Wen-Yin Chen

The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome

PURPOSE This study aimed to investigate the effect of elastic taping on kinematics, muscle activity and strength of the scapular region in baseball players with shoulder impingement. SCOPE Seventeen baseball players with shoulder impingement were recruited from three amateur baseball teams. All subjects received both the elastic taping (Kinesio Tex) and the placebo taping (3M Micropore tape) over the lower trapezius muscle. We measured the 3-dimensional scapular motion, electromyographic (EMG) activities of the upper and lower trapezius, and the serratus anterior muscles during arm elevation. Strength of the lower trapezius was tested prior to and after each taping application. The results of the analyses of variance (ANOVA) with repeated measures showed that the elastic taping significantly increased the scapular posterior tilt at 30 degrees and 60 degrees during arm raising and increased the lower trapezius muscle activity in the 60-30 degrees arm lowering phase (p<0.05) in comparison to the placebo taping. CONCLUSIONS The elastic taping resulted in positive changes in scapular motion and muscle performance. The results supported its use as a treatment aid in managing shoulder impingement problems.

Running injuries and associated factors in participants of ING Taipei Marathon

OBJECTIVES To investigate the distribution of lower extremity running injuries and their associated factors. DESIGN Descriptive and exploratory study. PARTICIPANTS 1004 participants of the 2005 ING Taipei International Marathon. MAIN OUTCOME MEASURES We used a self-developed questionnaire to collect data of previous running injuries and applied multivariate logistic regression modeling to examine relationships between these injuries and associated factors. RESULTS Of the 893 valid questionnaires, 396 (44.4%) reported having previous lower extremity pain related to running. Knee joint pain was the most common problem (32.5%). Hip pain was associated with the racing group, training duration, and medial arch support. Use of knee orthotics (P = 0.002) and ankle braces (P = 0.007) was related to a higher rate of knee and ankle pain. Participants of the full marathon group who practiced on a synthetic track had a higher incidence of ankle pain. A training duration of >60 min was linked to an increased rate of foot pain (P = 0.003). CONCLUSION Our data indicated that running injuries were associated with training duration and use of orthotics. Clinicians can use this information in treating or preventing running associated injuries and pain.

Lower extremity kinematics in children with and without flexible flatfoot: a comparative study

BackgroundA high percentage of young children present with flatfeet. Although the percentage of those with flatfeet declines with age, about 15% of the population maintains a flat arch. A reduction in longitudinal arch height usually combines with excessive subtalar joint pronation and may be related to other musculoskeletal problems of the lower extremity kinetic chain. The purpose of this study is to describe and compare the lower extremity kinematics between children with normal arches and those with flexible flatfeet, with the intent of providing practical information for decision making when treating children with flexible flatfeet.MethodsTwenty children with flexible flatfeet (years age mean (SD), 9.7 (0.9) years) and 10 children with normal arches (yeas age mean (SD), 9.6 (1.2) years) were included. Kinematic data (maximum and minimum angles, and movement range, velocity, and excursion) of the hip, knee and rearfoot were collected during walking using Liberty Electromagnetic Tracking System. Kinematic variables were compared between the normal arches and flexible flatfeet groups using repeated measures mixed effects ANOVA.ResultsMovement patterns at the hip, knee and ankle joints were similar between children with flexible flatfeet and with normal arches. The results of ANOVA showed no significant main effect or interaction in any of the kinematic variables (P ≥ 0.05).ConclusionsThis study identified no kinematic adaptation during walking in children with flexible flatfoot. We suggested that future research should take the influence of the mid-foot and forefoot into consideration when examining lower extremity kinematics in children with flexible flatfoot.

