STUDY DESIGN: Two group, repeated measures design. OBJECTIVES: To determine whether manually repositioning the scapula using the Scapula Reposition Test (SRT) reduces pain and increases shoulder elevation strength in athletes with and without positive signs of shoulder impingement. BACKGROUND: Symptom alteration tests may be useful in determining a subset of those with shoulder pathology who may benefit from interventions aimed at improving scapular motion abnormalities. METHODS AND MEASURES: One hundred forty-two college athletes underwent testing for clinical signs of shoulder impingement. Tests provoking symptoms were repeated with the scapula manually repositioned into greater retraction and posterior tilt. A numeric rating scale was used to measure symptom intensity under both conditions. Isometric shoulder elevation strength was measured using a mounted dynamometer with the scapula in its natural position and with manual repositioning. A paired t test was used to compare the strength between positions. The frequency of a significant increase in strength with scapular repositioning, defined as the minimal detectable change (90% confidence interval), was also assessed. RESULTS: Of the 98 athletes with a positive impingement test, 46 had reduced pain with scapular repositioning. Although repositioning produced an increase in strength in both the impingement (P=.001) and nonimpingement groups (P=.012), a significant increase in strength was found with repositioning in only 26% of athletes with, and 29% of athletes without positive signs for shoulder impingement. CONCLUSION: The SRT is a simple clinical test that may potentially be useful in an impairment based classification approach to shoulder problems. LEVEL OF EVIDENCE: Diagnosis, Level 4.

J Orthop Sports Phys Ther 2008;38(1):4-11, published online 7 September 2007. doi:10.2519/jospt.2008.2616

KEY WORDS: posture, rotator cuff, shoulder

STUDY DESIGN: Cross-sectional. OBJECTIVE: To determine if females presenting with patellofemoral pain syndrome (PFPS) from no discernable cause other than overuse demonstrate hip weakness and increased hip internal rotation, hip adduction, and knee valgus during stair descent. BACKGROUND: Historically, PFPS has been viewed exclusively as a knee problem. Recent findings have indicated an association between hip weakness and PFPS. Researchers have hypothesized that patients who demonstrate hip weakness would exhibit increased hip internal rotation, hip adduction, and knee valgus during functional activities. To date, researchers have not simultaneously examined hip and knee strength and kinematics in subjects with PFPS to make this determination. METHODS AND MEASURES: Eighteen females diagnosed with PFPS and 18 matched controls participated. Strength measures were taken for the hip external rotators and hip abductors. Hip and knee kinematics were collected as subjects completed a standardized stair-stepping task. Independent t tests were used to determine between-group differences in strength and kinematics during stair descent. RESULTS: Subjects with PFPS generated 24% less hip external rotator (P = .002) and 26% less hip abductor (P =. 006) torque. No between-group differences (P > .05) were found for average hip and knee transverse and frontal plane angles during stair descent. CONCLUSION: Subjects with PFPS had significant hip weakness but did not demonstrate altered hip and knee kinematics as previously theorized. Additional investigations are needed to better understand the association between hip weakness and PFPS etiology. LEVEL OF EVIDENCE: Symptom Prevalence, Level 4.

J Orthop Sports Phys Ther. 2008;38(1):12-18, published online 21 November 2007, doi:10.2519/jospt.2008.2462

KEY WORDS: anterior knee pain, hip abduction, hip external rotation, kinematics

STUDY DESIGN: A randomized clinical trial design. OBJECTIVE: To investigate the efficacy of high, repetitive, target-matching foot-stepping exercise (TMFSE) performed in a sitting position on proprioception, functional score, and walking velocity for patients with knee osteoarthritis (OA). BACKGROUND: Researchers have suggested that exercises to address knee OA should include proprioceptive training. However, most patients cannot tolerate conventional proprioceptive training performed in a standing position. METHODS AND MEASURES: Forty-nine subjects (mean age ± SD, 63.3 ± 8.1) with knee OA were randomly assigned to the exercise or no intervention groups. The exercise group practiced TMFSE in sitting, 3 sessions weekly for 6 weeks. All subjects underwent assessments of knee reposition error, functional incapacity score, and walking velocity prior to and after intervention. RESULTS: The TMFSE significantly improved reposition error from a mean ± SD of 3.0° ± 1.6° to 1.5° ± 0.6°, walking velocity on ground level from 44.1 ± 2.9 to 38.6 ± 2.5 sec for 60 meters, time to complete a stairs task from 34.2 ± 2.1 to 26.5 ± 2.3 seconds, time to complete a figure-of-eight from 51.3 ± 6.7 to 29.1 ± 3.6 seconds, and score on a functional incapacity scale from 12.0 ± 3.1 to 4.9 ± 1.7, in subjects with knee OA after 6-week intervention (P <.0125). In contrast, the control group showed no change in any of the measured tests. CONCLUSION: TMFSE in sitting appears to be an option for exercise in patients with mild to moderate knee OA. This may be an especially attractive option for patients who may have pain with weight-bearing exercises. A longitudinal study with a larger sample size is needed to confirm the potential use of TMFSE for patients with knee OA.

