David Tiberio

The Effects Of Ten Weeks Of Lower-body Unstable Surface Training On Markers Of Athletic Performance

Initially reserved for rehabilitation programs, unstable surface training (UST) has recently grown in popularity in strength and conditioning and general exercise scenarios. Nonetheless, no studies to date have examined the effects of UST on performance in healthy, trained individuals. The purpose of this study was to determine the effects of 10 weeks of lower-body UST on performance in elite athletes. Nineteen healthy, trained members (ages 18–23 years) of a National Collegiate Athletic Association Division I collegiate mens soccer team participated. The experimental (US) group (n= 10) supplemented their normal conditioning program with lower-body exercises on inflatable rubber discs; the control (ST) group (n = 9) performed the same exercises on stable surfaces. Bounce drop jump (BDJ) and countermovement jump (CMJ) heights, 40- and 10-yard sprint times, and T-test (agility) times were assessed before and after the intervention. The ST group improved significantly on predicted power output on both the BDJ (3.2%) and CMJ (2.4%); no significant changes were noted in the US group. Both groups improved significantly on the 40- (US = −1.8%, ST = −3.9%) and 10-yard sprint times (US = −4.0%, ST = −7.6%). The ST group improved significantly more than the US group in 40-yard sprint time; a trend toward greater improvement in the ST group was apparent on the 10-yard sprint time. Both groups improved significantly (US = 2.9%, ST = −4.4%) on T-test performance; no statistically significant changes were apparent between the groups. These results indicate that UST using inflatable rubber discs attenuates performance improvements in healthy, trained athletes. Such implements have proved valuable in rehabilitation, but caution should be exercised when applying UST to athletic performance and general exercise scenarios.

Knee Valgus During Drop Jumps in National Collegiate Athletic Association Division I Female Athletes: The Effect of a Medial Post

Background Female athletes land from a jump with greater knee valgus and ankle pronation/eversion. Excessive valgus and pronation have been linked to risk of anterior cruciate ligament injury. A medially posted orthosis decreases component motions of knee valgus such as foot pronation/eversion and tibial internal rotation. Hypothesis We hypothesized a medial post would decrease knee valgus and ankle pronation/eversion during drop-jump landings in NCAA-I female athletes. Study Design Controlled laboratory study. Methods Knee and ankle 3-dimensional kinematics were measured using high-speed motion capture in 10 National Collegiate Athletic Association Division I female athletes during a drop-jump landing with and without a medial post. Analysis of variance was used to determine differences in posting condition, t tests were used to determine dominant-nondominant differences, and the Pearson correlation coefficient was used to determine relationships between variables. Results Significant differences were found for all measures in the posted condition. A medial post decreased knee valgus at initial contact (1.24°, P< .01) and maximum angle (1.21 °, P< .01). The post also decreased ankle pronation/eversion at initial contact (0.77°, P < .01) and maximum angle (0.95°, P = .039). Conclusion The authors have demonstrated a significant decrease in knee valgus and ankle pronation/eversion during a drop jump with a medial post placed in the athletes’ shoes. Clinical Relevance A medial post may be a potential means to decrease risk of anterior cruciate ligament injury.

Effect of subtalar joint position on the measurement of maximum ankle dorsiflexic.

Measurements of maximum ankle dorsiflexion (MAD) are frequently performed in clinical practice, yet no single technique has gained universal acceptance. The purpose of this study was to determine whether a significant difference exists in passive MAD measurement with the subtalar joint in a neutral vs a pronated position. The 18 healthy females who participated in this study had their left ankles passively dorsiflexed with maximum force twice under the two conditions (neutral or pronated). The measurements were obtained from projections of 35 mm slides taken of each trial. A comparison of the mean MAD measurements for trials and condition was performed using a two-way repeated measures analysis of variance. There was no significant difference in the two trials in the neutral position or the two trials in the pronated position. There was, however, a significant difference between the neutral position and the pronated position.

