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BackgroundEhlers–Danlos syndrome (EDS) is a common group of inherited connective tissue disorders with a prevalence as high as 0.75%–2% of the population. Physical manifestations include pain and decreased proprioception, especially in more mobile joints, such as the shoulder. The kinesiology tape (K-Tape) is often used to treat patients with shoulder dysfunction. The effectiveness of the K-Tape is uncertain, and there is a lack of studies specifically studying the K-Tape in an EDS population.PurposeThe purpose of this study was to compare the short-term effects of two different K-Tape procedures on shoulder active joint reposition (AJR) and active range of motion (AROM) in patients with hypermobile EDS (hEDS) and shoulder pain.MethodsAll participants were recruited from the EDS support groups and presented with shoulder pain. Baseline demographic information was obtained for each participant, after which AROM and AJR were assessed. The participants were randomized to receive one of two K-Tape procedures. Testing was repeated immediately post-taping and 48 h post-taping.ResultsSignificant improvements in shoulder external (F = 10.917, p 0.05).ConclusionK-Tape may offer short-term improvements in shoulder rotation AROM in patients with hEDS and shoulder pain.

Objective: To assess the effects of 5 different durations of electro-dry needling (EDN) on asymptomatic individuals’ pain response after repeated noxious thermal stimuli. Design: Randomized, non-controlled intervention trial. Setting: University laboratory. Participants: Asymptomatic participants (N=50) were recruited for the study and randomized into 5 groups. There were 33 women with an average age of 26.8 (±4.8) years. To participate in the study, individuals had to be between the ages of 18 and 40, free of any musculoskeletal injury which prevented participation of daily activities, and not pregnant or trying to become pregnant. Interventions: Participants were randomly assigned to receive 5 different durations of EDN: 10, 15, 20, 25, and 30 minutes. To perform the EDN, 2 monofilament needles were inserted lateral to the lumbar spinous processes of L3 and L5 on the right. Needles were left in situ with electrical stimulation at a frequency of 2 Hz and an amplitude which resulted in a 3 to 6 out of 10 intensity pain rating by the participant. Main Outcome Measures: The change in the magnitude of pain in response to repetitive heat-pulses before and after the EDN procedure. Results: There was a significant reduction in the magnitude of pain in response across the groups after EDN (F(1,42)=94.12, P

BackgroundEhlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders which predominantly affects women and has a prevalence as high as 1 in 5,000 individuals. Hypermobile EDS (hEDS) is the most common subtype of EDS and is characterized by multi-joint pain, particularly in large joints such as the shoulder. Physical therapy is often utilized to address the pain, physical impairments, and functional loss in patients with EDS. Kinesiology Tape (KT) is an intervention commonly used by physical therapists for treating shoulder pain and dysfunction. Studies related to the effectiveness of KT in patients with shoulder pain is equivocal and there are a lack of studies specifically studying the effects of KT in an EDS population.PurposeThe purpose of this study was to assess the efficacy and short-term effects of two different KT techniques on shoulder pain and function in individuals with hEDS and shoulder pain.MethodsParticipants were recruited from EDS support groups in the New England area of the United States; were diagnosed with hEDS by their physician; and had shoulder pain. Baseline demographic information was obtained for each participant followed by completion of 4 patient reported outcome (PRO) measures: the Upper Extremity Functional Index, QuickDASH (Disabilities of the Arm, Shoulder, & Hand), Shoulder Pain and Disability Index, and the Western Ontario Shoulder Instability Index. Current pain level, average pain over the past 24 h, and worst pain over the past 24 h were recorded using the numeric pain rating scale (NPRS). Subjects were randomly assigned to receive either an experimental shoulder KT procedure or a control shoulder taping. Immediately after taping, the NPRS was reassessed. Subjects then returned 48 h later to repeat the NPRS and PRO measures.ResultsThere was no significant difference between the experimental and control tape groups for any outcome measure. There was a significant improvement from pre-taping to 48-hours post taping for each of the 4 PRO measures with large effect sizes (p

