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Martonick NJ, McGowan CP, Baker RT, Larkins LW, Seegmiller JG, Bailey JP. Effects of a Total Motion Release (TMR®) Protocol for the Single Leg Squat on Asymmetrical Movement Patterns. Int J Sports Phys Ther 2024; 19:1473-1483. [PMID: 38179584 PMCID: PMC10761630 DOI: 10.26603/001c.90703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/30/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Improving single leg squat (SLS) movement symmetry may benefit rehabilitation protocols. The Total Motion Release® (TMR®) protocol has been theorized to evaluate and improve patient-perceived movement asymmetries. HYPOTHESIS/PURPOSE The purpose of this study was to evaluate whether perceived asymmetries identified by a TMR® scoring protocol were related to biomechanical asymmetries and whether improving perceived asymmetries influenced movement mechanics. It was hypothesized that participants with perceived asymmetries would also present with biomechanical asymmetries. A secondary hypothesis was that participants would reduce their perceived asymmetries after performing the TMR® protocol and subsequently have greater biomechanical symmetry. STUDY DESIGN Descriptive Cohort (Laboratory Study). METHODS Twenty participants (10 female, 10 male) with self-identified bilateral differences of 10 points or greater on the TMR® scoring scale were recruited for the study. The non-preferred side was defined as the side that scored higher. 3Dimensional motion capture was used to bilaterally assess baseline SLS depth as well as hip, knee, and ankle kinematics and kinetics. For the TMR® protocol, sets of 10 SLSs were performed on the preferred leg until their perceived asymmetries were resolved (i.e., both sides scored equally), or four sets had been completed. Kinematics and kinetics were collected immediately after the intervention and after a 10-minute rest period. RESULTS Participants had biomechanical asymmetries at baseline for knee flexion, ankle flexion, and knee moments. Following the intervention, participants had reduced TMR® scores on the non-preferred leg, and this coincided with increased knee joint moments on that side. Although perceived asymmetries were resolved after the intervention, kinematic and kinetic asymmetries at the knee and ankle were still present. CONCLUSIONS A TMR® intervention could benefit rehabilitation protocols by reducing factors of dysfunction and increasing the ability of patients to load the non-preferred knee. Further investigations are necessary to elucidate the importance of asymmetrical movement patterns. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
| | - Craig P McGowan
- Department of Integrative Anatomical University of Southern California
| | | | - Lindsay W Larkins
- Movement Sciences University of Idaho
- Department of Integrative Anatomical University of Southern California
- Department of Movement Sciences University of Idaho
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Utsahachant N, Sakulsriprasert P, Sinsurin K, Jensen MP, Sungkue S. Effects of short foot exercise combined with lower extremity training on dynamic foot function in individuals with flexible flatfoot: A randomized controlled trial. Gait Posture 2023; 104:109-115. [PMID: 37379736 DOI: 10.1016/j.gaitpost.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/29/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Flexible flatfoot has demonstrated biomechanical linkages between distal and proximal lower extremities. However, supporting evidence is required to investigate the benefits of short foot exercise (SF) and short foot exercise in combination with lower extremity training (SFLE) on dynamic foot function. RESEARCH QUESTION This study aimed to determine the effects of a 6-week SF, 6-week SFLE, or control condition (no intervention) on dynamic foot function during gait in individuals with flexible flatfoot. METHODS Forty-five individuals with flexible flatfoot were randomly assigned into three conditions: (1) SF, (2) SFLE, and (3) control conditions. Participants in two intervention programs performed daily training via telerehabilitation and a home-based exercise program. Foot kinematics and center of pressure excursion index (CPEI) during the gait, intrinsic foot muscle test, and navicular drop test were assessed at baseline and after the 6-week intervention program. RESULTS Post-intervention participants in the SF and SFLE conditions showed a shorter time to the lowest medial longitudinal arch (MLA) and improved MLA motion during the stance phase compared with the baseline. In addition, participants in the SFLE conditions showed greater changes in CPEI than in the SF and control conditions. Improvements in intrinsic foot muscle and navicular drop tests were also observed in participants in both intervention programs post-intervention. SIGNIFICANCE A major finding of the study was the improvement in dynamic foot function during gait in individuals with flexible flatfoot after the six weeks of the SF and SFLE intervention programs. Both intervention programs appear to have the potential for inclusion in a corrective program for individuals with flexible flatfoot.
