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Ankle injuries are highly prevalent in ballet, with strength highlighted as a primary risk factor. To profile ankle strength, fourteen female ballet dancers (age: 19.29 ± 1.59 years) completed an isokinetic testing protocol comprising concentric eversion (CON

Occupational Abstract The aim of this project was to develop and test an application capable of quickly and repeatedly measuring trunk flexion angles during sagittal plane lifting tasks. The developed application uses the built-in accelerometer in mobile devices to approximate trunk flexion angle, as the user follows an operator as they perform a lift. A black line is superimposed over the camera feed, allowing the user to approximate the angle of inclination of a line connecting the operator's seventh cervical and first sacral vertebrae-thereby estimating the trunk flexion angle. The magnitude of this angle and its velocity have been linked to the development of occupational low back pain; thus the application provides ergonomists a more refined means of screening tasks beyond currently available survey tools.

Aims: This study evaluated, for youth with cerebral palsy (CP), the reliability of passive range of motion (PROM) measures taken with an inclinometer, a device that may be simpler to use th...

Background: Dart-throwing motion (DTM) is an important component of wrist function and, consequently, has the potential to become an evaluation tool in rehabilitation. However, no measurement method is currently available to reliably measure range of motion (ROM) of the wrist in the DTM plane. Objectives: To determine the reliability and responsiveness of a goniometric device to measure wrist ROM in the DTM plane. Methods: ROM of the wrist in the DTM plane was measured in 70 healthy participants. The intra-class correlation coefficient (ICC) was used to evaluate the relative reliability of measurement, and a Bland-Altman analysis conducted to establish its absolute reliability, including the 95% limits of agreement (95% LOA). The standard error of the measurement (SEM) and minimal detectable change at the 95% confidence level (MDC95) were calculated as measures of responsiveness. Results: The intra-rater ICC was 0.87, and an inter-rater ICC of 0.71. There was no evidence of a fixed or proportional bias. For intra- and inter-rater reliability, 95% LOA ranged from -13.83 to 11.12 and from -17.75 to 16.19, respectively. The SEM and MDC95 were 4.5° and 12.4°, respectively, for intra-rater reliability, and 6.0° and 16.6°, respectively, for inter-rater reliability. Conclusion: The ROM of the wrist in the DTM plane was measured with fair-to-good reliability and responsiveness and, therefore, has the potential to become an evaluation tool for rehabilitation.

In image-free total knee arthroplasty (TKA) navigation, infra-red markers are attached to bony landmarks to provide kinematic data intra-operatively, with the aim of improving the precision of implant placement. In non-invasive navigation, infra-red markers are attached to the skin surface, with recent evidence suggesting that this can give repeatable measurements of lower limb mechanical alignment. The aim of our study was to evaluate the use of a non-invasive navigation system in the assessment of mechanical alignment with applied coronal force through the range of flexion. A previously validated non-invasive system (Physiopilot™) was tested on 23 volunteers with healthy knees. Two users performed two registrations of the software workflow on each participant’s right and left knees. A force was manually applied to the end-point of varus and valgus knee laxity and the measured change in mechanical alignment was recorded. Force was applied with the knee positioned in increments of flexion from 0 to 90°. In keeping with previous studies, satisfactory values of coefficient of repeatability (CR) of 1.55 and 1.33 were found for intra-observer repeatability in measurement of supine mechanical femoro-tibial angle (MFTA) in extension, with a good inter-observer correlation of intraclass correlation coefficient (ICC) .72. However, when flexion was introduced, intra-observer and inter-observer reliability fell out with acceptable limits. Therefore, the trial did not support use of the Physiopilot™ system as a measure of MFTA when flexion is introduced. It was felt that learning-curve, soft tissue artefacts and lack of force standardisation equipment may have accounted for significant levels of error, with further studies required to address these issues.

To examine our hypothesis that the accuracy of visual estimation, while measuring the angles of forearm, wrist and elbow, may vary between the different angles, and that this may depend on the experience of the observer.A slide show comprising of clinical photos and radiographs of different elbow, forearm and wrist angles was presented to 164 attending orthopedic surgeons, orthopedic residents and medical students who made a visual estimation of the different joints' angles.Forearm pronation was found to be estimated most accurately (mean 6.1°) while radiographs of wrist flexion (mean 12°) and photos of wrist extension (mean 16°) were estimated the least accurately. Specialists estimated angles more accurately than residents and both were more accurate than students, regardless of the estimated joint.The accuracy of visual estimation of a joint's angle depends on the specific joint viewed. Experience in the practice of orthopedic surgery (and not only upper extremity surgery) will improve the accuracy of estimation in general. Regarding the elbow, forearm and wrist, the results of our study suggest that a goniometer should be used whenever an accuracy of up to 10° is important, and for measuring wrist flexion and extension.