Application of wedged foot orthosis effectively reduces pain in runners with pronated foot: a randomized clinical study

Objective: To examine the effects of foot orthosis intervention during a 60-minute running test in pronated-foot runners with overuse knee or foot pain during running. Design: A randomized, controlled design. Setting: Sports gym. Participants: Twenty-four runners with pronated foot who experienced pain over anterior knee or foot region during running were recruited and randomized into the treatment, or the control, group. Interventions: A soft insole with a semi-rigid rearfoot medial wedge was given to the treatment group, and a soft insole without corrective posting was applied to the control group. Outcome measures: The immediate and short-term effects of orthosis application on incidence of pain, pain intensity and onset time were evaluated using the 60-minutes treadmill test. Results: Immediately after wearing the foot orthosis, pain incidence reduced in the treatment group but not in the control group (P = 0.04). After two weeks, seven (58%) subjects in the treatment group and one (8%) in the control group were free of pain during the test (P = 0.01). The pain intensity score decreased significantly after orthosis application, from 35.5 to 17.2 (immediate effect, P = 0.014), then to 12.3 (short-term effect, P < 0.001). Conclusion: The rearfoot medially-wedged insole was a useful intervention for preventing or reducing painful knee or foot symptoms during running in runners with pronated foot.

Predictors for Identifying Patients With Patellofemoral Pain Syndrome Responding to Femoral Nerve Mobilization

OBJECTIVE To identify the predictors for successful neurodynamic management in patients with patellofemoral pain syndrome. DESIGN Prospective cohort, prediction rule study. SETTING Hospital. PARTICIPANTS Patients with patellofemoral pain syndrome (N=51) underwent clinical examination and measurement of physical parameters, including femoral slump test, lower-extremity alignment, flexibility and muscle strength, and functional level. INTERVENTION Patients received 6 treatment sessions of femoral nerve mobilization within 2 weeks. MAIN OUTCOME MEASURES Pain level during functional testing was assessed before and after the first and sixth session of treatment. Patients were then grouped into responder and nonresponder groups. Criteria for the responder group was a pain score decrease ≥50% or Global Rating Scale score ≥4. Chi-square and independent t tests were used to identify potential variables with a significance level of .10, and stepwise logistic regression was used to find predictors with a significance level of .05. RESULTS Twenty-five patients responded to the initial treatment (immediate effect), and 28 patients responded after 6 sessions (longer-term effect). A positive femoral slump test was identified as the predictor for the immediate treatment effect. The prediction factors for the longer-term effect included responding to femoral nerve mobilization the first time and a bilateral difference in hip extension angles. Application of the clinical predictors improved the success rate to 90% for 1 treatment session and 93% for 6 treatment sessions. CONCLUSIONS Clinicians could use the positive femoral slump test and a bilateral difference in hip extension angles during the femoral slump test to determine whether or not patients with patellofemoral pain syndrome might benefit from femoral nerve mobilization.

Specificity of the Femoral Slump Test for the Assessment of Experimentally Induced Anterior Knee Pain

OBJECTIVE To assess the specificity of the femoral slump test (FST) when assessing experimentally induced anterior knee pain. DESIGN Cross-sectional, exploratory study. SETTING Research laboratory. PARTICIPANTS Asymptomatic subjects (N=12; 6 men; 6 women) for the study. An experimental pain model was used to simulate anterior knee pain by injecting .25 mL of hypertonic saline solution (5% NaCl) into the medial infrapatellar fat pad. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The changes in pain intensity and diameter after applying the structure differential maneuver (neck flexion/extension) during the FST were recorded and analyzed. RESULTS Results revealed that the structure differential maneuver of the FST did not alter the pain intensity or diameter in 9 (neck extension) and 10 (neck flexion) out of 12 subjects, which meant that the FST provided appropriate testing responses in 75% to 83% cases when the anterior knee pain did not originate in neural tissues. CONCLUSIONS The FST had a specificity of more than .75 when detecting nerve mechanosensitivity problems of anterior knee pain.