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Affiliation(s)
- Nalut Utsahachant
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | | | - Komsak Sinsurin
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Sumarttra Sungkue
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
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Semjonova G, Davidovica A, Kozlovskis N, Okss A, Katashevs A. Smart Textile Sock System for Athletes’ Self-Correction during Functional Tasks: Formative Usability Evaluation. SENSORS 2022; 22:s22134779. [PMID: 35808274 PMCID: PMC9268753 DOI: 10.3390/s22134779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/24/2022]
Abstract
(1) Background: The development of a lightweight, easy-to-use system that measures the foot’s plantar pressure is becoming an increasingly important area of research in physiotherapy. For further development of the smart sock system, a formative usability study was conducted, where the smart textile sock sensor system was used for self-correction during functional tasks; (2) Methods: Five athletes from the football school participated in the formative usability study. Athletes performed pre-defined functional tasks for self-correction when interacting with the smart textile sock system. Formative usability evaluation methods: effectiveness (task success rate, error rate), efficiency (time-based), satisfaction evaluated by System Usability Scale (SUS); (3) Results: Formative usability indicators: task completeness effectiveness ranged from 40% to 100% in the first- and second-stage tasks. Completed task efficiency time: Stage 1, from 4.2 s (SD 1.3) to 88.8 s (SD 19.8); Stage 2, from 7.2 s (SD 1.9) to 9.6 s (SD 2.1). Satisfaction was assessed by the SUS system user group with 76 points (SD 7.42), which indicates “good” satisfaction; (4) Conclusions: formative usability indicators showed the need for technical improvements to the smart textile sock pressure sensor system. The SUS results indicate “good” satisfaction with the smart textile sock pressure sensor system and its application.
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Affiliation(s)
- Guna Semjonova
- Department of Rehabilitation, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia;
- Correspondence:
| | - Anna Davidovica
- Department of Rehabilitation, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia;
| | - Nikita Kozlovskis
- Institute of Applied Computer Systems, Riga Technical University, LV-1658 Riga, Latvia;
| | - Aleksandrs Okss
- Institute of Design Technologies, Riga Technical University, LV-1048 Riga, Latvia;
| | - Aleksejs Katashevs
- Institute of Biomedical Engineering and Nanotechnology, Riga Technical University, LV-1048 Riga, Latvia;
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Feasibility of Superimposed Neuromuscular Electrical Stimulation to the Gluteus Medius During a Resistance Training Program. J Sport Rehabil 2021; 31:279-285. [PMID: 34894628 DOI: 10.1123/jsr.2021-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/12/2021] [Accepted: 09/13/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Gluteus medius (GMed) weakness is a common impairment seen across multiple lower-extremity pathologies. Greater GMed weakness is moderately associated with greater frontal plane motion, often termed dynamic knee valgus during functional tasks which may increase risk of lower-extremity injury. Neuromuscular electrical stimulation (NMES) superimposed to targeted muscles has emerged in clinical practice; however, NMES superimposed to the GMed in unknown. It is essential to assess the safety, credibility, and expectancy of NMES superimposed to the GMed prior to implementation in clinical practice. The objective of this study was to evaluate feasibility, safety, credibility, and expectancy of improvement with a 2-week intervention with or without NMES to the GMed in females with dynamic knee valgus. DESIGN Feasibility study. METHODS A total of 22 adult females with dynamic knee valgus (age = 21.8 [1.4] y, mass = 76.9 [18.8] kg, height = 1.7 [0.1] m) completed a 2-week intervention with NMES or a sham treatment superimposed to the GMed during all therapeutic exercises. Feasibility was assessed by recruitment and completion rate, while safety was assessed by the total number of adverse events. Treatment credibility and expectancy was assessed with the Credibility Expectancy Questionnaire. Mixed-measure analysis of variance were used for statistical analysis (P ≤ .05). RESULTS Recruitment was completed in 5 months with 100% completion rate and no adverse events. There was no difference in treatment credibility between groups (NMES = 23.7 [2.3], sham = 21.7 [3.4], P = .12); however, the NMES group demonstrated a greater expectancy score (NMES = 20.0 [3.8], sham = 15.9 [5.1], P = .045). CONCLUSION Resistance training with NMES superimposed to the GMed is a feasible and safe intervention that resulted in greater expectance of success. Clinicians may consider superimposing NMES to the gluteal muscles when addressing muscle weakness in individuals with dynamic knee valgus.
