To investigate the effects of 2 different exercise programs on 3-dimensional scapular kinematics, disability, and pain in participants with subacromial impingement syndrome (SIS).
Randomized ...controlled trial.
Outpatient clinic and research laboratory.
Participants who were diagnosed with SIS and who also exhibited scapular dyskinesis (N=30).
The participants were randomized in 2 different exercise groups: (1) shoulder girdle stretching and strengthening with additional scapular stabilization exercises based on a kinetic chain approach (intervention group), and (2) shoulder girdle stretching and strengthening exercises only (control group).
Three-dimensional scapular kinematics, self-reported shoulder pain, and disability were evaluated at baseline, after 6 weeks of training, and after 12 weeks of training.
Significant differences were observed between the control and intervention groups in external rotation and posterior tilt after 6 weeks of training and in external rotation, posterior tilt, and upward rotation after 12 weeks of training. All groups showed improvement in self-reported pain and disability scores; however, there were no significant differences between the groups.
Progressive exercise training independent from specific scapular stabilization exercises provides decreased disability and pain severity in impingement syndrome.
Purpose
The aim of this prospective, randomized, controlled, double-blind clinical trial was to compare the outcomes, including knee strength, balance, coordination, proprioception and response time, ...of Nintendo Wii Fit with those of conventional rehabilitation on the subjects with anterior cruciate ligament reconstruction.
Methods
Thirty volunteer subjects were enrolled in either Wii Fit (
n
= 15; mean age, 29 ± 7 years) or conventional rehabilitation (
n
= 15; mean age, 29 ± 6 years) programmes from the first week up to 12th weeks of the operation. Endoscopic reconstruction of a completely ruptured ACL was performed by using graft harvested from hamstrings. Each subject underwent an individual therapeutic programme. Functional examinations included the measurements of the balance using modified star excursion balance test, coordination, proprioception and response time using functional squat system and strength of flexor and extensor muscles of the involved and uninvolved leg using an isokinetic machine.
Results
There was no significant difference between Wii Fit and conventional group in terms of isokinetic knee strength at 12th week, and dynamic balance, and functional squat tests including coordination, proprioception and response time at first, 8th and 12th weeks of the rehabilitation.
Conclusion
Two different 12-week-physiotherapy programmes following ACL reconstruction have the same affect on muscle strength, dynamic balance and functional performance values in both groups. We considered that the practice of Wii Fit activities like conventional rehabilitation could also address physical therapy goals, which included improving visual–perceptual processing, coordination, proprioception and functional mobility.
Level of evidence
Randomized, controlled trials with adequate statistical power, Level I.
The purpose of this study was to compare the effectiveness of rehabilitation approaches in individuals with low back pain (LBP) on pain, spinal mobility, disability, and muscular strength.
Ninety ...volunteers were included and divided into four groups depending on the rehabilitation approach: group 1, soft tissue mobilization techniques and stabilization exercises (n=24; 11 females F, 13 males M); group 2, Kinesio Taping and stabilization exercises (n=24; 12F, 12M); group 3, stabilization exercises (n=22; 11F, 11M); and group 4, reflex therapy and stabilization exercises (n=20; 10F, 10M). Visual Analog Scale for pain intensity, an isokinetic evaluation for strength at 60°/s and a side-plank position test for trunk stabilization were measured before and assessed at the beginning, after a 4-week treatment and during 4 weeks of follow-up. The functional status was evaluated with the Oswestry Disability Index.
Individuals in all groups showed similar decrease in pain after the treatment and at 1-month follow-up, but there were no significant differences in pain levels between the groups (P<0.05).
All therapeutic approaches were found to be effective in diminishing pain and thus helpful in increasing strength and stabilization in patients with LBP.
