Diana Hopper

Peroneal latency in normal and injured ankles at varying angles of perturbation.

The aim of this study was to determine whether there was a difference in latency of the peroneus longus muscle at varying amplitudes of ankle inversion perturbation and between individuals with and without a history of ankle injury. Thirty-four male athletes from different football codes (soccer, rugby) received four random tilts to their left ankles at 5°, 10°, and 15° in the frontal plane on a dual platform trap door. Peroneal latency was defined as the time difference between onset of the trap door movement, as detected by an accelerometer, and the onset of muscle activation above a resting baseline, as recorded using surface electromyography. Latency was determined using an algorithm. A series of repeated measures analyses of variance indicated that the latency was reliable between trials. There was no statistical evidence that history of injury or subjective ankle instability influenced the latency; however, there was a systematic difference between dominant and nondominant legs (dominant, 6.3 ms faster), and there was a small systematic effect (3 ms) for the angle of inversion perturbation. Muscle latency responses in male football players are thought to be influenced more by dominance than by history of injury or amplitude of perturbation.

Dynamic soft tissue mobilisation increases hamstring flexibility in healthy male subjects

Objectives: The purpose of this study was to investigate the effect of dynamic soft tissue mobilisation (STM) on hamstring flexibility in healthy male subjects. Methods: Forty five males volunteered to participate in a randomised, controlled single blind design study. Volunteers were randomised to either control, classic STM, or dynamic STM intervention. The control group was positioned prone for 5 min. The classic STM group received standard STM techniques performed in a neutral prone position for 5 min. The dynamic STM group received all elements of classic STM followed by distal to proximal longitudinal strokes performed during passive, active, and eccentric loading of the hamstring. Only specific areas of tissue tightness were treated during the dynamic phase. Hamstring flexibility was quantified as hip flexion angle (HFA) which was the difference between the total range of straight leg raise and the range of pelvic rotation. Pre- and post-testing was conducted for the subjects in each group. A one-way ANCOVA followed by pairwise post-hoc comparisons was used to determine whether change in HFA differed between groups. The α level was set at 0.05. Results: Increase in hamstring flexibility was significantly greater in the dynamic STM group than either the control or classic STM groups with mean (standard deviation) increase in degrees in the HFA measures of 4.7 (4.8), −0.04 (4.8), and 1.3 (3.8), respectively. Conclusions: Dynamic soft tissue mobilisation (STM) significantly increased hamstring flexibility in healthy male subjects.

Do selected kinanthropometric and performance variables predict injuries in female netball players

The aim of this study was to determine which kinanthropometric and performance variables predict injuries in female netball players. In a prospective study, 72 volunteer grade A netball players (mean age 20.6 +/- 3.6 years, range 15-36 years) were measured for hypermobility, somatotype, static balance, jumping abilities and anaerobic fitness at the University of Western Australia Human Movement Performance Laboratory prior to the start of their 14-week season. Injuries were classified by site, diagnosis and severity, and were monitored throughout the entire season by the same physiotherapist at the Western Australia (WA) Matthews Netball Centre, Perth, Australia. A total of 22 injuries in 22 players were recorded, affecting the ankle joint lateral ligament complex (59%), knee ligaments (18%), back (18%) and Achilles tendon (5%). Injuries were more common among grade A1 players than other grades (54 vs 19%, P < 0.001). Within grade A1 players, the proportion of injuries decreased with age (P < 0.05). Players were more likely to have had an injury if they had better jumping ability, better anaerobic fitness and if they were low on the endomorphy somatotype scale (P < 0.05). After allowing for both jumping ability and endomorphy, there was no longer a significant difference between A1 and non-A1 players in their risk for injury. Young elite players are at a substantially increased risk of injury. This higher risk appears to be associated with--if not a direct consequence of--their being thinner, fitter and having more powerful jumping capabilities. This suggests that injury-prevention programmes should be targeted at elite players, especially the younger ones.

Throwing velocity and jump height in female water polo players: performance predictors.

