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1.
Background
Foam rolling has become a popular form of self-myofascial release or roller massage among health and fitness professionals. Due to this popularity, foam roller devices can be found in many clinical and fitness settings. Despite the popularity, there are still several unknowns regarding foam rolling such the optimal technique. Specifically, there is a lack of research analyzing different foam roll techniques such as combining active joint motion with foam rolling.Purpose
The purpose of this study was to compare the effects of a foam rolling session to the left quadriceps with active joint motion and without joint motion on passive knee flexion range of motion (ROM) and pressure pain thresholds (PPT).Methods
Thirty healthy adults were randomly allocated to one of two intervention groups: active joint motion and no joint motion. Each foam roll intervention to the left quadriceps lasted a total of 2?min. Dependent variables included passive knee flexion ROM and pressure pain threshold measures (PPT). Statistical analysis included subject demographic calculations and appropriate parametric and non-parametric tests to measure changes within and between intervention groups.Results
For left knee ROM, the active joint motion group demonstrated the greatest immediate increase in passive ROM (8°, p?<?.001) than the non-motion group (5°, p?<?.001). For PPT, the active joint motion group demonstrated the greatest immediate increase (180?kPa, p?<?.001) followed by the non-motion group (133?kPa, p?<?.001). Between group comparisons revealed a significance between groups for passive knee ROM (p?<?.001) and PPT (p?<?.001).Conclusion
A short session of foam rolling with active joint motion appears to have a greater effect on passive joint ROM and PPT than rolling without motion. These observed changes may be influenced by the agonistic muscle activity during active motion. This activity may modulate activity of the antagonist muscle through reciprocal inhibition and other neural pathways. Future research is needed to confirm these findings. 相似文献2.
Birgit Skoffer Ulrik Dalgas Thomas Maribo Kjeld Søballe Inger Mechlenburg 《PM & R》2018,10(7):687-692
Background
Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion.Objective
To examine whether preoperative PRT initiated 5 weeks prior to TKA would exacerbate pain and knee effusion, and would allow a progressively increased training load throughout the training period that would subsequently increase muscle strength.Design
Secondary analyses from a randomized controlled trial (NCT01647243).Setting
University Hospital and a Regional Hospital.Patients
A total of 30 patients who were scheduled for TKA due to osteoarthritis and assigned as the intervention group.Methods
Patients underwent unilateral PRT (3 sessions per week). Exercise loading was 12 repetitions maximum (RM) with progression toward 8 RM. The training program consisted of 6 exercises performed unilaterally.Main outcome measures
Before and after each training session, knee joint pain was rated on an 11-point scale, effusion was assessed by measuring the knee joint circumference, and training load was recorded. The first and last training sessions were initiated by 1 RM testing of unilateral leg press, unilateral knee extension, and unilateral knee flexion.Results
The median pain change score from before to after each training session was 0 at all training sessions. The average increase in knee joint effusion across the 12 training sessions was a mean 0.16 cm ± 0.23 cm. No consistent increase in knee joint effusion after training sessions during the training period was found (P = .21). Training load generally increased, and maximal muscle strength improved as follows: unilateral leg press: 18% ± 30% (P = .03); unilateral knee extension: 81% ± 156% (P < .001); and unilateral knee flexion: 53% ± 57% (P < .001).Conclusion
PRT of the affected leg initiated shortly before TKA does not exacerbate knee joint pain and effusion, despite a substantial progression in loading and increased muscle strength. Concerns for side effects such as pain and effusion after PRT seem unfounded.Level of Evidence
I 相似文献3.
