spastic cerebral palsy, aged 5-15 years. The childrenwere dividedat random into three groups (14 in each group).In Group A, there were three (21.42%) males and 11 (78.57%) females, in Group B, eight (57.14%) were males and six (42.85%) were females, and in Group C, six (42.85%) children were males and eight (57.14%) were females. Group A received WBVT only, Group B received WBVT and FES, and Group C received WBVT and tDCS. The intervention was applied four times a week for four consecutive weeks. The data was collected two times before and immediatelyafter four weeks of intervention. Lower extremity ROM was measured by a goniometer, functional mobility or dynamic balance was measured by a Time Up and Go test, isometric muscle strength was measured by a digital force gauge, and hand grip strength was assessed by a digital hand-held dynamometer. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was utilized for statistical analysis. The mean age of the children in groups A, B, and C was 12.21±2.11 years, 11.71±2.01, and 11.07±2.01 years respectively. Intergroup analysis revealed a statistically significant difference (p<0.05) in the lower extremity range of motion, and functional mobility. Hand grip strength and isometric muscle strength between three groups. Post hoc analysis revealed that WBVT with transcranial direct current stimulation combined showed the most improvement. The study concluded that positive effects were seen in all three groups but tDCS with WBVT was found to be most effective in improving lower extremity ROM, functional mobility or dynamic balance, isometric muscle strength, and hand grip strength in children with spastic CP. The differences between the groups were statistically significant. The effect size was substantial enough to surpass established clinical benchmarks, indicating that the observed improvements are likely to have meaningful and beneficial impacts on patient outcomes.

Preseason lower extremity range of motion, flexibility, and strength in relation to in-season injuries in NCAA division I gymnasts

ABSTRACT Objectives To determine if preseason lower extremity ROM, flexibility, and strength differ in collegiate gymnasts (NCAA Division 1) who do or do not sustain an injury during the competitive season. Methods Over four seasons, a total of 15 female gymnasts (age = 20.5 ± 1.0 years) underwent preseason screening (30 gymnast-season). We tested joint ROM (hip: flexion, internal and external rotation; ankle: weightbearing dorsiflexion), muscle flexibility (passive straight leg raise, Thomas,’ Ober’s, Ely’s tests) and strength (hip extensors, abductors, and flexors isometric strength via a handheld dynamometer; knee: quadriceps and hamstring isokinetic strength at 60°/sec). The team athletic trainer tracked overuse lower extremity injuries (restricted gymnasts from full participation, occurred as from participation in organized practice or competition, and required medical attention) during each season. For athletes that tested multiple seasons, each encounter was considered independent, and each preseason assessment was linked to overuse injuries sustained during the same competitive season. Gymnasts were dichotomized into injured and non-injured groups. An independent t-test was used to measure differences in preseason outcomes between injured and non-injured groups. Results During four years, we recorded 23 overuse lower extremity injuries. Gymnasts that sustained an in-season overuse injury demonstrated significantly lower hip flexion ROM (mean difference: −10.6°; 95% confidence interval: −16.5, −4.6; p < 0.01) and lower hip abduction strength (mean difference: −4.7% of body weight; 95% confidence interval: −9.2, −0.3; p = 0.04). Conclusion Gymnasts who sustain an in-season overuse lower extremity injury have significant preseason deficit of hip flexion ROM and weakness in the hip abductors. These findings indicate potential impairments in the kinematic & kinetic chains responsible for skill performance and energy absorption during landing.

