Harvey W. Wallmann

The effect of modified jazz dance on balance, cognition, and mood in older adults

Purpose: The purpose of this pilot study was to evaluate the impact of jazz dance class instruction on balance, cognition, and mood (specifically depression) in 13 healthy, community‐dwelling, English‐speaking older women with a mean age of 68. Data sources: Data were collected using self‐report questionnaires (Folstein Mini Mental Status Examination [MMSE] and Geriatric Depression Scale [GDS]), and the sensory organization test (SOT) for balance measurements (using the NeuroCom Smart Balance Master) was performed at three time periods in the study: time 1: between week 1 and week 2 of jazz class (baseline), time 2: between week 8 and week 9 of jazz class (midpoint), and time 3: after week 15 of jazz class (final measurement). Conclusions: Differences in mean MMSE and GDS scores over time were not significant; however, SOT scores showed an increasing trend (p < .001). Data analysis using analysis of variance with repeated measures showed that balance measures improved throughout the duration of the study (F2,10 = 19.68, p < .001). Post hoc analyses using paired t tests with a Bonferroni correction indicated that significant increases in balance occurred from time 1 to time 2 and from time 2 to time 3. These preliminary pilot study findings suggest that jazz dance does not impact cognition or mood but may improve balance in older women. This finding may have significant implications for fall prevention in the postmenopausal population. Implications for practice: Because falls are a leading cause of morbidity and mortality in older adults of both genders, research is needed to evaluate both the impact of jazz dance on balance in older men and jazz dance as a fall prevention strategy in aging adults. Additionally, longitudinal research with a larger sample size is needed to test the effectiveness of jazz dance as a strategy for improving balance, cognition, and mood.

Surface Electromyographic Assessment of the Effect of Static Stretching of the Gastrocnemius on Vertical Jump Performance

The purpose of this study was to investigate the effects of static stretching of the gastrocnemius muscle on maximal vertical jump performance using electromyographic activity (EMG) of the gastrocnemius musculature to record muscle activation during vertical jump performance. Fourteen healthy adults (8 men and 6 women) aged 18–34 years, who were familiar with the vertical jumping task and had no lower extremity injuries or any bone or joint disorders within the past year, served as participants for this study. After a brief warm-up, participants performed the following sequence: (a) three baseline maximal vertical jump trials, (b) 15 minutes of quiet sitting and three 30-second bilateral static stretches of the gastrocnemius muscles, and (c) 3 maximal vertical jump trials. Jump height data were collected using the Kistler force plate, while muscle activity was recorded during the jumping and stretching trials using a Noraxon telemetry EMG unit. Vertical jump height data as well as EMG values were averaged for the 3 trials and analyzed using paired t-tests for pre- and poststretching (a5 0.05). Vertical jump height was 5.6% lower when poststretch heights were compared with prestretch heights (t 524.930, p < 0.005). Gastrocnemius EMG was 17.9% greater when the EMG during poststretch jumps was compared with prestretch jumps (t = 2.805, p < 0.02). The results from this study imply that, despite increased gastrocnemius muscle activity, static stretching of the gastrocnemius muscles had a negative effect on maximal jumping performance. The practical importance concerns coaches and athletes, who may want to consider the potential adverse effects of performing static stretching of the gastrocnemius muscles only before a jumping event, as jump height may be negatively affected. Future research is required to identify the mechanisms that affect vertical jump performance.

Acute Effects of Static and Ballistic Stretching on Measures of Strength and Power

Samuel, MN, Holcomb, WR, Guadagnoli, MA, Rubley, MD, and Wallmann, H. Acute effects of static and ballistic stretching on measures of strength and power. J Strength Cond Res 22(5): 1422-1428, 2008-Preactivity stretching is commonly performed by athletes as part of their warm-up routine. However, the most recent literature questions the effectiveness of preactivity stretching. One limitation of this research is that the stretching duration is not realistic for most athletes. Therefore, the purpose of this study was to determine the effects of a practical duration of acute static and ballistic stretching on vertical jump (VJ), lower-extremity power, and quadriceps and hamstring torque. Twenty-four subjects performed a 5-minute warm-up followed by each of the following three conditions on separate days with order counterbalanced: static stretching, ballistic stretching, or no-stretch control condition. Vertical jump was determined with the Vertec VJ system and was also calculated from the ground-reaction forces collected from a Kistler force plate, which also were used to calculate power. Torque output of the quadriceps and hamstrings was measured through knee extension and flexion on the Biodex System 3 Dynamometer at 60°·s−1. Data normalized for body weight were analyzed using five separate, 3 (stretch condition) × 2 (gender) analysis-of-variance procedures with repeated measures on the factor of stretch condition. The gender × stretch interaction was not significant for any of the four measures, suggesting that the stretching conditions did not affect men and women differently. The results of this study reveal that static and ballistic stretching did not affect VJ, or torque output for the quadriceps and hamstrings. Despite no adverse effect on VJ, stretching did cause a decrease in lower-extremity power, which was surprising. Because of the mixed results, strength coaches would be better served to use dynamic stretching before activity; this has been consistently supported by the literature.