S. Jun Son Hyunsoo Kim Matthew K. Seeley J. Ty Hopkins 《Archives of physical medicine and rehabilitation》2017,98(1):25-35
Objectives
To examine the effect of experimental knee pain on perceived knee pain and gait patterns and to examine the efficacy of transcutaneous electrical nerve stimulation (TENS) on perceived knee pain and pain-induced knee gait mechanics.Design
Crossover trial.Setting
Biomechanics laboratory.Participants
Recreationally active, individuals without musculoskeletal pain aged 18 to 35 years (N=30).Interventions
Thirty able-bodied individuals were assigned to either a TENS (n=15) or a placebo (n=15) group. All participants completed 3 experimental sessions in a counterbalanced order separated by 2 days: (1) hypertonic saline infusion (5% NaCl); (2) isotonic saline infusion (0.9% NaCl); and (3) control. Each group received sensory electrical stimulation or placebo treatment for 20 minutes, respectively.Main Outcome Measures
Perceived pain was collected every 2 minutes using a 10-cm visual analog scale (VAS) for 50 minutes and analyzed using a mixed model analysis of covariance with repeated measures. Gait analyses were performed at baseline, infusion, and treatment. Sagittal and frontal knee angles and internal net joint torque across the entire stance were analyzed using a functional data analysis approach.Results
Hypertonic saline infusion increased perceived pain (4/10cm on a VAS; P<.05) and altered right knee angle (more flexion and less abduction; P<.05) and internal net joint torque (less extension and greater abduction; P<.05) across various stance phases. TENS treatment reduced perceived pain and improved right sagittal gait abnormalities as compared with placebo treatment (P<.05).Conclusions
This pain model increases perceived pain and induces compensatory gait patterns in a way that indicates potential quadriceps weakness. However, TENS treatment effectively reduces perceived pain and restores pain-induced gait abnormalities in sagittal knee mechanics. 相似文献4.
Gabriela Lopes Santos Thiago Luiz Russo Angela Nieuwenhuys Davide Monari Kaat Desloovere 《Archives of physical medicine and rehabilitation》2018,99(3):501-511.e4
Objective
To compare sitting posture and movement strategies between chronic hemiparetic and healthy subjects while performing a drinking task, using statistical parametric mapping (SPM) and feature analysis.Design
Cross-sectional study.Setting
A university physical therapy department.Participants
Participants (N=26) consisted of chronic hemiparetic (n=13) and healthy individuals (n=13) matched for sex and age.Interventions
Not applicable.Main Outcome Measures
The drinking task was divided into phases: reaching, transporting the glass to mouth, transporting the glass to table, and returning to initial position. An SPM 2-sample t test was used to compare the entire kinematic waveforms of different joint angles (trunk, scapulothoracic, humerothoracic, elbow). Joint angles at the beginning and end of the motion, movement time, peak velocity timing, trajectory deviation, normalized integrated jerk, and range of motion were extracted from the motion data. Group differences for these parameters were analyzed using independent t tests.Results
At the static posture and beginning of the reaching phase, patients showed a shoulder position more deviated from the midline and externally rotated with increased scapula protraction, medial rotation, anterior tilting, trunk anterior flexion and inclination to the paretic side. Altered spatiotemporal variables throughout the task were found in all phases, except for the returning phase. Patients returned to a similar posture as the task onset, except for the scapula, which was normalized after the reaching phase.Conclusions
Chronic hemiparetic subjects showed more deviations in the proximal joints during seated posture and reaching. However, the scapular movement drew nearer to the healthy individuals' patterns after the first phase, showing an interesting point to consider in rehabilitation programs. 相似文献5.
Robert C. Lynall J. Troy Blackburn Kevin M. Guskiewicz Stephen W. Marshall Prudence Plummer Jason P. Mihalik 《Archives of physical medicine and rehabilitation》2018,99(5):880-886
Objective
To compare movement reaction time and joint kinematics between athletes with recent concussion and matched control recreational athletes during 3 functional tasks.Design
Cross-sectional.Setting
Laboratory.Participants
College-aged recreational athletes (N=30) comprising 2 groups (15 participants each): (1) recent concussion group (median time since concussion, 126d; range, 28–432d) and (2) age- and sex-matched control group with no recent concussions.Interventions
We investigated movement reaction time and joint kinematics during 3 tasks: (1) jump landing, (2) anticipated cut, and (3) unanticipated cut.Main Outcome Measures
Reaction time and reaction time cost (jump landing reaction time–cut reaction time/jump landing reaction time×100%), along with trunk, hip, and knee joint angles in the sagittal and frontal planes at initial ground contact.Results
There were no reaction time between-group differences, but the control group displayed improved reaction time cost (10.7%) during anticipated cutting compared with the concussed group (0.8%; P=.030). The control group displayed less trunk flexion than the concussed group during the nondominant anticipated cut (5.1° difference; P=.022). There were no other kinematic between-group differences (P≥.079).Conclusions
We observed subtle reaction time and kinematic differences between individuals with recent concussion and those without concussion more than a month after return to activity after concussion. The clinical interpretation of these findings remains unclear, but may have future implications for postconcussion management and rehabilitation. 相似文献6.