The aim of this study was to assess the concurrent validity and reliability of the Simple Goniometer (SG) iPhone® app compared to the Universal Goniometer (UG).Within subject comparison design comparing the UG with the SG app.James Cook University, Townsville, Queensland, Australia.Thirty-six volunteer participants, with a mean age of 60.6 years (SD 6.2).Not applicable.Thirty-six participants performed three standing lunges during which the knee joint angle was measured with the SG app and the UG.There were no significant differences in the measures of individual knee joint angles between the UG and the SG app. Pearson correlations of 0.96-0.98 and intraclass correlation coefficients of 0.97-0.99 (95% confidence interval: 0.95-1.00) were recorded for all measures. Using the Bland-Altman method, the standard error of the mean of the differences and the standard deviation of the mean of the differences were low.The measurements from the SG iPhone® app were reliable and possessed concurrent validity for this sample and protocol when compared to the UG.

The most common bike fitting method to set the seat height is based on the knee angle when the pedal is in its lowest position, i.e. bottom dead centre (BDC). However, there is no consensus on what method should be used to measure the knee angle. Therefore, the first aim of this study was to compare three dynamic methods to each other and against a static method. The second aim was to test the intra-session reliability of the knee angle at BDC measured by dynamic methods. Eleven cyclists performed five 3-min cycling trials; three at different seat heights (25°, 30° and 35° knee angle at BDC according to static measure) and two at preferred seat height. Thirteen infrared cameras (3D), a high-speed camera (2D), and an electrogoniometer were used to measure the knee angle during pedalling, when the pedal was at the BDC. Compared to 3D kinematics, all other methods statistically significantly underestimated the knee angle (P = 0.00; η(2) = 0.73). All three dynamic methods have been found to be substantially different compared to the static measure (effect sizes between 0.4 and 0.6). All dynamic methods achieved good intra-session reliability. 2D kinematics is a valid tool for knee angle assessment during bike fitting. However, for higher precision, one should use correction factor by adding 2.2° to the measured value.

The purpose of this experiment was to quantify the natural angle between the hand and a handle, and to investigate three design factors: handle rotation, handle tilt and between-handle width on the natural angle as well as resultant wrist radial/ulnar deviation ('RUD') for pushing tasks. Photographs taken of the right upper limb of 31 participants (14 women and 17 men) performing maximal seated push exertions on different handles were analysed. Natural hand/handle angle and RUD were assessed. It was found that all of the three design factors significantly affected natural handle angle and wrist RUD, but participant gender did not. The natural angle between the hand and the cylindrical handle was 65 ± 7°. Wrist deviation was reduced for handles that were rotated 0° (horizontal) and at the narrow width (31 cm). Handles that were tilted forward 15° reduced radial deviation consistently (12-13°) across handle conditions.Manual materials handling (MMH) tasks involving pushing have been related to increased risk of musculoskeletal injury. This study shows that handle orientation influences hand and wrist posture during pushing, and suggests that the design of push handles on carts and other MMH aids can be improved by adjusting their orientation to fit the natural interface between the hand and handle.

The goal of this study was to establish relationships between fitness (torso endurance, grip strength and pull-ups), hip range of motion (ROM) (extension, flexion, internal and external rotation) and movement quality in an occupational group with physical work demands. Fifty-three men from the emergency task force of a major city police force were investigated. The movement screen comprised standing and seated posture, gait, segmental spine motion and 14 tasks designed to challenge whole-body coordination. Relationships were established between each whole-body movement task, the measures of strength, endurance and ROM. In general, fitness and ROM were not strongly related to the movement quality of any task. This has implications for worker training, in that strategies developed to improve ROM or strength about a joint may not enhance movement quality.Worker-centered injury prevention can be described as fitting workers to tasks by improving fitness and modifying movement patterns; however, the current results show weak correlations between strength, endurance and ROM, and the way individuals move. Therefore, the development of occupation-specific injury prevention strategies may require both fitness and movement-oriented objectives.

