Journal of Orthopaedic & Sports Physical Therapy - William D. Bandy, PT, PhD, SCS, ATC

An Introduction to the Plica

Turner A. Blackburn, Gordon Eiland, William D. Bandy
Physical therapy literature has been void of information concerning the plica. The authors discuss the literature available past and present. Using current published information and clinical experience, the authors have described the functional anatomy, the evaluation, the surgery, and the prevention and postoperative rehabilitation programs. Case studies were used to demonstrate conservative and nonconservative approaches in treating the plica syndrome.

J Orthop Sports Phys Ther 1982;3(4):171-177.

Case Study: Compression Fracture of Thoracic Spine with Emphasis on Fabrication of a Protective Pad for Athletic Participation

Gordon Eiland, William D. Bandy
Preparation for return to full competition by an injured athlete can be enhanced by the use of a protective pad. This article presents the fabrication of a protective pad for a compression fracture of TI, with resulting prominence of the spinous process. The mechanism of injury of a compression fracture for the thoracic vertebrae is discussed and general guidelines for the proper construction of a pad are presented.

J Orthop Sports Phys Ther 1982;4(2):115-117.

A Case Study: The Importance of a Dynamic Evaluation in the Assessment of Posterior Knee Pain

William D. Bandy, Thomas C. McLaughlin, Beth McKitrick-Bandy

To evaluate and treat knee problems, it is important to have an understanding of the functional anatomy of the structures about the knee joint. Injuries involving the musculature that insert or originate about the knee can cause pain leading to loss of function. The gastrocnemius muscle, primarily a plantarftexor of the ankle; is also a flexor of the knee joint due to its origin just above the lateral and medial femoral condyles on the posterior surface of the femur.' The following case report is of a strain to the medial head of the gastrocnemius which resulted in pain located at the posteriormedial region of the knee. A differential test to distinguish between a lesion of the gastrocnemius and the posterior capsule of the knee is presented.

J Orthop Sports Phys Ther 1983;5(3):132-133.

Kinematic Effects of Heel Lift Use to Correct Lower Limb Length Differences*

William D. Bandy, Wayne E. Sinning
The effect of the heel lift to correct a limb length difference was studied by electrogoniometry (elgons) in four male subjects with a limb length inequality between 3/~6 inch (0.48 cm) and 3h inch (0.95 cm). Six elgons were attached to bilateral hip, knee, and ankle joints as the subject walked (3 mph) and jogged (6 mph) on the treadmill twice, once with the heel lift and once without. Recordings from the elgons examined maximal flexion and extension during support and swing phase, amplitude of movement (ROM), duration of each movement, and angular velocity of each joint. Within the limitations of the study, the following conclusions were drawn: 1) the addition of a heel lift did not appear to significantly affect biomechanical measures of gait; and 2) insertion of a heel lift did tend to cause more symmetrical movement for the maximum angle of hip extension and ROM of the swing plantarflexion phase of the ankle but more asymmetrical ROM of the swing flexion phase of the knee.

J Orthop Sports Phys Ther 1986;7(4):173-179.

Utilization of the Autorange� to Increase Range of Motion: A Pilot Study

Deborah Turner Starring, William D. Bandy
The purpose of this paper was to examine the use of the Autorange® to increase range of motion in patients with restricted joint motion. Twenty subjects were treated with the Autorange for decreased motion of knee flexion, elbow extension, or elbow flexion after conventional therapy had failed. Results indicated a significant improvement in range of motion utilizing the Autorange when compared to conventional therapy.

J Orthop Sports Phys Ther 1986;7(5):240-243.

Adaptation of Skeletal Muscle to Resistance Training

William D. Bandy, Venita Lovelace-CHandler, Beth McKitrick-Bandy
This paper was prepared in partial fulfillment for Doctoral Degree in Physical Therapy at Texas Woman's University in Houston, TX.

Resistance training is frequently used in rehabilitation to improve musculoskeletal function. The increased ability of skeletal muscle to generate force following resistance training results from two important changes: 1) the adaptation of the muscle fiber, and 2) the extent to which the motor unit can activate the muscle (neural adaption). The purpose of this article is to provide a review of research investigating the effects of resistance training on muscle fibers and on nervous system input. Muscle fiber adaptations caused by resistance training include increased cross-sectional area of the muscle (hypertrophy, hyperplasia, or both), selective hypertrophy of fast twitch fibers, decreased or maintained mitochondrial number and capillary density of muscle, and possible changes in energy sources. Changes in nervous system input resulting from resistance training include recruitment of an increased number and firing rate of motor units, increased reflex potentiation, and improved synchronization. An understanding of the adaptations occurring in muscle in response to resistance training provides a fundamental basis for which appropriate clinical exercise training programs can be developed for the rehabilitation of patients.