Derek N. Pamukoff Melissa M. Montgomery Kevin H. Choe Tyler J. Moffit Michael N. Vakula 《Archives of physical medicine and rehabilitation》2018,99(5):973-980
Objective
To examine the effect of whole-body vibration (WBV) on running biomechanics in individuals with anterior cruciate ligament reconstruction (ACLR).Design
Single-blind randomized crossover trial.Setting
Research laboratory.Participants
Individuals (N=20) with unilateral ACLR (age [± SD]=22.3 [±3.3] years; mass=71.8 [±15.3] kg; time since ACLR=44.9 [±22.8] months; 15 females, 10 patellar tendon autograft, 7 hamstrings autograft, 3 allograft; International Knee Documentation Committee Score=83.5 [±9.3]).Main Outcome Measure
Participants performed isometric squats while being exposed to WBV or no vibration (control). WBV and control conditions were delivered in a randomized order during separate visits separated by 1-week washout periods. Running biomechanics of the injured and uninjured limbs were evaluated before and immediately after each intervention. Dependent variables included peak vertical ground reaction force (GRF) and loading rate (LR), peak knee flexion angle and external moment, and knee flexion excursion during the stance phase of running.Results
There was an increase in knee flexion excursion (+4.1°, 95% confidence interval [CI]: 0.65, 7.5°) and a trend toward a reduction in instantaneous LR after WBV in the injured limb (?4.03 BW/sec?1, 95% CI ?0.38, ?7.69). No effect was observed on peak GRF, peak knee flexion angle, or peak external knee flexion moment, and no effect was observed in the uninjured limb.Conclusions
Our findings indicate that a single session of WBV acutely increases knee flexion excursion. WBV could be useful to improve running characteristics in individuals with knee pathology. 相似文献7.
Background
Neck pain is a common musculoskeletal complaint in computer users due to prolonged static or awkward work postures. It has been shown that pathogenesis of neck pain is associated with scapular movement impairment syndromes. However, there is a dearth of literature in treatment based on these syndromes.Aim
To identify the effects of movement impairment-based treatment in the management of mechanical neck pain, in computer users.Methods
In the present study, twenty-seven subjects were recruited. Based on the identified scapular impairment syndrome, they were trained with scapular movement impairment-based exercises for four weeks. Pain, disability and cervical range of motion were measured with numeric pain rating scale, neck disability index and inclinometer, respectively, at baseline and at four weeks.Results
Twenty-one subjects completed the study. After four weeks, a significant difference of 4.81 points for numeric pain rating scale and 24.47% for neck disability index at 95% CI were found. The cervical range of motion showed a significant change (p < 0.05) of 10.09° for flexion, 24.47° for extension, 7.42° for right lateral flexion, 6.23° for left lateral flexion, 15.52° for right rotation and 14.95° for left rotation at 95% CI.Conclusions
Exercises based on scapular impairment syndromes were given for four weeks. It was found to be effective in relieving pain and reducing dysfunction in computer users with mechanical neck pain 相似文献8.