The purpose of this study was to investigate the interrelationship between the thorax and pelvis during coupled movement patterns. Fifty-seven participants were assessed using an infrared motion analysis system to track trunk movement during maximal pelvis and thorax rotations over four trunk inclinations and two pelvic constraint conditions. A repeated-measures multivariate analysis of variance investigated the effects of forward trunk inclination and pelvic constraint on thorax and pelvic rotation. Forward trunk inclination from neutral to 45° resulted in a 46% (p0.001) decrease in axial pelvic rotation and a 15% (p0.001) decrease in axial thorax rotation with an unconstrained pelvis. A constrained pelvis resulted in a 15% (p0.001) decrease in axial thorax rotation. An externally constrained pelvis allowed the thorax to achieve an average of 18° (SD = 2°) greater rotational range of motion across all angles. This study reinforced the importance of allowing the pelvis to rotate during whole body axial rotation tasks.Results indicated that maximum axial trunk rotation is best achieved in a neutral posture, when the pelvis is allowed to contribute and flexion at the hips should be minimised. For example, if a recumbent task requires rotation of the torso, then the chair seat should be allowed to swivel.

Measuring trunk posture in the workplace commonly involves subjective observation or self-report methods or the use of costly and time-consuming motion analysis systems (current gold standard). This work compared trunk inclination measurements using a simple data-logging inclinometer with trunk flexion measurements using a motion analysis system, and evaluated adding measures of subject anthropometry to exposure prediction models to improve the agreement between the two methods. Simulated lifting tasks (n=36) were performed by eight participants, and trunk postures were simultaneously measured with each method. There were significant differences between the two methods, with the inclinometer initially explaining 47% of the variance in the motion analysis measurements. However, adding one key anthropometric parameter (lower arm length) to the inclinometer-based trunk flexion prediction model reduced the differences between the two systems and accounted for 79% of the motion analysis method's variance. Although caution must be applied when generalizing lower-arm length as a correction factor, the overall strategy of anthropometric modeling is a novel contribution. In this lifting-based study, by accounting for subject anthropometry, a single, simple data-logging inclinometer shows promise for trunk posture measurement and may have utility in larger-scale field studies where similar types of tasks are performed.

A CT-based imaging technique to investigate ulnohumeral joint congruency of elbows undergoing physiologic flexion is introduced. This technique, which employed landmark registration and a previously developed inter-bone distance algorithm, was validated experimentally. Results obtained with this imaging technique were validated in a single specimen by comparing the resulting joint congruency maps to results obtained with experimental casting in a static position. Additionally, the accuracy of the registration technique was assessed in four specimens using fiducial and target registration error to evaluate the positional and angular accuracy. Preliminary data from an intact cadaveric elbow was shown to demonstrate the utility of this technique. The overall accuracy of the registration was better than 1 mm, and the congruency maps showed excellent correspondence with the casting, validating the use of a CT-based imaging technique to examine the congruency of joints undergoing quasi-static flexion.

Case report.Scapular fractures are uncommon, and displaced glenoid fractures are even rarer. Surgery is usually performed for severely displaced fractures and positive outcomes have been reported, although some patients have residual limitations. Published rehabilitation guidelines are limited. The purpose of this case report is to describe the physical therapy (PT) rehabilitation of a patient with a complicated scapular fracture, and to describe factors influencing his outcome.Exercise, manual therapy, and modalities were used in the rehabilitation process. Outcome measures included manual muscle testing for strength, goniometry for range of motion (ROM), and the shoulder pain and disability index (SPADI) for function.Improvements in strength, ROM, and function were noted. The patient had full ROM, 4+ /5 to 5/5 strength, and a SPADI score of 3/100 at discharge from PT.The patient achieved a favorable outcome, in spite of having a long-duration wound infection and a second surgery for hardware removal. Further research should identify the optimal rehabilitation progression for patients with this type of surgery.

Upper extremity (UE) neurodynamic tests are used to examine neural tissue in patients with neuro-musculoskeletal disorders. Although comparisons between involved and uninvolved limbs are made clinically, minimal data exist reflecting the normal variation between sides. The purpose of this study was to determine if within-subject differences exist between limbs in the UE component of neurodynamic tests of the median, radial, and ulnar nerves. Sixty-one healthy subjects were examined. Difference between limbs for the median nerve-biased test was significant (right=16.4° ± 11.4°, left=20.1° ± 13.7°; p=0.045). There was no significant difference between limbs for the radial or ulnar nerve-biased tests. Correlation between limbs was poor for all tests (median r(2) =0.14; radial r(2) =0.20; ulnar r(2) =0.13). Lower-bound scores were calculated to determine the amount of difference needed to consider asymmetry beyond measurement error; the scores for each neurodynamic test were as follows: median 27°, radial 20°, and ulnar 21°. The results of this study show that between-limb values have low correlation and that it may be normal for an individual to have range of motion differences between limbs with neurodynamic tests.

