Study Design: Test-retest reliability study. Objectives: To determine intra- and intertester reliability of the hand-held pencil (HHP) and the plumbline goniometer (PLG) methods for measuring active forearm pronation and supination motions in individuals with and without injuries. Background: The distal forearm method has been considered the gold standard for measuring forearm pronation and supination motion. The HHP and PLG, however, are 2 more functional methods for measuring forearm motions, though limited information on the psychometric properties of these tests is currently available. Methods and Measures: Intra- and intertester reliability of the HHP and PLG methods were determined in 40 subjects of convenience (20 injured and 20 noninjured). Two testers performed 3 repeated measurements for each motion and method on all subjects. Intraclass correlation coefficients (ICC3,1 for intratester reliability, ICC2,3 for intertester reliability) and standard error of measurements (SEMs) were determined. Results: The ICCs for the measurements of pronation and supination using the HHP and PLG methods were high (range, 0.86-0.98) for individuals with and without injuries, with the reliability for the PLG method being equal or slightly greater than the HHP method for the majority of pronation and supination measurements. Intratester ICCs were higher (SEMs were conversely lower) than intertester ICCs for nearly all measurements. The ICC values were generally the same or higher for individuals with injuries compared to individuals without injuries. Conclusions: The HHP and PLG are highly reliable methods for measuring functional forearm pronation and supination. Because plumbline goniometers are not commercially available and the instrumentation for the HHP method is readily accessible, clinicians should consider the latter as their method of choice for measuring functional forearm pronation and supination.

J Orthop Sports Phys Ther. 2003;33(9):523-531.

Key Words: goniometry, radioulnar joints, upper extremity

Study Design: Within-group repeated measures. Objectives: To determine the effect of a semi-rigid prophylactic ankle stabilizer (PAS) on performance of subjects with post-acute, unilateral ankle sprains who have mechanically stable ankles, but are functionally impaired. Background: Most studies on PAS performance to date are limited to subjects with noninjured, nonimpaired ankles. No research has been reported to determine the effect PASs have on performance in subjects who have a mechanically stable, nonacute ankle sprain with functional impairment. Methods and Measures: Twenty-five subjects (8 men and 17 women; average height = 168.91 ± 33.02 cm, average weight = 61.10 ± 29.5 kg, and average age = 16.2 ± 6 years) met the qualification criteria of the study. Subjects had unilateral grade I or II lateral ankle sprains of 3 to 4 weeks duration and were cleared medically to return to activities of daily living. Each subject's injured ankle was mechanically stable as determined by physical exam but was functionally impaired as determined by instability during the modified Rhomberg test. Separate 2 x 2 ANOVAs with repeated measures on brace condition (Aircast SportStirrup and nonbraced control) and test session (test session 1 and test session 2) were completed to assess the effect of ankle stabilization on 2 dependent variables (36.58-m shuttle-run and vertical-jump). Results: Shuttle-run time was significantly faster for the braced condition (mean = 9.43 ± .72 seconds) than for the nonbraced control (mean = 9.57 ± .75 seconds), regardless of test session. Shuttle-run time was significantly faster for test session 2 (mean = 9.43 ± .79 seconds) than for test session 1 (mean = 9.57 ± .68 seconds), regardless of brace condition. No significant main or interaction effects occurred for vertical-jump. Conclusions: Use of a semi-rigid PAS significantly increased shuttle-run but not vertical-jump performance. This effect was immediate and did not require PAS acclimation.

J Orthop Sports Phys Ther. 2000;30(9):552-556.

Key Words: postural instability unilateral ankle sprain

Study Design: Experimental 3-factor design with repeated measures on all factors. Objectives: The purpose of this study was to determine the effectiveness of 3 prophylactic hyperextension elbow braces on limiting active and passive elbow extension before and after exercise. Background: Prophylactic hyperextension elbow braces are used to protect the joint against excessive extension, but their effectiveness for this purpose has not been determined. Methods and Materials: Twenty Division I intercollegiate football players (mean ± SD age, 20.2 ± 1.3 years; mean ± SD height, 184.4 ± 9.9 cm, mean ± SD mass, 102.9 ± 22.0 kg) completed all phases of the study. The Breg Functional Elbow Brace, PRO 470 Kendall Elbow Brace, and DonJoy Elbow Guard were tested both actively and passively before and after an isokinetic exercise session on a Biodex Multi-Joint Testing and Exercise Dynamometer. For all tests, the braces were set at a 30° flexion limit angle. The exercise session consisted of 1 set of reciprocal elbow extension and flexion at an angular velocity of 360°/s, totaling 1627 J of work. Results: None of the braces limited elbow extension to the 30° flexion limit. However, all of the braces were successful in preventing the elbow from reaching the vulnerable position of hyperextension. The Breg Functional Elbow Brace was the most effective for limiting elbow extension near its set angle, followed by the DonJoy Elbow Guard, and the PRO 470 Kendall Elbow Brace across all test conditions. Conclusion: The braces’ effectiveness to limit motion is enhanced when limits are set higher than the desired angle of the protected motion.

J Orthop Sports Phys Ther. 2005;35(12):837-843. doi:10.2519/jospt.2005.2045

Key Words: dislocation, elbow bracing, functional bracing, upper extremity bracing

No prophylactic ankle stabilizer performance study has been conducted to date using high school football players, ie., players who are at risk of ankle sprains. In addition, the effect that prophylactic ankle stabilizer use has on performance by player position is unknown. The purpose of this study was to determine the effect of a semirigid and softshell prophylactic ankle stabilizer on performance by football player position in events testing vertical jump, speed, and agility. Twenty-five high school football players participated in the study. All subjects denied any history of ankle injury within 1 year of the study and previous experience with prophylactic ankle stabilizer use. Subjects completed 3 tests [vertical jump, 36.56-m (40-yd) sprint, and 18.28-m (20-yd) shuttle run] under 3 different ankle treatments: Aircast SportStirrup, DonJoy RocketSoc, and nonbraced control. Results of the study indicated that the Aircast SportStirrup and DonJoy RocketSoc, when compared with a nonbraced control, had no significant effect on vertical jump, 36.56-m (40-yd) sprint, and 18.28-m (20-yd) shuttle run performance. Skill players had faster 36.56-m (40-yd) sprint times than strength players regardless of ankle treatment. In conclusion, the Aircast SportStirrup and DonJoy RocketSoc did not facilitate or adversely affect performance involving vertical jump, speed, and agility of high school football players.

J Orthop Sports Phys Ther. 1995;21(3):147-152.

Key Words: ankle, stabilizing prophylactic, athletic performance