Baseline Range of Motion, Strength, Motor Function, and Participation in Youth with Hutchinson-Gilford Progeria Syndrome

Aims Limited information is available on impairments, activity limitations and participation restrictions in youth with Hutchinson-Gilford progeria syndrome (HGPS), a rare genetic premature aging disease. The purposes were to: (1) describe range of motion (ROM), grip, pinch and quadriceps strength, functional balance, walking endurance, and gross motor limitations and participation restrictions; (2) evaluate the association between ROM impairments and age; and (3) evaluate the association between the Gross Motor Function Measure-88 (GMFM) scores and lower extremity (LE) ROM, quadriceps strength, and age. Methods Upper and LE ROM, grip, pinch and quadriceps strength, Timed Up and Go (TUG), Six Minute Walk Test, GMFM-88, and Canadian Occupational Performance Measure data were recorded for 38 participants with HGPS. Results All youth exhibited ROM impairments and most displayed decreased grip and pinch strength, walking endurance, and gross motor skills when compared to same-aged peers. However, the majority had good functional balance with TUG scores in the normal range. Participation restrictions included difficulty keeping up with peers when walking and difficulty completing activities of daily living. Some ROM measurements were negatively associated with age indicating that older participants had more extensive ROM limitation than younger participants. Conclusions Physical and occupational therapists can use this information when evaluating youth with HGPS, designing a plan of care, and providing treatment interventions.

An Evidence-based Physical Therapy Prescription for Adults With X-linked Hypophosphatemia.

ContextX-linked hypophosphatemia (XLH) is a rare and progressive metabolic phosphate-wasting disorder characterized by lifelong musculoskeletal comorbidities. Despite considerable physical disability, there are currently no disease-specific physical therapy (PT) recommendations for XLH designed to improve engagement and confidence in performing activities of daily living (ADL).ObjectiveThe objective of this patient-centered study was to develop an evidence-based PT program to address gaps in the management of adult XLH without imposing unintended harm.MethodsCreation of the program was informed by a prior controlled clinical study to evaluate the physical and functional effect of XLH on adulthood, and guided by the physical presentation of participants, subjective data and patient goals acquired at intake, and by performance on multiple active range of motion (ROM) movements from the standing position. A weekly standardized interview process was used to assess progression of physical and functional abilities, gains and concerns, and to obtain timely feedback to inform future exercise modifications. Outcomes were evaluated using validated functional tools and subjective data obtained throughout the study.ResultsA remote 12-week PT program was created based on collected data. Open and closed kinetic-chain exercises were developed and implemented. Functional improvements were documented, and weekly surveys indicated improved abilities and confidence to engage in ADL. Minimal improvements were observed in active upper and lower extremity ROM, reflective of substantial bony restrictions characteristic of XLH.ConclusionThis study represents the first disease-specific PT recommendations for XLH to mitigate the unique physical challenges of the adult disorder that can be modified to adapt to the current progression status of the adult disorder.

Perbaikan Ulkus Diabetik Dengan Penerapan Latihan Range Of Motion Ekstremitas Bawah Pada Diabetes Tipe 2

Diabetic ulcers are one of the chronic complications of type 2 diabetes due to chronic hyperglycemia resulting in impaired perfusion and neuropathy. Range of motion exercises in lower extremities improve peripheral perfusion with the aim of facilitating the diffusion of oxygen and adequate supply of nutrients to the ulcer area. The research objectives were identified and analyzed for diabetic improvement in the application of lower extremity range of motion exercises. Case study research design, 2 research subjects, at the Wound Clinic Diabetes Center Bandar Lampung for 2 weeks. The results of the study before the lower extremity range of motion of the degree of diabetes of the two respondents scored 2, after the range of motion of the lower extremity of the degree of diabetes both respondents scored 1. The conclusion of this study showed that lower extremity range of motion exercises can improve the repair of diabetic ulcers in type II diabetes patients. Lower extremity range of motion exercise can be one of the independent interventions carried out for the treatment of diabetic foot ulcers in type 2 diabetes.

Reliability and validity varies among smartphone apps for range of motion measurements of the lower extremity: a systematic review.

