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Background. The use of sonography is a cost-effective and reliable method to evaluate upper extremity superficial tissue structural integrity and pathology. Establishing the measurement reliability of widely used diagnostic ultrasound evaluation for musculoskeletal assessment is paramount enhance accurate clinical evaluations. The objective of this study was to establish the inter-rater and intra-rater reliability of select ulnar collateral ligament (UCL) thickness measures at two distinct anatomical locations in intercollegiate baseball athletes using ultrasound imaging (USI). Methods. This was a prospective cohort study conducted in a university research laboratory and included a total of 17 NCAA Division I baseball athletes (age 20.4 ± 1.43, height = 183.63 cm ± 6.27 cm, mass = 89.28 kg ± 8.24 kg). Two trained clinicians measured UCL mid-substance and apex thickness in the throwing extremity, prospectively, on 5 occasions at 1-month intervals during rest. Intraclass correlation coefficients (ICCs) (model 3,3), associated standard error of measurement, and 95% minimal detectable change in thickness were derived. Results. Intrarater reliability estimates for operator 1 were 0.90-0.98 (mid-substance) and 0.91-0.99 (apex). Operator 2's values were 0.92-0.97 and 0.93-0.99, respectively. The standard error of measurement (SEM) ranged from 0.045-0.071 cm (mid-substance) and 0.023-0.067 cm (apex). The minimal detectable difference (MDD95) was 0.12-0.20 cm (mid-substance) and 0.07-0.19 cm (apex). Interrater reliability was 0.86-0.96 (mid-substance) and 0.79-0.98 (apex); most ICCs were >0.90. Measurement of UCL thickness at two locations demonstrated very good to excellent reliability with high precision. Using this protocol, two evaluators can obtain consistent UCL measurement at two positions. This finding has significant implications for the clinical evaluation of superficial tissue pathology of the same individual by two experienced practitioners. [ABSTRACT FROM AUTHOR]

To determine differences in physiologic responses and perceived discomfort during maximal and submaximal exercise with 2 common exercise modalities, the elliptical cross-trainer (ECT) and the arc trainer (ARC) were used, which undergoes an excursion of motion using an arc pathway. Eighteen subjects (10 male and 8 female; age = 24.7 [+ or -] 2.6 yr, height = 172.2 [+ or -] 10.3 cm, mass = 69.8 [+ or -] 14.9 kg, %fat = 22.5 [+ or -] 8.1%; mean [+ or -] SD) performed maximal exercise protocols on a treadmill (TML), the ECT, and ARC. Subjects also performed 3 10-minute submaximal exercise bouts on the ECT and ARC at 55%, 65%, and 75% of TML maximal oxygen uptake ([??}[o.sub.2]max) in which heart rate (HR), [??|[o.sub.2], ventilation, respiratory exchange ratio, and hip, knee, and low-back discomfort were monitored. All testing on the ECT and ARC were performed in a counterbalanced order. The [??][o.sub.2]max was greater during TML exercise compared with ECT (p = 0.007) but similar to the ARC. Both ECT and ARC elicited lower maximal HR values compared with maximal TML exercise (p = 0.0001). No difference was observed between ECT and ARC for [??][o.sub.2] during the submaximal exercise bouts (p > 0.05). However, HR was greater during submaximal ECT exercise (p < 0.0001). Perception of discomfort was not different between ECT and ARC for knees (p > 0.05) and lower back (p > 0.05) but different for the hips (p = 0.02). Similar [??}[o.sub.2]max values were observed with ARC and TML modalities. Greater perceptions of discomfort were observed with ECT compared with ARC at similar submaximal exercise intensities, suggesting individuals with, or at risk for, lower-extremity joint pathology may benefit from exercise with modalities other than the ECT. KEY WORDS maximal exercise, submaximal exercise, [??][o.sub.2]; heart rate, joint discomfort

The effectiveness on various types of straight leg raises and knee extensions on the muscles of the knee was examined. Thirteen men were asked to do both exercises, once with the hips neutral and the other time with the hip laterally rotated. Hip orientation made no significant difference in muscle activity.

