Clinical Commentary
Carolyn Wadsworth
Hand rehabilitation is an area with the potential for providing orthopaedic physical therapists a challenging and rewarding practice. However, success in treating the patient with hand dysfunction is closely associated with the therapist's understanding of essential anatomic and pathokinesiologic principles and the related ability to adequately evaluate, plan, and perform treatment. The first article (Wadsworth CT: Clinical anatomy and mechanics of the wrist and hand. J. Orthop Sports Phys Ther 4:205-216) in this two-part series covered the background anatomic and pathokinesiologic concepts. This, the second article of the series, describes the format for examination of the patient with hand dysfunction and presents a practical but comprehensive evaluation form for clinical use. It also supplies information for interpretation of the examination which lays the foundation for goal setting and treatment planning.
J Orthop Sports Phys Ther 1983;5(3):108-120.
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Clinical Commentary
Clive E. Brewster, Diane R. Moynes Schwab, Frank W. Jobe
The rising number of knee ligament injuries which are subsequently surgically reconstructed require special rehabilitation programs. Casting is followed by a knee brace with careful attention paid to restricting full extension. A complete rehabilitation program must include provisions for strengthening knee muscles without placing excess stress on the surgical repair. This program must be coupled with a gradual increase in weight bearing and rigorous control of knee position to yield the optimal result.
J Orthop Sports Phys Ther 1983;5(3):121-126.
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Research Report
Paula Z. Dillon, Wynn F. Updyke, William C. Allen
This study analyzed the gait of women exhibiting symptoms of chondromalacia patellae, and compared them with a group of women without chondromalacia symptoms. High speed cinematography was used to film the subjects walking on a level surface and a 15 downhill slope. Flexion of the knee on both surfaces during the single support phase was significantly less for the chondromalacia subjects (P < 0.05). increased external femoral rotation was detected in chondromalacia patellae subjects (P < 0.05) during swing phase on level and sloping surfaces. A radical inward femoral rotation occurred immediately preceding heel strike (P < 0.001). We conclude that significant differences in gait are apparent in females exibiting chondromalacia patellae symptoms as compared with apparently normal female knees.
J Orthop Sports Phys Ther 1983;5(3):127-131.
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Case Report
William D. Bandy, Thomas C. McLaughlin, Beth McKitrick-Bandy
To evaluate and treat knee problems, it is important to have an understanding of the functional anatomy of the structures about the knee joint. Injuries involving the musculature that insert or originate about the knee can cause pain leading to loss of function. The gastrocnemius muscle, primarily a plantarftexor of the ankle; is also a flexor of the knee joint due to its origin just above the lateral and medial femoral condyles on the posterior surface of the femur.' The following case report is of a strain to the medial head of the gastrocnemius which resulted in pain located at the posteriormedial region of the knee. A differential test to distinguish between a lesion of the gastrocnemius and the posterior capsule of the knee is presented.
J Orthop Sports Phys Ther 1983;5(3):132-133.
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Clinical Commentary
Richard W. Bohannon
Neural and muscular factors contributing to the short duration tension-developing capacity of muscle are reviewed. Among the neural factors discussed are pyramidal tract activity, and the order, extent, frequency, and synchrony of motor unit recruitment. Muscular factors included within the review are muscle size, fiber type, and fiber number. Alterations in neural and muscular factors that accompany training are also presented as are the interactions between them.
J Orthop Sports Phys Ther 1983;5(3):139-147.
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