Physical Therapy

Rothstein, Jules, M

doi: 10.1093/ptj/70.1.1pmid: 2294525

The scientific world is still trying to forget a comic interlude that could be known as the “Cold Fusion Fiasco.” We remember the popular press heralding the triumph of Utah researchers who promised to revolutionize the world with their ability to generate power from cold fusion in a bottle. We also remember the circus atmosphere surrounding the announcement and the uproar that followed. Within weeks of the announcement, the scientists were condemned for reporting their results in the popular press. They were also condemned for the quality of their research. The episode was without heroes. Everybody involved ended up looking either foolish or vindictive. Many physical therapists can now identify with the world of the physicists. In the two days before I wrote this Editor's Note, reports on two television networks, NBC and CNN, related apparently wonderful news. This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

Gross, Michael, T;Credle, Jennifer, K;Hopkins, L, Annette;Kollins, Tracy, M

doi: 10.1093/ptj/70.1.3pmid: 2294529

The primary purpose of this study was to test the validity of predictive models relating isokinetic knee torque production to anthropometric and demographic variables. Subjects were 23 healthy female and 15 healthy male volunteers between the ages of 10 and 77 years. We measured subjects' peak knee flexion and extension torque production at two angular velocities. For each torque dependent variable, we calculated a Pearson product-moment correlation coefficient between the measured torque values and the values obtained with prediction equations. The difference between the squared value of the correlation coefficients and the regression multiple R2 values obtained for an original group of 134 subjects ranged between .05 and .10 for the torque dependent variables. The results indicate the validity of the regression models at the level specified by the multiple regression R2 values. Clinicians can use the prediction equations presented in this article to establish rehabilitation goals for patients and can estimate the error involved in applying each prediction equation. Kinesiology/biomechanics, lower extremity, Muscle atrophy, Muscle performance, lower extremity, Rehabilitation This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

Draper,, Vanessa

doi: 10.1093/ptj/70.1.11pmid: 2294526

The purpose of this study was to compare the effects of biofeedback-facilitated exercise with exercise alone on the recovery rate of quadriceps femoris muscle function following anterior cruciate ligament (ACL) reconstruction. Functional measures included 1) a dynamometric test of quadriceps femoris muscle isometric peak torque during the 12th postoperative week and 2) the number of days postoperatively that a patient achieved full active extension of the knee. Twenty-two patients with acute ACL injury were randomly assigned to a Treatment (biofeedback) Group (n = 11) or a Control (nonfeedback) Group (n = 11) during the first therapy session one week after reconstructive surgery. After the patients had completed the 12-week exercise program, the quadriceps femoris muscle isometric peak torque in the operative limb was compared with that in the nonoperative limb at three angles (90°, 60°, and 45°) of extension. An analysis of variance revealed significant differences between the Treatment and Control Groups at all three angles. Mean recovery time was calculated for each group, and a t test for independent samples indicated a significant difference between the groups. These results demonstrate that the addition of biofeedback to muscle strengthening exercises facilitates the rate of recovery of quadriceps femoris muscle function following ACL reconstruction. Biofeedback, Electromyography, Lower extremity, knee, Motor activity, Muscle performance, lower extremity This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

Annesley, Annette, L;Almada-Norfleet,, Monica;Arnall, David, A;Cornwall, Mark, W

doi: 10.1093/ptj/70.1.18pmid: 2294527

Energy expenditure is increased for ambulation with various assistive devices such as canes, walkers, and crutches compared with unassisted ambulation. The purpose of the present investigation was to determine whether a significant difference in oxygen consumption and heart rate existed during ambulation with two different types of crutches. Ten healthy male subjects between the ages of 40 and 60 years participated in this study. Each subject ambulated at 1.5 mph on a treadmill using two different types of crutches—the standard axillary crutch and the Sure-Gait® crutch. After walking on the treadmill without an assistive device, subjects ambulated using a three-point, swing-to gait pattern with one of the two types of crutches. This procedure was repeated using the other type of crutch. Oxygen consumption and heart rate were analyzed using an analysis of variance for repeated measures design. The results of the study showed a significant difference (p < .01) between ambulation with crutches and unassisted ambulation for oxygen consumption and heart rate. No difference, however, was found between the two crutch types. Crutches, Energy expenditure, Equipment, general, Gait, Orthotics/splints/casts, general This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

King, Carolyn, E;Clelland, Jo, Ann;Knowles, Cheryl, J;Jackson, James, R

doi: 10.1093/ptj/70.1.24pmid: 2294528

This study was conducted to examine the effects of helium-neon laser auriculotherapy on experimental pain threshold. Eighty healthy female and male subjects, aged 18 to 39 years, were assigned randomly to one of two treatment groups. Subjects in the Experimental Group (n = 41) received laser stimulation, and subjects in the Control Group (n = 39) received sham stimulation to appropriate acupuncture points on the left ear. Experimental pain threshold at the ipsilateral wrist was determined with an electrical stimulus immediately before and after treatment. The mean change (posttreatment minus pretreatment) for the Experimental Group was greater than the mean change for the Control Group (p < .05). The Experimental Group demonstrated a statistically significant (p < .05) increase in mean pain threshold after treatment, but the Control Group did not. Results indicate that helium-neon laser auriculotherapy can increase experimental pain threshold and suggest a possible alternative for patients intolerant of transcutaneous electrical nerve stimulation. Electrotherapy, electrical stimulation, Lasers, Pain, Transcutaneous electrical nerve stimulation This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

