Variability In Range Of Motion Research Articles

Does having an external focus in immersive virtual reality increase range of motion in people with neck pain?

BackgroundWhen instructing exercises to improve Range of Motion (ROM), clinicians often create an internal focus of attention, while motor performance may improve more when using an external focus. Objectives: Using Virtual Reality (VR), we investigated the effect of tasks with an internal and external focus on maximal ROM in people with neck pain and explored whether this effect was associated with fear of movement. MethodIn this cross-over experimental design study, the cervical ROM of 54 participants was measured while performing a target-seeking exercise in a VR-environment (external focus task) and during three maximal rotation and flexion-extension movements with the VR-headset on, without signal (internal focus task). The main statistical analysis included two dependent T-tests. Pearson correlation coefficients were calculated to investigate whether the differences in ROM in both conditions were correlated to fear of movement. ResultsMaximal neck rotation was larger in the external focus condition than in the internal focus condition (mean difference: 26.4°, 95% CI [20.6, 32.3]; p < 0.001, d = 1.24). However, there was a difference favouring the internal focus condition for flexion-extension (mean difference: 8.2°, 95% CI [-14.9, −1.5]; p = 0.018, d = 0.33). The variability in ROM was not explained by variability in fear of movement (for all correlations p ≥ 0.197). ConclusionAn external focus resulted in a larger range of rotation, but our flexion-extension findings suggest that the task has to be specific to elicit such an effect. Further research, using a task that sufficiently elicits movement in all directions, is needed to determine the value of an external focus during exercise.

Prognosis for Persistent Post Concussion Symptoms using a Multifaceted Objective Gait and Balance Assessment Approach

BackgroundConcussion prognosis is a challenging clinical task. Identification of measures useful for persistent symptom risk can help optimize treatment pathways and allow clinicians to offer appropriate anticipatory guidance. Research QuestionCan a multifaceted single/dual-task postural control assessment within one week of a diagnosed concussion identify the odds of developing persistent post-concussion symptoms (PPCS; symptoms that persist for more than 28 days post-concussion)? MethodsWe conducted a prospective cohort study of youth and young adult athletes who were evaluated within 7 days of injury, and followed until they no longer reported concussion symptoms. Participants were grouped into those who developed PPCS and those who did not. During the initial evaluation, participants completed a postural control evaluation in single/dual-task conditions. We calculated six gait performance variables (in single/dual-task conditions), nine quiet stance performance variables, and three cognitive task performance (standing and walking) variables. We conducted between-group comparisons to identify candidate PPCS prognostic variables, and multivariable models to adjust for covariates (age, post-injury evaluation time, history of concussion, and BMI). ResultsSixty-six participants completed the study: 24% reported PPCS (mean age = 16.9 ± 3.5 years; 50% female; evaluated 4.2 ± 1.9 days post-injury) and 74% (mean age = 18.3 ± 3.0 years; 52% female; evaluated 3.5 ± 1.6 days post-injury) did not. Between-group comparisons indicated greater dual-task transverse plane center-of-mass (COM) range of motion (ROM) (13.1 ± 4.3 vs. 9.9 ± 2.5 degrees; p = 0.013) and lateral step variability (5.1 ± 1.4 vs. 4.0 ± 1.2 cm; p = 0.003) for the PPCS group relative to the no PPCS group. After multivariable modeling, dual-task transverse plane COM ROM (adjusted odds ratio = 1.34, 95% CI = 1.07, 1.68) and lateral step variability (adjusted odds ratio = 1.85, 95% CI = 1.13, 3.05) were significantly associated with PPCS. SignificanceDual-task transverse plane movement and lateral step variability demonstrate viable prognostic ability for PPCS among youth and young adult athletes and, along with other established factors, may add incremental value to PPCS prognosis models.

Differences in kinematics of the support limb depends on specific movement tasks of take-off

