共查询到20条相似文献，搜索用时 46 毫秒
1.
Margaret Roller Aimie Kachingwe Janna Beling Dawn-Marie Ickes Allyson Cabot Gabrielle Shrier 《Journal of bodywork and movement therapies》2018,22(4):983-998
Objective
To investigate the effects of Pilates exercises using a Reformer on measures of fall risk, balance and mobility, self-efficacy, and active range of motion in adults age 65 and over at risk for falls compared to a control group.Design
Randomized Controlled Trial.Methods
Fifty-five subjects (27 Pilates intervention, 28 control; 38 females, 17 males; mean age 77.6 years, range 65–95) were randomly assigned to either a Pilates Reformer intervention group or a control group (no intervention). Subjects in the intervention group attended a Pilates Reformer exercise program in a group format once a week over a 10-week period. The primary outcome measures were the Sensory Organization Test (SOT) composite scores on the NeuroCom® system, Timed Up-and-Go (TUG), and Activities-specific Balance Confidence (ABC) scale. The secondary outcome measures were the Adaptation Test (ADT), straight leg raise (SLR), hip extension, and ankle dorsiflexion active range of motion (AROM), Berg Balance Scale (BBS), and 10 Meter Walk Test (10MWT).Results
There was a significant interaction between group and time on the TUG, BBS, 10MWT, and SLR, hip extension, and ankle dorsiflexion AROM measurements. Over time, subjects in the Pilates intervention group improved their scores significantly on all mentioned measures, whereas subjects in the control group did not (P ≤ 0.05). Significantly improved AROM was found between groups following the Pilates intervention for hip extension, left SLR, and right ankle dorsiflexion.Conclusion
Pilates Reformer exercises performed once per week for 10 weeks resulted in reduced fall risk and significant improvements in static and dynamic balance, functional mobility, balance self-efficacy, and lower extremity AROM in adults age 65 and older at risk for falling, whereas the control group did not significantly improve in any measures. Pilates Reformer exercises are more effective compared to no exercise intervention at improving hip and ankle AROM. 相似文献2.
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3.
Morgan K. Boes Rachel E. Bollaert Richard M. Kesler Yvonne C. Learmonth Mazharul Islam Matthew N. Petrucci Robert W. Motl Elizabeth T. Hsiao-Wecksler 《Archives of physical medicine and rehabilitation》2018,99(3):484-490
Objective
To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).Design
Short-term intervention.Setting
University research laboratory.Participants
Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO.Interventions
Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb.Main Outcome Measures
Distance walked and metabolic cost of transport were recorded during each 6MWT and compared between footwear conditions.Results
Each participant completed all three 6MWTs within the experimental design. PPAFO use resulted in a shorter 6MWT distance than did a passive AFO or shoe use. No differences were observed in metabolic cost of transport between footwear conditions.Conclusions
The current embodiment of this PPAFO did not improve endurance walking performance during the 6MWT in a sample of participants with gait impairment due to MS. Further research is required to determine whether expanded training or modified design of this powered orthosis can be effective in improving endurance walking performance in persons with gait impairment due to MS. 相似文献4.
AmirAli Jafarnezhadgero Morteza Madadi Shad Reed Ferber 《Journal of bodywork and movement therapies》2018,22(1):83-89
Introduction
It has been widely postulated that structural and functional misalignments of the foot, such as flat foot, may cause mechanical deviations of the lower limb during walking. The aim of this study was to investigate the effect of foot orthoses on lower extremity joint moment asymmetry during the stance phase of walking in children with asymptomatic flexible flat feet.Methods
Fourteen volunteer male children, clinically diagnosed with flexible flat feet, participated in this study. Subjects completed 12 walking trials at a self-selected walking speed while 3-dimensional kinematic and kinetic data were collected for two conditions: shod with no orthoses, and shod with orthoses. The gait asymmetry index for each variable for each subject was defined as: (1-(lesser moment/greater moment)) × 100.Results
Results reveal no significant differences in ankle or knee joint moment asymmetry. However, the use of foot orthoses decreased asymmetry for the hip abduction moment (P = 0.04) compared to walking without orthoses and also resulted in subtle, non-significant increases in frontal plane subtalar and sagittal plane knee and hip joints moment asymmetry.Conclusion
We conclude that foot orthoses decrease frontal plane hip joint moment asymmetry, but have little effect on ankle and knee joint asymmetry. 相似文献5.
