This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support children's motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties.

The hamstrings:quadriceps muscle strength ratio has been used as an indicator of normal balance between the knee flexors and extensors. A more functional approach to this strength ratio would be to compare opposite muscle actions of antagonistic muscle groups. The dynamic strength control ratio (DSCR) should give a more appropriate measure relating to knee function. There is a lack of normative data relating to DSCR for anterior cruciate ligament (ACL) deficient subjects. Effects of ACL deficiency on isokinetic peak torque for eccentric and concentric muscle actions of the quadriceps and hamstrings, in conjunction with isometric peak torque, were examined in 10 patients awaiting reconstructive surgery (male = 8, female = 2 ; age = 32.8 +/- 8.3 years; height = 1.77 +/- 0.08 m; mass = 72.1 +/- 12.5 kg). These variables were assessed using an isokinetic dynamometer. The results were considered in terms of the conventional ratio and DSCR. Anterior tibial drawer was measured using a knee ligament arthrometer to confirm clinical diagnosis of ACL rupture. The isokinetic peak torque data analysed were for angular velocities of 1.05 rad s(-1) (60 degrees s(-1)). Significant strength deficits were apparent between normal and injured sides for: concentric isokinetic quadriceps action (p < 0.05); isometric quadriceps action at 70 degrees of knee flexion (p < 0.05); isometric quadriceps action at 40 degrees of knee flexion (p<0.01); eccentric isokinetic hamstrings action (p < 0.05). With bilateral comparison, the conventional strength ratios showed no significant difference, as did the DSCR. The bilateral comparison of isometric strength ratios revealed significant losses in quadriceps strength for the injured side (p < 0.05) but no significant losses in hamstring strength (p > 0.05). Thus, differences can be seen in conventional ratios and DSCR for ACL-deficient subjects. This is an area of clinical interest with the increasing frequency of ACL reconstruction using hamstrings tendons.

Pectoralis major ruptures occur in large, muscular individuals, and repair constructs may experience significant tension. Four different suture techniques were evaluated biomechanically to determine the effect of suture technique on optimizing fixation strength. Forty fresh-frozen cadaveric shoulders were repaired using endosteal buttons. The control group was repaired with #2 polyblend suture in a modified Mason-Allen stitch configuration. The triple group was repaired using the same suture and configuration, but with the addition of triple-loaded buttons. The configuration group was repaired using the same suture in a Krackow/Bunnell configuration. The tape group was repaired using 2-mm polyethylene tape and #5 polyblend suture in the Krackow/Bunnell configuration. Under cyclic loading, there was no significant difference between groups. Under load-to-failure testing, the tape group withstood a significantly greater maximum load (726.0±90.0 N) than the control and triple groups (330.2±20.2 and 400.2±35.2 N, respectively; P<.005), and similar load to the configuration group (509.9±68.6 N; P=.16). The configuration group failed via suture breakage (9/10); the other groups failed via suture pullout, in which suture pulled through tendon (26/30). Pectoralis major repair in a running, locked configuration appears to improve biomechanical performance by preventing suture pullout. Use of a polyethylene tape construct demonstrates the potential for improved failure loads, but its role remains undefined.

No abstract