Yi-Fen Shih

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.

ISOKINETIC CHARACTERISTICS OF SHOULDER ROTATORS IN PATIENTS WITH ADHESIVE CAPSULITIS

OBJECTIVE To demonstrate the muscle strength characteristics of shoulder internal and external rotators and the effects of isokinetic exercise on muscle activity in patients with adhesive capsulitis. DESIGN Cohort study with control subjects. PARTICIPANTS Eight patients with adhesive capsulitis and 8 controls. METHODS Maximal isometric and isokinetic strength tests of shoulder internal and external rotators in the scapular plane were carried out. Muscle activities of the rotators were recorded in resting and during maximal isometrics. Muscle strength variables (peak torque, total work and power) and myoelectric variables (resting root-mean-square amplitude pre- and post-tests and the external-internal rotator co-activity in resting and during isometric contractions) were recorded. A mixed repeated-measure analysis of variance test was used to examine the within-group and between-group differences. RESULTS For affected shoulders, smaller isometric average torque of internal rotators and high-speed peak torque, total work and power of external rotator were observed. The external/internal rotator ratio of peak torque in high-speed testing also exhibited significant decrease. The myoelectric variables showed no significant changes. CONCLUSION High-speed external rotator strength and isometric internal rotator strength of the affected shoulders were decreased significantly. Isokinetic exercise may not increase the resting muscle activities and co-activity. These results provide a reference in planning muscle strengthening programmes and goals for these patients.

Impaired neural drive in patients with low back pain

Control of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients.

Influence of pain location and hand dominance on scapular kinematics and EMG activities: an exploratory study

BackgroundAssessment of three-dimensional kinematics and electromyography (EMG) activities is common in patients with chronic neck pain. However, the effect of hand dominance and neck pain location on the measurement of movement and EMG characteristics is still unclear. Therefore, the purpose of this study was to investigate the effect of neck pain location and arm dominance on the scapular kinematics and muscle EMG activities in patients with chronic neck pain.MethodsThirty subjects (10 males, 20 females; mean age (sd): 38 (11.9) years) with chronic neck pain for more than 3 months were recruited. The scapular kinematics and EMG activity of the upper trapezius and sternocleidomastoid muscles were measured during the bilateral arm elevation task. The three-way repeated measures ANOVA was used to examine the effect of neck pain location and hand dominance on the measurement of kinematics and EMG muscle activities.ResultsThe movement of scapular posterior tilt was significantly influenced by arm dominance (P = 0.001) and by the interaction of arm dominance and elevation angle (P = 0.002). The movement of scapular upward/downward rotation was affected by the interaction of arm dominance and elevation angle (P = 0.02). The location of pain did not show any significant influence on the scapular movement and muscle activities.ConclusionsHand dominance could have an influence on the scapular kinematics, which should be taken into consideration when describing and comparing neuromuscular characteristics in individuals with chronic neck pain.

Test validity and intra-rater reliability in the measurement of scapular position sense in asymptomatic young adults.

It is suggested that scapular joint position sense (JPS) contributes to scapular stability. However, there is a lack of studies describing the measurement method for three-dimensional (3D) scapular JPS. The purposes of this study were to investigate the measurement repeatability and validity of the scapular JPS, and examine the effect of arm dominance on the scapular JPS in asymptomatic young adults. Ten subjects participated in this study. The scapular JPS was measured as scapular reposition errors during scapular elevation, depression, protraction, and retraction. Both the 3D scapular kinematics and clinical scale rule measurement were recorded during the test. The results showed that the measurement of scapular reposition errors resulted in moderate to excellent within-day intra-rater reliability with intraclass correlation coefficient ICC(3,2) between 0.60 and 0.99 for 3D scapular rotations, between 0.56 and 0.96 for 3D scapular displacement, and between 0.73 and 0.98 for the clinical scale ruler measurement. Scapular reposition errors measured using a 3D electromagnetic tracking device and using a scale ruler had a significant relationship (r=0.74-0.98). There was no significant difference in scapular reposition errors between the dominant and non-dominant shoulders. Our findings indicated that both the 3D tracking device and scale ruler resulted in a reliable measurement of scapular JPS and the clinical measurement method could be used to provide valid data for scapular JPS evaluation. In addition, arm dominance did not influence the scapular JPS in asymptomatic young adults.

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.