Throwing velocity and vertical jumping ability are essential components for shooting and passing in water polo. The purpose of this study was to determine whether there is a relationship between throwing velocity and water jump height in highly skilled female water polo players. Throwing velocity and head height at ball release were measured in twenty-two female players (age 20.41 years (6.16); weight 68.28 kg (8.87)) with two 50 frames per second cameras while shooting at goal. Water jump height was also measured with a modified Yardstick device. Multiple regression analyses showed that peak lower limb power was the most significant predictor of maximal velocity. Power alone accounted for 62% of the variance in maximum velocity (p<0.001). Once power was entered into the model none of the other physical characteristics (lean mass, fat mass, land jump height and anthropometry) made a significant contribution to throwing velocity. After controlling for the effect of power, head height at ball release accounted for an additional significant proportion of the variance in maximal velocity (R(2) change 7%; p=0.049). Lower body power was a significant predictor of higher throwing velocity in highly skilled female water polo players. Players with relatively higher underlying levels of lower limb power who are able to generate greater elevation out of the water are able to throw the ball faster.

Functional measurement of knee joint position sense after anterior cruciate ligament reconstruction

OBJECTIVE To examine for differences in joint position sense (JPS) between knees with reconstructed anterior cruciate ligaments (ACLs) and uninjured knees by using a functional weight-bearing measurement method. DESIGN Two-way repeated-measures in a convenience sample. SETTING An Australian university rehabilitation laboratory. PARTICIPANTS Nine subjects presenting at 12 to 16 months after unilateral ACL reconstruction using the semitendinosus/gracilis graft who were recruited from 2 orthopedic surgeons. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES JPS of the reconstructed and uninjured knees was examined by using the Peak Motus motion measurement system to record target joint angles and to calculate reproduced angles after limb movement into flexion and extension, performed in a weight-bearing position. RESULTS There were no significant differences in JPS between reconstructed and uninjured knees (P=.68) or between the flexion and extension tasks (P=.47). CONCLUSION There was no deficit in knee JPS 12 to 16 months after ACL reconstruction, as measured by a functional weight-bearing method. Further studies should examine the clinical utility of the method as a way to evaluate functional aspects of knee joint proprioception.

Functional Recovery After Anterior Cruciate Ligament Reconstruction: A Longitudinal Perspective

OBJECTIVE To evaluate functional hop performance in subjects with an anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone graft during 12, 18, 26, 39, and 52 weeks. DESIGN A longitudinal comparative study. SETTING University research laboratory. PARTICIPANTS Patients (N=19) were evaluated at 12, 18, 26, 39, and 52 weeks after ACL reconstruction surgery. INTERVENTION Testing on 5 separate occasions. MAIN OUTCOME MEASURES The Cincinnati Knee Rating System and analog scales, the 6-meter timed hop, crossover hop, stair hop, and vertical hop, and limb symmetry indices. RESULTS The uninjured and injured legs and test order were randomized. There was a significant test occasion main effect for both the Cincinnati and analog scores (P=.001). Subjective rating scores improved over the 5 testing occasions. For all 4 hop tests, test occasion and limb main effects were significant (P=.001). Paired t test comparisons at each testing occasion indicated a significant difference between the reconstructed and uninjured limb (P<.05). Furthermore, significant test occasion main effects were noted for limb symmetry indices for the 4 hop tests (P=.001). Using a score of greater than or equal to 85% as a criterion for normative limb symmetry, normative scores were recorded in the 6-m timed hop at the week 18 test occasion, the stair hop and vertical hop at the week 26 test occasion, and the crossover hop at the week 39 test occasion. CONCLUSIONS These hop tests showed different levels of imposed demands on the knee that could be used to assess functional recovery and readiness to resume sport.