Débora Fortes Marizeiro Ana Carolina Lins Florêncio Ana Carla Lima Nunes Nataly Gurgel Campos Pedro Olavo de Paula Lima 《Journal of bodywork and movement therapies》2018,22(4):924-929
Background
Although diaphragmatic myofascial release techniques are widely used in clinical practice, few studies have evaluated the simultaneous acute effects of these techniques on the respiratory and musculoskeletal systems.Objective
To evaluate the immediate effects of diaphragmatic myofascial release in sedentary women on the posterior chain muscle flexibility; lumbar spine range of motion; respiratory muscle strength; and chest wall mobility.Design
A randomized placebo-controlled trial with concealed allocation, intention-to-treat analysis, and blinding of assessors and participants.Participants
Seventy-five sedentary women aged between 18 and 35 years.Intervention
The sample was randomly allocated into one of two groups; the experimental group received two diaphragmatic myofascial release techniques in a single session, and the control group received two placebo techniques following the same regimen.Outcomes measures
The primary outcome was chest wall mobility, which was analyzed using cirtometry. The secondary outcomes were flexibility, lumbar spine range of motion, and respiratory muscle strength. Outcomes were measured before and immediately after treatment.Results
The manual diaphragm release techniques significantly improved chest wall mobility immediately after intervention, with a between-group difference of 0.61 cm (95% CI, 0.12–1.1) for the axillary region, 0.49 cm (95% CI, 0.03–0.94) for the xiphoid region, and 1.44 (95% CI, 0.88–2.00) for the basal region. The techniques also significantly improved the posterior chain muscle flexibility, with a between-group difference of 5.80 cm (95% CI, 1.69–9.90). All movements except flexion of the lumbar spine significantly increased. The effects on respiratory muscle strength were non-significant.Conclusion
The diaphragmatic myofascial release techniques improve chest wall mobility, posterior chain muscle flexibility, and some movements of the lumbar spine in sedentary women. These techniques could be considered in the management of people with reduced chest wall and lumbar mobility.Trial registration
NCT03065283. 相似文献9.
Study design
Randomized controlled trial.Objectives
To improve hip function by an additional targeted mobilization and strength training of the hip muscles within the first postoperative week following a total hip arthroplasty (THA) in contrast to standard physiotherapy.Background
The aim of early postoperative physiotherapy is to improve the functioning of the artificial hip joint as well as the restoration of mobility and independence of the patient. Minimally invasive surgical techniques allow early mobilization with immediate full weight-bearing.Methods
39 patients were divided into an intervention (IG) and control group (CG). After implantation of THA the CG completed standard physiotherapy, while the IG had an intensified active treatment with additional mobilization and strength training. Passive range of motion (flexion, extension, abduction), thigh circumference, holding force of the gluteal muscles, one-leg stance, covered distance walked in 6-min and subjective parameters were tested one day before and six days after surgery.Results
Improvements in IG compared to CG were recorded in range of motion (flexion p < 0.01, extension p < 0.001, abduction p < 0.01) and gait performance (p < 0.001). No differences between groups were detected as regard thigh circumference, holding force of the gluteal muscles, one-leg stance and subjective parameters. Deterioration in IG compared to CG did not occur.Conclusion
An additional, targeted mobilization and strength training of the hip muscles with full weight-bearing, which begins at the 3rd day after implantation of a THA is tolerated well and improves within one week hip range of motion and gait performance compared to standard physiotherapy. 相似文献10.
P. Lobenhoffer 《Arthroskopie》2016,29(3):186-193
Background
Loss of range of motion of the knee joint causes significant disability. Surgical treatment should include arthroscopic as well as open arthrolysis procedures.Objectives
Impairments of extension and flexion can have capsular or extra-articular origins in the musculature. The techniques of open capsulotomy and interventions on the proximal and distal extension apparatus are presented.Methods
Discussion on the indications and surgical techniques for open arthrolysis of the knee joint are presented based on own results and the available literature.Results
The established surgical techniques can significantly improve the range of motion considering the severity of this case group.Conclusions
An exact analysis of the cause of knee stiffness is necessary. Only intra-articular problems can be arthroscopically treated and open techniques are indicated when the stiffness is caused by an extra-articular pathology. The techniques are established and reproducible.11.