Selected Measures of Ankle Dorsiflexion Range of Motion: Differences and Intercorrelations

The purpose of this investigation was to describe and compare ankle dorsiflexion range of motion (ADROM) measurements obtained using the heel, fifth metatarsal, and plantar surface of foot as distal surface landmarks while the ankle was dorsiflexed under three conditions. The conditions were: 1) passive ankle dorsiflexion with force adequate to encounter notable tension in the plantar flexor muscles, 2) passive ankle dorsiflexion with a maximal force, and 3) as in number 2 but actively assisted by the subject. Thirty-six women had their ankles dorsiflexed three times under each of the three conditions. Slide photographs were taken of the procedure. The photographs were projected and ADROM measured using the three distal landmarks. Analysis of variance demonstrated that ADROM measurements were significantly different (p < 0.001) under the three conditions of measurement and when the different landmarks were used. The majority (83.3%) of the ADROM measurements were correlated significantly (P < .01) with one another regardless of the condition or landmark of measurement. Clinicians should be aware that measurements of ADROM will differ depending on the conditions of measurement and the landmarks used. Despite the differences, measurements obtained using various combinations of conditions and landmarks will provide an indication of ADROM.

Pelvic and femoral contributions to bilateral hip flexion by subjects suspended from a bar

OBJECTIVE To quantify the contribution of the pelvis and femur to active bilateral hip flexion conducted while subjects are suspended by their hands from a bar. DESIGN Descriptive and experimental. BACKGROUND Voluntary hip flexion while in a suspended position is used in abdominal strengthening regimens and is required for certain athletic activities. The degree to which pelvic rotation contributes to this maneuver has not been established. METHODS Pelvic and femoral motions were documented in 14 subjects who performed bilateral hip flexion while they hung by their hands from a bar. A supporting board as well as the trunk, pelvis and thigh were marked with reflective spheres; motion of the pelvis and thigh relative to the board was captured by video analysis. Ratios of pelvic to femoral motion were calculated and the influence of hamstring length (<78 degrees vs >78 degrees of straight leg raising) and knee position (flexed vs extended) on the ratio was determined. RESULTS The mean pelvifemoral ratio ranged from 0.131 to 0.355, depending on hamstring length and knee position. Pelvic rotation therefore contributed a mean 13.1-35.5% of the observed hip flexion. A 2 x 2 mixed-model analysis of variance showed that the ratio was influenced significantly by each of these two independent variables. The largest pelvic contribution occurred during hip flexion with the knee in the extended position among subjects with shorter hamstrings. CONCLUSIONS Pelvic motion is an integral part of hip flexion conducted while subjects are suspended their hands from a bar. The pelvic contribution depends on knee position and hamstring length. RELEVANCE During suspended activities involving hip flexion (e.g. gymnastics), pelvic rotation plays an integral role throughout the range. Inherent or imposed differences in hamstring length can alter the contribution of the pelvis to the motion. Hip flexion, therefore, might be influenced by conditions affecting the ability of the pelvis to rotate (e.g. spinal fusion), or the femur to move on the pelvis (e.g. degenerative joint disease), or be altered by hamstring tension.

Pelvifemoral rhythm during unilateral hip flexion in standing

OBJECTIVE To quantify pelvifemoral rhythm during unilateral hip flexion in standing subjects, under different degrees of resistance. DESIGN Descriptive and correlational. BACKGROUND Pelvic rotation contributes to the change in hip flexion angle while individuals are supine. Degree of contribution in standing has not been described. METHODS Pelvic and femoral motions, relative to vertical, were documented while 14 subjects performed three trials of standing unilateral hip flexion, both with and without a 4.53 kg ankle weight. Pelvic and thigh segments were marked with reflective spheres, and motion was captured by video analysis. RESULTS Pelvic rotation contributed 18.1% of the change in hip flexion angle. Pelvic rotation occurred throughout the movement. Neither presence of external resistance nor direction of movement significantly changed this contribution. CONCLUSIONS A strong relationship exists between pelvic rotation and hip flexion in standing subjects. RELEVANCE Hip flexion, while standing, is a common element of many functional activities. Knowledge of the pelvic contribution increases our understanding of hip and lumbar spine motion during standing activities.

Effect of Frequency on Human Unipedal Hopping

All mature forms of locomotion involve periods of unilateral stance. Unipedal hopping may provide useful information about the neuromuscular and biomechanical capabilities of a single lower extremity in adults. This study investigated whether hopping influenced vertical stiffness and lower extremity angular kinematics during human unipedal hopping. Vertical force and two-dimensional kinematics were measured in 10 healthy males hopping at three frequencies: preferred, +20%, and −20%. At +20%, compared to preferred, vertical stiffness increased 55% as hip flexion, knee flexion, and ankle dorsiflexion decreased, while at −20% vertical stiffness decreased 39.4% as hip flexion, knee flexion, and ankle dorsiflexion increased. As in bipedal hopping, the force-displacement relationship was more springlike at the preferred rate and +20% than at −20%. Given the prevalence of unilateral stance during walking, running, and skipping, findings related to unipedal hopping may be useful in the rehabilitation or conditioning of lower extremities.

