Joe H. Gieck

Minor Head Injury in Sports: A New System of Classification and Management

In brief: The potential for head injury exists in almost all sports. The classification of head injury helps the clinician in evaluation and management, but no system is universally accepted. The a...

Effect of Preload and Range of Motion on Isokinetic Torque in Women

The purposes of this study were to compare the effects of two preload settings (0 N, 75 N) and two ranges of motion (5-90 degrees ROM, 25-70 degrees ROM) on torque output of the knee musculature. Twenty females were randomly assessed for isokinetic concentric (CON) and eccentric (ECC) torque of the knee extensor (EXT) and flexor (FLEX) musculature at a velocity of 1.62 rads.s-1. Two four-way ANOVAs (muscle x mode x range of motion x preload) revealed significant differences in average torque between the preload and range of motion conditions (CONEXT: 5-90 degrees ROM, 75 N = 74.3 +/- 17.2 Nm; 5-90 degrees ROM, 0 N = 68.3 +/- 17.2 Nm; 25-70 degrees ROM, 75 N = 79.0 +/- 13.0 Nm; 25-70 degrees ROM, 0 N = 71.5 +/- 20.8 Nm) (ECCEXT: 5-90 degrees ROM, 75 N = 85.6 +/- 28.6 Nm; 5-90 degrees ROM, 0 N = 82.8 +/- 27.8 Nm; 25-70 degrees ROM, 75 N = 97.7 +/- 23.4 Nm; 25-70 degrees ROM, 0 N = 93.6 +/- 26.5 Nm) (CONFLEX: 5-90 degrees ROM, 75 N = 43.5 +/- 9.2 Nm; 5-90 degrees ROM, 0 N = 43.1 +/- 5.6 Nm; 25-70 degrees ROM, 75 N = 44.2 +/- 8.9 Nm; 25-70 degrees ROM, 0 N = 41.2 +/- 8.9 Nm) (ECCFLEX: 5-90 degrees ROM, 75 N = 56.7 +/- 16.3 Nm; 5-90 degrees ROM, 0 N = 55.6 +/- 17.8 Nm; 25-70 degrees ROM, 75 N = 57.3 +/- 14.0 Nm; 25-70 degrees ROM, 0 N = 51.8 +/- 14.0 Nm) (P < 0.05). No differences in peak torque values were observed. Based on the findings of this study, preload and range of motion should remain constant between and among subjects if average torque is used as a criterion measure.

Intercollegiate Lacrosse Injuries.

In brief:Injury data for an intercollegiate lacrosse team were collected after one season of practices and games and compared with injury data from a summer league team. Only five players (15%) completed the season without injury, and there were 78 total injuries to the 34 players. The most frequent injury was ankle sprain. The experience, skills, and age of collegiate athletes are more homogeneous and they often have superior equipment and playing surfaces, which suggests that they should have fewer injuries. However, the authors believe that the competitiveness of collegiate lacrosse results in higher frequency of injury.

