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1.
Int J Sports Phys Ther ; 14(3): 368-375, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31681496

RESUMEN

Background: Kinesio Tape® (KT) is an elastic therapeutic tape that is applied to the skin for treatment of sport-related injuries. Its application has been purported to facilitate the neuromuscular system, thus altering skeletal muscle activity to increase joint range of motion and improve performance. Due to its proposed therapeutic effect, KT may benefit individuals with excess foot pronation in order to decrease pain and improve function. Unfortunately, current research regarding the ability of KT to alter foot biomechanics is limited. Purpose: The purpose of this study was to determine if the application of KT to the ankle and lower leg would alter static foot posture, plantar pressure, and foot motion during walking in individuals with foot pronation. Study Design: Prospective Cohort Study. Methods: Thirty participants (10M/20F) were recruited for this study. Each participant had their dorsal arch height and midfoot width measured prior to the application of the KT. In addition, their dynamic rearfoot eversion and plantar pressure was recorded during walking using an electrogoniometer and plantar pressure system. After these measurements were collected, KT was applied to their right foot and lower leg in order to attempt to facilitate activity in the posterior tibialis muscle. After applying the tape, the above measurements were repeated. Results: None of the variables measured were statistically significantly different between the pre-test and post-test. Conclusion: Application of KT did not result in a change in static foot posture, plantar pressure, and frontal plane rearfoot motion during walking. As such, KT cannot be recommended as a treatment for reducing excessive foot pronation where such a goal would be beneficial. Level of Evidence: Level 3.

2.
Gait Posture ; 70: 130-135, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30852439

RESUMEN

BACKGROUND: It is estimated that nearly 2 million individuals sprain their ankle each year in the US. A majority of these are recurrent injuries, which often results in chronic ankle instability. To better understand the cause of instability, previous research has looked at the coupling or coordination between leg and foot motion during locomotion. RESEARCH QUESTION: Determine the coupling between the tibia and the calcaneus during the stance phase of walking in those without a history of ankle instability compared to those with either moderate or severe instability. METHODS: Fifty-four individuals between the age of 18-30 years (15 males; 39 females) participated in this study. Each participant's history of ankle sprains and score on the Cumberland Ankle Instability survey was used to assign them to either a no, moderate or severe instability group. Electromagnetic sensors attached to the tibia and calcaneus recorded three-dimensional movement of their tibia and calcaneus during the stance phase of barefoot over ground walking. The kinematic data was referenced to the subject's standing position and time normalized to each subject's stance phase duration. The relative phase (RP) angle and RP variability between tibia internal/external rotation and calcaneal inversion/eversion motion was then calculated. A one-way analysis of variance test was used to determine if significant differences existed between the three groups of subjects on mean RP angle or variability. An alpha level of .05 was used to determine statistical significance. RESULTS: A significant increase in RP angle and variability was found during the mid-stance phase of walking for those with severe ankle joint instability compared to those with moderate or no instability. SIGNIFICANCE: The observed decreased coordination and increased coupling variability observed for those with severe ankle instability suggests either residual ligamentous damage, inadequate sensorimotor control, or both.


Asunto(s)
Traumatismos del Tobillo/fisiopatología , Articulación del Tobillo/fisiopatología , Calcáneo/fisiopatología , Inestabilidad de la Articulación/fisiopatología , Tibia/fisiopatología , Caminata/fisiología , Adolescente , Adulto , Fenómenos Biomecánicos , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Adulto Joven
3.
J Interprof Care ; 33(5): 590-592, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30444153

RESUMEN

Interprofessional education (IPE) is vital in university clinical settings to prepare graduate students to engage in today's health care system. However, few university programs have successfully implemented IPE into existing clinical programs. The purpose of this pilot study was to evaluate the effectiveness of an interprofessional (IP) training and clinical experience on graduate students' and caregivers perceptions on quality of care in a pre-existing clinical program. Speech-language pathology (SLP) and Physical Therapy (PT) faculty, worked to coordinate and develop an IP training and clinical experience. Graduate students from both disciplines participated in the IP training and completed a pre-post training questionnaire. Students then participated in an IP clinical experience with three preschool-age children with complex sensory motor needs and completed the questionnaire again following this experience. Students' attitudes and perceptions of readiness for IP engagement following IPE training showed a positive trend but not following an IP clinical experience. Subjective feedback from students and caregivers was highly favorable. The results provide further evidence of the benefits of IP training and clinical experience. More effective qualitative and quantitative tools must be developed to capture the effectiveness of direct IP clinical collaboration.

