Journal of Orthopaedic & Sports Physical Therapy - January 2002 Volume 32, No. 1

Introductions and a Bit of Business

The Effects of Patellar Taping on Knee Kinetics, Kinematics, and Vastus Lateralis Muscle Activity During Stair Ambulation in Individuals With Patellofemoral Pain

Gretchen B. Salsich, Jacklyn H. Brechter, Daniel Farwell, Christopher M. Powers
Study Design: Pre- and postintervention repeated measures design.

Objective:To determine the effects of patellar taping on knee kinetics, kinematics, and vastus lateralis muscle activity during stair ambulation in individuals with patellofemoral pain (PFP).

Background: Patellar taping is a common treatment technique for individuals with PFP. Specific data on whether patellar taping improves gait variables, however, are limited.

Methods and Measures: Ten subjects with a diagnosis of PFP were studied (5 men, 5 women). The subjects’ mean age, height, and mass were 36.5 ± 11.1 years, 173.1 ± 10.3 cm, and 70.9 ± 13.3 kg, respectively. Lower extremity kinematics, ground reaction forces, and vastus lateralis EMG were obtained simultaneously while subjects ascended and descended stairs, under taped and untaped conditions. Knee moments were calculated using inverse dynamics equations. Four 2 ×2 (tape condition x stair condition) ANOVAs for repeated measures were generated for cadence and average stance phase knee extensor moment, knee flexion angle, and EMG.

Results: On the average, a 92.6% reduction in pain was observed following the application of tape. Increases in cadence, knee flexion angles, and knee extensor moments were observed under the taped condition for both stair ascent and descent; however, no difference in average vastus lateralis EMG was found.

Conclusions: Although patellar taping resulted in decreased pain and increased knee extensor moments, knee flexion angles, and cadence during stair ambulation, the vastus lateralis EMG activity level did not change with taping. Based on data from the vastus lateralis, care must be taken if improved gait parameters indicate change in muscle recruitment.

J Orthop Sports Phys Ther. 2002; 32(1):3–10.

Key Words: biomechanics, gait, patella, physical therapy

The Effect of Bracing on Proprioception of Knees With Anterior Cruciate Ligament Injury

Bruce D. Beynnon, Lars Good, May Arna Risberg
This paper is a comprehensive review of the effect of bandaging, bracing, and neoprene sleeves on knee proprioception following anterior cruciate ligament (ACL) injury and reconstruction with a focus on studies that have measured joint position sense and threshold to detection of passive knee motion. Disruption of the ACL does not appear to alter joint position sense soon after injury, although there is evidence that in some subjects deterioration may occur over time. An ACL tear creates a deficit in the threshold to detection of passive knee motion soon after injury and in those with chronic tears. The magnitude of worsening is less then 1.0° of movement in flexion-extension and of questionable concern from a clinical and functional perspective. Application of a functional brace or neoprene sleeve to the ACL-deficient limb does not improve the threshold to detection of passive knee motion; however, application of an elastic bandage to a knee with an ACL tear improves joint position sense. Reconstruction of a torn ACL is associated with a deficit in the threshold to detection of passive knee motion, and during the first year of healing the use of a neoprene sleeve provides improvement. Two years following ACL reconstruction there is no deficit in the threshold to detection of passive knee motion and the use of a brace has no effect on this outcome.

J Orthop Sports Phys Ther. 2002; 32(1):11–15.

Key Words: anterior cruciate ligament, bracing, proprioception

The Relationship Between Self-Reported and Clinical Measures and the Number of Days to Return to Sport Following Acute Lateral Ankle Sprains

Kevin M. Cross, Teddy W. Worrell, James E. Leslie, Renee Van Veld Khalid
Study Design: This is a prospective observational study.

Objective:To determine the relationship of self-reported and clinical measures to the number of days to return to sport following acute lateral ankle sprains.

Background: In order to direct rehabilitation, injury classification schemes should include self-reported and clinical measures that help prognosticate the number of days to return to sport (DAYS).

Methods and Measures: Twenty Division II college athletes (7 men, 13 women; mean age = 19.2 ± 1.1 years) were assessed following an acute lateral ankle sprain and upon return to sport. Athletes were assessed by 3 self-reported measures: global function question, Short Form–36 Physical Function scale (SF36PF), visual analog pain scale, and 4 clinical measures: ankle active range of motion (AROM), ankle dorsiflexion strength, ankle plantar flexion strength, ambulation status. Simple regression, multiple regression, and effect sizes (ES) were used to analyze these data.

Results: The simple regression revealed a statistically significant relationship between DAYS and the global function question (r2 = .22), the SF36PF (r2 = .28), and the patient’s ambulation status (r2 = .27). A multiple regression using these 3 variables in combination was also statistically significant (P = .015) and explained approximately one-third of the variance in DAYS, (r2 = .37). All dependent variables revealed large or moderate ES.

Conclusion: Self-reported functional measures in conjunction with the athlete’s ambulation status are important factors in predicting the number of days to return to sport following acute lateral ankle sprains. Further research using large sample sizes and other clinical and functional measures is necessary.

J Orthop Sports Phys Ther. 2002; 32(1):16–23.

Key Words: ankle sprains, injury classification, prognosis

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 is scheduled for February 20-24 in Boston, Massachusetts.

Included in this special section of the January 2002 JOSPT are:

§ Editor-in-Chief Dr. Guy G. Simoneau’s introduction to the CSM abstracts

§ CSM Programming 2002

§ Orthopaedic Section Research Abstracts – Platform Presentations (Abstracts 1-64)

§ Orthopaedic Section Research Abstracts – Poster Presentations (Abstracts 127-184)

§ Sports Physical Therapy Section Research Abstracts – Platform Presentations (Abstracts 1-17

) § Sports Physical Therapy Section Research Abstracts – Poster Presentations (Abstracts 58-7

5) J Orthop Sports Phys Ther. 2002; 32(1):24-28, A-1-A-54.