JOINT MOBILIZATION CHANGES ACTIVATIONS IN GLUTEUS AND VASTI MUSCLES DURING FUNCTIONAL ACTIVITIES IN PEOPLE WITHOUT AND WITH PATELLOFEMORAL PAIN SYNDROME

We aimed to examine whether patellofemoral joint mobilization altered the activation in vasti and gluteus muscles in people with and without PFPS during functional activities. A total of 40 young collegiate students with and without PFPS were recruited. After the intervention of patellofemoral joint mobilization, there were significant earlier activations of vasti muscles and delayed activation of gluteus muscles such as heel rise, step up and down and drop landing in people with PFPS compared to that of healthy controls (

Sensorimotor and functional deficits following acute lateral ankle sprains

Lateral ankle sprain is the most common injury in the lower extremity during sports activities. Following injury and despite initial recovery, recurrent and/or persistent symptoms often remain unresolved. Over the past four decades, numerous studies have demonstrated impairments and dysfunctions in people with recurrent ankle sprains. Although many hypotheses have been proposed with regards to the mechanisms that underpin recurrence of symptoms following injury, recurrence rates are still high due to a poor understanding of the mechanisms and sequelae following acute ankle sprains. Clinically, acute ankle sprains result in limited ankle dorsiflexion, persistent pain, swelling and functional limitations. However, little information is available as to on whether these factors may contribute or lead to re-injury over time or functional deficits. Recurrence following lateral ankle sprains is therefore an enigma that requires further exploration to improve understanding of underlying physiological mechanisms. This thesis aimed to understand the physiological mechanisms of persistent symptoms and dysfunction following lateral ankle sprains at the acute, sub-acute and recurrent phases. Measures included ankle dorsiflexion range of motion, proprioception, peripheral sensory function measures, balance and selected functional performance tests. In addition, the thesis aimed to assess kinematic and kinetic factors during stair walking in people with acute lateral ankle sprains that may contribute to recurrence of symptoms and functional deficits. The thesis involved a series of five experiments, including three single blind, cross-sectional and two case-control experiments. Experiment 1 investigated the validity and reliability of a new digital imaging-based measure for the assessment of weight-bearing ankle dorsiflexion range. Experiments 2 and 3 examined possible impairments in joint position sense (JPS), sensory function, ankle dorsiflexion, balance and functional performance at different phases of lateral ankle sprains (acute, sub-acute and recurrent). Experiments 4 and 5 explored new kinematic and kinetic measurements of the lower limbs to evaluate alterations in movement patterns and motor control during stair ascent and descent in people with an acute lateral ankle sprain. The data showed that a deficit in JPS was present in individuals with recurrent ankle sprains, but this was not present in the acute stage. Reduced ankle dorsiflexion, balance ability and functional performance were demonstrated in the acute phase following injury, but these findings were not observed in latter stages of lateral ankle sprain. In addition, significant mechanical hyperalgesia over the anterior talofibular ligament and inferior tibiofibualr joints were found in people with acute and sub-acute ankle sprains. All injured groups (acute, sub-acute and recurrent) reported mild to severe pain in the self-reported pain visual analogue scale (VAS). VAS was moderately associated with functional impairments (30 m run) in the injured groups. Following lateral ankle sprains, subjects presented with local sensory dysfunction, pain and functional deficits, and these were present regardless of the phase of injury. During stair descent and ascent, the results showed highly acceptable coefficients of multiple correlations (CMC) for the sagittal angular kinematics and ground reaction forces. In contrast, CMC's for angular kinematics in frontal and transverse planes were poor. The electromagnetic motion capture system can be used as a reliable measurement tool for lower limb kinematics in the sagittal plane, whereas ground reaction forces were reliable in all planes during stair descent and ascent. Furthermore, ankle angular kinematics (i.e., range of motion) and were reduced bilaterally during stair walking in 3 acute ankle sprained subjects were found when compared to healthy subjects. This suggests the presence of alterations in motor strategies. Interestingly, these changes were observed on the injured and non-injured sides. This novel finding demonstrates that alterations in motor strategies occur at an early phase following acute lateral ankle sprains, and may be a critical factor that contributes to recurrence. The findings of this thesis provide improved understanding of the characteristics of sensorimotor and functional impairments at various phases following lateral ankle sprains. Notably, the studies elucidate some of the underlying mechanisms that immediately follow an episode of acute lateral ankle sprain, which may contribute to recurrence and re-injury. Clinically, the data highlights the need for early rehabilitation that aims to improve ankle dorsiflexion, balance and functional activity performance following acute ankle sprain, which may aid in the prevention of further impairments and re-injury

