Journal of Orthopaedic & Sports Physical Therapy - March 2002 Volume 32, No. 3

One-Arm Hop Test: Reliability and Effects of Arm Dominance

Susan Appling Falsone, Kevin M. Guskiewicz, Robert A. Schneider, Michael T. Gross
Study Design: Test-retest reliability analysis and 2-factor ANOVA contrast of athletic group and limb dominance.

Objectives: To determine the reliability of the one-arm hop test and the effects of upper-extremity dominance on test scores for 2 athletic groups.

Background: Limited information is available regarding functional performance tests of the upper extremity that involve axial loading. Methods and Measures: Thirteen male collegiate wrestlers (mean age, 20.3 � 1.6 years) and 13 male collegiate football players (mean age, 20.0 � 1.7 years) without upper-extremity pathology participated in the study. Subjects were trained to perform the one-arm hop test, starting from a one-arm push-up position and then hopping as quickly as possible onto and off of a 10.2-cm platform 5 times. Subjects returned to the test site 1 to 2 days later and were timed for 2 trials of the one-arm hop test for each upper extremity.

Results: Within-session ICC2,1 reliability values were 0.78 for the football players and 0.81 for the wrestlers. Mean absolute differences between trials were 0.64 seconds for the football players and 0.47 seconds for the wrestlers. Trial 2 performance times were significantly faster than trial 1 times for the wrestlers. Although performance time for the nondominant side was on average 4.4% slower than that of the dominant side, performance times for the dominant side were not significantly different from those of the nondominant upper extremities.

Conclusions: The results provide preliminary evidence that the one-arm hop test may be a reliable upper-extremity functional performance test with sufficient training of the subject. Uninjured upper-extremity performance for the one-arm hop test may be useful as a basis for comparing performance of an injured contralateral upper extremity.

J Orthop Sports Phys Ther. 2002; 32(3):98�103.

Key Words: functional performance test, upper extremity

Physical Functional Performance in Persons Using a Manual Wheelchair

M. Elaine Cress, Susan Kinne, Erin Maher, Donald L. Patrick
Study Design: Descriptive study.

Objectives: To develop a performance-based physical functional measure for people using a manual wheelchair, and to evaluate the feasibility and reliability of the administration of the new procedure.

Background: Most performance-based measures of physical function focus on balance and ambulation impairments. Recent developments of performance measures fail to produce a valid and reliable performance-based measure to quantify physical function in people who must rely on upper-body function to mobilize.

Methods:Eighteen adults (ages 18 to 67 years) who used a nonmotorized wheelchair participated in this study. Volunteers performed selected tasks from the Continuous Scale Physical Functional Performance (CS�PFP) test, modified for persons using a wheelchair. Outcome measures included scores on the Wheelchair Physical Functional Performance (WC�PFP) test and the Sickness Impact Profile (SIP) questionnaire.

Results: Participants had substantial disability (mean total SIP > 20). Total and domain scores of the WC�PFP had no ceiling or floor effects and were reproducible with intraclass correlation coefficients ranging from 0.87 to 0.96. Poorer self-rated health was correlated with poorer performance in the upper-body domain of the WC�PFP (r = -0.45). Those reporting disability in bathing and dressing using the SIP had significantly lower WC�PFP scores, indicating that the WC�PFP had construct validity. A significant correlation was not found between WC�PFP and the ambulation and mobility domains of the SIP.

Conclusion: The WC�PFP provides a reliable and quantifiable measure of mobility in persons who use a manual wheelchair.

J Orthop Sports Phys Ther. 2002; 32(3):104�113.

Key Words: disability, functional limitation, mobility impairments, physical function, wheelchair

A Lesson From John Hughlings Jackson

Katrina S. Maluf

Orthopaedic Section and Sports Physical Therapy Section Abstracts

Each year, the Journal of Orthopaedic & Sports Physical Therapy publishes abstracts of the research platform and poster presentations sponsored by the Orthopaedic and Sports Physical Therapy Sections of the American Physical Therapy Association at APTA�s Combined Sections Meeting (CSM). This year, CSM was held from February 20-24 in Boston, Massachusetts. The poster abstracts in this issue of the JOSPT were not ready to be included in the January 2002 issue with the other research presentations made at CSM in February.