Safety of cervical spine manipulation: are adverse events preventable and are manipulations being performed appropriately? A review of 134 case reports

Abstract Background Cervical spine manipulation (CSM) is a commonly utilized intervention, but its use remains controversial. Purpose To retrospectively analyze all available documented case reports in the literature describing patients who had experienced severe adverse events (AEs) after receiving CSM to determine if the CSM was used appropriately, and if these types of AEs could have been prevented using sound clinical reasoning on the part of the clinician. Data sources PubMed and the Cumulative Index to Nursing and Allied Health were systematically searched for case reports between 1950 and 2010 of AEs following CSM. Study selection Case reports were included if they were peer-reviewed; published between 1950 and 2010; case reports or case series; and had CSM as an intervention. Articles were excluded if the AE occurred without CSM (e.g. spontaneous); they were systematic or literature reviews. Data extracted from each case report included: gender; age; who performed the CSM and why; presence of contraindications; the number of manipulation interventions performed; initial symptoms experienced after the CSM; and type of resultant AE. Data synthesis Based on the information gathered, CSMs were categorized as appropriate or inappropriate, and AEs were categorized as preventable, unpreventable, or unknown. Chi-square analysis with an alpha level of 0·05 was used to determine if there was a difference in proportion between six categories: appropriate/preventable, appropriate/unpreventable, appropriate/unknown, inappropriate/preventable, inappropriate/unpreventable, and inappropriate/unknown. Results One hundred thirty four cases, reported in 93 case reports, were reviewed. There was no significant difference in proportions between appropriateness and preventability, P = .46. Of the 134 cases, 60 (44·8%) were categorized as preventable, 14 (10·4%) were unpreventable and 60 (44·8%) were categorized as ‘unknown’. CSM was performed appropriately in 80·6% of cases. Death resulted in 5·2% (n = 7) of the cases, mostly caused by arterial dissection. Limitations There may have been discrepancies between what was reported in the cases and what actually occurred, since physicians dealing with the effects of the AE, rather than the clinician performing the CSM, published many of the cases. Conclusions This review showed that, if all contraindications and red flags were ruled out, there was potential for a clinician to prevent 44·8% of AEs associated with CSM. Additionally, 10·4% of the events were unpreventable, suggesting some inherent risk associated with CSM even after a thorough exam and proper clinical reasoning.

Surface Electromyographic Assessment of the Effect of Dynamic Activity and Dynamic Activity with Static Stretching of the Gastrocnemius on Vertical Jump Performance

The purpose of this study was to investigate the effects of dynamic activity and dynamic activity/static stretching of the gastrocnemius muscle on vertical jump (VJ) performance. Additionally, muscle activity was recorded using electromyography. Thirteen healthy adults (7 men and 6 women) with a mean age of 26 ± 4 years served as subjects. The average jump height and muscle activity from 3 separate maximal VJ attempts were performed at the start of each session to be used as baseline measures using the Kistler force plate and the Noraxon telemetry EMG unit. Subjects then performed 1 of 2 protocols: dynamic activity only or dynamic activity with static stretching. Each protocol was followed by 3 maximal VJ trials. Average VJ height was analyzed using a 2 (time: pre, post) × 2 (prejump protocol: dynamic activity, dynamic activity + stretching) analysis of variance with repeated measures on both factors. A paired-samples t-test was used to compare the intraday difference scores for EMG activity between the 2 conditions. Jump height was not influenced by the interaction of pre-post and protocol (p = 0.0146. There was no difference for the main effects of time (p = 0.274) and pre-jump protocol (p = 0.595). Gastrocnemius muscle activity was likewise not different for the 2 prejump protocols (p = 0.413). The results from this study imply that the use of static stretching in combination with dynamic activity of the gastrocnemius muscle does not appear to have an adverse affect on VJ height performance. The practical importance concerns the warm-up routine that coaches and athletes employ; that is, they may want to consider including an aerobic component when statically stretching the gastrocnemius immediately prior to a vertical jumping event.

The Effect of a Senior Jazz Dance Class on Static Balance in Healthy Women Over 50 Years of Age: A Pilot Study

The purpose of this pilot study is to assess the impact of a senior jazz dance class on static balance for healthy women over 50 years of age using the NeuroCom Smart Balance Master System (Balance Master). A total of 12 healthy women aged 54—88 years completed a 15-week jazz dance class which they attended 1 time per week for 90 min per class. Balance data were collected using the Sensory Organization Test (SOT) at baseline (pre), at 7 weeks (mid), and after 15 weeks (post). An equilibrium score measuring postural sway was calculated for each of six different conditions. The composite equilibrium score (all six conditions integrated to 1 score) was used as an overall measure of balance. Repeated measures analyses of variance (ANOVAs) were used to compare the means of each participants SOT composite equilibrium score in addition to the equilibrium score for each individual condition (1—6) across the 3 time points (pre, mid, post). There was a statistically significant difference among the means, p < .0005. Pairwise (Bonferroni) post hoc analyses revealed the following statistically significant findings for SOT composite equilibrium scores for the pre (67.33 + 10.43), mid (75.25 + 6.97), and post (79.00 + 4.97) measurements: premid (p = .008); prepost (p < .0005); midpost (p = .033). In addition, correlational statistics were used to determine any relationship between SOT scores and age. Results indicated that administration of a 15-week jazz dance class 1 time per week was beneficial in improving static balance as measured by the Balance Master SOT.