4.
J Geriatr Phys Ther ; 42(4): 249-255, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-29095771

RESUMEN

BACKGROUND AND PURPOSE: Several measures of fall risk have been previously developed and include forward walking, turning, and stepping motions. However, recent research has demonstrated that backwards walking is more sensitive at identifying age-related changes in mobility and balance compared with forward walking. No clinical test of backwards walking currently exists. Therefore, this article describes a novel clinical test of backwards walking, the 3-m backwards walk (3MBW), and assessed whether it was associated with 1-year retrospective falls in a population of healthy older adults. Diagnostic accuracy of the 3MBW was calculated at different cutoff points and compared with existing clinical tests. METHODS: This study was a retrospective cohort study including residents of a retirement community without a history of neurological deficits. Demographics, medical history, and falls in the past year were collected, and clinical tests included the 3MBW and the Timed Up and Go (TUG), the 5 times sit-to-stand, and the 4-square step test. Frequency distributions and t tests compared baseline characteristics of people who reported falling with people who did not. Diagnostic accuracy (sensitivity and specificity) was calculated for a series of cutoffs for the 3MBW, the TUG (≥8, 10, and 13.5 seconds), 5 times sit-to-stand (≥12 and ≥15 seconds), and 4-step square test (>15 seconds). Receiver operating curve analyses were used to define 3MBW optimal cutoffs, and the difference between the overall area under the curve (AUC) was statistically tested. SPSS 24.0 and MedCalc 17.1 were used for all analyses. RESULTS AND DISCUSSION: Fifty-nine adults with a mean (SD) age of 71.5 (7.6) years participated, with 25 people reporting falls in the past year. The mean (SD) time for the 3MBW was 4.0 (2.1) seconds. People who fell had a significantly slower 3MBW time (4.8 vs 3.5 seconds for people who did not fall, P = .015), but not a significantly slower 4-step square test (9.5 vs 8.1 seconds, P = .056), TUG (9.3 vs 8.0 seconds, P = .077), and 5 times sit-to-stand (12.5 vs 10.3 seconds, P = .121). The highest overall AUC for any measure was for the 3MBW at 3.5 seconds (0.707, 95% confidence interval = 0.570-0.821; sensitivity = 74%, specificity = 61%), which was significantly higher than the TUG at 8 seconds (AUC = 0.560, P = .023) and 13.5 seconds (AUC = 0.528, P = .011), the 4-step square test (AUC = 0.522, P = .004), but not significantly higher than the TUG at 10 seconds (P = .098) and the 5 times sit-to-stand at 12 (P = .092) or 15 seconds (P = .276). On the 3MBW, more than 75% of people who were faster than 3.0 seconds did not report any falls, and 94% of people who did not report falling were faster than 4.5 seconds. Of the people who were slower than 4.5 seconds, 81% reported falling. CONCLUSIONS: In a study of healthy older adults, the 3MBW demonstrated similar or better diagnostic accuracy for falls in the past year than most commonly used measures. People walking faster than 3.0 seconds on the 3MBW were unlikely to have reported falling, whereas people slower than 4.5 seconds were very likely to have reported falling. Further validation of the 3MBW in prospective studies, larger samples, and clinical populations is recommended.