J Orthop Sports Phys Ther 1990;12(6):248-255.

Rehabilitation of the Ruptured Biceps Brachii Muscle of an Athlete

William D. Bandy, Venita Lovelace-CHandler, Andrea L. Holt

The purposes of this case study are to report on the successful rehabilitation program of a college football player diagnosed as having a ruptured biceps brachii muscle and to discuss the basic rehabilitation concepts used for treatment planning. A review of the literature indicated agreement that the ruptured biceps brachii is a rare event, but the pathology does occur, and the opportunity for the clinician to evaluate and treat the injury may arise. Following a rupture of the biceps brachii muscle, a player was treated conservatively (nonsurgically) using rehabilitation concepts that included ice during acute phase; heat during chronic phase; submaximal exercise prior to maximal exercise; multiple angle isometric exercise prior to isotonic and isokinetic exercise; and functional progression to field activities. The athlete was able to avoid surgery, successfully return to competition in three weeks, and compete in the final five football games without reinjury. One year follow-up evaluation revealed that the athlete had full strength with no residual problems, a finding not commonly reported in conservatively treated biceps brachii ruptures.

J Orthop Sports Phys Ther 1991;13(4):184-190.

Relationship between Peak Torque, Work, and Power for Knee Flexion and Extension in Clients with Grade I Medial Compartment Sprains of the Knee

William D. Bandy, Kent E. Timm

Past research has reported a high level of correlation between peak torque (PT) and work and between PT and power in the muscles surrounding normal and selected pathological knees. No research to date has examined whether such similarities exist in clients with pathology to the medial compartment of the knee. The purpose of this study was to investigate the relationship between the isokinetic parameters of PT, work, and power for the flexor and extensor muscle groups of patients with grade I medial compartment knee sprains. Isokinetic data were collected from 77 patients (41 males, 36 females; mean age 24.6 yrs) on a Merac dynamometer at the speeds of 60, 180, 300, and 420°/set. The ranges of Pearson correlations between PT and work and between PT and power were 0.75-0.96 for the involved knee flexors, 0.67-0.99 for the involved knee extensors, 0.76-0.98 for the uninvolved knee flexors, and 0.85-0.97 for the uninvolved knee extensor muscles. These findings suggest that PT is representative of work and power and may be the only necessary parameter for isokinetic muscle performance testing of the flexor and extensor muscles of the knee in clients with grade I medial compartment sprain.

J Orthop Sports Phys Ther 1992;16(6):288-292.

Key Words: peak torque, work/power, knee sprain

Rehabilitation of the Elbow Complex Requires a Joint Effort

William D. Bandy

Intramachine and Intermachine Reliability for Selected Dynamic Muscle Performance Tests

William D. Bandy, Scott McLaughlin
The Cybex 6000 isokinetic dynamometer is a new isokinetic device for which no published reports of reliability have been presented in the literature. In addition, the manufacturer not only claims that the new Cybex 6000 is reliable but that torque data obtained from the Cybex 6000 are consistent with data obtained from past Cybex systems, such as the Cybex II. The purpose of this study was to investigate the intramachine reliability of the Cybex 6000 to itself and the intermachine reliability of the Cybex 6000 and the Cybex II. Data on peak torque, work, and power were collected using the Cybex 6000, and data on peak torque were obtained using the Cybex II for knee flexion and extension in 20 volunteers (10 males, 10 females). Subjects were tested three times, twice on the Cybex 6000 and once on the Cybex II, approximately 1 week apart across a 3-week period of time at angular velocities of 60, 180, and 300°/sec. Data were analyzed using intraclass correlations. Results indicated that the majority of test-retest correlation coefficients for all parameters for intramachine reliability of the Cybex 6000 were above .90. Comparing peak torque obtained with the Cybex 6000 to that obtained with the Cybex II (intermachine reliability), correlation coefficients ranged from .72 to .89. In conclusion, information obtained on the Cybex 6000 appears to be quite reliable in a test-retest situation using the same equipment and moderately reliable when compared to the Cybex II. Clinical implications for these results are discussed.

J Orthop Sports Phys Ther 1993;18(5):609-613.

Key Words: peak torque, work, power, reliability