Quasistatic TS exercises did not improve core strength, trunk control, or knee loading relative to RT potentially because of a lack of exercises, including unexpected perturbations and dynamic movement. Together, these results suggest the potential importance of targeted trunk control training to address these known anterior cruciate ligament injury risk factors.
Altered trunk muscle reflexes have been observed in patients with low back pain (LBP). Altered reflexes may contribute to impaired postural control, and possibly recurrence of LBP. Specific stabilization exercise (SSE) programs have been shown to decrease the risk of LBP recurrence in a select group of patients with acute, first episode LBP. It is not known if trunk muscle reflex responses improve with resolution of subacute, recurrent LBP when treated with a SSE program. A perturbation test was used to compare trunk muscle reflexes in patients with subacute, recurrent LBP, before and after 10 weeks of a SSE program and a group of matched control subjects (CNTL). The LBP group pre therapy had delayed trunk muscle reflexes compared with the CNTL group. Post therapy reflex latencies remained delayed, but amplitudes increased. Increased reflex amplitudes could limit excessive movement of the spine when perturbed; potentially helping prevent recurrence.
The authors conducted a two-part study to compare in vivo acetabular contact pressures during the acute and postacute phases of rehabilitation. This report compares in vivo acetabular contact pressures generated during selected "inpatient" rehabilitation activities and their relationship to pain, range of motion, and other clinical indicators. A pressure-instrumented Moore-type endoprosthesis was implanted in a 73-year-old woman who had sustained a femoral neck fracture. Acetabular contact pressures during the first 2 weeks after surgery were rank-ordered. Clinical data, including range of motion, manual muscle test grade, use of pain medication, and independence in gait, were collected simultaneously. Acetabular pressures did not follow the predicted rank order corresponding to the commonly prescribed temporal order of inpatient rehabilitation activities. Isometric hip extension and active hip flexion generated the highest pressures of all the studied activities, including those measured during gait activities. Isometric exercises, therefore, may not be entirely benign preparation for ambulatory activity. Clinical data did not correspond with peak pressure data, suggesting that observed responses to rehabilitation may not be dependable criteria for progressing the acute hip rehabilitation protocol. We discuss applications for rehabilitation programs based on hip contact pressure data as an initial attempt to formulate more defensible rehabilitation approaches for patients with acutely painful hips.
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