Closed kinetic chain exercises have been promoted as more functional and more appropriate than open kinetic chain exercises. Limited research exists demonstrating the effect of closed kinetic chain exercise on quadriceps and lower extremity performance. The purpose of this study was to determine the effect of a lateral step-up exercise protocol on isokinetic quadriceps peak torque and the following lower extremity activities: 1) leg press, 2) maximal step-up repetitions with body weight plus 25%, 3) hop for distance, and 4) 6-m timed hop.

Twenty subjects participated in a 4-week training period, and 18 subjects served as controls. For the experimental group, a repeated measure ANOVA comparing pretest and posttest values revealed significant improvements in the leg press (p≤.05), step-ups (p≤.05), hop for distance (p≤.05), and hop for time (p≤.05) and no significant increase in isokinetic quadriceps peak torque (p≥.05). Over the course of the training period, weight used for the step-up exercise increased (p≤.05), repetitions decreased (p≤.05), and step-up work did not change (p≥.05). For the control group, no significant change (p≥.05) occurred in any variable.

The inability of the isokinetic dynamometer to detect increases in quadriceps performance is important because the isokinetic values are frequently used as criteria for return to functional activities. We conclude that closed kinetic chain testing and exercise provide additional means to assess and rehabilitate the lower extremity.

J Orthop Sports Phys Ther. 1993;18(6):646-653.

Key Words: hop tests, lateral step-up, muscle strength

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Although tape measurement of thigh girth is a common component of a clinical knee examination, the implications of thigh girth asymmetry are not well understood. The purpose of this study was to examine the relationship between thigh girth asymmetry and torque asymmetry for extension and flexion of the knee.

Thirty subjects with thigh girth asymmetry of at least 2 cm, measured at a site 15 cm proximal to the superior pole of the patella, were studied. Subjects were measured for girth at 10 sites along each thigh. Knee flexion and extension torque production were also tested on a Cybex II isokinetic dynamometer. Girth asymmetry was determined by the difference in measurements between the subjects' smaller and larger thighs. Percent girth asymmetries varied by site, with the greatest average girth asymmetry (asymmetry = 5.94%) at 16 cm proximal to the superior patellar pole. Percent peak torque asymmetries were computed from the differences between subjects' stronger versus weaker thighs.

Correlations and regressions of both extension and flexion torque asymmetries upon girth asymmetry sites showed higher associations and less error for more proximal measurements. Fair to moderate correlation coefficients (r = .37-.42, p<.05) were statistically significant for extension torque asymmetry compared with girth asymmetry at sites 12, 14, 16, and 20 cm proximal to the patella and for flexion torque asymmetry only at the 14 cm site. Although girth and torque asymmetries were found to be somewhat related, percent girth asymmetry provided only a limited prediction of percent peak torque asymmetry.

J Orthop Sports Phys Ther. 1993;18(6):661-666.

Key Words: knee, girth, muscle strength

The opinions or assertions in this research are the private views of the author and are not to be construed as official or reflecting views of the United States Army, the Department of Defense, or the United States government.

Industrial physical therapists (IPTs) are working as external consultants with business and industry to provide injury prevention and/or rehabilitation services. This consulting presents a very new practice setting for therapists and requires specialized nonclinical competencies. The purpose of this study was to identify these nonclinical competencies.

The research was based on an evaluation research model using a stakeholder group. Stakeholders represented 5 groups: 1) IPTs, 2) continuing education providers, 3) business and industry employers of IPTs, 4) safety/risk managers, and 5) human resource development professionals. Thirty-five nonclinical competencies were identified through qualitative analysis of in-depth interviews with 17 subject matter experts representing the 5 groups. The competencies addressed marketing, program planning, managing the consulting process, training, and understanding organizations.

This list of nonclinical competencies may serve as a self-assessment tool that IPTs can use to help plan their professional development. It may also facilitate planning continuing education programs for IPTs.

J Orthop Sports Phys Ther. 1993;18(6):673-681.

Key Words: competencies, industrial physical therapy

Frequently, joint range of motion is reported for a single plane (eg, sagittal, coronal, or transverse). However, the arc of joint motion during functional activities and many clinical tests encompasses motion in all 3 planes simultaneously. The purposes of this paper are to discuss a method to obtain relative joint 3-dimensional angular displacement measurements using coordinates from skeletal landmarks and provide an analytical example of the method using 3-dimensional angular displacement of the knee joint as a model.

In order to calculate the 3-dimensional relative motion, an orthogonal reference frame for each bone needs to be established. To establish the local reference frame, 3 noncollinear points are used to define unit vectors that are mutually perpendicular. Three-dimensional angles can be determined to describe the magnitude of the moving body rotation angles about the X, Y, and Z axes. These angles indicate the relative motion of body segments for abduction/adduction, flexion/extension, and internal/external rotation.

The technique provides a more vigorous biomechanical understanding of joint motion and may have implications for measuring patient progress and evaluating joint mobilization treatment. This technique may also serve as a basis for developing new evaluation and treatment techniques.

 J Orthop Sports Phys Ther. 1993;18(6):687-691.

Key Words: range of motion, kinematics, biomechanics

This index includes all authors and co-authors of manuscripts published in the Journal from July through December 1993.