Xue-Cheng Liu David Embrey Channing Tassone Kim Zvara Brenna Brandsma Roger Lyon Karin Goodfriend Sergey Tarima John Thometz 《PM & R》2018,10(3):269-275
Background
Orthoses commonly are prescribed to children with cerebral palsy (CP) to provide foot correction and to improve ambulatory function. Immediate effects of ankle foot orthosis (AFOs) have been investigated, but long-term kinematic effects are lacking clinical evidence.Objective
To determine changes in 3-dimensional ankle and foot segment motion in pediatric patients with CP between initial and follow-up visits (18-month average time differences) in both barefoot gait and gait with their AFO. We also investigated intravisit changes between barefoot and AFO gait.Design
A prospective cohort study.Setting
Children’s Hospital of Wisconsin, Department of Orthopaedic Surgery, Medical College of Wisconsin.Patients
A total of 23 children with CP, mean age 10.5 years (6.2-18.1 years) were clinically prescribed either a solid ankle foot orthotic (SAFO), hinged ankle foot orthotic (HAFO), or supramalleolar orthotic.Methods
Holes were cut in the study orthoses so that electromagnetic markers could be directly placed on the skin. A 6-foot segment model was used.Outcome Measurements
Kinematic and kinetic data were recorded for each patient’s initial and follow-up visit (18-month follow-up average, 15-20 months range).Results
For the SAFO group (gait with AFO), a significant decrease in dorsiflexion was found between the initial and third visit (P = .008). Furthermore, the SAFO group (barefoot gait) had an increased eversion at the midfoot for most of the gait cycle (P < .008). Sagittal forefoot range of motion was reduced for all 3 groups between the barefoot and AFO groups.Conclusion
The use of AFOs long term either maintained or improved foot deformities or dysfunction.Level of Evidence
Level II. 相似文献6.
Jarred G. Gillett Glen A. Lichtwark Roslyn N. Boyd Lee A. Barber 《Archives of physical medicine and rehabilitation》2018,99(5):900-906.e1
Objective
To investigate the relation between lower limb muscle strength, passive muscle properties, and functional capacity outcomes in adults with cerebral palsy (CP).Design
Cross-sectional study.Setting
Tertiary institution biomechanics laboratory.Participants
Adults with spastic-type CP (N=33; mean age, 25y; range, 15–51y; mean body mass, 70.15±21.35kg) who were either Gross Motor Function Classification System (GMFCS) level I (n=20) or level II (n=13).Interventions
Not applicable.Main Outcome Measures
Six-minute walk test (6MWT) distance (m), lateral step-up (LSU) test performance (total repetitions), timed up-stairs (TUS) performance (s), maximum voluntary isometric strength of plantar flexors (PF) and dorsiflexors (DF) (Nm.kg?1), and passive ankle joint and muscle stiffness.Results
Maximum isometric PF strength independently explained 61% of variance in 6MWT performance, 57% of variance in LSU test performance, and 50% of variance in TUS test performance. GMFCS level was significantly and independently related to all 3 functional capacity outcomes, and age was retained as a significant independent predictor of LSU and TUS test performance. Passive medial gastrocnemius muscle fascicle stiffness and ankle joint stiffness were not significantly related to functional capacity measures in any of the multiple regression models.Conclusions
Low isometric PF strength was the most important independent variable related to distance walked on the 6MWT, fewer repetitions on the LSU test, and slower TUS test performance. These findings suggest lower isometric muscle strength contributes to the decline in functional capacity in adults with CP. 相似文献7.