Abstract Background This study analyzed the dynamic three-dimensional scapular kinematics and scapular asymmetry in participants with and without shoulder impingement syndrome. Methods Twenty-nine ...participants with shoulder impingement syndrome, have been suffering from unilateral shoulder pain at the dominant arm lasting more than six weeks and thirty-seven healthy controls participated in the study. Scapular kinematics was measured with an electromagnetic tracking device during shoulder elevation in the sagittal plane. Data for bilateral scapular orientation were analyzed at 30°, 60°, 90°, and 120° of humerothoracic elevation and lowering. The symmetry angle was calculated to quantify scapular asymmetry throughout shoulder elevation. Findings Statistical comparisons indicated that the scapula was more downwardly rotated ( p < 0.001) and anteriorly tilted ( p = 0.005) in participants with shoulder impingement syndrome compared to healthy controls. Side-to-side comparisons revealed that the scapula was more anteriorly tilted on the involved side of participants with shoulder impingement syndrome ( p = 0.01), and the scapula was rotated more internally ( p = 0.02) and downwardly ( p = 0.01) on the dominant side of healthy controls. Although there were side-to-side differences in both groups, symmetry angle calculation revealed that the scapular movement was more asymmetrical for scapular internal and upward rotation in individuals with shoulder impingement syndrome when compared with healthy controls ( p < 0.05). Interpretation The findings of the study increase our knowledge and understanding of scapular alterations in symptomatic and asymptomatic populations, which creates biomechanical considerations for shoulder assessment and rehabilitation.
Purpose
To evaluate muscle torque, lower extremity coordination, and knee laxity after ACL reconstruction comparing patients operated on with semitendinosus graft (ST) and patients with combined ...semitendinosus and gracilis (STGR) grafts.
Methods
Forty-six subjects who underwent ST (
n
= 23) or STGR harvest (
n
= 23) ACL reconstruction participated in this study. Quadriceps and hamstring torque were recorded using an isokinetic dynamometer. The anterior tibial translation was measured using the Kneelax 3 Arthrometer. The eccentric and concentric motor coordination was tested by multi-joint lower-limb tracking-trajectory test. All measurements were taken 12 months after surgery. Side-to-side differences were determined for all subjects.
Results
Side-to-side differences in extensor peak torque at 180°/s and 60°/s did not differ between semitendinosus (ST) and semitendinosus + gracilis (STGR) groups (n.s.). However, side-to-side differences in flexor peak torque were significantly higher at 60°/s for the STGR group than the ST group (
P
= 0.002). Side-to-side differences in eccentric and concentric parts of tracking-trajectory test and anterior tibial translation did not differ between the STGR and the ST groups (n.s.).
Conclusion
The outcomes of this study suggested that additional harvest of gracilis did not influence lower extremity motor control, quadriceps muscle torque, and anterior tibial translation; however, it affected knee flexion isokinetic torque negatively at low angular velocity. This finding could be important for functional activity or sports with high demands on hamstring muscle strength. It is recommended that gracilis muscle should be preserved as possible during ACL reconstruction.
Level of evidence
Prospective comparative study, Level II.
Background
The aim of this study was to compare the plantar pressure distribution and knee and ankle muscle architecture in women with and without knee osteoarthritis (OA).
Methods
Fifty women with ...knee OA (mean age = 52.11 ± 4.96 years, mean Body mass index (BMI) = 30.94 ± 4.23 kg/m2) and 50 healthy women as a control group (mean age = 50.93 ± 3.78 years, mean BMI = 29.06 ± 4.82 kg/m2) were included in the study. Ultrasonography was used to evaluate knee and ankle muscles architecture and femoral cartilage thickness. The plantar pressure distribution was evaluated using the Digital Biometry Scanning System and Milleri software (DIASU, Italy). Static foot posture was evaluated using the Foot Posture Index (FPI), and pain severity was assessed using the Visual Analog Scale.
Results
The OA group exhibited lower muscle thickness in Rectus Femoris (RF) (p = 0.003), Vastus Medialis (VM) (p = 0.004), Vastus Lateralis (p = 0.023), and Peroneus Longus (p = 0.002), as well as lower Medial Gastrocnemius pennation angle (p = 0.049) and higher Fat thickness (FT) in RF (p = 0.033) and VM (p = 0.037) compared to the control group. The OA group showed thinner femoral cartilage thickness (p = 0.001) and higher pain severity (p = 0.001) than the control groups. FPI scores were higher (p = 0.001) in OA group compared to the control group. The plantar pressure distribution results indicated an increase in total surface (p = 0.027), total load (p = 0.002), medial load (p = 0.005), and lateral load (p = 0.002) on dominant side in OA group compared to the control group.