Tibiofemoral Joint Positioning for the Valgus Stress Test

CONTEXT Recommendations on the positioning of the tibiofemoral joint during a valgus stress test to optimize isolation of the medial collateral ligament (MCL) from other medial joint structures vary in the literature. If a specific amount of flexion could be identified as optimally isolating the MCL, teaching and using the technique would be more consistent in clinical application. OBJECTIVE To determine the angle of tibiofemoral joint flexion between 0 degrees and 20 degrees that causes a difference in the slope of the force-strain line when measuring the resistance to a valgus force applied to the joint. DESIGN Cross-sectional study. SETTING University research laboratory. PATIENTS OR OTHER PARTICIPANTS Twelve healthy volunteers (6 men, 6 women: age = 26.4 +/- 5.6 years, height = 170.9 +/- 8.4 cm, mass = 75.01 +/- 14.6 kg). INTERVENTION(S) Using an arthrometer, we applied a valgus force, over a range of 60 N, to the tibiofemoral joint in 0 degrees , 5 degrees , 10 degrees , 15 degrees , and 20 degrees of flexion. MAIN OUTCOME MEASURE(S) Force-strain measurements were obtained for 5 positions of tibiofemoral joint flexion. RESULTS As knee flexion angle increased, slope values decreased (F(4,44) = 17.6, P < .001). The slope at full extension was not different from that at 5 degrees of flexion, but it was different from the slopes at angles greater than 10 degrees of flexion. Similarly, the slope at 5 degrees of flexion was not different from that at 10 degrees of flexion, but it was different from the slopes at 15 degrees and 20 degrees of flexion. Further, the slope at 10 degrees of flexion was not different from that at 15 degrees or 20 degrees of flexion. Finally, the slope at 15 degrees of flexion was not different from that at 20 degrees of flexion. CONCLUSIONS When performing the manual valgus stress test, the clinician should fully extend the tibiofemoral joint or flex it to 5 degrees to assess all resisting medial tibiofemoral joint structures and again at 15 degrees to 20 degrees of joint flexion to further assess the MCL.

Fitting of protective football equipment

As no other guide was found to illustrate and describe protec tive equipment and its fitting, we have prepared this treatise. Properly fitted protective equipment for football is a must to prevent injury from occurring. Many injuries result from im properly fitted equipment. The helmet and shoulder pads are the most important pieces of equipment that require proper fit. Adequate face masks and jaw pads are essential to the helmet. Cantilever shoulder pads are necessary for most positions, with straps for those with subluxating or dislocating shoulders. Other pieces of equipment that need attention are cervical collars, hip pads, thigh pads, knee pads, pants, and shoes. Elbow, forearm, wrist, hand, and mouthpieces are essential to the player and care must be taken to see that they are compat ible with proper fit. Special materials such as Ensolite,@ Hex- celite,® RTV-11,® Orthoplast, Lightcast, or Therm-O-Foam® may be utilized to construct special pads. Todays modern football equipment provides adequate protection. It is impera tive that all personnel involved in fitting equipment be knowl edgeable about the subject.

Syncope, Bradycardia, and Hypotension After a Lacrosse Shot to the Neck.

In brief: A lacrosse goalie was hit in the right neck lateral to the cricoid cartilage. He fainted, but responded to conservative measures of supine rest, elevated legs, and close observation. He now wears a neck protector similar to those worn by baseball catchers. This case report emphasizes that someone who is trained in basic life support and understands cardiovascular physiology should attend practices and games.

Poster 51: Effects of the proprioceptive feedback intervention with SENSERite and circumferential ankle pressure on proprioception and balance performance in community-dwelling older adults with diminished ankle perception1

Abstract Objective: To investigate the effects of proprioceptive feedback intervention (PFI) with the SENSERite system and circumferential ankle pressure on ankle proprioceptive acuity and balance performance. Design: Repeated measure with double-blinded assessments of outcomes at 3 points. Setting: A university laboratory. Participants: 40 community-dwelling older adults with either lower (diminished) entering proprioceptive acuity (LEPA) or higher entering proprioceptive acuity (HEPA). Intervention: The control group received PFI alone and used perceptual error feedback presented in the SENSERite system’s screen in terms of knowledge of results to match a self-selected target position as accurately as possible. The experimental group received concurrent PFI and circumferential ankle pressure. Main Outcome Measures: Electromechanically measured absolute constant error, variable error, and equilibrium score. Results: LEPA participants in the experimental group demonstrated significantly reduced absolute constant error across time ( P Conclusions: LEPA participants enhanced proprioceptive accuracy more from a combination of PFI and circumferential ankle pressure than from PFI alone via a mechanism known as peripheral control. In contrast, HEPA participants did not show significant improvement across time and may have relied on central control mechanisms to maintain accuracy. Balance performance was essentially unaffected by either intervention, perhaps due to lack of practice specificity.