Azam Karimi-AhmadAbadi Soofia Naghdi Noureddin Nakhostin Ansari Zahra Fakhari Maede Khalifeloo 《Journal of bodywork and movement therapies》2018,22(2):242-246
Summary
Balance disorder is a very common cause of disability in patients after a stroke. Vibration therapy is one of the physiotherapeutic modalities used to improve balance.Objective
To investigate the immediate effects of plantar vibration on balance in patients with stroke.Methods
In this single blind comparative study, 22 patients with stroke (8 females, 14 males; age 55.82 ± 11.87 years old) participated. Patients underwent treatment, first with the placebo vibration and 1 week later with active vibration (frequency 100 HZ, 5 min). Mini-BESTest score, Modified Modified Ashworth Scale for plantar flexor spasticity, and ankle dorsiflexion passive range of motion (PROM) were evaluated before and immediately after the placebo or active vibration.Results
A significant clinical improvement in balance, ankle plantar flexor spasticity, and the ankle dorsiflexion PROM was observed following either placebo or active vibration. The improvements after active vibration were significantly greater for all outcome measures compared with placebo vibration. There was a large effect size (Cohen's d = 0.85) for balance after active vibration.Conclusion
The vibration applied to the sole of the affected foot of patients after stroke was effective for improving balance, reducing ankle plantar flexor spasticity, and increasing ankle dorsiflexion PROM. 相似文献8.
Nobushige Takahashi Hidetoshi Takahashi Osamu Takahashi Ryosuke Ushijima Rie Umebayashi Junji Nishikawa Yasutomo Okajima 《PM & R》2018,10(2):168-174
Background
Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified.Objective
To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor.Design
An interventional before–after study.Setting
Acute stroke unit or ambulatory rehabilitation clinic of a university hospital in Japan.Participants
Ten subjects (47-84 years) with hemiparesis and 10 healthy male control subjects (31-59 years) were recruited.Methods
RI of the spastic soleus in response to the electrical stimulation of the deep peroneal nerve was evaluated by stimulus-locked averaging of rectified electromyography (EMG) of the soleus while subjects were standing.Main Outcome Measurements
The magnitude of RI, defined as the ratio of the lowest to the baseline amplitude of the rectified EMG at approximately 40 milliseconds after stimulation, was measured while subjects were standing with and without the tone-inhibiting insole on the hemiparesis side.Results
Enhancement of EMG reduction with the tone-inhibiting insole was significant (P < .05) in the subjects with hemiparesis, whereas no significant changes were found in controls.Conclusion
Tone-inhibiting insoles enhanced RI of the soleus in subjects after stroke, which might enhance standing stability by reducing unfavorable ankle plantarflexion tone.Level of Evidence
III 相似文献9.
Alessio Gallina Michael A. Hunt Paul W. Hodges S. Jayne Garland 《Archives of physical medicine and rehabilitation》2018,99(5):907-913
Objective
To compare neural drive, determined from motor unit firing rate, in the vastus medialis and lateralis in women with and without patellofemoral pain.Design
Cross-sectional study.Setting
University research laboratory.Participants
Women (N=56) 19 to 35 years of age, including 36 with patellofemoral pain and 20 controls.Interventions
Not applicable.Main Outcome Measures
Participants sustained an isometric knee extension contraction at 10% of their maximal voluntary effort for 70 seconds. Motor units (N=414) were identified using high-density surface electromyography. Average firing rate was calculated between 5 and 35 seconds after recruitment for each motor unit. Initial firing rate was the inverse of the first 3 motor unit interspike intervals.Results
In control participants, vastus medialis motor units discharged at higher rates than vastus lateralis motor units (P=.001). This was not observed in women with patellofemoral pain (P=.78) because of a higher discharge rate of vastus lateralis compared with control participants (P=.002). No between-group differences were observed for vastus medialis (P=.93). Similar results were obtained for the initial motor unit firing rate.Conclusions
These findings suggest that women with patellofemoral pain have a higher neural drive to vastus lateralis but not vastus medialis, which may be a contributor of the altered patellar kinematics observed in some studies. The different neural drive may be an adaptation to patellofemoral pain, possibly to compensate for decreased quadriceps force production, or a precursor of patellofemoral pain. 相似文献10.