The aim of this review was to determine whether smartphone applications are reliable and valid to measure range of motion (RoM) in lower extremity joints. A literature search was performed up to October 2020 in the databases PubMed and Cochrane Library. Studies that reported reliability or validity of smartphone applications for RoM measurements were included. The study quality was assessed with the QUADAS-2 tool and baseline information, validity and reliability were extracted. Twenty-five studies were included in the review. Eighteen studies examined knee RoM, whereof two apps were analysed as having good to excellent reliability and validity for knee flexion ("DrGoniometer", "Angle") and one app showed good results for knee extension ("DrGoniometer"). Eight studies analysed ankle RoM. One of these apps showed good intra-rater reliability and excellent validity for dorsiflexion RoM ("iHandy level"), another app showed excellent reliability and moderate validity for plantarflexion RoM ("Coach's Eye"). All other apps concerning lower extremity RoM had either insufficient results, lacked study quality or were no longer available. Some apps are reliable and valid to measure RoM in the knee and ankle joint. No app can be recommended for hip RoM measurement without restrictions.

Validity and Reliability of a Smartphone and Digital Inclinometer in Measuring the Lower Extremity Joints Range of Motion

In clinical settings, available valid and reliable tools are important components in evaluating the lower extremity range of motion. Although the digital inclinometer is highly reliable compared to the universal goniometer, its availability and high cost impede its extensive use. Nowadays, smartphone applications have become widely available to clinicians for assessing the joint range of motion. The present study aims to assess the validity and intra-rater reliability of the smart- phone application “Clinometer” for measuring hip, knee, and ankle sagittal ranges of motion, using the digital inclinom- eter as the reference standard. Active hip, knee flexion and ankle dorsiflexion and plantarflexion range-of-motion mea- surements were recorded in 102 young, healthy female participants on two separate occasions using Clinometer and a digital inclinometer. Pearson’s correlation coefficients (r) were used to evaluate the smartphone application’s validity against the digital inclinometer. To assess the reliability of the Clinometer app, the intra-class correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable difference (MDD) were used. Clinometer displayed excellent validity when compared to the digital inclinometer for hip and knee movements (r&gt;0.90), while ankle ROM displayed moderate validity (r = 0.52-0.57). Additionally, Clinometer demonstrated excellent reliability (ICC &gt; 0.90) for hip and knee sagittal plane motion and moderate reliability for the ankle sagittal plane motion (ICC = 0.53–0.67). Cli- nometer is a portable, low-cost, valid, and reliable tool for assessing active hip and knee range of motions and can be easily incorporated into clinical settings; however, it cannot be used interchangeably for ankle measures.

Running Biomechanics of Adolescents With Autism Spectrum Disorder.

Research examining gait biomechanics of persons with autism spectrum disorder (ASD) has grown significantly in recent years and has demonstrated that persons with ASD walk at slower self-selected speeds and with shorter strides, wider step widths, and reduced lower extremity range of motion and moments compared to neurotypical controls. In contrast to walking, running has yet to be examined in persons with ASD. The purpose of this study was to examine lower extremity running biomechanics in adolescents (13-18-year-olds) with ASD and matched (age, sex, and body mass index (BMI)) neurotypical controls. Three-dimensional kinematics and ground reaction forces (GRFs) were recorded while participants ran at two matched speeds: self-selected speed of adolescents with ASD and at 3.0 m/s. Sagittal and frontal plane lower extremity biomechanics and vertical GRF waveforms were compared using two-way analyses of variances (ANOVAs) via statistical parametric mapping (SPM). Adolescents with ASD ran with reduced stride length at self-selected speed (0.29 m) and reduced vertical displacement (2.1 cm), loading-propulsion GRFs (by 14.5%), propulsion plantarflexion moments (18.5%), loading-propulsion hip abduction moments (44.4%), and loading knee abduction moments (69.4%) at both speeds. Running at 3.0 m/s increased sagittal plane hip and knee moments surrounding initial contact (both 10.4%) and frontal plane knee angles during midstance (2.9 deg) and propulsion (2.8 deg) compared to self-selected speeds. Reduced contributions from primarily the ankle plantarflexion but also knee abduction and hip abduction moments likely reduced the vertical GRF and displacement. As differences favored reduced loading, youth with ASD can safely be encouraged to engage in running as a physical activity.