Conclusions
Knee and ankle muscle architecture, knee extensor muscle FT, and plantar pressure distribution in the dominant foot differed in individuals with knee OA compared to the control group.
Purpose
To evaluate the sonographic characteristics, functional aspects and life quality of a group of adolescent patients 2 years after having been diagnosed with Osgood–Schlatter disease and ...compare them with an age-matched healthy control group.
Methods
The study was conducted on eighteen Osgood–Schlatter patients with unilateral involvement and 14 age-matched healthy controls. The Flaviis classification and patellar tendon characteristics were observed using a GE Logiq 9 scanner. Broad and vertical jump tests were used for jumping performance. The coordination, proprioception, strength and endurance functions were assessed with the Functional Squat System. For the quality of life, the SF-36 questionnaire was used. The Wilcoxon test for the patients’ initial and second-year assessment and Mann–Whitney U test for the comparison between the patient and control groups were used.
Results
By the end of second year, 38.9 % of the patients had totally recovered. The patellar tendon lengthened, distal diameter and distal area of the tendon had lessened, and no significant difference was observed between patient and control groups (n.s). Improvements were detected for the bilateral broad jump test scores, the quality of life and coordination of the patients after 2 years (
p
< 0.05). The average power of endurance and the total work of strength were significantly higher in control group (
p
< 0.05).
Conclusions
According to the sonography results 2 years after diagnosis, nearly half of the patients had totally recovered. Coordination was the only parameter that improved over the 2-year period. The patient group strength and endurance function remained lower than the control group.
Level of evidence
III.
The present study tested the reliability and validity of the Turkish version of the visual analog scale foot and ankle (VAS-FA) among healthy subjects and patients with foot problems. A total of 128 ...participants, 65 healthy subjects and 63 patients with foot problems, were evaluated. The VAS-FA was translated into Turkish and administered to the 128 subjects on 2 separate occasions with a 5-day interval. The test–retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbach's α. The validity was assessed using the correlations with Turkish versions of the Foot Function Index, the Foot and Ankle Outcome Score, and the Short-Form 36-item Health Survey. A statistically significant difference was found between the healthy group and the patient group in the overall score and subscale scores of the VAS-FA (p < .001). The internal consistency of the VAS-FA was very good, and the test–retest reliability was excellent. Adequate to good correlations were found between the overall VAS-FA score and the Foot Function Index, Foot and Ankle Outcome Score, and Short-Form 36-item Health Survey scores in the healthy and patient groups both. The Turkish version of the VAS-FA is sensitive enough to distinguish foot and ankle-specific pathologic conditions from asymptomatic conditions. The Turkish version of the VAS-FA is a reliable and valid method and can be used for foot-related problems.
Functional balance training is crucial for both rehabilitation and prevention. A Dynamic Innovative Balance System (DIBA) is readily available for utilization in both functional and postural control ...training in a wide variety of dynamic conditions.
The purpose of this study was to compare the effectiveness of the DIBA and standard balance training tools on dynamic and static balance.
Randomized controlled trial.
Thirty-six healthy males (18 to 32 years) were randomly assigned to group DIBA (n=18) or to the control group (n=18) who performed balance training using a balance board, a wobble board, the BOSU, or a soft cushion block for eight weeks. Each participant was assessed before training, at the end of the fourth and eighth week by using the Flamingo balance test (FBT) for assessing static balance ability and using Y-Balance Test (YBT) for dynamic balance ability.
No significant differences were found in FBT and YBT between the DIBA and control groups at the end of fourth week (p>0.05). However, at the end of the eighth week, the DIBA group demonstrated statistically significantly better balance ability on the anterior component of YBT (p=0.001) and FBT (p=0.024) than controls.
The results of this study suggest that the DIBA was effective in both static and dynamic balance training and it may be used alongside other balance tools in a clinical setting. Further studies should include in lower extremity problems to confirm that DIBA training adaptations are transferred to clinical improvements in performance and balance qualities.
2d.
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