Rehabilitation Following Lumbosacral Percutaneous Nucleoplasty: A Case Report

STUDY DESIGN Case report. BACKGROUND Lumbar spine nucleoplasty is a new surgical option for patients with disc pathology. There are no reports in the literature describing the role of physical therapy in postoperative lumbar nucleoplasty management. The purpose of this case is to describe the postoperative physical therapy management of a patient who underwent this procedure. CASE DESCRIPTION A 50-year-old male, 7 weeks following a L5/S1 lumbar nucleus replacement, completed 6 weeks of rehabilitation. The focus of the treatment was controlled reloading of the spine through a spinal stabilization progression in weight-bearing and non-weight-bearing activities. In addition, education, spinal manual therapy techniques, and a home exercise program were also incorporated. OUTCOMES The patients Oswestry Disability Index decreased from 56% to 4% over 6 weeks of treatment. When contacted at 6, 12, 18, and 24 months posttherapy, his Oswestry Disability Index was 2%, 2%, 0%, and 0%, respectively, and he had returned to all previous activities without recurrence of symptoms. DISCUSSION This case report outlines the clinical decision-making process during the postoperative management of an individual who had undergone a single-level lumbar nucleoplasty. A postoperative regimen of education, segmental spinal stabilization, and a home exercise program might have contributed to the observed improvement in pain and disability levels in this patient. The role of these postoperative interventions warrants further research. LEVEL OF EVIDENCE Therapy, level 4.

Interrater Reliability of the Five-Times-Sit-to-Stand Test

The sit-to-stand (STS) task, an important activity required to maintain functional independence, can be used to assess physical performance. The purpose of this study was to determine the interrater reliability of the five-times-sit-to-stand test (FTSTS). Ninety-two subjects, mean age of 65 years, performed the FTSTS without the use of the upper extremities. A video recording of each subject’s performance was independently assessed to determine the test completion time by three clinicians with similar education and years of clinical experience. An intraclass correlation coefficient (ICC2,1) was used to determine the interrater reliability of the FTSTS. Statistical analysis revealed excellent interrater reliability among all three researchers: ICC = 1.000. When clinicians with equal education and clinical experience administer the FTSTS, it has excellent interrater reliability.

Body weight supported treadmill training at very low treatment frequency for a young adult with incomplete cervical spinal cord injury

INTRODUCTION Body weight supported treadmill training (BWSTT) using high treatment frequency has been shown to improve gait after spinal cord injury (SCI). This case report describes the use of BWSTT at a very low treatment frequency. SUBJECT The subject was a 19 y.o. female with an incomplete C6 SCI, one year post-injury, with multiple gait deficits. INTERVENTION BWSTT was combined with conventional rehabilitation. Mean treatment frequency was 1.16 days/wk over 28.5 wks. A BWSTT progression algorithm based on observational gait analysis guided progressive changes in support levels, treadmill speed, and session length. OUTCOMES During the first 3 sessions, the subject tolerated an average of 15.7 minutes of BWSTT with 26% BWS at 0.8 m/s, improving to an average of 28 minutes of BWSTT with 10% BWS at 1.6 m/s in the last 3 sessions. Following 28.5 wks of very low frequency BWSTT, the subject displayed improved kinematics, walking speed, endurance, and distance during overground gait. CONCLUSION Very low frequency BWSTT combined with conventional treatment improved quality and endurance of walking for a person with incomplete cervical SCI. Further work is needed to evaluate the long-term outcome of very low frequency BWSTT and the interaction of BWSTT with other interventions.

Validity of measuring leg length with a tape measure compared to a computed tomography scan.

A frequently used technique to measure leg length (LL) is the supine tape measure method (TMM). However, radiographic imaging, more recently computed tomography (CT) scans, has been considered the most accurate. The purpose of this study was to assess the validity of the TMM for measuring LL compared to CT scans. Additionally, intrarater and interrater reliability of the TMM were assessed. LL measurements of 30 adults (mean  =  38.4 years, SD  =  13.1 years) were obtained by two physical therapists (PT) using the TMM method, anterior superior iliac spine (ASIS) to medial malleoli. Lower extremity CT scans were completed and subsequent LL measurements were obtained. The validity of a single TMM LL compared to CT scan was ICC(2,1) of 0.984 for examiner 1 and 0.978 for examiner 2, while the ICC(2,2) validity of the mean of two measures was 0.992 and 0.990, respectively. Excellent intrarater (ICC3,2 of 0.990 and 0.985) and interrater reliability (ICC2,1 of 0.991) were also found. The supine TMM for measuring LL was shown to have excellent validity when compared to CT scans and excellent intrarater and interrater reliability. These results indicate that the supine TMM is a valid and reliable clinical measurement for PTs when measuring LL.