Research Report
David C. Feiring, Todd S. Ellenbecker, Gary L. Derscheid
The purpose of this study was to determine the test-retest reliability of the Biodex (Biodex, Corp., Shirley, NY) isokinetic concentric mode for a healthy active population for knee extension/flexion utilizing the parameters peak torque and work. Nineteen healthy active male and female subjects ages 20-35 with no history of knee injury were tested bilaterally for concentric knee extension and flexion at 60, 180, 240, and 300°/sec., utilizing standard Biodex protocol. Seven days following the pre-test, a post-test was administered using identical protocol. Data collection of pre- and posttesting was done via a Compaq Desk Pro personal computer and Biodex software programming. The parameters of peak torque and single repetition work were analyzed for knee extension/flexion. Statistical analysis of data showed the intraclass correlation coefficient (ICC) of knee extension peak torque at 60°/sec to be r = 0.95; at 180°/sec, r = 0.96; at 240°/sec, r = 0.95; and at 300°/sec, r = 0.97. Knee extension work ICC values were at 60°/sec, r = 0.96; at 180°/sec, r = 0.97; at 240°/sec, r = 0.96 and r = 0.95 at 300°/sec. All ICCs are significant at the 0.05 level. Therefore, the isokinetic concentric mode of the Biodex dynamometer was reliable for test-retest measures of peak torque, and single repetition work.
J Orthop Sports Phys Ther 1990;11(7):298-300.
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Case Report
Andrew Novick, David L. Kelley
Foot orthotics have proven to be an effective means of reducing clinical symptoms in the lower limb. Kinematic studies of runners have substantiated these findings by showing significant changes in a number of parameters describing foot function. This study examines the effect of foot orthotics during the loading response of walking, the period of stance when angular movements and positions of the calcaneus typically attain peak values. Twenty subjects exhibiting a minimum of 5 calcaneal eversion in static stance volunteered for this study. A musculoskeletal examination of the lower limb was performed on all subjects and rigid orthotics were fabricated based upon the findings. All subjects participated in both the orthotic and no-orthotic treatment conditions. A VlCON three-dimensional motion analysis system with a force platform was used to collect data. A MANOVA procedure was used to perform statistical analysis on the multiple dependent variables. Results showed significant changes in the following variables: 1) maximum calcaneal and calcaneal eversion angles, 2) total rearfoot movement, 3) height of the ankle joint center when both the maximum calcaneal angles occurred, 4) minimum height of the ankle joint center, 5) mediolateral lever arm of the point of application of the ground reaction force when both the maximum calcaneal angles occurred, 6) maximum eversion moment due to ground reaction, 7) maximum calcaneal and calcaneal eversion angular velocity, and 8) maximum calcaneal eversion and tibia vara angular acceleration.
J Orthop Sports Phys Ther 1990;11(7):301-312.
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Research Report
Mark J. Horacek, Alvin M. Earle, W. K. Metcalf
Transcutaneous medium frequency electrical stimulation is used extensively to improve muscle strength in people who encounter difficulty in improving strength voluntarily. The purpose of this study was to describe some morphometric effects of electrical stimulation applied to rabbit skeletal muscle and peripheral nerve tissue (N = 5 control and 7 experimental rabbits). Intermittent electrical current (4000 Hz pulse modulated at 50 Hz) was applied transcutaneously to adult female rabbit thigh muscle 3 times/week for 3 months. Muscle ATPase histochemical staining, followed by morphometric analysis, demonstrated that type IIB fibers in stimulated muscles (sartorius and vastus lateralis) had larger cross-sectional areas in comparison to nonstimulated muscle fibers. Type IIA fibers of the stimulated sartorius muscle also were hypertrophied in comparison to nonstimulated muscle fibers. The percentage distribution of muscle fiber types did not change significantly as a result of stimulation. The femoral nerves of these rabbits were fixed and stained. Morphometric analysis did not detect any significant change in myelin cross-sectional area or thickness. Also, nerve axoplasmic cross-sectional area in stimulated femoral nerves was not significantly different from controls. These data suggest that electrical stimulation can increase the size of skeletal muscle fibers if applied consistently for an extended period of time. Further research is needed to further characterize this effect and to determine whether the same effect can be observed in humans after prolonged stimulation.
J Orthop Sports Phys Ther 1990;11(7):313-320.
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Case Report
Margaret J. Satterfield, Deborah Dowden, Kathleen Yasumura
The views and findings contained in this report are those of the authors and should not be construed as an official Department of the Army position, policy, or decision unless so designated by other official documentation.
An avid 39-year-old female runner experiencing left groin pain was initially assessed as having a muscle strain but treated conservatively with crutch ambulation since the possibility of a left femoral neck stress fracture was not ruled out. A subsequent bone scan revealed a left medial femoral neck stress fracture. In the ensuing 18 months, evidence of stress fractures at multiple sites differing from the original fracture surfaced due to her noncompliance to the rehabilitation program and restrictions. Counseling for lifestyle modification were rejected by the patient. Resultant healing of her stress fracture was poor. Alerting clinicians to the importance of referral to behavior modification specialists from the onset of treatment for avid runners appears to be critical. In addition, a review of two other contributory factors possibly predisposing one to stress fractures was examined for consideration for future research.
J Orthop Sports Phys Ther 1990;11(7):321-325.
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