Lower Limb and Back Injury Patterns of Elite Netball Players

SummaryThe purpose of this study was to investigate the relationships between lower limb and back injuries with perceived landing patterns and podiatric variables for injured and uninjured elite netball players. 228 players of a possible 240 participants at the 1988 Australian netball championships completed injury questionnaires and were assessed for injury status. Approximately 92% of those who were part of the injury surveys were also given a podiatric assessment. Pearson x2 and unpaired t-tests were used to assess relationships between injury status in 2 groups (history of injury, and injuries sustained during the championships) and perceived landing patterns during play and podiatric variables.A significant association was found between history of lower limb and back injuries and level of competition. Open age netballers reported more injuries than the younger players. During each championship, a similar number of players (23%) were injured irrespective of playing level. 71% of these players sustained a grade 1 injury, 15.4% a grade 2 injury and 13.5% presented with severe grade 3 injuries. 2 players were diagnosed with an anterior cruciate ligament injury and a further 3 players sustained a fracture during the championships. Most of the injuries were ligamentous (40.5%) with some overuse tendinitis (11.5%) problems.The injury history profiles of the elite players surveyed showed that ankle and knee injuries were the most common lower limb injuries with incidences of 58 and 22%, respectively. More than a quarter of the players had overuse type injuries (24% retropatellar pain, 38% shin soreness) and 33% complained of back problems during their careers. 18 significant relationships were found between injuries sustained during a player’s career and podiatric measures. Only 22.5% of a player’s foot types were classified as normal while 42% presented with rearfoot varus and 20% were grouped into pronated foot postures.

Clinical Evaluation of Cervicogenic Headache: A Clinical Perspective

Abstract Headache is a common complaint that affects the majority of the population at some point in their lives. The underlying pathological bases for headache symptoms are many, diverse, and o en difficult to distinguish. Classification of headache is principally based on the evaluation of headache symptoms as well as clinical testing. Although manual therapy has been advocated to treat a variety of different forms of headache, the current evidence only supports treatment for cervicogenic headache (CGH). This form of headache can be identified from migraine and other headache forms by a comprehensive musculoskeletal examination. Examination and subsequent diagnosis is essential not only to identify patients with headache where manual therapy is appropriate but also to form a basis for selection of the most appropriate treatment for the identified condition. The purpose of this paper is to outline, in clinical terms, the classification of headache, so that the clinician can readily identify those patients with headache suited to manual therapy.

A survey of netball injuries and conditions related to these injuries.

In 1983, during the winter Saturday afternoon season at the Western Australian Matthews Netball Centre, 3108 players participated in the netball competition. The study examines the incidence of netball injuries and conditions related to these injuries. One hundred and fifty-eight injuries were surveyed throughout this fourteen week season. Each injured player filled in the first two pages of the questionnaire; the final page was filled in by the physiotherapist. Data was compiled and processed using the S.P.S.S. systems file including frequencies and cross tabulations. Many statistically significant results were recorded and recommendations for further investigation are included.

Long-Term Stability and Minimal Detectable Change of the Cervical Flexion-Rotation Test

STUDY DESIGN Reliability of clinical measurements over time. OBJECTIVES To determine the long-term stability and minimal detectable change (MDC) of the flexion-rotation test (FRT) measurements over days in subjects with cervicogenic headache (CGH). BACKGROUND The FRT is used by physical therapists to assist in identifying upper cervical movement impairment, as well as to gauge treatment effectiveness. Test-retest reliability for the FRT has been reported, but the stability of range-of-motion measures taken during the FRT over time and the MDC have not been investigated. METHODS Fifteen subjects with CGH were evaluated on headache-free days using the FRT by a blinded examiner at baseline, 2, 4, and 14 days later. An additional 10 asymptomatic subjects were included for blinding purposes. On each occasion, the examiner measured range of motion and determined whether the FRT was positive or negative. RESULTS For subjects with CGH, there was no significant change in FRT range of motion over days (P>.05). Intraclass correlation coefficients for intratester reliability were 0.95 (95% CI: 0.90 to 0.98) and 0.97 (95% CI: 0.94 to 0.99) for right and left rotation, respectively. MDC90 was 4.7 degrees for right rotation and 7 degrees for left rotation. Examiner interpretation of the FRT was consistent over time, with kappa = 0.92. CONCLUSIONS This study provides evidence that FRT measurements are stable over time, and the MDC90 indicates that a change in FRT range of motion of at least 7 degrees is required to be confident that a change has occurred due to an intervention rather than measurement error.