Included in this section of the March 2002 JOSPT are:

� Orthopaedic Section Research Abstracts � Poster Presentations (Abstracts 156, 157,159, 173, 181, and 184)

� Sports Physical Therapy Section Research Abstracts � Poster Presentations (Abstracts 60 and 75)

J Orthop Sports Phys Ther. 2002; 32(3):A-55-A-58.

Differential Diagnosis and Treatment of Subcalcaneal Heel Pain: A Case Report

Kornelia Kulig, Robert F. Landel, John L. Meyer
Study Design: Case report. Objective:To describe the examination and intervention strategy utilized in the differential diagnosis and treatment of a patient with subcalcaneal heel pain. Background: The patient was a 44-year-old man with an 8-month history of left subcalcaneal heel pain. He presented with a chief complaint of limited standing and walking tolerance secondary to pain in the left heel. He had not responded to previous treatments of rest, anti-inflammatory medication, cortisone injections, and exercise prescription. Materials and Methods: The patient’s subcalcaneal heel pain was reproduced utilizing the straight leg raise (SLR) in combination with ankle dorsiflexion and eversion to sensitize the tibial nerve. These findings suggested a neurogenic component to the dysfunction. Because restricted ankle dorsiflexion, excessive pronation, and posterior tibialis weakness were also found, mechanical dysfunctions also likely contributed to the etiology of heel pain. The patient was treated for 10 visits over a period of 1 month. Treatment consisted of active and passive motions aimed at restoring pain-free soft-tissue motion along the course of the tibial nerve. In addition, low-dye taping and therapeutic exercises were utilized to control excessive pronation and reduce stress on the plantar structures of the foot. Results: The patient’s SLR increased from 42° to 54° and became pain-free. Dorsiflexion range of motion increased from 3° to 8° in the left ankle, and left posterior tibialis strength was normalized. Over a period of 1 month the patient’s symptoms were resolved, and his standing and walking tolerance was fully restored. Conclusion: Assessment and potential contribution of neural dysfunction should be considered in patients with subcalcaneal heel pain.

J Orthop Sports Phys Ther. 2002; 32(3):114–124.

Key Words: neural entrapment, plantar fasciitis

Mobilization With Movement as an Adjunct Intervention in a Patient With Complicated De Quervain’s Tenosynovitis: A Case Report

Karen Maloney Backstrom
Study Design: Case study. Objectives: To describe the use of conventional physical therapy interventions together with Mobilization With Movement (MWM) techniques in the treatment of an individual with a complicated scenario of de Quervain’s tenosynovitis. Background: The patient was a 61-year-old woman who presented with signs and symptoms consistent with de Quervain’s tenosynovitis of the right hand. Range limitations in all motions of the right wrist and first carpometacarpal joint complicated her presentation. Methods and Measures: Physical therapy included conventional intervention with superficial heat, ice, iontophoresis, and transverse friction massage directed to the first dorsal tunnel. Conventional joint mobilization techniques addressed the motion limitations of the first carpometacarpal, radiocarpal, and midcarpal joints. In addition, MWM techniques were utilized to promote pain-free wrist and thumb mobility. The specific MWM techniques used with this patient involved active movements of the thumb and wrist superimposed on a passive radial glide of the proximal row of carpal bones. Results: The described treatment regime, which involved conventional physical therapy interventions, along with MWM, aided in the complete resolution of this patient’s impairments and functional limitations. Conclusion: The combination of conventional physical agents, exercise, and manual therapy, and the less conventional MWM techniques, proved successful with this patient. MWM involving the correction of minute joint malalignments, coupled with active motion of the wrist and first carpometacarpal joints, was an effective and efficient adjunct physical therapy intervention. Because subtle changes in joint alignment may contribute to painful syndromes in the tendon complexes that cross a malaligned joint, use of MWM as a treatment technique warrants continued research.

J Orthop Sports Phys Ther. 2002; 32(3):86–97.

Key Words: joint alignment, manual therapy, tendinitis