Our objective was to evaluate the effectiveness of manual therapy (MT) associated with upper limb (UL) exercises in women with impaired shoulder range of motion (ROM) after axillary lymph node dissection (ALND) for breast cancer. A randomized, prospective, blinded clinical trial with 131 women with a ROM - 100° for shoulder flexion and/or abduction on the first day postoperatively were evaluated. Sixty-six women were allocated to group exercises and 65 underwent the exercises followed by MT. Shoulder ROM was measured by goniometry, and function was evaluated by the Modified-University of California at Los Angeles Shoulder Rating Scale--the UCLA Scale, in the 1st, 6th, 12th, and 18th month after surgery. The chi-square test was used for the relationship between clinical characteristics and oncological treatment between groups, and ANOVA for repeat measures was used. No difference in recovery of shoulder ROM as well as UL function was observed between groups. Improvement in ROM was gradual from the 1st to the 18th month, and the function achieving a good classification at 18th month. MT associated with exercises did not enhance the results obtained with exercises alone for shoulder ROM and ipsilateral UL function.

This study determined reliability and concurrent validity of measurements of the single leg squat made by novice examiners. Twelve video recordings of individuals performing a single leg squat were evaluated by six student physical therapists. Students assessed movement quality on an ordinal scale and manually measured frontal plane knee movement quantity on a video monitor. Inter- and intrarater reliability of ordinal scale ratings were determined via quadratically weighted kappa. Inter- and intrarater reliability of frontal plane knee measures were determined through intraclass correlation coefficient models 2,k and 3,k (k = 3 ratings), respectively. Concurrent validity of frontal plane knee measures was examined by comparison with Vicon-Peak motion-tracking system measures via Bland-Altman scatterplots. Ordinal scale measures displayed intrarater reliability ranging from 0.38 to 0.94 and interrater reliability of 0.68 (0.46-0.87). Intrarater reliability of frontal plane knee measures ranged from 0.88 to 0.98 and interrater reliability of 0.99 (0.97-1.00). Difference scores between student and computer-generated measures of frontal plane knee movement were significantly different as determined through Bland-Altman scatterplots and calculation of the upper and lower limits of agreement.

This study investigated the reliability and concurrent validity of active shoulder elevation in the scapular plane (scaption) using a digital inclinometer and goniometer. Two investigators used a goniometer and digital inclinometer to measure scaption on 30 asymptomatic participants in a blinded repeated measures design. Good reliability was present with intraclass correlation coefficients (ICCs) for intrarater reliability of goniometry = 0.87, intrarater digital inclinometry = 0.88, interrater goniometry = 0.92, and interrater digital inclinometry = 0.89. The minimal detectable change (MDC95) for the interrater analysis indicated that a change equal to or greater than 8 degrees for goniometry and 9 degrees for inclinometry is required to be 95% certain that the change is not due to intertrial variability or measurement error. The concurrent validity between goniometry and digital inclinometry was excellent with an ICC value of 0.94 for both raters. The 95% limits of agreement suggest that the difference between these two measurement instruments can be expected to vary by up to ±11 degrees. The results support the interchangeable use of goniometry and digital inclinometer for measuring scaption. Clinicians and researchers should consider the MDC values presented when interpreting change during subsequent measurement sessions.

This pilot study assesses the suitability of three electronic instruments for the potential to objectively and consistently measure the effectiveness of adaptive seating for children with neuromotor disorders such as cerebral palsy and muscular dystrophy.A MiniMicroactigraph, an XSens accelerometer and an Xsensor pressure mapping system were assessed for their ability to measure change in five participants' stability, movement and posture when seating in a flat CAPS II chair and a contoured CAPS II chair.The accelerometer and pressure mapping system showed a difference in amount of movement and body/seat interface between two contrasting seated surfaces on all children, demonstrating potential for use in future research. The results of the actigraph were inconclusive, but did highlight the importance of instrument placement for future studies that utilise this technology.The three instruments have potential suitability for use in future, more comprehensive studies of adaptive seating. It is recommended that future studies explore the additional features of these instruments for their potential to provide objective data regarding the effects of adaptive seating on children's postural alignment and support, pressure management, stability, functional ability and comfort.