A cetylated fatty acid topical cream with menthol reduces pain and improves functional performance in individuals with arthritis.

This investigation was an extension of a previous study conducted in our laboratory in which we showed that 1 month of treatment with a topical cream (Celadrint) consisting of cetylated fatty acids was effective for reducing pain and improving functional performance in individuals with osteoarthritis (OA) of the knee (Kraemer et al., Journal of Rheumatology, 2004). We wanted to verify that the addition of menthol to the compound would produce a similar percentage of improvement in therapeutic effects. We used a single treatment group with a pre-post experimental design to examine % treatment changes. Individuals diagnosed with OA of the knee (N = 10; age, 66.4 ± 11.5 years) and severe pain (e.g., OA, rheumatoid arthritis) of the elbow (N = 8; age, 59.1 ± 18.2 years) and wrist (N = 10; age, 60.3 ± 16.8 years) were tested for pain and functional performance before and after 1 week of treatment with a topical cream consisting of cetylated fatty acids and menthol applied twice per day. In individuals with knee OA, significant improvements in stair-climbing ability (about 12%), “up-and-go‘” performance (about 12%), balance and strength (about 16.5%), and range of motion (about 3.5%) were observed, as were reductions in pain. In individuals with severe pain of the elbow and wrist, significant improvements in dynamic (about 22 and 24.5%, respectively) and isometric (about 33 and 42%, respectively) local muscular endurance were observed, as was a reduction in pain. Neither group demonstrated significant changes in maximal grip strength or maximal force production. One week of treatment with a topical cream consisting of cetylated fatty acids and menthol was similarly effective for reducing pain and improving functional performance in individuals with arthritis of the knee, elbow, and wrist. The % changes were consistent with our prior work on the compound without menthol. Further work is needed to determine the impact of menthol in such a cream. Nevertheless, our data support the use of a topical cream consisting of cetylated fatty acids (with or without menthol) for enhancing the potential for exercise training in this population.

Effects of treatment with a cetylated fatty acid topical cream on static postural stability and plantar pressure distribution in patients with knee osteoarthritis.

The purpose of the present investigation was to examine the effects of 30 days of treatment with a topical cream consisting of cetylated fatty acids on static postural stability and plantar pressures in patients with osteoarthritis (OA) of one or both knees. Forty patients diagnosed with knee OA were randomly assigned to 1 of 2 topical treatment groups: (a) cetylated fatty acid (CFA; N = 20; age = 62.7 ± 11.7 years); or (b) placebo (P; N = 20; age = 64.6 ± 10.5 years). Patients were tested on 2 occasions: (a) baseline (T1), and (b) following a 30-day treatment period consisting of cream application twice per day (T2). Assessments included 20- and 40-second quiet standing protocols on a force plate to measure center of pressure (COP) total excursion length, COP velocity, and rearfoot and forefoot plantar pressure distribution. In the CFA group, a significant reduction in the COP excursion length and velocity were observed at T2, whereas no significant differences were observed in the P group. No significant differences in mean forefoot, rearfoot, or rearfoot-to-forefoot plantar pressure ratios were observed in either group at T2. However, in a subgroup of participants designated to be right- or left-side dominant, improvements in the right-to-left forefoot plantar pressure ratios were observed in both groups. These data indicate that 30 days of treatment with a topical cream consisting of cetylated fatty acids improves static postural stability in patients with knee OA presumably due to pain relief during quiet standing. Such over-the-counter treatment may help improve the exercise trainability of people with OA.

Physiotherapy literature in medical indexes: How comprehensive is index coverage of journals cited frequently by five physiotherapy journals?

The reasoning behind this study was to determine the most frequently cited journal publications in five physiotherapy journals during a one-year period, and which of five medical indexes provides the most comprehensive review of journals cited. The list of journals most frequently cited in the five journals of interest was created by determining the citation frequency of all cited journals in each of the ‘core’ citing journals. The top 10% of journals (in terms of citation frequency) from each of the five citing journals were combined to produce a master list of the most frequently cited journals. This master list was cross-tabulated with five different medical indexes (Cumulative Index of Nursing and Allied Health, Excerpta Medica, Index Medicus, Physiotherapy Index, Science Citation Index) to determine the comprehensiveness of the database of each index with regard to physiotherapy literature. The Cumulative Index of Nursing and Allied Health was not as thorough as the other indexes in its inclusion of ...