Joint movement variability during landing in patients with anterior cruciate ligament reconstruction.

Rapid knee valgus and knee internal rotation motions in the initial phase of landing are the known mechanisms for anterior cruciate ligament injury, and many studies have been investigated on knee joint peak angle during landing. However, the variability in joint movement during landing has not been fully investigated. This study aimed to compare the coefficient of variation of lower extremity range of motion in patients with anterior cruciate ligament reconstruction and healthy subjects during landing. In this cross-sectional study, 54 patients with anterior cruciate ligament reconstruction and 44 healthy subjects were enrolled. All participants underwent six trials of single-leg hop landing for maximum safe horizontal distance. The kinematic variables were the coefficient of variation during two discrete (0.05 after initial contact and maximum knee flexion) time points for selected three-dimensional hip and knee joint range of motion. Comparisons were performed between the two groups. Compared with healthy subjects, patients with anterior cruciate ligament reconstruction had greater the coefficient of variation in hip internal/external rotation range of motion (patients with anterior cruciate ligament reconstruction had 41.9%, healthy subjects had 25.5%; P=0.0018; effect size: 0.32) and knee internal/external rotation range of motion (patients with anterior cruciate ligament reconstruction had 68.4%; healthy subjects had 48.1%; P=0.0014; effect size: 0.32) for periods that spanned 0.05 s from the initial contact. Patients with anterior cruciate ligament reconstruction could be disadvantageous in ability to control and adapt hip and knee joint rotations when controlling landings.

The Immediate Effects of Instrumented-Assisted Soft Tissue Mobilization on Range of Motion, Strength, and Power in the Lower Extremity: A Critically Appraised Topic

Focused Clinical Question: What are the immediate effects of instrumented-assisted soft tissue mobilization (IASTM) application on measures of lower extremity range of motion, muscular power, and strength in physically active adults not currently suffering from a musculoskeletal injury? Clinical Bottom Line: Grade 1 evidence supports immediate improvements in lower extremity range of motion in physically active adults after IASTM application. However, the evidence is lacking to support IASTM to improve muscular power and strength. Therefore, additional research is warranted to determine the acute effects of IASTM use on muscular power and strength in healthy, physically active adults.

A Model Used to Consider Lower Extremity Range of Motion to Identify Fall Experience in Community-Dwelling Older Women: A Retrospective Study

Background: Reduced lower extremity range of motion (ROM) with aging is related to the frequency of falls in older adults. Therefore, this study developed and assessed a model that considers lower extremity ROM in identifying the frequency of fall in community-dwelling older women. Methods: Seventy-eight community-dwelling older women (mean age ± SD, 70.4 ± 4.6 years; age range, 65-81 years) were recruited in this study. Nine lower extremity ROMs (hip flexion, hip extension, hip abduction, hip adduction, internal and external hip rotation, knee flexion, ankle dorsiflexion, and ankle plantar flexion) were bilaterally measured. The classification and regression tree methodology was used to develop a model that identifies fall experience for the past 12 months. Results: Twenty-seven participants reported falling in the past 12 months. The model included left ankle dorsiflexion, left hip flexion, and right hip external rotation ROMs. The area under the receiver operating characteristic curve of this model was 0.710 (95% confidence interval, 0.596-0.825). Conclusion: The accuracy of the model that considers lower extremity ROMs is moderate for the fall experience in community-dwelling older women.

Effects of an Overground Walking Program With a Robotic Exoskeleton on Long-Term Manual Wheelchair Users With a Chronic Spinal Cord Injury: Protocol for a Self-Controlled Interventional Study.