The present study investigated the intrarater reliability, interrater reliability and minimal detectable change at the 90% confidence interval (MDC₉₀) of active shoulder range of motion measurements using digital inclinometry. Two investigators each measured two repetitions of active flexion, abduction, external rotation (ER), and internal rotation (IR) on the nondominant shoulder of 30 asymptomatic participants in a blinded repeated measures design. Results indicated good intrarater reliability with Intraclass Correlation Coefficients (ICCs) (3, k) of Flexion=0.83, Abduction=0.91, ER=0.94 and IR=0.87. Interrater ICC values (2, k) were moderate to good with Flexion=0.58, Abduction=0.95, ER=0.88 and IR=0.93. The MDC₉₀ for the interrater analysis indicated that a change of equal to or greater than 8° (Flexion), 4° (Abduction), 8° (IR), and 9° (ER) would be required to be 90% certain that the change is not due to intertrial variability or measurement error. Digital inclinometry appears to be a reliable instrument for quantifying normal shoulder mobility when strict measurement protocols are adhered to. Clinicians and researchers should consider the MDC values presented when interpreting change values during subsequent measurement sessions.

Hamstring stretching is a common practice in physical therapy to change not only hamstring muscle length (HML), but also lumbar flexion range of motion (LROM) or lumbar curvature (LC). Yet limited published research compares the effectiveness of two commonly used hamstring stretch positions, sitting and standing. The purposes of this study were to determine the effect of (1) stretch position on HML; and 2) HML on LROM and LC. Thirty-six participants (M=44.8 years, SD=17.1) with short HML (i.e., with shortness for men ≥45° and for women ≥ 24° of active knee flexion with 90° hip flexion) were measured for HML, LROM, and LC; randomly allocated to one of three groups: (1) hamstring stretching in sitting (SI); (2) standing (ST); or (3) no stretching (control); and remeasured after 4 weeks. Participants in the stretching groups performed two 30-second static stretches 4 days per week for 4 weeks. Multivariate analysis of covariance (MANCOVA) showed significance between the stretching groups and nonstretching group for HML only. Nonsignificance was shown for HML between the stretch positions (i.e., SI-active knee extension (AKE) and ST-AKE), indicating that both were equally effective for increasing HML. However, there was no change in LROM or in LC even though HML increased.

This study determined the reliability of muscle function and sensory perception measures of the wrist extensors. The test-retest reliability of the measurements was determined by an intraclass correlation coefficient (ICC), coefficient of variation (CV), standard error of measurements (SEMs), and one-way repeated measures ANOVA using the values collected from 25 young (20.6 +/- 1.3 years) healthy male volunteers on two occasions separated by 1 day. The measures consisted of grip strength, wrist extension strength (WES), range of motion in active and passive wrist flexion and extension, choice reaction time (CRT), vibration sense (VIB), joint position error sense (JPE), cold pain (CP) and heat pain threshold, and pressure pain threshold. An acceptable reliability was determined as the ICC values greater than 0.85, CV less than 15%, and SEMs less than 5%. ICC of all measures except for JPE were greater than 0.85, only CV of JPE, CP, and VIB exceeded 15%, SEMs were higher than 5% only for JPE and CP, and the ANOVA showed a significant time effect for CRT and WES. It is concluded that most of the measurements except JPE are reliable and can be used to investigate effects of a physiotherapy intervention on the wrist extensors.

Within subjects test-retest design.Neural tissue provocation tests (NTPTs) are used clinically to examine neural tissue mechanosensitivity in patients with musculoskeletal conditions. Previous studies suggest the median and radial nerve biased tests can be applied reliably using external fixation devices. Transfering these reliability data to a clinical setting where external fixation devices are not used may not be appropriate. Although median nerve biased NTPT can be applied reliably without external fixation devices, no data exist for the radial and ulnar nerve biased tests.The purpose of this study was to examine intrarater reliability of the NTPTs biased toward the radial and ulnar nerves without external fixation devices.The NTPTs biased towards the radial and ulnar nerves were examined on 45 asymptomatic participants. The examiner's perception of firm resistance defined the end position of each NTPT. Elbow range of motion was measured at this end position with an electrogoniometer. The order of NTPTs and side tested were randomized for each participant.Repeated measures analysis of variance revealed no significant difference in elbow extension or flexion mobility between two trials for each NTPT (p0.05). Intraclass correlation coefficient (ICC((2,1))) values ranged from 0.65 to 0.81 and minimal detectible difference (MDD) values ranged from 9.20 to 13.44 degrees.The examiner in this study was able to apply the NTPTs biased toward the radial and ulnar nerve in a reliable fashion on asymptomatic participants without external fixation devices. This study provides a basis for further research to investigate interexaminer reliability and between session reliability in a symptomatic population.