Donna Bergman Lynnette Rasmussen Kate Wan-Chu Chang Lynda J-S. Yang Virginia S. Nelson 《PM & R》2018,10(1):64-71
Background
The term self-determination refers to decision-making, goal setting, and perseverance to achieve those goals. Numerous studies have established the importance of self-determination to enhance learning and improve postschool outcomes. However, most studies evaluate students with learning disabilities, cognitive impairment, or behavioral disabilities. There is an absence of research on self-determination for adolescents with physical disabilities.Objective
To assess self-determination of adolescents with neonatal brachial plexus palsy (NBPP) compared with their typically developing peers via self-reported measures of function.Design
Case-control study.Setting
Brachial plexus clinic.Participants
Twenty adolescents with NBPP (aged 10-17 years) and their parents and 20 age/gender-matched typically developing adolescents and their parents were recruited. Non–English-speaking participants and those with other physical impairments were excluded from study.Methods
Participants completed demographic and American Institutes for Research (AIR) self-determination surveys. One of two designated occupational therapists evaluated participant physical function.Main Outcome Measurements
A demographic survey and AIR self-determination assessment were administered, and active range of motion measurements in shoulder forward flexion, elbow flexion, elbow extension, forearm pronation, and supination were obtained. Grip/pinch strength, MRC muscle strength, 9-Hole Peg Test, and Mallet scale scores also were evaluated.Results
Despite physical differences, adolescents with NBPP presented similar self-determination levels as their typically developing peers. Adolescents with NBPP rated their opportunities to engage in self-determined behaviors at school significantly lower than at home. Both adolescents with NBPP and those in the control group rated their opportunities to engage in self-determined behaviors at school significantly lower than at home.Conclusions
Adolescents with NBPP presented similar self-determination scores as their age/gender-matched typically developing peers. These results could be a reflection of our program’s patient- and family-centered care approach. Therefore, caregivers and providers should encourage personal development and fulfillment in adolescents with NBPP. Teachers and schools should be aware that opportunities for acquiring self-determination skills might be more limited at school than at home in this age group.Level of Evidence
III 相似文献12.
Leyla Sefiddashti Nastaran Ghotbi Mahyar Salavati Ali Farhadi Masood Mazaheri 《Journal of bodywork and movement therapies》2018,22(3):805-809
Purpose
Hamstring strain is a common sport injury that results in pain and functional limitation. Despite its high frequency in active populations, there is no agreement regarding the best method used for early intervention of hamstring strain. The aim of the present study was to compare the effects of cryotherapy and cryostretching on clinical and functional outcomes in athletes with acute hamstring strain.Materials and methods
Thirty seven elite athletes with an acute grade I or II hamstring strain were randomly assigned to either cryotherapy (n = 19) or cryostretching (n = 18) group, receiving 5 sessions of supervised treatment plus home-based intervention monitored by the therapist. Pre-treatment to post-treatment changes in pain, active and passive knee extension range of motion and functional status were compared between the two groups.Results
Compared to cryotherapy, cryostretching resulted in larger improvement of function and passive knee extension range of motion. Changes in active knee extension range of motion and pain severity were not significantly different between the two groups.Conclusion
A rehabilitation protocol involving gentle stretching following cryotherapy is more effective than cryotherapy alone in the improvement of function and passive knee range of motion in patients with grade I and II hamstring strain. 相似文献13.
Danielle Cristine Carvalho Muniz e Silva Dângelo José de Andrade Alexandre Júlio Guilherme Silva 《Journal of bodywork and movement therapies》2018,22(4):930-936
Objectives
The role of a myofascial release (MFR) on flexion contractures after total knee arthroplasty (TKA) has not yet been elucidated. Therefore, the purpose of this study was to determine its immediate effect on such patients.Methods
In this A-B single subject experimental study, 33 TKA's patients with knee flexion contracture had their gluteal, posterior fascia lata, posterior crural and plantar fasciae released. Patients' knee range of motion (KROM), pain and muscle electric activity were assessed pre- and post-intervention.Results
An increase in electric activity of the biceps femoris muscle was identified after treatment (pre RMS = 0.087 ± 0.066 V; post RMS = 0.097 ± 0.085 V; p = 0.037). Mean gain of KROM was 5.72 ± 6.27, correspondent to an 11.9% improvement (p = 0.01). Eight subjects had their pain decreased on 56.9% (p = 0.04).Conclusions
MFR increased muscle activity, reduced pain and improved the KROM of TKA patients. Thus, MFR is a useful resource of rehabilitation after TKA. 相似文献14.