BackgroundIn wheelchair users with a chronic spinal cord injury (WUSCI), prolonged nonactive sitting time and reduced physical activity—typically linked to this mode of mobility—contribute to the development or exacerbation of cardiorespiratory, musculoskeletal, and endocrine-metabolic health complications that are often linked to increased risks of chronic pain or psychological morbidity. Limited evidence suggests that engaging in a walking program with a wearable robotic exoskeleton may be a promising physical activity intervention to counter these detrimental health effects.ObjectiveThis study’s overall goals are as follows: (1) to determine the effects of a 16-week wearable robotic exoskeleton–assisted walking program on organic systems, functional capacities, and multifaceted psychosocial factors and (2) to determine self-reported satisfaction and perspectives with regard to the intervention and the device.MethodsA total of 20 WUSCI, who have had their injuries for more than 18 months, will complete an overground wearable robotic exoskeleton–assisted walking program (34 sessions; 60 min/session) supervised by a physiotherapist over a 16-week period (one to three sessions/week). Data will be collected 1 month prior to the program, at the beginning, and at the end as well as 2 months after completing the program. Assessments will characterize sociodemographic characteristics; anthropometric parameters; sensorimotor impairments; pain; lower extremity range of motion and spasticity; wheelchair abilities; cardiorespiratory fitness; upper extremity strength; bone architecture and mineral density at the femur, tibia, and radius; total and regional body composition; health-related quality of life; and psychological health. Interviews and an online questionnaire will be conducted to measure users’ satisfaction levels and perspectives at the end of the program. Differences across measurement times will be verified using appropriate parametric or nonparametric analyses of variance for repeated measures.ResultsThis study is currently underway with active recruitment in Montréal, Québec, Canada. Results are expected in the spring of 2021.ConclusionsThe results from this study will be essential to guide the development, implementation, and evaluation of future evidence-based wearable robotic exoskeleton–assisted walking programs offered in the community, and to initiate a reflection regarding the use of wearable robotic exoskeletons during initial rehabilitation following a spinal cord injury.Trial RegistrationClinicalTrials.gov NCT03989752; https://clinicaltrials.gov/ct2/show/NCT03989752International Registered Report Identifier (IRRID)DERR1-10.2196/19251

Lower extremity range of motion and alignment: A reliability and concurrent validity study of goniometric and three-dimensional motion analysis measurement

BackgroundKnowing correlations between passive goniometric and dynamic three-dimensional motion analysis measurements of lower extremity range of motion and alignment would benefit knee injury risk assessment. PurposeTo investigate reliability and concurrent validity of lower extremity assessment with goniometry and three-dimensional motion analysis. MethodsThirty-eight participants (76 limbs) were examined in standardized positions by two physiotherapists with simultaneous goniometric and three-dimensional motion analysis measurements of passive range of motion and alignment. Intra-class correlation coefficient (ICC) and median differences were calculated. ResultsHip rotation reliability, ICC 0.74–0.89 and validity 0.74–0.94. Tibial rotation reliability, ICC 0.24–0.75 and validity 0.08–0.61. Knee extension reliability, ICC 0.44–0.73 and validity 0.22–0.60. Knee valgus/varus reliability, ICC 0.36–0.68 and validity 0.25–0.62. Tibial torsion reliability, ICC 0.52–0.77 and validity 0.58–0.81. Ankle dorsiflexion reliability, ICC 0.12–0.73 and validity 0.51–0.83. Median differences in reliability and validity ranged from -2.0° to 3.0° and from -6.6° to 7.5° respectively. ConclusionGoniometric and three-dimensional motion analysis methods define the lower body segments differently making some degree of discrepancy in the measurements inevitable. Nevertheless, the variables chosen in this study are all strongly associated with anterior cruciate ligament rupture and some may prove useful to identify individuals at risk of knee injury during sport activities. Study designCross-sectional laboratory study.

Effects of Age and Maturation on Lower Extremity Range of Motion in Male Youth Soccer Players.