Michael Bade Tamara Struessel Roger Paxton Joshua Winters Carol Baym Jennifer Stevens-Lapsley 《Archives of physical medicine and rehabilitation》2018,99(1):99-106
Objective
To determine the relation between performance on a clinical quadriceps activation battery with (1) activation measured by doublet interpolation and (2) recovery of quadriceps strength and functional performance after total knee arthroplasty (TKA).Design
Planned secondary analysis of a randomized controlled trial.Setting
University research laboratory.Participants
Patients (N=162; mean age, 63±7y; 89 women) undergoing TKA.Main Outcome Measures
Patients were classified as high (quadriceps activation battery ≥4/6) or low (quadriceps activation battery ≤3/6) based on performance on the quadriceps activation battery measured 4 days after TKA. Differences between groups in activation and recovery at 1, 2, 3, 6, and 12 months after TKA were compared using a repeated-measures maximum likelihood model.Results
The low quadriceps activation battery group demonstrated poorer quadriceps activation via doublet interpolation (P=.01), greater quadriceps strength loss (P=.01), and greater functional performance decline (all P<.001) at 1 month after TKA compared with the high quadriceps activation battery group. Differences between low and high quadriceps activation battery groups on all measures did not persist at 3 and 12 months (all P>.05).Conclusions
Poor performance on the quadriceps activation battery early after TKA is related to poor quadriceps activation and poor recovery in the early postoperative period. Patients in the low quadriceps activation battery group took 3 months to recover to the same level as the high quadriceps activation battery group. The quadriceps activation battery may be useful in identifying individuals who need specific interventions to target activation deficits or different care pathways in the early postoperative period to speed recovery after TKA. 相似文献11.
Background
Isometric assessment of muscular function using a handheld dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinicians do not often use 1RM testing, preferring to be cautious with clients who have preexisting impairments. If strength testing using an HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments.Objective
To establish the relationship and agreement between 1RM and isometric strength scores measured using HHD for the biceps and quadriceps muscle groups and to determine if HHD measurements can be used to predict 1RM.Design
Criterion standard comparison.Setting
Tertiary institution gymnasium.Participants
Convenience sample of 50 healthy adults (26 women) aged 19-33 years (mean 23.38 ± 3.11 years).Methods
Muscle strength of the biceps and quadriceps muscle groups measured by 1RM and isometric maximal voluntary contraction measured using an HHD.Main Outcome Measures
Statistical analysis of the relation between the measures of strength was established using Pearson correlation and a Bland-Altman plot. A linear regression analysis with included covariates (gender, age, resistance training history, and body mass index) was used to derive the prediction equations.Results
A significant correlation was found between 1RM and HHD scores for the biceps (r = .83, P < .001) and quadriceps muscle groups (r = .82, P < .001). However, strength scores were not in agreement. Linear regression analysis found significance in predicting 1RM from all HHD scores (P < .001). Gender as a covariate significantly influenced the prediction of 1RM for the biceps (P = .005) and quadriceps (P = .003) muscle groups.Conclusions
There is a significant relationship between 1RM and HHD measures of strength, and measures taken using an HHD can be used to predict 1RM in the biceps and quadriceps muscle groups. The use of an HHD may therefore provide a more accessible alternative to 1RM for muscle strength assessments. Further research is warranted to determine if results are applicable in clinical populations.Level of Evidence
NA 相似文献12.