Background
Women are at greater risk for knee osteoarthritis and numerous other lower limb musculoskeletal disorders. Arch drop during pregnancy and the resultant excessive pronation of the feet may alter loading patterns and contribute to the greater prevalence of knee osteoarthritis in women.Objective
To determine the effect of arch drop on tibial rotation and tibiofemoral contact stress.Design
Interventional study with internal control.Setting
Biomechanics laboratory.Participants
Eleven postpartum women (age 33.4 ± 5.3 years, body mass 76.1 ± 13.5 kg) who had lost arch height with pregnancy in a previous study.Methods
Subjects underwent standing computed tomography (SCT) with their knees in a 20° fixed-flexed position with and without semirigid arch supports to reconstitute prepregnancy arch height. Magnetic resonance imaging of the knee was acquired at a flexion angle equivalent to that of SCT. Bone and cartilage were manually segmented on the magnetic resonance images and segmented surfaces were registered to the 3-dimensional SCT image sets for the arch-supported and -unsupported conditions. These models were used to measure changes in tibial rotation, as well as to estimate contact stress in the medial and lateral tibiofemoral compartments, using computational methods.Main Outcome Measures
Change in tibial rotation and tibiofemoral contact stress with arch drop.Results
Arch drop resulted in a mean tibial internal rotation of 0.75 ± 1.33° (P = .02). Changes in mean or peak contact stress were not detected.Conclusions
Arch drop causes internal tibial rotation, resulting in a shift in the tibiofemoral articulation. An associated increase in contact stress was not detected. Internal rotation of the tibia increases stress on the anterior cruciate ligament and menisci, potentially explaining the greater prevalence of knee disorders in postpartum women.Level of Evidence
NA 相似文献15.
Matteo Vitali Nadim Naim Rodriguez Alberto Pedretti Andreas Drossinos Pierluigi Pironti Gaia Di Carlo Gianfranco Fraschini 《Archives of physical medicine and rehabilitation》2018,99(5):873-879
Objective
To determine the validity of extracorporeal shock wave therapy (ESWT) in the treatment of bone marrow edema (BME) of the medial condyle of the knee.Design
Retrospective.Setting
Orthopedic Surgery outpatient clinic.Participants
Symptomatic patients (N=56) affected by BME of the medial condyle of the knee. Patients were equally divided into an ESWT-treated group and a control group, which was managed conservatively.Interventions
ESWT delivery to the medial condyle of the affected knee.Main Outcome Measures
Clinical and functional assessment of the knee was performed with the use of the clinical and functional scores of the Knee Society Score (KSS). Pain was measured with the visual analog scale (VAS). BME area was measured with magnetic resonance imaging (MRI) before treatment and at 4 months' follow-up.Results
Clinical evaluation of patients at final follow-up of 4 months posttreatment showed a significant improvement (P<.0001) of symptoms and knee functionality, both for range of motion and strength in both groups. VAS values were significantly improved (P<.0001) in both groups, with 3 patients in the ESWT group being pain-free (VAS=0) at 4 months' follow-up. At 4 months, MRI assessments on both sagittal and coronal views showed a significant reduction in BME in the ESWT group compared with the control group.Conclusions
Our findings show that ESWT is a valid nonpharmacologic and noninvasive therapy for spontaneous BME of the medial condyle that improves the affected vascular and metabolic state present in this pathologic disorder through its metabolic mechanisms of action. 相似文献16.
17.
Ramya V. Rao Ganesh Balthillaya Anupama Prabhu Asha Kamath 《Journal of bodywork and movement therapies》2018,22(3):572-579
Background
Maitland Mobilization or Mulligan Mobilization with Movement (MWM) approaches have been widely used clinically for pain relief and improving mobility in Osteoarthritis knee. However the experimental evidence supporting the usage of these mobilization techniques as sole interventions in management of Osteoarthritis knee is insufficient.Objective
To determine from Maitland Mobilization and Mulligan MWM, which mobilization technique will be more effective in reducing pain and improving mobility and function in OA knee immediately after the intervention.Study design
Randomized Crossover trial.Materials and methods
30 subjects with osteoarthritis knee were recruited and 15 each were randomly allocated to two intervention sequences-one sequence was where Maitland was given first followed by Mulligan and the other was where Mulligan was given first followed by Maitland with a washout period of 48 h in between the two interventions. Numeric Pain Rating Scale (NPRS), Timed Up and Go (TUG) test and Pain free Squat Angle were the outcome measures measured before and immediately after both interventions.Results
Using Repeated Measures ANOVA for analysis of outcomes between and within interventions, no significant differences were seen between Maitland Mobilization and Mulligan MWM, for NPRS, TUG and Pain free Squat Angle (p = 0.18, p = 0.27,p = 0.17) respectively whereas within the interventions both Maitland and Mulligan all outcome measures showed significant changes (p < 0.001).Conclusion
Thus it can be seen that Maitland mobilization and Mulligan MWM, both are equally effective in osteoarthritis knee in reducing pain and improving functional mobility and pain free squat angle immediately post treatment. 相似文献18.
