Functional Knee Extension Test (FKET): Inter-rater palpatory agreement and visual analysis during a non-weight bearing functional assessment of the knee.

OBJECTIVE: The purpose of this study was to evaluate the inter-rater reliability of the Functional Knee Extension Test (FKET), a non-weight bearing functional assessment of the knee that is utilized within clinical practice. METHODS: The design was a single-session, test-retest reliability study. Active knee extension was assessed and documented by each examiner for each of the visual, palpatory and vastus medialis obliqus (VMO) components of the FKET on fifty-seven healthcare professionals. RESULTS: The Kappa (κ) statistic for the inter-rater reliability for the visual, palpatory and VMO variables of the FKET were slight-to-fair (0.13-0.26), fair-to-moderate (0.39-0.50), and moderate-to-almost perfect (0.57-0.93) reliability, respectively. The p-values for all variables, besides 'Visual RIGHT: TibTubExt' and 'Visual LEFT: TibTubExt' indicated statistically significant evidence of agreement above random guessing. Estimates for κ on the 'VMO Quantity: No contact' and 'VMO Timing: Start then stop' variables could not be calculated as ratings only existed across one row of the crosstabulation. CONCLUSION: This study demonstrated that the palpatory and VMO components of the FKET have sufficient reliability to justify utilization within clinical practice. Future research is needed to determine whether the implementation of a functional knee assessment protocol, including the FKET could enhance levels of reliability in clinical decision-making of knee function.

Individualized multi-modal management of osteitis pubis in an Australian Rules footballer.

OBJECTIVE: The purpose of this case report is to describe and discuss the successful management of osteitis pubis in a semi-elite Australian Rules football player through the utilization of an individualized multi-modal treatment approach provided by a chiropractor. CLINICAL FEATURES: A 20-year-old male semi-elite Australian Rules football player presented to a chiropractic clinic with groin pain of eight months duration. A clinical diagnosis of osteitis pubis was made through synthesis of the patient history and physical examination. INTERVENTION AND OUTCOME: Treatment consisted of high velocity low amplitude spinal manipulative therapy, mechanically assisted adjusting techniques utilizing a hand-held mechanical thrusting instrument and drop piece table, myofascial release and active release soft tissue techniques, proprioceptive neuromuscular facilitation stretching, and an individually designed rehabilitation program. Resolution of signs and symptoms occurred over four weeks. No recurrence of injury was reported over a six-month period. CONCLUSIONS: This case suggests that the implementation of an individualized multi-modal management approach directed specifically toward an athlete's deficiencies and requirements, may lead to a more rapid recovery from osteitis pubis.

The effect of close proximity holographic wristbands on human balance and limits of stability: a randomised, placebo-controlled trial.

The purpose of this study was to investigate the effect of holographic technology wristbands on human balance and stability performance. Forty-two individuals volunteered to participate in the study. A performance technology silicone wristband containing two holograms was utilised as the 'Device'. A 'placebo' performance technology silicone wristband was utilised where the two holograms were removed and replaced with two stainless steel discs to the same dimensions and weight as the Device. Each participant was randomly allocated into two different testing protocol groups: Protocol 1 (Device-baseline-placebo) and Protocol 2 (placebo-baseline-Device). One week following the initial testing, the Protocol 1 group was tested under the conditions of Protocol 2, and vice versa, so that all participants were taken through both protocols. Results indicated that there was no statistically significant mean change in balance performance brought about by either the placebo or the Device. Notably, the sample data indicated an overall decrease in balance and stability. However, these mean changes are still within the bounds of what would be expected assuming the Device had no overall effect. The findings of this study indicate that holographic technology wristbands have no effect on human balance and stability performance.

Chiropractic management of a medial meniscus tear in a patient with tibiofemoral degeneration: a case report.

OBJECTIVE: The purpose of this case report is to describe and discuss the clinical diagnosis of a medial meniscus tear in an older patient using a multimodal management approach provided by a chiropractor. CLINICAL FEATURES: A 60-year-old woman reported to a chiropractic clinic with left knee pain and swelling. The history and physical examination findings suggested a medial meniscus tear, which was confirmed with magnetic resonance imaging. INTERVENTION AND OUTCOME: Treatment consisted of therapeutic ultrasound; rest, ice, compression, and elevation protocol; soft tissue therapy using effleurage and lymphatic drainage; chiropractic mechanically assisted adjusting techniques to the left knee using a handheld mechanical thrusting instrument; sports taping applied to assist facilitation of the vastus medialis obliquus; and a specific rehabilitation program aimed at strengthening this musculature. The patient's pain was assessed using a quadruple numeric pain scale. Function of the left knee was examined using McMurray, Apley, and a variation of Helfet orthopedic tests, as well as joint line tenderness. Monitoring was done at the initial consultation and at the sixth and 12th treatments. The patient reported being able to walk, swim, and ride a bicycle asymptomatically. Her pain score at the concluding visit was 16.7%, indicating low-intensity pain. CONCLUSION: This case indicated that conservative management of a meniscus tear through a chiropractic multimodal treatment approach provided an alternative or adjunctive therapy to routine orthopedic surgery for this patient.