Francisco Rodriguez-Fontan Nicolas S. Piuzzi Matthew J. Kraeutler Cecilia Pascual-Garrido 《PM & R》2018,10(12):1353-1359
Background
Bone marrow aspirate concentrate (BMC) is one of the few cell-based therapies available as a possible biological treatment for early osteoarthritis (OA). Its efficacy, safety, and benefit compared with other treatments are still to be determined.Objective
To assess the clinical outcomes of patients undergoing intra-articular injection of BMC for the treatment of early knee and hip OA.Design
Prospective, cohort study.Setting
Single institution, quaternary level of care.Patients
Nineteen patients (16 female and 3 male), totaling 25 joints (10 knees, 15 hips), treated with intra-articular BMC for early OA between 2014 and 2016. The mean age at time of the procedure was 58 ± 12.7 years (range, 30-80 years). The mean follow-up was 13.2 ± 6.3 months (range, 6-24 months). Inclusion criteria included ≥18 years; knee OA, Kellgren–Lawrence grade I-II; hip OA, Tönnis grade I-II; first-time intra-articular BMC therapy, after unsuccessful symptomatic and conservative treatments (ie, physical therapy, analgesics and anti-inflammatory drugs) for 6 months. Exclusion criteria included pregnancy; malignancy; rheumatologic diseases; infection; Kellgren–Lawrence grade III-IV; Tönnis grade III; and previous intra-articular injections or surgery.Interventions
All patients had autologous bone marrow aspirate harvested from the iliac crest and centrifuged to achieve BMC, for intra-articular injection.Main Outcome Measurements
The hypothesis was formulated before the study. Patient-reported outcomes measures were assessed preoperatively and at last follow-up using the Western Ontario and McMaster Universities Arthritis Index.Results
Western Ontario and McMaster Universities Arthritis Index improved from a baseline of 40.8 ± 18.3% to 20.6 ± 17% (P < .001) at final follow-up. The satisfaction rate was 63.2%. The minimal clinically important difference threshold of 9.15 points was reached by 64% of the patients. Two patients were converted to total hip arthroplasty at 8 months after BMC injection.Conclusions
Intra-articular injections of BMC for the treatment of early knee or hip OA were safe and demonstrated satisfactory results in 63.2% of patients. Future studies are necessary to determine the efficacy of this technique and its safety profile.Level of Evidence
II 相似文献13.
Heidi Prather Andrew Creighton Chris Sorenson Scott Simpson Maria Reese Devyani Hunt Monica Rho 《PM & R》2018,10(5):455-461
Background
In young and middle-aged adults with and without hip deformity, hip pain receives treatment focused primarily related to hip structure. Because this hip pain may be chronic, these patients develop other coexisting, modifiable disorders related to pain that may go undiagnosed in this young and active population, including insomnia and anxiety.Objective
The objective of this study was to compare assessments of insomnia and anxiety in young and middle-aged adults presenting with hip pain with no greater than minimal osteoarthritis (OA) compared to asymptomatic healthy controls. Comparisons between types of hip deformity and no hip deformity in hip pain patients were performed to assess whether patients with specific hip deformities were likely to have insomnia or anxiety as a cofounding disorder to their hip pain.Design
Prospective case series with control comparison.Setting
Two tertiary university physiatry outpatient clinics.Participants
A total of 50 hip pain patients aged 18-40 years and 50 gender- and age-matched healthy controls.Methods
Patients were enrolled if 2 provocative hip tests were found on physical examination and hip radiographs had no or minimal OA. Radiographic hip deformity measurements were completed by an independent examiner. Comparisons of insomnia and anxiety were completed between 50 hip pain patients and 50 controls and between patients with different types of hip deformity.Main Outcome Measures
Insomnia Severity Index (ISI) and Pain Anxiety Symptoms Scale (PASS).Results
A total of 50 hip pain patients (11 male and 39 female) with mean age of 31.2 ± 8.31 years enrolled. Hip pain patients slept significantly less (P = .001) per night than controls. Patients experienced significantly greater insomnia (P = .0001) and anxiety (P = .0001) compared to controls. No differences were found in insomnia and anxiety scores between hip pain patients with and without hip deformity or between different types of hip deformity.Conclusion
Hip pain patients with radiographs demonstrating minimal to no hip arthritis with and without hip deformity experience significant cofounding yet modifiable disorders of sleep and anxiety. If recognized early in presentation, treatment of insomnia and anxiety ultimately will improve outcomes for hip patients treated either conservatively or surgically for their hip disorder.Level of Evidence
II 相似文献14.