Background: Many sport activities are a sequence of jumps (running, jumping, hurdling etc.). Each jump flight phase is the result of the execution of the previous support phase. Objective: The goal of the research was to identify differences in adjustment of the support lower limb and differences in take-off kinematics in specific take-off movement task. Methods: 14 male athletes (22.6 ± 4.4 years; 182.4 ± 5.3 cm; 74.7 ± 6.2 kg) took part in a laboratory experiment. Each athlete performed five different take-off movements (running, acceleration running - second step, long jump take-off, high jump take-off and take-off to the hurdle). System Qualisys was used to analyze the kinematics of the support limb. Dynamics of the support phase was monitored via force plate. ANOVA and Bonferroni post-hoc test were used to measure the significance of the differences between different take off tasks. Results: Dynamic characteristic showed significant differences in take-off (p < .001). This variability is caused by differences in kinematic parameters at the instant of touch-down, minimum joint angles and take-off. The most important finding was different variability in range of motion in eccentric or concentric phases of each jump. Vertically orientated jumps are terminated in a higher degree of extension. Horizontal take-off types are characterized by the highest ranges of motion especially in the ankle joint. Conclusions: The support lower limb compliance is adjusted to the required task, which is related to lower limb kinematics during the support phase. High range of motion in each joint refers to more compliant adjustment of the joint.

Determination of vertebral range of motion using inertial measurement units in 27 Franches-Montagnes stallions and comparison between conditions and with a mixed population.

The diagnosis of equine back disorders is challenging. Objectively determining movement of the vertebral column may therefore be of value in a clinical setting. To establish whether surface-mounted inertial measurement units (IMUs) can be used to establish normal values for range of motion (ROM) of the vertebral column in a uniform population of horses trotting under different conditions. Vertebral ROM was established in Franches-Montagnes stallions and a general population of horses and the variability in measurements compared between the two groups. Repeatability and the influence of specific exercise condition (on ROM) were assessed. Finally, attempts were made to explain the findings of the study through the evaluation of factors that might influence ROM. Dorsoventral (DV) and mediolateral (ML) vertebral ROM was measured at a trot under different exercise conditions in 27 Franches-Montagnes stallions and six general population horses using IMUs distributed over the vertebral column. Variability in the ROM measurements was significantly higher for general population horses than for Franches-Montagnes stallions (both DV and ML ROM). Repeatability was strong to very strong for DV measurements and moderate for ML measurements. Trotting under saddle significantly reduced the ROM, with sitting trot resulting in a significantly lower ROM than rising trot. Age is unlikely to explain the low variability in vertebral ROM recorded in the Franches-Montagnes horses, while this may be associated with conformational factors. It was possible to establish a normal vertebral ROM for a group of Franches-Montagnes stallions. While within-breed variation was low in this population, further studies are necessary to determine variation in vertebral ROM for other breeds and to assess their utility for diagnosis of equine back disorders.

Side-to-side range of movement variability in variants of the median and radial neurodynamic test sequences in asymptomatic people

Side-to-side discrepancy in range of motion (ROM) during upper limb neurodynamic testing is used in part to identify abnormal peripheral nerve mechanosensitivity and is one of three factors to consider in determining a positive test. Large side-to-side variability is reported for some variants of the upper limb neurodynamic test sequences, however discrepancies for other test variants are unknown. Hence the purpose of this study was to evaluate side-to-side discrepancy in elbow flexion ROM during two variants of upper limb neurodynamic test sequence for the median and radial nerves. 51 asymptomatic subjects (26 females, mean age 29.69 years) were evaluated. A uniaxial electrogoniometer was used to measure elbow flexion ROM at onset of resistance (R1) and onset of discomfort (P1) during the median and radial neurodynamic tests on each side. Reliability was determined by testing 20 subjects twice and was found to be good (ICC greater than 0.88 and SEM less than 4.02°). There was no significant difference in mean ROM between sides. Lower-bound scores indicate that intra-individual, inter-limb differences of more than 15° for the median nerve and 11° for the radial nerve exceeds the range of normal ROM asymmetry on neurodynamic testing at R1 and P1. Correlation of ROM between limbs was significant with R2 values of 0.62 and 0.85 for the median and radial nerves respectively. These finding provide clinicians with information regarding normal side-to-side variability in ROM during two commonly used variants of neurodynamic tests.

No association between COL3A1, COL6A1 or COL12A1 gene variants and range of motion

Approximately 64–70% of the variability in joint range of motion (ROM) is heritable. A common variant within a type V collagen (COL5A1) gene is associated with joint range of motion. Like type V collagen, types III, VI and XII collagen are also involved in fibril assembly and/or diameter regulation. Mutations within the genes that encode these proteins, COL3A1, COL6A1 and COL12A1, also cause connective tissue hypermobility disorders and phenotypes. The aim of this study was to determine if variants within these genes are associated with measures of joint range of motion. Three hundred and fifty apparently healthy and physically active Caucasian participants were recruited. Anthropometric measurements were taken. Sit-and-reach (SR), straight leg raise (SLR) and total shoulder rotation (ShTR) range of motion were measured. All participants were genotyped for COL3A1 rs1800255, COL6A1 rs35796750 and COL12A1 rs970547. COL3A1 rs1800255, COL6A1 rs35796750 and COL12A1 rs970547 were not significantly associated with sit-and-reach, straight leg raise or total shoulder rotation range of motion. Furthermore, no significant age-genotype interaction effects were identified between the variants and range of motion measurements. None of the variants investigated in this study were significantly associated with any of the measures of range of motion used. Further studies are required to identify additional intrinsic and extrinsic factors that may determine range of motion, including the genetic component.