Jacob G. McPherson Arno H. Stienen Justin M. Drogos Julius P. Dewald 《Archives of physical medicine and rehabilitation》2018,99(3):491-500
Objective
To systematically characterize the effect of flexion synergy expression on the manifestation of elbow flexor stretch reflexes poststroke, and to relate these findings to elbow flexor stretch reflexes in individuals without neurologic injury.Design
Controlled cohort study.Setting
Academic medical center.Participants
Participants (N=20) included individuals with chronic hemiparetic stroke (n=10) and a convenience sample of individuals without neurologic or musculoskeletal injury (n=10).Interventions
Participants with stroke were interfaced with a robotic device that precisely manipulated flexion synergy expression (by regulating shoulder abduction loading) while delivering controlled elbow extension perturbations over a wide range of velocities. This device was also used to elicit elbow flexor stretch reflexes during volitional elbow flexor activation, both in the cohort of individuals with stroke and in a control cohort. In both cases, the amplitude of volitional elbow flexor preactivation was matched to that generated involuntarily during flexion synergy expression.Main Outcome Measures
The amplitude of short- and long-latency stretch reflexes in the biceps brachii, assessed by electromyography, and expressed as a function of background muscle activation and stretch velocity.Results
Increased shoulder abduction loading potentiated elbow flexor stretch reflexes via flexion synergy expression in the paretic arm. Compared with stretch reflexes in individuals without neurologic injury, paretic reflexes were larger at rest but were approximately equal to control muscles at matched levels of preactivation.Conclusions
Because flexion synergy expression modifies stretch reflexes in involved muscles, interventions that reduce flexion synergy expression may confer the added benefit of reducing spasticity during functional use of the arm. 相似文献19.
Kuan-yi Li Yu-pei Hsiao Rou-shayn Chen Ching-yi Wu 《Archives of physical medicine and rehabilitation》2018,99(7):1303-1310
Objective
To investigate the kinematic and myographic effects of weighted wrist cuffs on individuals with Parkinson disease (PD) during a reaching task.Design
Cross-sectional study.Setting
Biomechanics research laboratory.Participants
Individuals (N=39) with PD (n=19) and healthy age-matched control subjects (n=20).Interventions
Participants were instructed to reach and grasp a can at a distance of 80% of their arm length without a wrist cuff, while wearing separate 0.5- and 1.0-kg wrist cuffs, and subsequently without a wrist cuff.Main Outcome Measures
Movement time, kinematic, and electromyographic data were recorded during all reach and grasp movements. Four end point coordinate strategy variables, 3 joint recruitment variables, and 2 co-contraction indices were derived from the raw data for analysis.Results
Significant interaction effects were found in the trunk and index finger movement time as the weight of the cuff increased from 0.5 to 1.0kg. The group of individuals with PD showed decreased movement times in both instances, whereas the control group showed increased movement times as the weight of the wrist cuff increased from baseline to 0.5 and 1.0kg. No group difference was observed in the co-contraction index of the upper arm and forearm.Conclusions
Adoption of weighted wrist cuffs in the clinic should be cautiously undertaken because compensatory movements may be induced in the trunk of individuals with PD. 相似文献20.
Jarred G. Gillett Glen A. Lichtwark Roslyn N. Boyd Lee A. Barber 《Archives of physical medicine and rehabilitation》2018,99(5):900-906.e1