Robert L. Baker Richard B. Souza Mitchell J. Rauh Michael Fredericson Michael D. Rosenthal 《PM & R》2018,10(10):1032-1039
Background
Iliotibial band syndrome has been associated with altered hip and knee kinematics in runners. Previous studies have recommended further research on neuromuscular factors at the hip. The frontal plane hip muscles have been a strong focus in strength comparison but not for electromyography investigation.Objective
To compare hip surface electromyography, and frontal plane hip and knee kinematics, in runners with and without iliotibial band syndrome.Design
Observational cross-sectional study.Setting
Biomechanics research laboratory within a university.Participants
Thirty subjects were recruited consisting of 15 injured runners with iliotibial band syndrome and 15 gender-, age-, and body mass index–matched controls. In each group, 8 were male runners and 7 were female runners. Inclusion criteria for the injured group were pain within 2 months related to iliotibial band syndrome and a positive Noble compression test. Participants were excluded if they reported other lower extremity diagnoses within the last year or active lower extremity or low back pain not related to iliotibial band syndrome. Controls were excluded if they reported a history of iliotibial band syndrome. Convenience sampling was used based on referrals from local running clinics and orthopedic clinics.Methods
Three-dimensional motion capture was performed with 10 high-speed cameras synchronized with wireless surface electromyography during a 30-minute run. The first data point was at 3 minutes, using a constant speed of 2.74 meters per second. A second data point was at 30 minutes, using a self-selected pace by the participant to allow for a challenging run until completion at 30 minutes.Main Outcome Measurements
Motion capture was reported as peak kinematic values from heel strike to peak knee flexion for hip adduction and knee adduction. Surface electromyography was reported as a percentage of maximal voluntary contraction for the gluteus maximus, gluteus medius and tensor fascia latae muscles.Results
Injured runners demonstrated increased knee adduction compared with control runners at 30 minutes (P = .002, control = –1.48°, injured = 3.74°). Tensor fasciae latae muscle activation in injured runners was increased compared with control runners at 3 minutes (P = .017, control = 7% maximal voluntary isometric contraction, injured = 11% maximal voluntary isometric contraction).Conclusion
The results of this study suggest that lateral knee pain in runners localized to the distal iliotibial band is associated with increased knee adduction at 30 minutes. Increased tensor fasciae latae muscle activation at 3 minutes is noted, but more investigation is needed to better understand the clinical meaning. These findings are consistent with but not conclusive evidence supporting the theory that neuromuscular factors of the hip muscles may contribute to increased knee adduction in runners with iliotibial band syndrome. We advise caution using these findings to support treatments intended to modify tensor fasciae latae activation, given the small differences of 4% in muscle activation. Increased knee adduction in runners at 30 minutes was over 5° and beyond the minimal detectable difference. Additional research is needed to confirm whether the degree of knee adduction changes earlier versus later in a run and whether fatigue is a clinically relevant factor.Level of Evidence
III 相似文献15.
