doi: 10.1093/ptj/75.8.655pmid: 7644569
Article PDF first page preview Close This content is only available as a PDF. © 1995 by the American Physical Therapy Association Inc.
Damiano, Diane, L;Kelly, Luke, E;Vaughn, Christopher, L
doi: 10.1093/ptj/75.8.658pmid: 7644570
Background and Purpose. Despite evidence of weakness in children with cerebral palsy, the use of strength training in this population remains controversial. Subjects. Fourteen children with spastic diplegia, ranging in age from 6 to 14 years (X̅=9.1, SD=2.5), participated in a bilateral quadriceps femoris muscle strengthening program. Methods. The children exercised three times per week for 6 weeks using ankle weights at loads of approximately 65% of each child's maximum isotonic force production. The maximal voluntary contraction of the quadriceps femoris muscles was measured before, at the midpoint of, and immediately following the exercise program at 30, 60, and 90 degrees of knee flexion. Gait analyses were performed before and after the strengthening program to determine whether quadriceps femoris muscle strengthening influenced gait. Results. Children with spastic diplegia can increase quadriceps femoris muscle strength through heavy resistance exercise. Repeated-measures analysis of variance and multivariate analysis of variance procedures were used to assess changes in force and in gait variables. Improvement in the degree of crouch at initial floor contact at the freely selected speed and an increase in stride length at free and fast speeds were found. Conclusion and Discussion. These findings suggest that resistance exercise is an effective treatment strategy and as such should be considered as one component in the habilitation of children with cerebral palsy. Cerebral palsy, Crouch, Gait, Quadriceps femoris muscle, Strengthening This content is only available as a PDF. Author notes This study was approved by the Human Investigation Committee, University of Virginia. © 1995 by the American Physical Therapy Association Inc.
Westcott, Sarah, L;Pax Lowes,, Linda
doi: 10.1093/ptj/75.8.668pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © 1995 by the American Physical Therapy Association Inc.
doi: 10.1093/ptj/75.8.670pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © 1995 by the American Physical Therapy Association Inc.
doi: 10.1093/ptj/75.8.672pmid: 7644571
Background and Purpose. The purpose of this study was to determine which of selected exercises with and without the feet free to move would enhance vastus medialis oblique muscle (VMO) activity over that of the vastus lateralis muscle (VL) and whether the use of taping would increase VMO activity. Subjects. Twenty-one subjects without patellofemoral pain (PFP) syndrome and 10 subjects with PFP syndrome, aged 19 to 43 years (X̅=26, SD=7), participated. Methods. Subjects were studied for the normalized, integrated electromyographic (IEMG) activity of their VMO, VL, and adductor magnus muscle (subjects without PFP syndrome) and the VMO/VL ratio using wire electrodes. Results. One exercise demonstrated greater activation of the VMO over the VL when compared with similar exercises in subjects without PFP syndrome. The mean VMO/VL activity ratio for terminal knee extension was 1.2 (SD=0.5) with the hip medially rotated and 1.0 (SD=0.4) with the hip laterally rotated. Although subjects reported that patellar taping decreased pain 94% during the step-down exercise, the VMO/VL ratio was not changed. Conclusion and Discussion. The results suggest that neither exercises purported to selectively activate VMO activity nor patellar taping improve the VMO/VL ratio over similar exercises. Adductor magnus, Electromyography, Patellofemoral, Vastus lateralis, Vastus medialis oblique This content is only available as a PDF. Author notes The study protocol was approved by the Human Subjects Committee, California State University, Long Beach. Results of this research were previously presented at the 1991 and 1992 Annual Conferences of the California Chapter of the American Physical Therapy Association and at the 1991 and 1922 Annual Conferences of the Long Beach Veterans Administration Hospital-California State University, Long Beach-Memorial Medical Center of Long Beach. © 1995 by the American Physical Therapy Association Inc.
Mueller, Michael, J;Minor, Scott, D;Schaaf, James, A;Strube, Michael, J;Sahrmann, Shirley, A
doi: 10.1093/ptj/75.8.684pmid: 7644572
Background and Purpose. Limited ankle plantar-flexor moments and power during walking have been documented in several patient populations and are believed to contribute to gait deviations. The primary purpose of this study was to determine the relationship of plantar-flexor peak torque (PFPT) and dorsiflexion range of motion (ROM) to peak ankle moments and power during walking in a group of subjects without diabetes mellitus (DM) and in a group of subjects with DM and associated peripheral neuropathies. Subjects. Nineteen subjects, 9 with DM and associated peripheral neuropathies (mean age=58 years, SD=14, range=35–75 years) and 10 without DM (mean age=57 years, SD=11, range=37–68 years), were evaluated. Methods. The following data were collected on all subjects: PFPT, dorsiflexion ROM, and ankle moments and power during walking (using a two-dimensional link-segment model). Hierarchical multiple regression was used for data analysis. Results. Plantar-flexor peak torque made substantial contributions to the ankle moment (40%) and ankle plantar-flexor power (53%) during walking. There also was a high correlation between PFPT and dorsiflexion ROM (r=.78) and between dorsiflexion ROM and ankle power (r=.72). Conclusion and Discussion. Plantar-flexor peak torque and dorsiflexion ROM are interrelated and appear to be important factors that contribute to ankle plantar-flexor moments and power during walking. This finding suggests that increasing PFPT and dorsiflexion ROM may help decrease gait deviations such as decreased step length and walking speed. When increasing PFPT is not possible, the natural occurrence of limited dorsiflexion ROM may help to maximize ankle moments during walking. Further research is needed to test whether these proposed treatment strategies can have a clinically useful effect. Diabetes, Kinesiology/biomechanics, gait analysis, Kinetics, Lower extremity, ankle and foot, Muscle performance, lower extremity This content is only available as a PDF. Author notes This study was approved by the Human Studies Committee of Washington University School of Medicine. This study was supported by a grant from the Foundation for Physical Therapy Inc. © 1995 by the American Physical Therapy Association Inc.