J Orthop Sports Phys Ther. 2008;38(1):19-25, published online 29 August 2007, doi:10.2519/jospt.2008.2512

KEY WORDS: arthritis, OA, tibiofemoral joint

Continued advances in communication technologies have made publishing an increasingly dynamic venture, offering authors and editors the ability to reach and interact with readers around the world in exciting and enlightening ways. Today's publications share information more quickly through diverse and sophisticated means. The new international partnerships and recent print and online enhancements described in this editorial reflect JOSPT's response to the technological possibilities now within our grasp. We believe that, ultimately, our expanding global audience and additional features will provide the profession as a whole with a better Journal.

J Orthop Sports Phys Ther. 2008;38(1):1-3. doi:10.2519/jospt.2008.0100

KEY WORDS: international partners, musculoskeletal imaging, Read for Credit, website

The radiographs of this patient, an 11-year-old female with progressively worsening right knee pain, were significant for a right slipped capital femoral epiphysis (SCFE). The patient was referred to the orthopaedic surgeon on-call and underwent surgical fixation of her SCFE on the day of diagnosis.

J Orthop Sports Phys Ther. 2008;38(1):26. doi:10.2519/jospt.2008.0401

KEY WORDS: musculoskeletal imaging, hip radiographs, slipped capital femoral ephiphysis

JOSPT is pleased to publish abstracts of the 2008 Combined Sections Meeting (CSM), which takes place in Nashville, Tennessee, February 6-10, 2008. This collection of abstracts provides a glimpse into the research presented as part of the scientific programming of the Orthopaedic and Sports Physical Therapy Sections. The number and variety of the presentations scheduled for CSM are testimony to the dynamic research activities underway in the field of musculoskeletal health and rehabilitation. The abstracts presented in the January issue of the Journal are reviewed and selected by members of the research committee of each section based on content and format. The abstracts are not, however, reviewed by the Associate Editors or the Editor-in-Chief of JOSPT. By design, each abstract presents only a brief summary of a research project - a summary that typically does not permit a full evaluation of the scientific rigor with which the work was conducted. In may cases, these abstracts serve the purpose of sharing new research ideas and, therefore, offer only preliminary results that will require future validation. Yet, presenting this type of research information at CSM plays an important role in encouraging a dialog among researchers, clinicians, and educators. The annual Combined Sections Meeting provides a valuable forum for learning from clinical and research experts in physical therapy and related fields. Moreover, unlike reading a manuscript in a journal, attending a professional conference presents us the opportunity to interact with the authors - our colleagues - by asking questions and exchanging ideas.

J Orthop Sports Phys Ther. 2008;38(1):A1.

KEY WORDS: Combined Sections Meeting, CSM

A summary of the schedule of platform and poster research presentations made by the Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association during APTA's Combined Sections Meeting, February 6-10, 2008, in Nashville, TN.

J Orthop Sports Physi Ther. 2008;38(1):A2-A9.

KEY WORDS: Combined Sections Meeting, CSM

The abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, OPL designates an Orthopaedic platform presentation.

J Orthop Sports Phys Ther. 2008;38(1):A10-A35.

KEY WORDS: Combined Sections Meeting, CSM, Orthopaedic Section platforms

The abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, OPO designates an Orthopaedic poster presentation.

J Orthop Sports Phys Ther. 2008;38(1):A36-A70.

KEY WORDS: Combined Sections Meeting, CSM, Orthopaedic Section posters

The abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, SPL designates a Sports platform presentation.

J Orthop Sports Phys Ther. 2008;38(1):A71-A82.

KEY WORDS: Combined Sections Meeting, CSM, Sports platforms