No abstract

Objectives: The purpose of this study was to evaluate the intrarater reliability of selected clinical outcome measures in patients having ACL reconstruction. Background: Several investigations have reported the reliability of isokinetic testing and knee ligament arthrometry. Fewer studies have examined the reliability of lower extremity functional tests, with most of these studies evaluating normal subjects. Methods and Measures: Fifteen physically active males with unilateral ACL-reconstructed knees were evaluated with the KT-1000, Biodex isokinetic dynamometer, and 3 functional hop tests on 5 occasions. Results: lntraclass correlation coefficients (ICCs) revealed good to high intrarater reliability (ICC >0.80) of the functional hop tests and isokinetic peak torque values. KG were higher for the involved limb than the uninvolved limb using the scores from the KT-1000 Manual Maximum Test. Conclusions: The outcome measures examined in this investigation have been shown to be reliable in patients with ACL reconstructions, and support previous investigations in nonimpaired populations. Further research is needed to examine the validity of these postoperative outcome measures in patients with ACL reconstructions. ) . . -Greater demands are being placed on sports physical therapists to improve the measurement and documentation of clinical outcomes following rehabilitation programs of injured athletes. Success is often determined by a return to the same or better level of functional performance than before the injury. The final phase in the management of an injured athlete requires the timely and safe transition from the rehabilitation environment to actual competition. Although physical characteristics such as range of motion, girth, isokinetic strength, and static ligamentous laxity tests provide useful information about an athlete's postinjury or postoperative Isokinetic testing, commonly used by sports medicine clinicians to assess strength and muscle performance, has been determined to be safe17 and reliableS.19.40.P9.S8.~~41~45~~52P58~74~~ with reported intraclass coefficients (ICCs) ranging from 0.72 to 0.99.Many functional tests have been reported to identi-Q, assess, and evaluate knee stability and function following ACL injury or reconstruction. Some of the more commonly used functional tests reported in the literature include the single-leg hop(s), figure 8 run, shuttle run, vertical jump, joint position reproduction, and a crossover cutting maneu~er.~J~v~~.~2. M.75.76 These research investigations provided useful information regarding assessment following ACL injury or reconstruction, but the investigators declined to report on the reliability of the functional tests examined. A recent investigation by Risberg and Ekeland62 examined 6 functional tests performed by patients after ACL reconstruction, but did not report on the tests' reliability. Lephart et a14S.M suggested that the best assessment of functional capacity in athletes with ACL insufficiency is achieved through the use of 3 "functional perfor...

Study Design: Repeated-measures design comparing 7 static weight-bearing shoulder exercises. Objective: The purpose of this study was to determine the demand on shoulder musculature during weight-bearing exercises and the relationship between increasing weight-bearing posture and shoulder muscle activation. Background: Weight-bearing shoulder exercises are commonly prescribed in the rehabilitation of shoulder injuries. Limited information is available as to the demands placed on shoulder musculature while these exercises are performed. Methods: Eighteen healthy college students volunteered for this study. Surface bipolar electrodes were applied over the infraspinatus, posterior deltoid, anterior deltoid, and pectoralis major muscles. Fine-wire bipolar intramuscular electrodes were inserted into the supraspinatus muscle. Electromyographic (EMG) root mean square signal intensity was normalized to 1 second of EMG obtained with a maximal voluntary isometric contraction (MVIC). Subjects were tested under 7 isometric exercise positions that progressively increased upper extremity weight-bearing posture.Results: There was a high correlation between increasing weight-bearing posture and muscular activity (r = 0.97, PϽ0.01). There was relatively little demand on the shoulder musculature for the prayer and quadruped positions (2%-10% MVIC). Muscular activation was greater for the infraspinatus than for other shoulder muscles throughout most of the exercise positions tested. Conclusion: These results indicate that alterations of weight-bearing exercises, by varying the amount of arm support and force, resulted in very different demands on the shoulder musculature. Specifically, the infraspinatus was particularly active during the weight-bearing exercises used in this study.

RESULTS:During the prone upper extremity lifting task with a hand weight, there was a significant P = .03) and at L5-S1 (P = .04), and during volitional activation for the TrA (P .01). Post hoc testing revealed the rection specific and stabilization categories at the L4-L5 level, between control and direction specific category for the L5-S1 level, and between controls and all 3 categories for the TrA. CONCLUSION:Deficits in the ability to generate muscle thickness changes in the TrA and LM occurred across categories of the TBC system. Intervention studies should be performed to determine if intervention can correct these deficits and if deficit corrections are related to outcomes.

A small short muscle frequently acts across a joint in parallel with a vastly larger and longer muscle; therefore it should play a minimal role in the mechanical control of that joint. This study provides evidence suggesting that the small member of such a "parallel muscle combination" (PMC) may serve an important sensory feedback role. The spindle densities of large and small members of PMCs in man and the dog were determined and compared. Epaxial PMCs controlling canine intervertebral joints were dissected and tissue samples were embedded in paraffin, sectioned transversely to the muscles' long axis and, stained with hematoxylin-periodic acid-Schiff (PAS). Representative tissue sections were projected on to stereological grids and the percentage volume of spindles was determined. Data existing in the literature were used to ascertain spindle densities in human PMCs controlling joints in the cervico-occipital region and the extremities. The spindle density for each muscle in a group of PMCs controlling a particular motion was listed, and the mean spindle densities were determined for both the large and the small members of the group. Student's unpaired t test was used to determine the significance of the differences between mean spindle densities. Linear regression was calculated and the data were plotted graphically. In all PMCs examined, the spindle density of the small muscles was significantly higher than that of their large counterparts. It is therefore proposed that the small muscles of PMCs may function as "kinesiological monitors" generating important proprioceptive feedback to the central nervous system.