The clinical use of digital levels, for joint measurement, may be a viable alternative to standard goniometry. The purpose of this study was to determine the intra- and intertester reliability of a construction grade digital level compared to the standard universal goniometer for measurements for active assisted shoulder range of motion (ROM). Two experienced physical therapists measured shoulder flexion, external rotation (ER), and internal rotation (IR) ROM bilaterally, on two different occasions, in 20 patients (9 males, 11 females, 18-79 years old) with unilateral shoulder pathology, using a goniometer and a digital level. Relative reliability was assessed by using intraclass correlation coefficients (ICC), and absolute reliability was assessed by using 95% limits of agreement (LOA). Intratester ICCs ranged from 0.91 to 0.99, and LOA ranged from 3 degrees to 9 degrees for measurements made with the goniometer and digital level. Intertester ICCs ranged from 0.31 to 0.95, and LOA ranged from 6 degrees to 25 degrees . For the comparison of goniometric vs. digital level ROM, ICCs ranged from 0.71 to 0.98. ER and IR ROM were 3-5 degrees greater for the digital level than the goniometer (p < 0.01). Goniometric vs. digital level LOA ranged from 6 degrees to 11 degrees for shoulder flexion. Both measurement techniques had excellent intratester reliability, but for intertester reliability ICCs were 20% lower and LOA were 2.3 times higher than intratester values. Reliability estimates were similar between the digital level and the goniometer. However, because glenohumeral rotation was 3-5 degrees greater for the digital level than the goniometer (systematic error), the two methods cannot be used interchangeably. On the basis of the average intratester LOA for the goniometer and the digital level, a change of 6-11 degrees is needed to be certain that true change has occurred. For comparison of measures made by two different therapists, a change is of 15 degrees is required to be certain a true change has occurred. A digital level can be used to reliably measure shoulder ROM but should not be used interchangeably with a standard goniometer.

Electromechanical above-knee prosthetics are widely available, and are reliant on repetitive knee movements of fixed length/angle. This work explores the viability of developing adaptive movements on existing prototypes, through embedded controls from 8051-class 8-bit microcontroller units (MCUs). The system includes an integrated goniometer, intended for measuring the knee angle of the sound limb. The phase delay is subsequently processed to bring about kinematic coordination in the proposed echo-controlled prosthetic.

Latissimus dorsi is a muscle theorized to undergo length changes due to shoulder region pathology or treatment such as stretching. A latissimus dorsi length measurement would be valuable to determine if length changes have occurred within an individual over time. With no such measurement known, we examined a proposed technique believed to isolate latissimus dorsi. The aim of this study was to determine how accurately a rater could reproduce this measurement in the same individual over a 6-week interval. Thirty subjects without shoulder symptoms were measured at 6-week intervals by either an experienced or novice clinician. A repeated-measures analysis of variance estimated the measurement error used for calculating intrarater correlation coefficients (ICC(3,1)). The standard error of measurement (SEM), confidence intervals (CI), and the smallest real difference (SRD) were also determined. The ICCs for all raters combined and for the separate groups indicated poor reliability. The SEM and SRD values were similar between groups, but they suggest poor measurement reproducibility in the same subject over a 6-week interval. This technique is not recommended for measuring latissimus dorsi length clinically to assess within-subject change over time.

This study examined validity indices of the Trendelenburg test as a measure of hip abductor muscle performance (adduction of pelvis-on-femur [P-O-F]) when identifying subjects with and without hip joint osteoarthritis (OA). Muscle performance of the hip abductor muscles was obtained in standing by using the P-O-F position measured with a goniometer and in supine using a handheld dynamometer (HHD) and a manual muscle test (MMT). We studied 20 healthy adults (10 men and 10 women) and 20 adults (10 men and 10 women) with radiographically documented hip joint OA. Indices including sensitivity, specificity, and positive likelihood ratios examined values obtained from the P-O-F position and the MMT when used to identify subjects with and without hip joint OA. Sensitivity of the P-O-F position for identifying subjects with hip joint OA was 0.55, and specificity was 0.70, yielding a positive likelihood ratio of 1.83. Sensitivity of normalized hip abductor MMT strength for identifying subjects with hip joint OA was 0.35 and specificity was 0.90, yielding a positive likelihood ratio of 3.5. Based on validity information from the present study, the Trendelenburg test (P-O-F angle) is not useful in identifying subjects in the early stages of hip joint OA.