Common Running Musculoskeletal Injuries and Associated Factors among Recreational Gorge Marathon Runners: An Investigation from 2013 to 2018 Taroko Gorge Marathons

Many studies exist on the incidence and related risk factors of running injuries, such as those obtained during marathons. However, in gorge-terrain marathons, an insufficient number of reports exist in the relevant literature. Therefore, this study aimed to explore the incidence of musculoskeletal injuries occurring in participants in the 2013 to 2018 Taroko Gorge Marathons in Taiwan and the distribution of running injuries and related influencing factors. A total of 718 runners who entered the physiotherapy station presented with records of treatment and injuries and filled out a running-related injury and self-training questionnaire for further statistical analysis. The association between risk factors and injury were evaluated by logistic regression. The injured areas on the lower extremities after the gorge marathon were as follows: 28% in the knees, 20% in the posterior calves, 13% in the thighs, 10% in the ankles, and 8% in the feet. The analysis of injury-related risk factors showed that male athletes demonstrated a higher risk of thigh injury than female athletes (OR = 2.42, p = 0.002). Underweight runners exhibited a higher risk of thigh injury (OR = 3.35, p = 0.006). We conclude that in the gorge marathon the rates of knee, calf, thigh, and foot injuries are significantly increased. Medical professionals, coaches, and runners may use the findings of this study to reduce the potential risk of running injuries in marathons

Impact of order of movement on nerve strain and longitudinal excursion: A biomechanical study with implications for neurodynamic test sequencing

It is assumed that strain in a nerve segment at the end of a neurodynamic test will be greatest if the joint nearest that nerve segment is moved first in the neurodynamic test sequence. To test this assumption, the main movements of the median nerve biased neurodynamic test were applied in three different sequences to seven fresh-frozen human cadavers. Strain and longitudinal excursion were measured in the median nerve at the distal forearm. Strain and relative position of the nerve at the end of a test did not differ between sequences. The nerve was subjected to higher levels of strain for a longer duration during the sequence where wrist extension occurred first. The pattern of excursion was different for each sequence. The results highlight that order of movement does not affect strain or relative position of the nerve at the end of a test when joints are moved through comparable ranges of motion. When used clinically, different neurodynamic sequences may still change the mechanical load applied to a nerve segment. Changes in load may occur because certain sequences apply increased levels of strain to the nerve for a longer time period, or because sequences differ in ranges of joint motions. Copyright © 2010 Elsevier Lt

COMPARISON OF PLANTAR PRESSURE DISTRIBUTION BETWEEN DIFFERENT SPEED AND INCLINE DURING TREADMILL JOGGING

The aim of this study was to examine the effect of changes in speed and incline slope on plantar pressure distribution of the foot during treadmill jogging. Plantar pressure parameters were measured with the Pedar-X system in twenty healthy girls (mean age of 20.7 years, mean height of 1.60m, and a mean weight of 53.35kg). Because variations in walking speed or slope can significantly change the magnitude of plantar pressure, comparisons of plantar pressure distribution between the two independent protocols during treadmill jogging were considered in this study. First, the subjects ran at the same speed of 2 m·s-1 with different incline slopes of 0%, 5%, 10%, and 15%. Second, they ran on the same slope of 0% with different speeds of 1.5 m·s-1, 2.0 m·s-1, and 2.5 m·s-1. The peak pressure of the eight plantar surface areas, apart from the medial forefoot and the hallux, significantly increased (p < 0.05) with an increase of 33% of peak pressure from 1.5 m·s-1 to 2.5 m·s-1 (speed) at heel region. In contrast, the peak pressures at the heel, medial fore-foot, toe and hallux decreased significantly (p < 0. 05) with increasing incline slope. At the heel, peak pressure reduced by 27% from 0% to 15% incline, however, pressure at the lateral midfoot region increased as following. Different speeds and incline slopes during jogging were associated with changes in plantar pressures. By systematic investigation of foot kinematics and plantar pressure during jogging with varying incline slope and speed, the results of this study provided further insight into foot biomechanics during joggin