BackgroundIntegrated movement and cognitive load paradigms are used to expose impairments associated with concussion and musculoskeletal injury. There is currently little information on the discriminatory nature of dual-task complexity and the relative influence of physical exertion on cognitive outcomes.PurposeAssess cognitive performance while under motor conditions of increasing complexity before and after a standardized exercise protocol.Methods34 participants were recruited (17 male and 17 female; 24 ± 1.4 yrs). A modified Eriksen flanker test was used to assess cognitive performance under four conditions (seated, single-leg stance, walking, and lateral stepping) before and after a 20-min moderate-to vigorous intensity treadmill protocol. The flanker test consisted of 20 sets of 5-arrow configurations, appearing in random order. To complete the response to cognitive stimulus, participants held a smartphone horizontally and were instructed to respond as quickly and as accurately as possible by tilting the device in the direction corresponding to the orientation of the middle arrow. The metrics used for analysis included average reaction time (ms), inverse efficiency index (average reaction time penalized for incorrect responses), and conflict effect (the average time cost of responding to an incongruent repetition vs. a congruent repetition). Mixed effects (condition by time) RMANOVAs were conducted to examine the effects of motor task complexity and physical exertion on cognitive performance.ResultsThere was a condition by time interaction for inverse efficiency index (p < 0.001), in which participants displayed higher cognitive efficiency for the pre-activity lateral stepping condition compared to the other three conditions (Cohen's d = 1.3–1.6). For reaction time and conflict effect, there were main effects for condition (p = 0.004 and 0.006, respectively), in which performance during lateral stepping was improved in relation to the seated condition (reaction time Cohen's d = 0.68; conflict effect Cohen's d = 0.64).ConclusionParticipants tended to display better dual-task cognitive performance under more stimulating or complex motor tasks before physical exertion, likely associated with the inverted-U arousal-performance relationship. When using dual-task assessments, clinicians should be mindful of the accompanying motor task and baseline exertion levels and their potential to disrupt or optimize cognitive performance.

Introduction: Doctor of Physical Therapy (DPT) education has traditionally been delivered in a face-to-face format. However, alternative educational models are on the rise with the proliferation of hybrid programs. Although hybrid education may benefit students in unique ways, many students prefer the personal interaction afforded by a face-to-face format. An alternative model, Hybrid-Flexible (HyFlex), allows students to have the benefits of a hybrid education while allowing for face-to-face interactions. Therefore, the purpose of this study was to describe the application of an alternative educational method-HyFlex-in the DPT classroom., Review of Literature: In a HyFlex model, students can choose to attend each class period in person, synchronously online, or asynchronously. Although previous research has found that hybrid programs have equivalent performance compared with traditional style, there is a paucity of published research on the effectiveness of HyFlex in the DPT classroom., Subjects: Thirty-six students (n = 26 female students) enrolled in a first-year DPT kinesiology course participated in this study., Methods: Students chose which method of engagement they preferred, and attendance choice was recorded. Students were categorized into synchronous engagement, partial asynchronous engagement, or asynchronous engagement groups. Quantitatively, grades for quizzes, tests, and the final examination were recorded and compared across the groups. Qualitatively, the students filled out a survey asking about their experience, and answers were assessed using a qualitative descriptive approach., Results: Quantitative data analysis revealed no differences between the groups in academic performance. Qualitative data revealed that students felt the HyFlex model allowed for better organization, flexibility, and reduced stress. However, there were concerns about the social impact, academic loss, decreased motivation, and technological issues., Discussion and Conclusion: This study describes how a HyFlex model can be implemented in a DPT classroom that allows for greater flexibility and reports of improved stress reduction with no academic loss., Competing Interests: The authors declare no conflicts of interest, (Copyright © 2023 Academy of Physical Therapy Education, APTA.)