Objective: Our aim was to develop and validate a user-friendly data logger system (SUDALS) for use with flexible electrogoniometry.Methods: Data pertaining to flexion/extension of the knee from 10 normal subjects were collected during a range of activities of daily living (ADL) such as walking, ascending and descending stairs, getting in and out of a chair and deep squatting. The accuracy, reliability and reproducibility of the data from SUDALS were verified by comparing against the data simultaneously collected from the Vicon system.Results: The results of these studies indicate that the SUDALS together with flexible electrogoniometers is able to produce stable, precise, accurate and repeatable knee flexion/extension angles with little variation existing between the data produced by the SUDALS, the Vicon system and that reported in the literature.Conclusion: The SUDALS together with flexible electrogoniometers is a useful clinical tool, capable of recording knee flexion/extension angles accurately during...

Currently, there are no standards for the development of posture classification systems used in observation-based ergonomic posture assessment methods. This study was conducted to determine if an optimal posture category size for different body segments and posture views could be established by examining the trade-off between magnitude of error and the number of posture category misclassification errors made. Three groups (trunk flexion/extension and lateral bend; shoulder flexion/extension and adduction/abduction; elbow flexion/extension) of 30 participants each selected postures they perceived to correctly represent the video image shown on a computer screen. For each view, 10 images were presented for five different posture category sizes, three times each. The optimal posture category sizes established were 30 degrees for trunk, shoulder and elbow flexion/extension, 30 degrees for shoulder adduction/abduction and 15 degrees for trunk lateral bend, suggesting that posture category size should be based on the body segment and view of the image being assessed. Across all conditions, the posture category sizes were comparable to those used in published ergonomic tools.

Prehospital cervical spinal cord injuries (SCIs) are rare but potentially catastrophic. Although spinal immobilization is resource-intensive, emergency medical services (EMS) personnel commonly immobilize trauma patients to prevent exacerbation of unrecognized SCI during transport. We compared the stabilization properties of a novel rigid, cervical immobilization collar (XCollar) with those of one-piece and two-piece rigid collars commonly used in the prehospital setting.This was a prospective laboratory study of healthy adult volunteers to determine total cervical motion in the horizontal, coronal, and sagittal planes in both seated and supine positions. Goniometric techniques were used to measure head and neck movement after marking anatomic landmarks. Ranges of motion were compared with a one-way analysis of variance (ANOVA). A Bonferroni correction was applied for multiple comparisons, setting significance at por= 0.004.Twenty-five subjects (11 men; 14 women) completed the study. The subject pool represented a wide range of morphometrics. For most measurements, the XCollar permitted 10-15 millimeters of movement when applied without manual cervical stabilization. This was less than the movement permitted by both comparison collars. On average, the XCollar permitted less than 10 millimeters of movement in the sagittal and horizontal planes when the subject was in the seated position.The XCollar provided superior cervical stabilization without augmentation by manual stabilization in healthy adult volunteers in both the seated and supine positions when compared with other one-piece and two-piece rigid cervical collars. Although maximal stabilization was achieved only after the subjects were secured to a long spine board with a cervical immobilization device, the XCollar can provide an acceptable alternative to manual cervical stabilization in situations where the number of patients exceeds the number of EMS providers available to provide care.

The aim of this study was to determine the relationship between discus throwing performance and the following technical parameters: hip-shoulder and shoulder-arm separation, trunk forward-backward tilt, throwing-arm elevation angles, and the absolute and relative throwing procedure phase times. Videographic data of 51 male and 53 female discus throwers' competitive performances were captured during major meets. The three-dimensional coordinates of 21 body landmarks and the discus were obtained for each thrower's best trial using direct linear transformation. The technical parameters were reduced from the three-dimensional data at six critical instants during the throwing procedure. Hierarchical stepwise multiple regression analyses were performed to determine the relative influence of linear combinations of the technical parameters on discus throwing performance. Specific techniques associated with linear combinations of certain technical parameters were identified using canonical correlations. Males and females were analysed separately. Suggestions for controlling the height of release and the vertical component of the speed of release using an effective technique are made.

The purpose of this paper is to provide an overview of the techniques of evaluation of patients, suffering from idiopathic scoliosis.The presentation is provided, concerning the medical history, clinical examination, conventional radiography, stereo-radiography, surface topography, ultrasounds, computer tomography, and magnetic resonance imaging, focusing on the points specific for the pathology of idiopathic scoliosis.Use of the scoliometer became systematic in the clinical evaluation. Quality of life questionnaires, including those endorsed by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), oriented towards scoliotic patients, gain on popularity and are extremely helpful to objectively evaluate the disability related to scoliosis. Classical radiography serves as the basic exam to determine the curve type and magnitude. Ultrasounds, computer tomography and magnetic resonance imaging are indicated in precisely defined clinical situations. Stereo-radiography and surface topography seem to be the most promising techniques, however requiring standardisation.Apart from sophisticated measurements, the experience of a physician cannot be underestimated. High standard clinical evaluation will probably continue to serve as a reference for other methods of assessment of patients with scoliosis. Stereo-radiography and surface topography deserve common use, after standardization is achieved.