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Impact of Three Strengthening Exercises on Dynamic Knee Valgus and Balance with Poor Knee Control among Young Football Players: A Randomized Controlled Trial. Healthcare (Basel) 2021; 9:healthcare9050558. [PMID: 34068810 PMCID: PMC8151944 DOI: 10.3390/healthcare9050558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
The observed dynamic knee valgus and the limited dynamic balance described in the literature are modifiable risk factors for injuries in athletes. Therefore, identification and appropriate prevention are crucial in managing the development of young athletes. The aim of the study was to assess the effectiveness of three exercises strengthening the muscles: gluteal medius, popliteal and tibialis posterior to reduce dynamic knee valgus and improve the dynamic balance of the lower limbs in young football players with poor knee control. A total of 134 footballers were assessed for eligibility, and finally 45 participants (age 12–15) met the inclusion criteria. Participants were assessed with 2D video kinematic analysis during single-leg squats to assess the knee valgus angles and the dynamic balance (Y-Balance Test). No significant interactions between groups (Control and Exercise) and time (baseline and after 6 week) were noted for dynamic valgus for the left and right knee (p > 0.05). For the dynamic balance, there were statistically significant results, but not clinically relevant for anterior, posteromedial, and composite direction for the right lower limbs and for the anterior direction for left lower limbs in the exercise group. However, there were no significant differences (p > 0.05) in all of the YBT scores for both lower limbs between groups. This study demonstrated that there were no statistically significant differences in dynamic knee valgus angles and dynamic balance values after 6 weeks of exercise program in young footballers with poor knee control. Future randomized trials should focus on more comprehensive exercises, where possible using biofeedback methods to improve knee kinematics.
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Dynamic Knee Valgus in Single-Leg Movement Tasks. Potentially Modifiable Factors and Exercise Training Options. A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218208. [PMID: 33172101 PMCID: PMC7664395 DOI: 10.3390/ijerph17218208] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/29/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022]
Abstract
Dynamic knee valgus (DKV) as an incorrect movement pattern is recognized as a risk factor for lower limb injuries. Therefore, it is important to find the reasons behind this movement to select effective preventive procedures. There is a limited number of publications focusing on specific tasks, separating the double-leg from the single-leg tasks. Test patterns commonly used for DKV assessment, such as single-leg squat (SLS) or single leg landings (SLL), may show different results. The current review presents the modifiable factors of knee valgus in squat and landing single-leg tests in healthy people, as well as exercise training options. The authors used the available literature from PubMed, Scopus, PEDro and clinicaltrials.gov databases, and reviewed physiotherapy journals and books. For the purpose of the review, studies were searched for using 2D or 3D motion analysis methods only in the SLL and SLS tasks among healthy active people. Strengthening and activating gluteal muscles, improving trunk lateral flexion strength, increasing ROM dorsiflexion ankle and midfoot mobility should be taken into account when planning training programs aimed at reducing DKV occurring in SLS. In addition, knee valgus during SLL may occur due to decreased hip abductors, extensors, external rotators strength and higher midfoot mobility. Evidence from several studies supports the addition of biofeedback training exercises to reduce the angles of DKV.
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Bennett H, Arnold J, Martin M, Norton K, Davison K. A randomised controlled trial of movement quality-focused exercise versus traditional resistance exercise for improving movement quality and physical performance in trained adults. J Sports Sci 2019; 37:2806-2817. [PMID: 31500505 DOI: 10.1080/02640414.2019.1665234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this trial was to compare an eight-week individual movement quality versus traditional resistance training intervention on movement quality and physical performance. Forty-six trained adults were randomised to a movement quality-focused training (MQ) or a traditional resistance training (TRAD) group, and performed two individualised training sessions per week, for 8 weeks. Session-RPE (sRPE) was obtained from each session. Measures of movement quality (MovementSCREEN and Functional Movement Screen (FMS)) and physical performance were performed pre- and post-intervention. All measures improved significantly in both groups (3-14.5%, p = <0.005). The between-group difference in MovementSCREEN composite score was not statistically significant (0.3, 95% CI -3.4, 4.1, p = 0.852). However, change in FMS composite was significantly greater in MQ (1.3, 95% CI 0.8, 1.8, p < 0.001). There were no significant between-group differences in physical performance (p = 0.060-0.960). The mean sRPE was significantly lower in MQ (5.25, SD 1.2) compared to TRAD (6.6 SD 1.0, p = <0.001). Thus, although movement quality scores were not distinctly greater in the MQ group, a movement quality specific intervention caused comparable improvements in physical performance compared to traditional resistance training but at lower perceived training intensity.