Context: Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lowerextremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear. Objective: To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures. Design: Case control. Setting: Sports-medicine research laboratory. Participants: 18 participants with knee OA and 18 healthy matched controls. Intervention: Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN). Main Outcome Measures: WOMAC scores, A-P (mm), and ALIGN (°). Results: A significant multivariate main effect for group (Wilks' Λ = 0.30, F7,26 = 8.58, P < .0001) was found. Knee-OA participants differed in WOMAC scores (P < .0001) but did not differ from healthy controls on ALIGN (P = .49) or total A-P (P = .66). No significant relationships were identified among main outcome measures. Conclusion: These data demonstrate that participants with early-stage knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants' subjective scores, ALIGN, or A-P measures in this study. [ABSTRACT FROM AUTHOR]

Isokinetic and isotonic exercises were studied to determine which of the two would result in the greatest increase in one-legged jump reaction force, and accurately predict the peak force produced during one-legged jumps. Analysis of variance did not reflect any difference between the exercises. An increase in strength was noted, although this cannot be correlated with changes in one-legged reaction force. This means that increased force production in functional rehabilitation is not a result of isokinetic nor isotonic training.

EGb 761 has been shown to increase acetylcholine synthesis and release and increase cholinergic receptors leading to an increase in cholinergic neurotransmission. These effects may be observed in the neuromuscular system, manifested by changes in motoneuron pool excitability as measured by the Hoffmann reflex to motor response (H/M) ratio. The objective was to determine whether a single dose of EGb 761 affects motoneuron pool excitability of the soleus muscle as measured by the H/M ratio. Following initial soleus H/M measurements, 20 healthy volunteers were randomly assigned to 1 of 3 treatment groups (control, 180 g cellulose placebo, and 180 g EGb 761). H/M ratios were recorded 1, 2, and 3 hours post treatment. A 3 x 4 repeated-measures analysis of variance was used to analyze differences in H/M ratio between treatments. No differences were observed between treatments (p = 0.75) or over time (p = 0.17), and there was not a treatment by time interaction (p = 0.27). A single dose of 180 g of EGb 761 does not affect soleus motoneuron pool excitability. Key Words: phytotherapy, nutritional supplement, Hoffmann reflex, acetylcholine Reference Data: Stone, M.B., M.A. Vaughan, C.D. Ingersoll, J.E. Edwards, J.P. Babington, R.M. Palmieri, M.L. Cordova, and B.A. Krause. A single dose of Ginkgo biloba does not affect soleus motoneuron pool excitability. J. Strength Cond. Res. 17(3):587-589. 2003.

Objective: To investigate the effects of external ankle support (EAS) on lower extremity joint mechanics and vertical ground-reaction forces (VGRF) during drop landings. Design: A 1 × 3 repeated-measures, crossover design. Setting: Biomechanics research laboratory. Patients: 13 male recreationally active basketball players (age 22.3 ± 2.2 y, height 177.5 ± 7.5 cm, mass 72.2 ± 11.4 kg) free from lower extremity pathology for the 12 mo before the study. Interventions: Subjects performed a 1-legged drop landing from a standardized height under 3 different ankle-support conditions. Main Outcome Measures: Hip, knee, and ankle angular displacement along with specific temporal (TGRFz1, TGRFz2; s) and spatial (GRFz1, GRFz2; body-weight units [BW]) characteristics of the VGRF vector were measured during a drop landing. Results: The tape condition (1.08 ± 0.09 BW) demonstrated less GRFz1 than the control (1.28 ± 0.16 BW) and semirigid conditions (1.28 ± 0.21 BW; P < .0001), and GRFz2 was unaffected. For TGRFz1, no-support displayed slower time (0.017 ± 0.004 s) than the semirigid (0.014 ± 0.001 s) and tape conditions (0.014 ± 0.002 s; P < .05). For TGRFz2, no-support displayed slower time (0.054 ±.006 s) than the semirigid (0.050 ± 0.006 s) and tape conditions (0.045 ± 0.004 s; P < .05). Semirigid bracing was slower than the tape condition, as well (P < .05). Ankle-joint displacement was less in the tape (34.6° ± 7.7°) and semirigid (36.8° ± 9.3°) conditions than in no-support (45.7° ± 7.3°; P < .05). Knee-joint displacement was larger in the no-support (45.1° ± 9.0°) than in the semirigid (42.6° ± 6.8°; P < .05) condition. Tape support (43.8° ± 8.7°) did not differ from the semirigid condition (P > .05). Hip angular displacement was not affected by EAS (F2,24 = 1.47, P = .25). Conclusions: EAS reduces ankle- and knee-joint displacement, which appear to influence the spatial and temporal characteristics of GRFz1 during drop landings. [ABSTRACT FROM AUTHOR]

This article describes the importance of exercise in the treatment of patients with knee osteoarthritis (OA). The authors discuss problem of muscular atrophy for knee OA patients and the importance of exercise in helping to slow articular cartilage degeneration. Exercise goals such as flexibility, strength, and control of movement are noted and treatment methods are recommended based upon exercise priorities.