Our objectives were to examine interrater reliability for inclinometer and goniometric measurements of hip extension flexibility and the intra- and interrater reliability between instruments when measuring hip extension flexibility with the modified Thomas test. The modified Thomas test is frequently used by clinicians to assess hip extension flexibility. Studies examining the reliability of measures of the modified Thomas test are limited. This study included 42 healthy subjects. The modified Thomas test was performed on each subject to quantify hip extension flexibility by using an inclinometer and a goniometer. High interrater reliability was determined for each instrument (r = 0.91-0.93; ICC = 0.89-0.92). High intrarater parallel-forms reliability was found for each examiner between the instruments (r = 0.089-0.92; ICC = 0.91-0.93). High interrater parallel-forms reliability also was found between instruments (r = 0.86-0.93; ICC = 0.86-0.92). The high correlations obtained in this study suggest that the inclinometer and the goniometer are reliable instruments for measuring hip extension flexibility. The results also indicate that the two instruments can be used interchangeably for measuring hip extension flexibility.

The ability to place the hands to the floor forms part of the assessment of joint hypermobility. The test may be symptom free, or in the case of joint hypermobility syndrome, may be associated with pain in the spine, hip, and knee. The aim of this study was to identify the relative amount of movement at the lumbar spine and hip during this test in people with asymptomatic and symptomatic hypermobility compared with a control group. Thirty-six female subjects (10 asymptomatic hypermobility, 13 symptomatic hypermobility, and 13 control) ranging between 18 and 60 years of age participated in the investigation. Measurements were made by using digital photography and inclinometers. Measurement reliability was established prior to the investigation. There was a significant difference (p0.05) between hip flexion range in the two hypermobility groups compared to the control group; there was no significant difference in lumbar spine movement between the three groups. The findings suggest that people with asymptomatic or symptomatic hypermobility perform the hand to floor test with the same relative contribution from the lumbar spine and hip joints. Both groups perform the hands to floor test and with a greater relative hip flexion range than a control group.

The purpose of this study was to determine the effects of a 15-day pragmatic hamstring stretching program on lower extremity performance as measured by the single hop for distance test (SHDT) in subjects with limited hamstring flexibility. Thirteen cadets enrolled at a military academy participated in the study. Subjects randomly were assigned to stretch the hamstrings of one lower extremity for 15 consecutive days (experimental lower extremity group) and not stretch the other (control lower extremity group). Pre- and post-test measurements showed significant improvements in the hamstring flexibility and SHDT scores for the experimental lower extremities. No significant change occurred for the control lower extremity group for the AKET and SHDT scores. The results suggest that in addition to a routine 15-day stretching program, a brief purposeful delay between stretching and performance testing may negate the detrimental effect on performance that may be caused by the acute effects of stretching. Because subjects also stretched on the day of the SHDT posttest, but with a purposeful delay of 10 minutes between stretching and testing, it is believed the design of this study more closely mimics stretching activities as commonly performed by athletes.

Use of the tibia as a lever to produce hip rotation for the purpose of measuring passive hip rotation range of motion (ROM) could result in inaccurate values if motion is allowed at the tibiofemoral joint (TFJ). The purpose of this study was to examine the effect of stabilizing the TFJ during measurement of prone hip rotation ROM in men and women. Passive hip rotation was measured in 20 unimpaired subjects (M = 10, F = 10) in two different stabilization conditions, with the TFJ stabilized and without the TFJ stabilized. A 2 x 2 analysis of variance was used to test for the effects of stabilization condition and gender on hip rotation measures. A significant interaction of gender and stabilization condition was obtained. Women displayed more hip rotation when the TFJ was not stabilized (M = 41.03 degrees , SD = 6.53 degrees ) than when the TFJ was stabilized (M = 35.05 degrees ; SD = 5.12 degrees ). Men displayed no difference in ROM between the two stabilization conditions (not stabilized: M = 39.07 degrees , SD = 4.87 degrees ; stabilized: M = 37.60 degrees , SD = 5.12 degrees ). To avoid measurement error of hip rotation ROM, use of the tibia as a lever to produce passive hip rotation should be used with caution, particularly in women.