Stratford, Paul, W;Thomson, Mary, Ann;Sanford,, Julie;Saarinen,, Helen;Dilworth,, Peter;Solomon,, Patty;Nixon,, Patty;Fraser-MacDougall,, Vicki;Pierce-Fenn,, Halyna

doi: 10.1093/ptj/70.1.31pmid: 2294530

This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study were 1) to examine how two item-sampling strategies (one based on different diagnostic concepts, or diagnostic probes, and the other based on different anatomical sites) influenced the generalizability of a station examination, 2) to determine the interrater reliability during the station examination, and 3) to determine whether the status of the rater (that of observer or simulated patient) influenced the rating. Using a nested study design, 24 physical therapy students were assessed by eight raters. The raters were randomly and equally assigned to four teams. Each team assessed six students. One rater acted as the simulated patient for the first three students in each group, and the other rater acted as observer. This order was reversed for the last three students. Each student performed nine mini-diagnostic patient cases consisting of three diagnostic probes reproduced at three different anatomical sites. The results demonstrate that 1) similar diagnostic concepts can be generalized across anatomical sites, although different concepts or skills cannot be generalized at a given anatomical site or across sites; 2) interrater reliability was excellent; and 3) the status of the raters (ie, simulated patient or observer) did not bias the ratings. These findings suggest that increasing the number of diagnostic probes is a better strategy than increasing the number of anatomical sites for improving the overall test generalizability. Furthermore, costs (ie, expenditures of faculty time and funds) can be reduced by using a single rater acting as both the simulated patient and the rater. Competency-based education, Education: physical therapist, clinical education, Educational measurement, Program evaluation, Students This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

Im, Michael, J;Lee, W P, Andrew;Hoopes, John, E

doi: 10.1093/ptj/70.1.37pmid: 2294531

The purpose of this study was to investigate the effect of electrical stimulation on ischemia-induced tissue injury in skin flaps. Bipedicle skin flaps measuring 4 × 20 cm were created bilaterally on the flanks of 12 Yorkshire pigs. The ischemic central portions of the flaps were treated with 35 mA of electrical current at a frequency of 128 Hz for 30 minutes twice daily during the initial nine days following skin-flap elevation. The treatment schedule consisted of negative-electrode stimulation during the first three days, positive-electrode stimulation during the second three days, and negative-electrode stimulation during the seventh to ninth days. Five control pigs underwent either no treatment (n = 3) or sham treatment (n = 2). The mean area of the skin flaps exhibiting necrosis was 28.0% in the control animals and 13.2% in the stimulated animals. These areas were significantly different (p < .001). The results indicate that pulsed electrical stimulation can improve the survival of skin flaps. Animals, laboratory, Electrotherapy, electrical stimulation, Ischemia, Tissue survival, Wound healing This content is only available as a PDF. Author notes This work was supported in part by a grant from Staodynamics, Inc, and in part by National Institutes of Health Grant AR 33638. A preliminary report of this study was presented at the National Symposium on Wound Repair, Denver, CO, March 7, 1987. © 1990 by the American Physical Therapy Association Inc.

Cibulka, Michael, T

doi: 10.1093/ptj/70.1.41pmid: 2294532

A 16-year-old high school track athlete developed forefoot pain near the end of track season. He developed pain around the metatarsophalangeal joint of his hallux, with pain mostly during propulsion. On examination, he exhibited limited dorsiflexion of the first metatarsophalangeal joint. Treatment for the restricted metatarsophalangeal joint was aimed at restoring normal motion. After five sessions of mobilizing the restricted metatarsophalangeal joint, the patient was able to return to track without complaint. This case report demonstrates the importance of metatarsophalangeal joint dorsiflexion in the management of forefoot pain. Forefoot, human, Kinesiology/biomechanics, lower extremity, Lower extremity, ankle and foot, Physical therapy This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

Twist, Donna, J

doi: 10.1093/ptj/70.1.45pmid: 2294533

This case report documents the treatment of a spinal cord injured patient with acrocyanosis of both feet. The 37-year-old white male patient sustained a traumatic spinal cord injury at the age of 16 years, which resulted in an incomplete vertebral fracture of the C5-C6 level. He was treated with computerized neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle with weights applied to the ankles an average of two times per week for six weeks. Improvements in the color of the patient's skin and toe ulcers, stronger pedal pulses bilaterally, decreased swelling bilaterally, and subjective reports of less discomfort were noted. The empirical findings of this case report suggest that computerized NMES may be effective for improving circulation in the spinal cord injured individual with acrocyanosis. Further study, however, is needed to determine whether a relationship may exist between blood flow and computerized NMES. Electrotherapy, electrical stimulation, Equipment, exercise, Exercise This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.

doi: 10.1093/ptj/70.1.54pmid: N/A

Please note the following correction in the article “A Model for Multisystem Evaluation and Treatment of Individuals with Parkinson's Disease” by Schenkman and Butler, which appeared in the November 1989 issue of Physical Therapy. In the Appendix on page 942, the term Balance Control/Postural Control should read “Refers to the outcome as an individual attempts to maintain stability.” The Journal regrets the error. This content is only available as a PDF. © 1990 by the American Physical Therapy Association Inc.