Robles-Palazón, FJ, Ayala, F, Cejudo, A, De Ste Croix, M, Sainz de Baranda, P, and Santonja, F. Effects of age and maturation on lower extremity range of motion in male youth soccer players. J Strength Cond Res 36(5): 1417-1425, 2022-Restricted joint range of motion (ROM) has been considered as a primary risk factor for some sport-related injuries. Consequently, preparticipation assessment of lower extremity joints ROM could help identify youth soccer players at high risk of injury and to aid in the design of tailored age and maturational specific training interventions. The purpose of this study was to analyze and compare the influence of chronological age and maturational stage on several lower extremity ROM measures, as well as to describe the lower extremity ROM profile using a comprehensive approach in youth soccer players. A total of 286 male youth soccer players' ROM were assessed including passive hip (extension [PHE], adduction with hip flexed 90° [PHADHF90°], flexion with knee flexed [PHFKF] and extended [PHFKE], abduction with hip neutral [PHABD] and flexed 90° [PHABDHF90°], external [PHER] and internal [PHIR] rotation), knee (flexion [PKF]) and ankle (dorsiflexion with knee flexed [ADFKF] and extended [ADFKE]) ROMs. Between-group differences were analyzed using a one-way analysis of variance (ANOVA) and magnitude-based decisions. The results only report statistically significant (p < 0.05; d > 0.5) and clinically relevant differences (>8°) for the PKF ROM between U12 vs. U19, and Pre-PHV vs. Post-PHV groups. Furthermore, approximately 40, 35, and 20% of players displayed restrictions in their PHFKE, PKF, and ADFKF ROM values, respectively. These findings emphasize the necessity of prescribing (across all age groups and periods of growth and maturation) compensatory measures in daily soccer training, and these exercises should be equally applied to both limbs with the aim of improving PHFKE, PKF and ADFKF ROM values.

Upper Extremity and Hip Range of Motion Changes Throughout a Season in Professional Baseball Players

Background: Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis: The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would lose ROM, specifically total shoulder motion (total ROM [TROM]) and hip internal rotation (IR), over the course of a season and their careers. Study Design: Case series; Level of evidence, 4. Methods: Upper and lower extremity ROM measurements were recorded during pre-, mid-, and postseason on all professional baseball players for a single organization between 2011 and 2018. ROM measurements were compared for pitchers and position players over the course of the season and their careers. Also, ROM measurements over the pre-, mid-, and postseason were compared between pitchers and position players. Results: A total of 166 professional baseball players (98 pitchers, 68 position players) were included. Pitcher hip external rotation (ER; P < .001), IR (P = .010), and TROM (P < .001) for lead and trail legs decreased over the course of the season. Pitcher shoulder ER (P = .005), TROM (P = .042), and horizontal adduction (P < .001) significantly increased over the course of the season. Position player shoulder flexion (P = .046), hip ER (P < .001, lead leg; P < .001, trail leg), and hip TROM (P = .001; P = .002) decreased over the course of the season. Position player shoulder ER (P = .031) and humeral adduction (P < .001) significantly increased over the course of the season. Over the course of pitchers’ careers, there was decreased shoulder IR (P = .014), increased shoulder horizontal adduction (P < .001), and hip IR (P = .042) and hip TROM (P = .027) for the lead leg. Position players experienced loss of hip TROM (P = .010, lead leg; P = .018, trail leg) over the course of their careers. Pitchers started with and maintained more shoulder ER and gained more shoulder TROM over a season as compared with position players. Conclusion: Pitchers and position players saw overall decreases in hip ROM but increases in shoulder ROM over the course of the season and career.