Heidi Prather Abby Cheng Karen Steger-May Vaibhav Maheshwari Linda VanDillen 《PM & R》2018,10(1):11-18
Background
Relationships between low back pain (LBP) and the hip in patient cohorts have been described primarily in patients with moderate to severe hip osteoarthritis (OA). Less is known about the links of LBP with hip radiographic findings of hip deformity and minimal OA.Objective
To describe the incidence of radiographic hip deformity or hip OA; to describe and compare spine- and hip-related pain and function in the subset of patients who were found to have radiographic hip deformity or hip OA; and to compare patients with evidence of radiographic hip deformity or hip OA to patients without hip radiographic findings.Design
Prospective cohort study with cross-sectional design.Setting
Tertiary university.Patients
A total of 63 patients (40 women, 23 men) with a mean age of 48.5 ± 14 years with LBP and a minimum of one positive provocative hip test.Methods
Hip radiographs were assessed by an independent examiner for hip OA and deformity.Main Outcome Measurements
Comparisons of hip and lumbar spine pain and function were completed for patients with radiographic findings of hip OA or deformity.Results
Moderate to severe hip OA was found in 12 of 60 patients (20.0%). At least one measurement of femoroacetabular impingement (FAI) was found in 14 of 60 patients (23.3%) to 33 of 45 patients (73.3%). At least one measurement of developmental hip dysplasia (DDH) was found in 7 of 60 patients (11.6%) to 11 of 63 patients (17.4%). Greater pain and reduced hip and lumbar spine function were found in the patients with moderate to severe hip OA. Patients with LBP and FAI were found to have significantly greater extremes of pain and reduced lumbar spine function.Conclusion
Links between the hip and the spine affecting pain and function may be found in patients with LBP and hip deformity and before the onset of radiographic hip OA, and may be associated with hip deformity. Further investigation is needed to better understand these links and their potential impact on prognosis and treatment of LBP.Level of Evidence
II 相似文献16.
Sabrina Eun Kyung Lee Claudio Andre Barbosa de Lira Viviane Louise Andree Nouailhetas Rodrigo Luiz Vancini Marilia Santos Andrade 《Journal of bodywork and movement therapies》2018,22(2):430-437
Introduction
Several studies have been developed to determine which type of muscular action (isometric, isotonic and isokinetic) elicits more gains in functional strength and muscle mass. The comparisons between training outcomes are inconclusive due to lack of exercise standardization.Objective
To compare muscle strength, mass, and functional performance in response to isometric, isotonic, and isokinetic contractions, when training loads (volume and intensity) are equated.Method
Data were derived from a university community-recruited sample (n = 31 men).Interventions
Untrained men were assigned to isotonic (IT), isometric (IM), or isokinetic (IK) group, and trained their dominant quadriceps muscle 3 sessions/week for 8 weeks with a dynamometer. Muscle strength was assessed using Cybex 6000 dynamometer; the triple-hop-distance test was used to assess functional performance, and dual energy x-ray absorptiometry to assess lean muscle mass.Results
After training, muscle lean muscle mass increased in isometric (+3.1%, p < 0.01) and isotonic groups (+3.9%, p < 0.01); only the isokinetic group showed a significant improvement in the triple-hop-distance test (4.84%, p < 0.01).Conclusion
Clinicians should consider isometric training as an alternative for isotonic training to gain muscle mass, and isokinetic training to improve functional performance of daily activities and/or sports. 相似文献17.