5.
Artículo en Inglés | MEDLINE | ID: mdl-27642647

RESUMEN

BACKGROUND: Balance training has been shown to be effective in preventing ankle sprain recurrences in subjects with chronic ankle instability (CAI) but the biomechanical pathways underlying the clinical outcomes are still unknown. This study was conducted to determine if a 4-week balance training intervention can alter the mechanical characteristics in ankles with CAI. METHODS: Twenty-two recreationally active subjects with unilateral CAI were randomized to either a control (n = 11, 35.1 ± 9.3 years) or intervention (n = 11, 33.5 ± 6.6 years) group. Subjects in the intervention group were trained on the affected limb with static and dynamic components using a Biodex balance stability system for 4-weeks. The ankle joint stiffness and neutral zone in inversion and eversion directions on the involved and uninvolved limbs was measured at baseline and post-intervention using a dynamometer. RESULTS: At baseline, the mean values of the inversion stiffness (0.69 ± 0.37 Nm/degree) in the involved ankle was significantly lower (p < 0.011, 95% CI [0.563, 0.544]) than that of uninvolved contralateral ankle (0.99 ± 0.41 Nm/degree). With the available sample size, the eversion stiffness, inversion neutral zone, and eversion neutral zone were not found to be significantly different between the involved and uninvolved contralateral ankles. The 4-week balance training intervention failed to show any significant effect on the passive ankle stiffness and neutral zones in inversion and eversion. CONCLUSION: Decreased inversion stiffness in the involved chronic unstable ankle was found that of uninvolved contralateral ankle. The 4-week balance training program intervention was ineffective in altering the mechanical characteristics of ankles with CAI. LEVEL OF EVIDENCE: Randomized controlled clinical trial; Level of evidence, 1.

7.
Gait Posture ; 39(1): 529-33, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24119321

RESUMEN

The purpose of this research study was to determine the dynamics of early human response from sudden ankle inversion (30° tilt). Changes in vertical ground reaction forces (GRFs) following trapdoor release in a group of healthy subjects were compared to those from the similar experiments using a chair with two U shaped steel legs and matched weights of the human subjects. The experiments with the chair were further repeated with additional foam paddings at their bases to introduce visco-elastic properties to legs of the chair. Following the trapdoor release a decrease in the vertical ground reaction force under the inverting leg and subsequent increase in the supporting leg were observed in both human and chair experiments. The short onset of changes in vertical GRFs in our experiments indicate that the dynamic features of early response following trapdoor release are primarily due to mechanical events and may not be significantly affected by the neuromuscular reaction of human subjects.


Asunto(s)
Traumatismos del Tobillo/fisiopatología , Articulación del Tobillo/fisiología , Soporte de Peso/fisiología , Adulto , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Adulto Joven
8.
J Back Musculoskelet Rehabil ; 27(3): 247-73, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24284277

RESUMEN

BACKGROUND AND OBJECTIVE: Frozen shoulder is a common condition, yet its treatment remains challenging. In this review, the current best evidence for the use of physical therapy interventions (PTI) is evaluated. METHOD: MEDLINE, CINAHL, Cochrane, PEDro, ProQuest, Science Direct, and Sport Discus were searched for studies published in English since 2000. RESULTS: 39 articles describing the PTI were analyzed using Sackett's levels of evidence and were examined for scientific rigor. The PTI were given grades of recommendation that ranged from A to C. CONCLUSIONS: Therapeutic exercises and mobilization are strongly recommended for reducing pain, improving range of motion (ROM) and function in patients with stages 2 and 3 of frozen shoulder. Low-level laser therapy is strongly suggested for pain relief and moderately suggested for improving function but not recommended for improving ROM. Corticosteroid injections can be used for stage 1 frozen shoulder. Acupuncture with therapeutic exercises is moderately recommended for pain relief, improving ROM and function. Electro- therapy can help in providing short-term pain relief. Continuous passive motion is recommended for short-term pain relief but not for improving ROM or function. Deep heat can be used for pain relief and improving ROM. Ultrasound for pain relief, improving ROM or function is not recommended.


Asunto(s)
Bursitis/terapia , Terapia por Ejercicio , Modalidades de Fisioterapia , Rango del Movimiento Articular , Humanos , Resultado del Tratamiento
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