Many authors have demonstrated that low back pain sufferers have impaired spinal motion. However, it is not known to what degree the patient's signs and symptoms influence this impairment in motion. The aim of this study was therefore to conduct an explorative study to investigate the relationship between low back pain patients' signs and presenting symptoms and objective measurements of motion. One hundred thirty-eight patients with low back pain completed a questionnaire detailing their signs and symptoms and underwent a full clinical examination. A potentiometric motion analysis system of known accuracy and repeatability was used to measure their spinal motion during a flexion-extension test. The effects of a variety of subjective and clinical findings on the motion characteristics were examined, which revealed that certain factors, such as diagnosis, pain characteristics, symptom severity, and level of disruption, were related to the resulting motion measurements. The strength of these relationships was not as strong as anticipated (accounting for 16-45% of the variability). This suggests that routine objective assessments cannot be used as a substitute for a thorough physical and subjective examination.

J Orthop Sports Phys Ther. 1998;28(6):370-377.

Key Words: low back pain, lumbar spine, motion, subjective findings, clinical findings

Patellofemoral joint deterioration (PFJD) is frequently seen in physical therapy clinics and represents a significant problem for both patients and rehabilitation clinicians. The vastus medialis oblique (VMO) muscle is reported to be the primary stabilizer of the patella during knee extension. Most studies and treatment protocols emphasize strengthening of the VMO as the nonsurgical treatment of choice for patients with PFJD. The purpose of this study was to determine whether any relationship exists between the morphology of the VMO and the presence and severity of PFJD in human cadavers. Dissection of 374 vastus medialis (VM) muscles and patellofemoral joints was performed on 229 human cadaver lower limbs to determine what relationships exist between gender, VMO features, and PFJD. Patellofemoral joint deterioration was determined by direct visual observation and assigned a score based on severity of joint deterioration present. Two-way chi-square tests were performed to determine the relationships between cadaver gender, the presence of VMO features, and the presence and severity of PFJD. Linear regression was performed to determine whether any correlation existed between the VMO fiber angle and the severity of PFJD. A one-way analysis of variance was performed to determine whether any differences existed between the VMO fiber angle and the PFJD groups. No statistically significant relationships, correlation, or differences existed in any of the tests performed between cadaver gender, VMO features, and presence or severity of PFJD. The presence or severity of PFJD in human cadavers is not related to either gender or VMO morphologic features. The results of this study do not support the premise that a more distal insertion of the VMO onto the patella of the VMO will have any effect on the presence or severity of PFJD.

J Orthop Sports Phys Ther. 1998;28(6):384-391.

Key Words: cadaver, patellofemoral joint, vastus medialis, deterioration

The evaluation of lower limb preference in physical therapy practice is critical in order for the clinician to assist patients with functional retraining tasks. No studies in the physical therapy literature present a systematic approach to determine the criteria needed to identify the preferred limb. This research was designed to present a series of tests for effectiveness in determining limb preference. The purpose of this study was to determine whether lower limb preference existed in a group of recreationally athletic women when performing either stability or dynamic skills with the lower extremities while sitting or standing. The relationship of such a preference to handedness was also determined. Forty female recreational athletes, 20 right-handed subjects and 20 left-handed subjects, who ranged in age from 21 to 35 years, participated in this study. Subjects performed three repetitions of the following tests in both sitting and standing: kick a ball, swing a leg over a box, pick up a marble with the toes, and trace a triangle with the toes. The subjects were also asked to stand on one leg. The order of performing the tests was randomized. The results indicated that right-handed subjects performed activities more consistently with one lower extremity when compared with left-handed subjects, regardless of posture (sitting or standing). The difference in limb choice between right- and left-handed subjects was significant for all activities (p < .05). The considerable sensitivity of foot and leg performance following neurological insult renders the assessment of foot and leg preference very important for purposes of clinical rehabilitation.

J Orthop Sports Phys Ther. 1998;28(6):400-404.

Key Words: motor control, kicking, foot preference, hand preference, laterality

Index by subject of all manuscripts published by the Journal from July through December 1998.

J Orthop Sports Phys Ther. 1998;28(6):431-437.