Hui-Fen Mao Hsing-Po Huang Tung-Wu Lu Ting-Ming Wang Cheng-Hua Wu Jwu-Sheng Hu 《Archives of physical medicine and rehabilitation》2018,99(10):1982-1990
Objective
To quantify the effects of initial hip angle and angular hip velocity settings of a lower-limb wearable robotic exoskeleton (WRE) on the balance control and mechanical energy requirements in patients with paraplegic spinal cord injuries (SCIs) during WRE-assisted sit-to-stand (STS).Design
Observational, cross-sectional study.Setting
A university hospital gait laboratory with an 8-camera motion analysis system, 3 forceplates, a pair of instrumented crutches, and a WRE.Participants
Patients (N=12) with paraplegic SCI.Interventions
Not applicable.Main Outcome Measures
The inclination angle (IA) of the body’s center of mass (COM) relative to the center of pressure (COP), and the rate of change of IA (RCIA) for balance control, and the mechanical energy and forward COM momentum before and after seat-off for energetics during WRE-assisted STS were compared between conditions with 2 initial hip angles (105° and 115°) and 3 initial hip angular velocities (800, 1000, 1200 rpm).Results
No interactions between the main factors (ie, initial hip angle vs angular velocity) were found for any of the calculated variables. Greater initial hip angle helped the patients with SCI move the body forward with increased COM momentum but reduced RCIA (P<.05). With increasing initial angular hip velocity, the IA and RCIA after seat-off (P<.05) increased linearly while total mechanical energy reduced linearly (P<.05).Conclusions
The current results suggest that a greater initial hip angle with smaller initial angular velocity may provide a favorable compromise between momentum transfer and balance of the body for people with SCI during WRE-assisted STS. The current data will be helpful for improving the design and clinical use of the WRE. 相似文献18.
Bo Hu Søren Thorgaard Skou Barton L. Wise Glenn N. Williams Michael C. Nevitt Neil A. Segal 《Archives of physical medicine and rehabilitation》2018,99(7):1352-1359
Objective
To determine the association between quadriceps rate of force development (RFD) and decline in self-reported physical function and objective measures of physical performance.Design
Longitudinal cohort study.Setting
Community-based sample from 4 urban areas.Participants
Osteoarthritis Initiative participants with or at risk for knee osteoarthritis, who had no history of knee/hip replacement, knee injury, or rheumatoid arthritis (N=2630).Interventions
Not applicable.Main Outcome Measures
Quadriceps RFD (N/s) was measured during isometric strength testing. Worsening physical function was defined as the minimal clinically important difference for worsening self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale score, 20-m walk time, and repeated chair stand time over 36 months.Results
Compared with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an odds ratio (OR) of .68 (95% confidence interval [CI], .51–.92) after adjustment for age, sex, body mass index, depression, history of chronic diseases, and knee pain. In women, in comparison with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an adjusted OR of .57 (95% CI, .38–.86). This decreased risk did not reach statistical significance in men (OR, 0.81; 95% CI, 0.52–1.27). No statistically significant associations were detected between baseline RFD and walk or chair stand times.Conclusions
Our results indicate that higher RFD is associated with decreased risk for worsening self-reported physical function but not with decreased risk for worsening of physical performance. 相似文献19.
Jerin Mathew Kavitha Raja Febin P. Baby Basima Barikkal 《Journal of bodywork and movement therapies》2018,22(3):622-626
Background
In most developing countries, accessibility for people using walking aids is limited due to architectural and environmental barriers. As observed from anecdotal accounts, even a minor orthopaedic injury/disorder may restrict a person's ambulation due to fatigue associated with using walking aids. Hence this study was undertaken with the following objective.Objective
to estimate the magnitude of energy consumption using energy expenditure index (EEI) during gait under different conditions.Design
Repeated measures design (within subjects study).Setting
School.Participants
Ten healthy, typical young adults between 17 and 25 years of age.Outcome measure
Energy Expenditure Index (EEI) was estimated for each of the conditions of the study using consistent measurement procedures.Results
Energy consumption with immobilization is greater (ankle-16.2%, knee-36.7% and ankle and knee-49.2%) than typical self-selected ambulation. During on ground ambulation the energy cost was greatest for an axillary crutches than a standard walker with ankle and knee immobilized being the highest in relation to typical ambulation (78.2% greater). Axillary crutches were more efficient than a walker during stair climbing.Conclusion
For young adults a standard walker may be the right option for over-ground ambulation, when a lower limb joint in immobilized; with an axillary crutch used during stair climbing. 相似文献20.
Marcos Eduardo Scheicher Ligia Cristiane Santos Fonseca Tiago Buso Bortolloto Isabela Feitosa de Carvalho 《Journal of bodywork and movement therapies》2018,22(2):482-486