Lunsford, Brenda, Rae;Perry,, Jacquelin
doi: 10.1093/ptj/75.8.694pmid: 7644573
Background and Purpose. Manual muscle testing with the examiner providing the resistance has long been a standard test of muscle strength. Through the use of extremities acting as levers, clinicians have been able to effectively apply resistance to all muscle groups except the the ankle plantar flexors. As a result, a standing heel-rise test that uses body weight as the resistance has been substituted. The number of heel-rises that represent normal plantar-flexor “strength” and the ability of subjects to repeatedly use that “strength” remain unresolved. Because walking is an endurance task, the hypothesis tested by this study was that individuals without known weakness would be able to perform more than the standard recommended one to five standing heel-rises. The purpose of this study was to measure the number of standing heel-rises that individuals without known weakness could accomplish. Subjects. Two hundred three subjects were studied for their ability to do standing heel-rises, as is done when testing plantar-flexion strength using the upright test. There were 122 male subjects and 81 female subjects, ranging in age from 20 to 59 years. Methods. Each subject was asked to do as many standing heel-rises as he or she could, with careful monitoring of body and limb alignment and of ankle motion, with specific criteria for stopping. Results. The average number of heel-rises was 27.9 (SD=11.1, minimum=6, maximum=70) for all groups and both genders, with no differences between male and female subjects. The lower 99% confidence interval was 25. Conclusion and Discussion. A recommendation is made to change the standard of testing plantar-flexion function, when using the standing heel-rise test, to require 25 repetitions for a grade of Normal. Function, Muscle test, Plantar flexion, Strength, Terminal stance This content is only available as a PDF. Author notes This study was approved by the Los Amigos Research and Educational Institute Research Review Committee. © 1995 by the American Physical Therapy Association Inc.
Nichols, Deborah, S;Glenn, Terri, M;Hutchinson, Karen, J
doi: 10.1093/ptj/75.8.699pmid: 7644574
Background and Purpose. The analysis of standing balance is now possible using commercially available force platforms. In order to establish appropriate testing and treatment protocols for patient populations, we contend data should be collected relative to the typical response of nonpatient groups. More importantly, we need to better understand response characteristics of persons with intact nervous systems. The purpose of this study was to evaluate the typical response of young adults without known musculoskeletal or neurological impairments to balance testing with the Balance System™. Subjects. Sixty-six subjects without known impairments (mean age=23.6 years, SD=4.5, range=21–47) were evaluated in a single testing session. Methods. Center of balance (COB), a vertical force measurement, was evaluated under each of 18 conditions: 2 visual conditions (eyes open, eyes closed), 3 platform conditions (stable, vertical tilt, linear translation), and 3 foot positions (apart, together, tandem). Results. An effect was found for average displacement to the left along the x axis under all testing conditions. The COB locus along the y axis was dependent on the foot position, platform condition, and visual condition. Conclusion and Discussion. Movement of the COB toward the center of the base of support accompanied closing of the eyes, narrowing of the base of support, and movement of the support surface. These findings are consistent with the need to move the center of gravity away from the limits of stability under more challenging stance conditions. This study contributes to the existing knowledge base related to standing balance function in young adults without musculoskeletal or neurological impairments and provides data that can be used for criterion-based comparisons of young adult patients. Balance assessment, Center of pressure, Postural control This content is only available as a PDF. Author notes The testing protocol was approved by The Ohio State University Biomedical Sciences Human Subject Review Committee. © 1995 by the American Physical Therapy Association Inc.
doi: 10.1093/ptj/75.8.707pmid: 7644575
Article PDF first page preview Close This content is only available as a PDF. © 1995 by the American Physical Therapy Association Inc.
doi: 10.1093/ptj/75.8.765pmid: 7644576
To the Editor: Valma Robertson's conclusion that published research reports in our profession show little evidence of cumulation of knowledge, within the areas of literature she studied,1 helps cast a harsh and embarrassing light on a continuing intellectual deficit in physical therapy, namely, the lack of theory required to direct research efforts and make sense out of research results. As the “So what?” of research, theory is the sine qua non for creating and expanding knowledge and for developing a science of physical therapy. A decade ago, the American Physical Therapy Association's Committee on Research (COR) identified the need for a major effort to promote the development of theory in physical therapy. In 1986, the COR issued its first call for theory papers to be presented at the Association's 1987 Annual Conference.… Response: Valma J Robertson, PhD, BAppSc(Phty), BA(Hons), Senior Lecturer, School of Physiotherapy, La Trobe University, Locked Bag 12, Carlton South 3053, Victoria, Australia This content is only available as a PDF. © 1995 by the American Physical Therapy Association Inc.
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