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1.
Proprioceptivetrainingandrehabilitationtechniquesareusedextensivelytotrytomaximizeprotectionfrominjuryandalsoprovideoptimalfunctionalrestorationinrehabilitationprograms.Jointlaxityitselfdoesnotnecessarilypredictthepresenceorseverityoffunctionalinstability[1] .Inaddition ,studieshaveshownthatproprioceptionistrainableandthatproprioceptive basedrehabilitationprogramsimproveobjec tivemeasurementsoffunctionalstatusindependentofchangesinjointlaxity[2 ] .Ithasbeenpostulatedthatim paired”positionsens…  相似文献
2.

Background

Sensorimotor control is permanently impaired following functional ankle instability and temporarily decreased following fatigue. Little is known on potential interactions between both conditions. The purpose was to investigate the effect of fatiguing exercise on sensorimotor control in athletes with and without (coper, controls) functional ankle instability.

Methods

19 individuals with functional ankle instability, 19 ankle sprain copers, and 19 non-injured controls participated in this cohort study. Maximum reach distance in the star excursion balance test, unilateral jump landing stabilization time, center of pressure sway velocity in single-leg-stance, and passive ankle joint position sense were assessed before and immediately after fatiguing treadmill running. A three factorial linear mixed model was specified for each outcome to evaluate the effects of group, exhausting exercise (fatigue) and their interactions (group by fatigue). Effect sizes were calculated as Cohen's d.

Findings

Maximum reach distance in the star excursion balance test, jump stabilization time and sway velocity, but not joint position sense, were negatively affected by fatigue in all groups. Effect sizes were moderate, ranging from 0.27 to 0.68. No significant group by fatigue interactions were found except for one measure. Copers showed significantly larger prefatigue to postfatigue reductions in anterior reach direction (P ≤ 0.001; d = − 0.55) compared to the ankle instability (P = 0.007) and control group (P = 0.052).

Interpretation

Fatiguing exercise negatively affected postural control but not proprioception. Ankle status did not appear to have an effect on fatigue-induced sensorimotor control impairments.  相似文献
3.

Background

A functionally induced, transient low back pain model consisting of exposure to prolonged standing has been used to elucidate baseline neuromuscular differences between previously asymptomatic individuals classified as pain developers and non-pain developers based on their pain response during a standing exposure. Previous findings have included differences in frontal plane lumbopelvic control and altered movement strategies that are present prior to pain development. Control strategies during sagittal plane movement have not been previously investigated in this sample. The purpose of this research was to investigate neuromuscular control differences during the extension phase from trunk flexion between pain developers and non-pain developers.

Methods

Continuous electromyography and kinematic data were collected during standing trunk flexion and extension on 43 participants (22 male) with an age range of 18–33 years, prior to entering into the prolonged standing exposure. Participants were classified as pain developer/non-pain developer by their pain response (≥ 10 mm increase on a 100 mm visual analog scale) during standing. Relative timing and sequencing data between muscle pairs were calculated through cross-correlation analyses, and evaluated by group and gender.

Findings

Pain developers demonstrated a ‘top-down’ muscle recruitment strategy with lumbar extensors activated prior to gluteus maximus, while non-pain developers demonstrated a typical ‘bottom-up’ muscle recruitment strategy with gluteus maximus activated prior to lumbar extensors.

Interpretation

Individuals predisposed to low back pain development during standing exhibited altered neuromuscular strategies prior to pain development. These findings may help to characterize biomechanical movement profiles that could be important for early identification of people at risk for low back pain.  相似文献
4.
Given the important role of the shoulder sensorimotor system in shoulder stability, its assessment appears of interest. Force platform monitoring of centre of pressure (CoP) in upper‐limb weight‐bearing positions is of interest as it allows integration of all aspects of shoulder sensorimotor control. This study aimed to determine the feasibility and reliability of shoulder sensorimotor control assessment by force platform. Forty‐five healthy subjects performed two sessions of CoP measurement using Win‐Posturo® Medicapteurs force platform in an upper‐limb weight‐bearing position with the lower limbs resting on a table to either the anterior superior iliac spines (P1) or upper patellar poles (P2). Four different conditions were tested in each position in random order: eyes open or eyes closed with trunk supported by both hands and eyes open with trunk supported on the dominant or non‐dominant side. P1 reliability values were globally moderate to high for CoP length, CoP velocity and CoP standard deviation (SD), standard error of measurement ranged from 6·0% to 26·5%, except for CoP area. P2 reliability values were globally low and not clinically acceptable. Our results suggest that shoulder sensorimotor control assessment by force platform is feasible and has good reliability in upper‐limb weight‐bearing positions when the lower limbs are resting on a table to the anterior superior iliac spines. CoP length, CoP velocity and CoP SD velocity appear to be the most reliable variables.  相似文献
5.

Background

Female neuromuscular control during dynamic landings is considered central to their increased ACL injury risk relative to males. There is limited insight, however, into the neuromuscular parameters governing this risk, which may hinder prevention success. This study targeted a new screenable and potentially trainable neuromuscular risk factor. Specifically, we examined whether lower limb muscle pre-motor times, being the time between stimulus presentation and initiation of the muscle EMG burst, elicited during a simple choice reaction task correlated with knee abduction loads during separate single leg landings.

