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2.  Intrarater Reliability of Functional Performance Tests for Subjects With Patellofemoral Pain Syndrome 
Journal of Athletic Training  2002;37(3):256-261.
Objective: Patellofemoral pain syndrome (PFPS) is a common clinical entity seen by the sports medicine specialist. The ultimate goal of rehabilitation is to return the patient to the highest functional level in the most efficient manner. Therefore, it is necessary to assess the progress of patients with PFPS using reliable functional performance tests. Our purpose was to evaluate the intrarater reliability of 5 functional performance tests in patients with PFPS.
Design and Setting: We used a test-retest reliability design in a clinic setting.
Subjects: Two groups of subjects were studied: those with PFPS (n = 29) and those with no known knee condition (n = 11). The PFPS group included 19 women and 10 men with a mean age of 27.6 ± 5.3 years, height of 169.80 ± 10.5 cm, and weight of 69.59 ± 15.8 kg. The normal group included 7 women and 4 men with a mean age of 30.3 ± 5.2 years, height of 169.55 ± 9.9 cm, and weight 69.42 ± 14.6 kg.
Measurements: The reliability of 5 functional performance tests (anteromedial lunge, step-down, single-leg press, bilateral squat, balance and reach) was assessed in 15 subjects with PFPS. Secondly, the relationship of the 5 functional tests to pain was assessed in 29 PFPS subjects using Pearson product moment correlations. The limb symmetry index (LSI) was calculated in the 29 PFPS subjects and compared with the group of 11 normal subjects.
Results: The 5 functional tests proved to have fair to high intrarater reliability. Intrarater reliability coefficients (ICC 3,1) ranged from .79 to .94. For the PFPS subjects, a statistical difference existed between limbs for the anteromedial lunge, step-down, single-leg press, and balance and reach. All functional tests correlated significantly with pain except for the bilateral squat; values ranged from .39 to .73. The average LSI for the PFPS group was 85%, while the average LSI for the normal subjects was 97%.
Conclusions: The 5 functional tests proved to have good intrarater reliability and were related to changes in pain. Future research is needed to examine interrater reliability, validity, and sensitivity of these clinical tests.
PMCID: PMC164353  PMID: 12937582
step-down; squat; limb symmetry; knee
3.  LOWER EXTREMITY KINEMATICS IN RUNNING ATHLETES WITH AND WITHOUT A HISTORY OF MEDIAL SHIN PAIN 
Purpose/Background:
Medial shin pain (MSP) is a common complaint that may stop an athlete from running. No previous study has identified deficits in pelvic, hip or knee motion as potential contributing factors to MSP. The purpose of this study was to investigate the differences in kinematics during running between uninjured athletes and those with MSP. Secondary analyses investigated differences in limbs between groups and differences between sexes.
Methods:
This case-control study investigated fourteen runners aged 18–40 years old with a history of unilateral MSP and fourteen runner controls. Three dimensional lower quarter kinematics were captured as runners ran on a treadmill. Specifically, peak hip internal rotation (IR), frontal plane pelvic tilt (PT) excursion, and knee flexion were examined.
Results:
Groups were similar in age, mass, height, and training mileage. Subjects with a history of MSP demonstrated significantly greater frontal plane PT (P = 0.002, Effect size = 0.55) and peak hip IR (P = 0.004, Effect size = 0.51); and less knee flexion (P = 0.02, Effect size = 0.46) than the control group. No significant difference was found in kinematics of the MSP group during their involved side stance phase as compared to their non-involved side.
Conclusions:
Runners with MSP displayed greater PT excursion, peak hip IR, and decreased knee flexion while running as compared to a control group. These results should help guide treatment for the running athlete that experiences MSP.
Level of Evidence:
3b
PMCID: PMC3414067  PMID: 22893855
Exercise related leg pain; running; overuse injuries; shin splints
4.  The Foot and Ankle: An Overview of Arthrokinematics and Selected Joint Techniques 
Journal of Athletic Training  1996;31(2):173-178.
Limited range of motion of the ankle is common following a period of immobilization or injury to the lower extremity. If not corrected, this limited range of motion will disturb normal joint arthrokinematics and could affect the athlete's performance. Consequently, the athletic trainer must thoroughly evaluate the various joints of the ankle and foot in order to determine appropriate treatment. A comprehensive evaluation should include assessment of passive accessory motions at the foot and ankle. If accessory movements are restricted at any joint, mobilization techniques can be used to restore normal ankle/foot joint arthrokinematics. This article describes the biomechanics of the tibiofibular, talocrural, subtalar, and midtarsal joints and is a presentation of basic mobilization techniques for the ankle and related joints.
Images
PMCID: PMC1318451  PMID: 16558394

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