Olympic style games for athletes with a disability were organized for the first time in Rome, Italy, in 1960. This event is now referred to as the Paralympic Games. It includes elite athletes primarily from 5 different disability groups, including amputation, cerebral palsy, visual impairment, spinal cord injuries, and "les autres" (individuals with physical disabilities that do not fit into the other groups). The Paralympic movement emphasizes athletic achievement rather than disability. The author of this editorial describes his experience working with the United States Paralympic Archery and Judo Teams at the 2008 Paralympic Games in Beijing, China, in 2008.

J Orthop Sports Phys Ther 2009;39(4):243-245. doi:10.2519/jospt.2009.0112

KEY WORDS: 2008 Paralympic Games, archery, disability

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To examine differences between arms in humeral torsion in adult and adolescent throwing and nonthrowing athletes, and nonathletic adults. BACKGROUND: It is hypothesized that humeral retrotorsion develops by, and is beneficial for, throwing. Thus throwers should demonstrate greater retrotorsion in their dominant arm relative to their nondominant arm and have more side-to-side retrotorsion difference than nonthrowing groups. In addition, adult throwers should have a greater side-to-side retrotorsion difference than adolescent throwers, and swimmers should not demonstrate a retrotorsion difference. METHODS AND MEASURES: Using ultrasound to standardize the location of the bicipital groove, the amount of humeral torsion was measured in both arms of male baseball players (85 adult, 35 adolescent), female softball players (16 adult, 37 adolescent), 29 elite adolescent swimmers (19 female), and 16 nonathletic adults (8 female). RESULTS: More retrotorsion was found in the dominant arm of almost all throwing athletes, irrespective of their gender or whether they were adults or adolescents (mean ± SD side-to-side difference, 11.9° ± 10.5°). This difference was less for swimmers (6.4° ± 9.9°) and nonathletic adults (1.3° ± 8.9°). CONCLUSION: Greater dominant armhumeral retrotorsion is observed contingent with participation in throwing sports.

J Orthop Sports Phys Ther 2009;39(4):256-263, Epub 24 February 2009. doi:10.2519/jospt.2009.2821

KEY WORDS: pitching, retrotorsion, retroversion, shoulder, swimming, ultrasound

STUDY DESIGN: Cross-sectional. OBJECTIVES: This study examined the baseline relationship of pain intensity, physical impairment, and pain-related fear to shoulder function. BACKGROUND: There is no consensus regarding the influence psychological variable have on function and recovery in individuals with shoulder pathologies. While pain-related fear has been shown to predict disability for patients with low-back and cervical pain, this relationship has not been consistently reported for patients with shoulder pain. METHODS AND MEASURES: One hundred forty-two subjects (78 male, 64 female; mean age, 41.4 years) with nonoperative unilateralshoulder disorders were identified from a clinical database of impairment and outcome measures.Demographic information, duration of symptoms, mechanism of injury, pain intensity, pain-related
fear, and range-of-motion (ROM) measures were collected. Self-report of function was measured with the Shoulder Pain and Disability Index (SPADI). Hierarchical regression analysis determinedthe proportions of explained variance in function. RESULTS: Demographic variables (durationof symptoms, sex, age, and mechanism of injury) collectively contributed approximately 9% (P = .003) of the variance in function scores. Average pain intensity and flexion ROM contributed an additional 22% (P<.001) of the variance, and Tampa Scale of Kinesiophobia (TSK-11) scores contributed an additional 3% (P<.001). In the final parsimonious model, presence of symptoms longer than 3 months (ß = .23, P = .003), pain intensity (ß = .25, P = .002), shoulder flexion ROM index (ß = –.35, P = .001), and kinesiophobia (ß = .17, P = .026) explained 33% of the variance in SPADI function score (P<.001). CONCLUSIONS: Presence of symptoms longer than 3 months, average pain intensity, flexion ROM index (strongest contributor in multivariate model), and fear-of-pain scores all contributed to baseline shoulder function. The immediate clinical relevance of these findings is unclear but they do provide direction for prospective studies. LEVEL OF EVIDENCE: Prognosis, level 2b.

J Orthop Sports Phys Ther 2009;39(4):270-277, Epub 15 December 2008. doi:10.2519/jospt.2009.2879

KEY WORDS: disability, kinesiophobia, psychological, physical therapy, shoulder flexion

STUDY DESIGN: Technical note. OBJECTIVES: To provide background theory and information and to describe relevant applications of autocorrelation and cross-correlation methodology as they apply to the field of motor control in human movement and rehabilitation research. BACKGROUND: Commonly used methodologies for pattern and event recognition, determination of muscle activation timing for investigation of movement coordination, and motor control are generally difficult to implement, particularly with large datasets. A brief description of the underlying mathematical theory of correlation analyses is given, followed by 4 different examples of how this methodology is useful for research in the movement sciences. METHODS: Examples demonstrating the utility of correlation analyses are presented from several different studies conducted at the University of Waterloo. RESULTS: Autocorrelation was used to demonstrate the presence of 60-Hz noise in anelectromyography signal that was not visible in the raw data. A "top-down" paraspinal muscle activation pattern was demonstrated for healthy adults during gait, with the use of cross-correlation. Cross-correlation was also used to quantify coactivation of bilateral gluteus medius muscles during standing in individuals who developed low-back pain. Gender differences in gluteus medius control of mediolateral center of pressure were seen with the use of cross-correlation. CONCLUSION: Autocorrelation and crosscorrelation have been shown to be an effective tool for several different applications in the movement sciences. Examples of the method’s utility include noise detection within a signal, determination of relative muscle activation onsets for postural control, objective quantification of muscle coactivation, and relating muscle activations with mechanical events.

J Orthop Sports Phys Ther 2009;39(4):287-295, Epub 17 December 2008. doi:10.2519/jospt.2009.2969

KEY WORDS: EMG, methodology, motor control

The Orthopaedic Section of the American Physical Therapy Association presents this third set of clinical practice guidelines on hip osteoarthritis, linked to the International Classification of Functioning, Disability, and Health (ICF). The purpose of these practice guidelines is to describe evidence-based orthopaedic physical therapy clinical practice and provide recommendations for (1) examination and diagnostic classification based on body functions and body structures, activity limitations, and participation restrictions, (2) prognosis, (3) interventions provided by physical therapists, and (4) assessment of outcome for common musculoskeletal disorders.

J Orthop Sports Phys Ther 2009;39(4):A1-A25. doi:10.2519/jospt.2009.0301

KEY WORDS: APTA, clinical practice guidelines, ICD, ICF, Orthopaedic Section

A selection of products and developments of interest to JOSPT readers.

J Orthop Sports Phys Ther 2009;39(4):298-300.