Rehabilitation of the patellofemoral joint.

Nonsurgical care by a specialist in physical medicine and rehabilitation is typically a multifaceted approach, which can include modalities, bracing, medication, injection, proprioceptive techniques, restoration of normal movement patterns, and overall conditioning. There is evidence that physical therapy interventions have significant beneficial effect on pain and function compared with no treatment.

The anatomy and biomechanics of running.

To understand the normal series of biomechanical events of running, a comparative assessment to walking is helpful. Closed kinetic chain through the lower extremities, control of the lumbopelvic mechanism, and overall symmetry of movement has been described well enough that deviations from normal movement can now be associated with specific overuse injuries experienced by runners. This information in combination with a history of the runner's errors in their training program will lead to a more comprehensive treatment and prevention plan for related injuries.

Rehabilitation of running injuries.

Rehabilitating the injured runner involves a thorough evaluation of the runner. The running history is at least as critical as the physical examination to determine the risk factors for injury and goals for rehabilitation. The medical assessment should include an office situation in which the runner can be seen walking and running to ensure that the rehabilitation program is complete and successful.

A preliminary study to examine the effects of aerobic and therapeutic (nonaerobic) exercise on cardiorespiratory fitness and coronary risk reduction in stroke survivors.

OBJECTIVES: To compare the effects of 3 different exercise training regimens on cardiorespiratory fitness and coronary risk factor reduction in subjects with unilateral stroke. DESIGN: A cluster assignment by residential location repeated-measures design. SETTING: University-based medical center. PARTICIPANTS: Fifty-five subjects with unilateral ischemic stroke were assigned to the following groups: intensity (n=18), duration (n=19), and therapeutic exercise (n=18). INTERVENTION: A 14-week intervention with subjects randomized to 1 of 3 interventions: (1) moderate intensity, shorter duration (MISD) exercise (gradually increasing exercise intensity while keeping exercise duration constant at 30 min), (2) low-intensity, longer duration (LILD) exercise (gradually increasing duration to 60 min while keeping exercise intensity constant), or (3) conventional therapeutic exercise (TE) consisting mainly of strength, balance, and range of motion activities. All groups exercised 3 days per week. MAIN OUTCOME MEASURES: Peak oxygen consumption (VO2peak), submaximal oxygen consumption (VO2), lipid panel, and resting blood pressure. RESULTS: The MISD group attained more favorable effects on systolic (P<.04) and diastolic blood pressure (P<.002) and total cholesterol (TC) (P<.036) compared with LILD and TE groups. Both MISD (P<.029) and LILD (P<.045) showed significant reductions in triglycerides compared with TE (P<.029). There was no significant change in VO2peak and submaximal VO2 in any of the groups. CONCLUSIONS: Overall, both MISD and LILD conditions achieved greater clinical and significant gains in coronary risk reduction compared with TE.

Outcomes of a home-based walking program for African-American women.

PURPOSE: As compared with minimal treatment (MT), to determine the effectiveness of a home-based walking intervention enhanced by behavioral strategies targeted and tailored to African-American women (enhanced treatment [ET]) on adherence, physical activity, fitness, and body composition at 24 and 48 weeks. DESIGN: Using a quasi-experimental design, treatments were randomly assigned to one of two community health centers. SETTING: The centers were in predominately African-American communities. PARTICIPANTS: Sedentary women (156 ET, 125 MT) 40 to 65 years were recruited within a 3-mile radius of each center. INTERVENTION: Both treatments had the same orientation. The ET group had four targeted workshops followed by weekly tailored telephone calls over 24 weeks. METHODS: Generalized linear mixed models were used to test effects of treatments on adherence, physical activity, aerobic fitness, and body composition. RESULTS: Adherence was significantly higher in the ET than the MT group and was related to the number of workshops attended (r = .58) and tailored calls (r = .25) received. On-treatment analysis showed significant postintervention improvement in waist circumference and fitness in the ET group; however, these improvements were not statistically different between the two groups. Intent to treat analysis showed a significant increase in fitness, decrease in waist circumference, and no change in body mass index in both treatments. CONCLUSION: Findings suggest the potential impact of workshop group support on adherence in African-American women.