Methods

Twenty female NCAA athletes had muscle (n = 8) pre-motor time and knee biomechanics data recorded bilaterally during a choice reaction task. Knee biomechanics were also quantified during anticipated and unanticipated single (dominant and non-dominant) leg landings. Mean peak knee abduction loads during landings were submitted to a two-way ANOVA to test for limb and decision effects. Individual regression coefficients were initially computed between-limb-based muscle pre-motor times and peak abduction moments elicited during both the choice reaction and landing tasks. Limb-based linear stepwise regression coefficients were also computed between muscle PMT's demonstrating significant (P < 0.05) individual associations and peak knee abduction moments during landings.

Findings

Peak knee abduction moments were significantly (P = 0.0001) larger during unanticipated (51.25 (7.41) Nm) compared to anticipated (38.93 (9.32) Nm) landings. Peak abduction moments were significantly (P < 0.05) correlated with bilateral medial gastrocnemius (r = 0.62 dominant; r = 0.63 non-dominant) and medial hamstring (r = 0.77 dominant; r = 0.79 non-dominant) pre-motor times elicited within the choice reaction task. Peak abduction moments during anticipated landings were significantly (P < 0.05) correlated with both dominant (r = 0.60) and non-dominant (r = 0.59) medial hamstring pre-motor times. For unanticipated landings, non-dominant and dominant peak knee abduction moments were significantly correlated with medial hamstring pre-motor time (r = 0.78) and combined medial gastroc and medial hamstring pre-motor times (r = 0.94) respectively.

Interpretation

Medial muscle pre-motor times during a specific choice reaction task are associated with peak knee abduction loads during separate single leg landings. These muscles appear critical in stabilizing the knee against the extreme dynamic load states associated with such tasks. Targeted screening and training of supraspinal processes governing these muscle pre-motor times may ultimately enable external knee loads associated with landings to be more effectively countered by the overarching neuromuscular strategy.  相似文献
6.

Background

The aims of this study were to determine the prevalence and incidence of patellofemoral pain (PFP) in young female athletes and prospectively evaluate measures of frontal plane knee loading during landing to determine their relationship to development of PFP. We hypothesized that increased dynamic knee abduction measured during preseason biomechanical testing would be increased in those who developed PFP relative to teammates who did not develop PFP.

Methods

Middle and high school female athletes (n = 240) were evaluated by a physician for PFP and for landing biomechanics prior to their basketball season. The athletes were monitored for athletic exposures and PFP injury during their competitive seasons.

Findings

At the beginning of the season, the point prevalence of PFP was 16.3 per 100 athletes. The cumulative incidence risk and rate for the development of new unilateral PFP was 9.66 per 100 athletes and 1.09 per 1000 athletic exposures, respectively. All new PFPs developed in middle school athletes who demonstrated mean International Knee Documentation Committee score of 85.6 ± 7.7 at diagnosis. The new PFP group demonstrated increased knee abduction moments at initial contact (95% CI: 0.32 to 4.62 N m) on the most-symptomatic limb and maximum (95% CI: 1.3 to 10.1 N m; P = 0.02) on the least-symptomatic (or no symptoms) limb relative to the matched control limbs. Knee abduction moments remained increased in the new PFP group when normalized to body mass (P < 0.05).

Interpretation

The increased knee abduction landing mechanics in the new PFP group indicate that frontal plane loads contribute to increased incidence of PFP.  相似文献
7.

Background

Deficiency in hip girdle neuromuscular control can cause exaggerated Dynamic Knee Valgus (DKV) which afflicts the knee joint and lead to knee injuries especially ACL injury in sports. Though Kinesio taping (KT) is known to improve function, stability and proprioception, the evidence is inconclusive on its effectiveness in athletes. We hypothesized that kinesio taping could enhance neuromuscular control of the hip girdle there by causing a reduction in DKV.

Aim/Objective

To determine whether KT on Gluteus medius can correct exaggerated dynamic knee valgus and improves hip abductor strength when compared to sham KT.

Method

40 collegiate level athletes, aged between 18 and 28 years, of both genders with presence of dynamic knee valgus (>8° for men and >13° for women) were recruited in the study. Athletes were excluded if they had history of lower back pain, history of any injury or surgery to the lower extremities during the past year. Subjects who met the inclusion criteria were randomized into kinesio taping (KT) group and sham taping (ST) group. The Drop Jump test and the Donnatelli Drop Leg Test (DDT) were performed before, and on the third day, immediately after the application of KT on them and documented.

Results

There was a significant reduction in DKV among male [4.0° (95% CI 3.5–4.5); p < 0.001] and female [4.3° (95% CI 3.5–5.2); p < 0.002] immediately after application of taping but not on the third day after application of KT. There was a significant rise in DDT immediately and on the third day after application of KT between KT group and SC group.

Conclusion

There was a reduction in DKV immediately after the application of KT. However, there was no significant difference between KT group and SC group on the third day. Meanwhile, gluteus medius strength also showed significant improvement immediately after taping and it was maintained even on the third day.  相似文献
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