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Affiliation(s)
- Hunter Bennett
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide , Australia
| | - John Arnold
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide , Australia
| | - Max Martin
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide , Australia
| | - Kevin Norton
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide , Australia
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide , Australia
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Myers NL, Kibler WB, Axtell AH, Herde BJ, Westgate PM, Uhl TL. Musculoskeletal capacity and serve mechanics in professional women’s tennis players. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2019. [DOI: 10.1007/s12662-019-00574-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dos’Santos T, McBurnie A, Donelon T, Thomas C, Comfort P, Jones PA. A qualitative screening tool to identify athletes with ‘high-risk’ movement mechanics during cutting: The cutting movement assessment score (CMAS). Phys Ther Sport 2019; 38:152-161. [DOI: 10.1016/j.ptsp.2019.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/07/2019] [Accepted: 05/20/2019] [Indexed: 01/14/2023]
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Taylor JB, Ford KR, Schmitz RJ, Ross SE, Ackerman TA, Shultz SJ. Sport-specific biomechanical responses to an ACL injury prevention programme: A randomised controlled trial. J Sports Sci 2018; 36:2492-2501. [PMID: 29671383 DOI: 10.1080/02640414.2018.1465723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Anterior cruciate ligament (ACL) injury prevention programmes have not been as successful at reducing injury rates in women's basketball as in soccer. This randomised controlled trial (ClinicalTrials.gov #NCT02530333) compared biomechanical adaptations in basketball and soccer players during jump-landing activities after an ACL injury prevention programme. Eighty-seven athletes were cluster randomised into intervention (6-week programme) and control groups. Three-dimensional biomechanical analyses of drop vertical jump (DVJ), double- (SAG-DL) and single-leg (SAG-SL) sagittal, and double- (FRONT-DL) and single-leg (FRONT-SL) frontal plane jump landing tasks were tested before and after the intervention. Peak angles, excursions, and joint moments were analysed using two-way MANCOVAs of post-test scores while controlling for pre-test scores. During SAG-SL the basketball intervention group exhibited increased peak knee abduction angles (p = .004) and excursions (p = .003) compared to the basketball control group (p = .01) and soccer intervention group (p = .01). During FRONT-SL, the basketball intervention group exhibited greater knee flexion excursion after training than the control group (p = .01), but not the soccer intervention group (p = .11). Although women's soccer players exhibit greater improvements in knee abduction kinematics than basketball players, these athletes largely exhibit similar biomechanical adaptations to ACL injury prevention programmes.
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Affiliation(s)
- Jeffrey B Taylor
- a Department of Physical Therapy , High Point University , High Point , NC , USA.,b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Kevin R Ford
- a Department of Physical Therapy , High Point University , High Point , NC , USA
| | - Randy J Schmitz
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Scott E Ross
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
| | | | - Sandra J Shultz
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
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Martinez AF, Lessi GC, Carvalho C, Serrao FV. Association of Hip and Trunk Strength With Three-Dimensional Trunk, Hip, and Knee Kinematics During a Single-Leg Drop Vertical Jump. J Strength Cond Res 2018. [PMID: 29528957 DOI: 10.1519/jsc.0000000000002564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Martinez, AF, Lessi, GC, Carvalho, C, and Serrao, FV. Association of hip and trunk strength with three-dimensional trunk, hip, and knee kinematics during a single-leg drop vertical jump. J Strength Cond Res 32(7): 1902-1908, 2018-Kinematic changes have been correlated with different lower-limb injuries. Movement is influenced by multiple factors and strength is one of the contributors that can influence it. Thus, the aim of this study was to evaluate the correlation among trunk and hip isometric strength with trunk and lower-limb kinematics during a single-leg drop vertical jump. Twenty-three healthy recreational female athletes aged between 18 and 35 years underwent isometric evaluation of hip abductor, hip extensor, and lateral trunk muscle strength and 3-dimensional trunk and lower-limb kinematics during a single-leg drop vertical jump. Pearson's correlation coefficients (r) were calculated to establish the association among hip and trunk strength and trunk, hip, and knee kinematics. As result, no significant correlations were found between the peak and movement excursion values of kinematic and hip and trunk isometric strength data. The lack of correlation between isometric strength and kinematics in healthy female athletes indicates that intervention programs should not be focused solely on strength exercises to influence the movement pattern during single-landing activities.
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Affiliation(s)
- Adalberto F Martinez
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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