Neurodynamic Responses to the Femoral Slump Test in Patients With Anterior Knee Pain Syndrome

STUDY DESIGN Matched-control, cross-sectional study. OBJECTIVES The purpose of this study was to compare the responses to the femoral slump test (FST), including the change in hip range of motion and level of discomfort, between subjects with and without anterior knee pain. BACKGROUND Anterior knee pain syndrome is a common problem among adults. The FST is the neurodynamic test used to assess the mechanosensitivity of the femoral component of the nervous system. However, as of yet, there is no literature discussing the use of the FST in patients with anterior knee pain. METHODS Thirty patients with anterior knee pain and 30 control participants, matched by gender, age, and dominant leg, were recruited. The subjects received the FST, during which the hip extension angle and the location and intensity of pain/discomfort were recorded. Reproduction of symptoms that were alleviated by neck extension was interpreted as a positive test. Differences in hip extension angle and pain intensity between groups were examined using a 2-way, repeated-measures analysis of variance and a Kruskal-Wallis analysis. The level of significance was set at α = .05. RESULTS Subjects with anterior knee pain had a smaller hip extension angle than that of controls (-3.6° ± 5.3° versus 0.6° ± 6.1°; mean difference, 4.2°; 95% confidence interval [CI]: 1.24°, 7.15°; P = .006). Eight patients with anterior knee pain showed a positive FST, and those with a positive FST had a smaller hip extension angle (-5.7° ± 4.5°) than that of controls (mean difference, 6.3°; 95% CI: 0.8°, 11.8°; P = .007). There was no difference in the hip extension angle between the positive and negative FST groups (mean difference, 2.9°; 95% CI: -8.5°, 2.0°) or between the negative FST and control groups (mean difference, 3.4°; 95% CI: -0.4°, 7.3°). CONCLUSION Results of this study suggest that altered mechanosensitivity of the femoral nerve occurred in the patients with anterior knee pain who presented with a positive FST. The role of increased mechanosensitivity in the development and management of anterior knee pain should be investigated in the future.

The effect of additional joint mobilization on neuromuscular performance in individuals with functional ankle instability

OBJECTIVES To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI). DESIGN A cross-sectional study. PARTICIPANTS Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr). INTERVENTION Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG. MAIN OUTCOME MEASURES Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p < .05. RESULTS MANOVA found significant group by time interactions on posterolateral reaching distance (p = .032), PL activation (p = .006-.03), DFROM (p < .001), CAIT (p < .001) and GRS (p < .001). The post hoc tests indicated significantly improved PL muscle activity and posterolateral reaching distance for MTG compared to TG (p = .004) and CG (p = .006). CONCLUSION Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain.

Short-Term Effects of Cervical Kinesio Taping on Pain and Cervical Range of motion in Patients with Acute Neck Pain: a Randomized Clinical Trial

Purpose: Neck pain is a common musculoskeletal condition that may result in functional limitation, disability, and high medical costs. This study was designed to investigate the effect of Kinesio tape application on pain intensity, cervical range of motion, and personal satisfaction in patients with acute neck pain. Methods: This was an exploratory, randomized controlled trial and participant-blinded, within-subject repeated-measures design. Patients with acute neck pain (24 males, 26 females, 32.7±7.4 y/o) were recruited and randomly divided into the intervention group (Kinesio taping with pain relief method) and the control group (Kinesio taping with placebo method). The primary outcomes were pain intensity (100 mm visual analog scale, VAS) and cervical pain-free active range of motion. The secondary outcomes were pressure pain threshold (PPT) over the upper trapezius and global rating of change scales (GRCS). These measurements were performed before (T1), immediately (T2) and 24 hours (T3) after intervention. Results: The results of repeated measures ANCOVA revealed that there was a significant group by time interaction for pain-free rightward (p=0.037) and leftward cervical rotation (p≦0.000). A significant time effect was found for VAS (p=0.024) and cervical flexion (p=0.008), extension (p=0.035), and leftward (p=0.023) and rightward (p=0.023) side-bending. No significant time effect or group by time interaction was found for the pressure pain threshold. Although patients in both groups reported improvement in GRCS 24 hours post intervention, no significant group difference was identified. Conclusions: Our data showed that Kinesio taping improved movement range of cervical rotation. Clinicians could integrate this taping method into the management of acute neck pain.