Catch! Movement kinematics of two-handed catching in boys with Developmental Coordination Disorder

PurposeTo quantify two-handed catching in boys with Developmental Coordination Disorder (DCD) by examining sequencing of the upper limb and trunk segments, and degree of symmetry. MethodThirteen boys with DCD (x¯=9.36 years±0.68) and 13 Controls (x¯=9.16 years±0.68) participated. Children performed 10 two-handed central catching trials, with the best five trials selected for analysis. ResultsThe DCD group displayed greater variability in range of motion across all joint rotations in the catch phase. Specifically, increased shoulder flexion, thorax extension and elbow extension. Although the initiation of segmental movement occurred in the same order for the two groups, the DCD group initiated wrist extension considerably earlier. The DCD group also exhibited significant asymmetry in elbow flexion–extension. ConclusionDespite success in performing this simple catching task (88% successful), the DCD group displayed an inefficient, variable and less symmetrical catching technique.

Inter-laboratory variability in in vitro spinal segment flexibility testing

In vitro spine flexibility testing has been performed using a variety of laboratory-specific loading apparatuses and conditions, making test results across laboratories difficult to compare. The application of pure moments has been well established for spine flexibility testing, but to our knowledge there have been no attempts to quantify differences in range of motion (ROM) resulting from laboratory-specific loading apparatuses. Seven fresh-frozen lumbar cadaveric motion segments were tested intact at four independent laboratories. Unconstrained pure moments of 7.5Nm were applied in each anatomic plane without an axial preload. At laboratories A and B, pure moments were applied using hydraulically actuated spinal loading fixtures with either a passive (A) or controlled (B) XY table. At laboratories C and D, pure moments were applied using a sliding (C) or fixed ring (D) cable–pulley system with a servohydraulic test frame. Three sinusoidal load-unload cycles were applied at laboratories A and B while a single quasistatic cycle was applied in 1.5Nm increments at laboratories C and D. Non-contact motion measurement systems were used to quantify ROM. In all test directions, the ROM variability among donors was greater than single-donor ROM variability among laboratories. The maximum difference in average ROM between any two laboratories was 1.5° in flexion-extension, 1.3° in lateral bending and 1.1° in axial torsion. This was the first study to quantify ROM in a single group of spinal motion segments at four independent laboratories with varying pure moment systems. These data support our hypothesis that given a well-described test method, independent laboratories can produce similar biomechanical outcomes.

The Relationship Between Frontal Plane Gait Variability and Ankle Range of Motion in Middle-Aged and Older Persons with Neuropathy

To explore the relationship between frontal plane ankle range of motion (ROM) and frontal plane control during gait, as determined by step-width variability and step-width range, among middle-aged and older persons with peripheral neuropathy (PN). Observational study of 39 adults (mean age +/- standard deviation = 64.7 +/- 9.5 yrs) with PN. Demographic and clinical data, including measures of ankle ROM and PN severity, and spatiotemporal gait measures were obtained. Correlation and multivariate analyses were used to identify relationships between measures of ankle ROM and frontal plane gait variability. Significant negative correlations were identified between frontal plane ankle ROM (inversion + eversion), and step-width variability (r = -0.344; P = 0.032) and step-width range (r = -0.386, P = 0.015). Multivariate analyses showed that the relationship between ankle ROM and step-width variability weakened in the presence of PN severity, with ROM and PN severity both demonstrating trends toward independent associations with step-width variability (P = 0.086 and 0.083, respectively; adjusted r2 = 0.145). However, ankle ROM demonstrated a stronger association with step-width range than did PN severity (P = 0.043 and 0.098, respectively; adjusted r2 = 0.169). Increased frontal plane ankle ROM is associated with decreased variability in frontal plane foot placement during gait among middle-aged and older persons with PN, a population at high risk for falls.