47. The effect of surgical decompression on spine and lower extremity range of motion during gait in patients with cervical spondylotic myelopathy

BACKGROUND CONTEXT Cervical spondylotic myelopathy (CSM) is a neurologic condition resulting from spinal cord compression due to degenerative narrowing of the spinal canal. It is the most common cause of spinal cord dysfunction in patients older than 50. Symptoms of CSM may include numbness or weakness in the extremities, loss of fine motor dexterity, and difficulty with balance and gait. The natural history is typically one of progressive decline in neurologic function, so surgery to decompress the spinal cord is generally indicated to prevent progression in symptomatic patients. Despite the prevalence of this condition, relatively little quantitative kinematic information is available on the effect of surgical intervention on the gait of patients with CSM. PURPOSE To evaluate for changes in the spine and lower extremity range of motion (RoM) during gait in patients with CSM before and after surgical intervention. STUDY DESIGN/SETTING Non-randomized, prospective, concurrent cohort study. PATIENT SAMPLE Thirty-eight patients with symptomatic CSM. OUTCOME MEASURES Lower extremity and spine range of motion (RoM), spatiotemporal parameters, and pain level. METHODS Clinical gait analysis was performed one week before surgery (Pre) and three months after surgery (Post). Fifty reflective markers (9.5 mm diameter) attached to the patients; bodies were utilized to collect full body three-dimensional kinematics using 10 cameras (VICON) at a sampling rate of 100 Hz. Each patient performed a series of over-ground gait trials at a comfortable, self-selected speed. Neck and mid-back visual analog scale (VAS), Oswestry Disability Index (ODI), and Neck Disability Index (NDI) scores were also collected at both time points. Repeated measurements ANOVA was used to analyze data. RESULTS When comparing preoperative to postoperative gait parameters, significant increases in walking cadence (98.28 vs 103.37 steps/minutes, p=0.004), stride length (1.02 vs 1.07 m, p=0.018), and walking speed (0.86 vs 0.94 m/s, p=0.001) were observed. The amount of time spent in double support decreased after surgery (0.37 vs 0.32 s, p=0.032). The only significant difference in spine and lower extremity joint RoM measures was a decline in coronal RoM of both the knees and ankles postoperatively. VAS neck and mid-back as well as ODI improved significantly postoperatively, while the reduction in NDI did not attain statistical significance. CONCLUSIONS Despite conventional teaching that the goal of surgical intervention for CSM is to halt symptomatic progression, the data presented here demonstrate that significant improvements in gait are frequently observed after surgical management of CSM. Postoperative patients walk more quickly as a result of increased stride length and cadence. Furthermore, they lift their knees and dorsiflex/plantarflex their ankles less, consistent with a more efficient gait pattern. While surgeons should remain conservative with respect to how they counsel patients and set expectations preoperatively, cautious optimism regarding improvements in gait may be warranted in the setting of surgery for CSM. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Biomechanical Comparison of the Reverse Hyperextension Machine and the Hyperextension Exercise.

Lawrence, MA, Chin, A, and Swanson, BT. Biomechanical comparison of the reverse hyperextension machine and the hyperextension exercise. J Strength Cond Res 33(8): 2053-2056, 2019-The purpose of this study was to compare activation of the erector spinae, gluteus maximus, and biceps femoris muscles, lower back extension moment, and lower extremity range of motion (ROM) between the reverse hyperextension (RHE) and hyperextension (HE) exercises. Motion and muscle activation of the trunk and lower extremity were measured while 20 recreationally active individuals performed 2 sets of 10 repetitions of each exercise. Equivalent loads were used for each exercise. Peak, average, and integrated muscle activity, low back moment, and ROM between the trunk and pelvis and the thigh and trunk were calculated. A Wilcoxon signed-rank test (p = 0.05) revealed significantly greater integrated activity of the biceps femoris and gluteus maximus during the HE exercise. The RHE exercise generated greater peak (+129%), integrated (+63%), and mean (+78%) low back moment as compared to the HE exercise. The RHE resulted in a significantly greater thigh to trunk ROM, 76.6 compared with 64.7. However, the RHE used less lumbar flexion, 20.4 compared with 31.1 for the HE. The RHE movement profile is preferable because it provides greater hip ROM with less angular stress and equivalent erector spinae activity.