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1.  VALIDATION OF A NEW METHOD FOR ASSESSING SCAPULAR ANTERIOR‐POSTERIOR TILT 
Background:
Electromagnetic tracking systems have enabled some investigators and clinicians to measure tri‐planar scapular motion; yet, they are not practical and affordable options for all clinicians. Currently, the ability to affordably quantify scapular motion is limited to monitoring only the motion of scapular upward rotation, with use of a digital inclinometer.
Hypothesis/Purpose:
The objective of this study was to determine the criterion‐related validity of a modified digital inclinometer when used to measure the motion of scapular anterior‐posterior (AP) tilt.
Materials & Methods:
Thirteen volunteers, free from any history of shoulder injury, reported for a single testing session. Each subject underwent a brief shoulder and posture examination in order to confirm the absence of pathology. Subjects actively performed clinically relevant amounts of humeral elevation in the scapular plane while in a seated position. An electromagnetic tracking system (Ascension Technology, Burlington, VT) and a modified inclinometer (Pro 360, Baseline®, Fabrication Enterprises, White Plains, NY) were used to acquire scapular AP tilt over the same shoulder motions. Criterion‐related validity was determined using Pearson Product Moment correlations.
Results:
Correlation analyses revealed significant moderate to good associations (r = 0.63 to 0.86, p < 0.01) between scapular AP tilt measures obtained with a digital inclinometer and an electromagnetic tracking system.
Conclusions
A modified digital inclinometer is a moderately valid device to use for the quantification of scapular AP tilt. Further study is warranted to establish reliability and to validate use of the device in patients with shoulder injury or pathology. The modified inclinometer expands the clinician's ability to quantify scapular kinematic motion during the clinical evaluation and rehabilitation process.
Level of Evidence:
Level 3
PMCID: PMC4196329  PMID: 25328827
inclinometer; scapula; scapular kinematics shoulder; validity
2.  SIDELYING GLENOHUMERAL PASSIVE INTERNAL ROTATION RANGE OF MOTION VALUES IN A HEALTHY COLLEGIATE POPULATION 
Purpose/Background:
The sleeper stretch is a common intervention prescribed for individuals with decreased glenohumeral internal rotation. Passive glenohumeral internal rotation (GHIR) when quantified in sidelying has been suggested to be a more reliable measure as compared to measurments performed in supine with the humerus abducted to 908. Recently, the sidelying position has also been proposed as an evaluative measure to quantify GHIR. Minimal work however has described mean GHIR values in sidelying. Therefore, the objective of this study was to establish preliminary mean passive GHIR values in sidelying for a healthy, college‐age population. Secondary purposes were to ascertain if mean values were affected by upper extremity dominance or sex.
Methods:
Using a standardized protocol, passive GHIR was measured using a digital inclinometer on the dominant and non‐dominant shoulders of 60 healthy, college‐age participants (32 female [20.66±1.15 years, 170.70±14.38 cm, 63.34±7.51 kg] and 28 male [21.50±1.40 years, 183.81±13.17 cm, 90.04±17.91 kg]).
Results:
The sidelying passive GHIR grand mean for all participants bilaterally was 50.4 ± 11.78. Mean passive GHIR values on the non‐dominant side (52.7 ± 10.28) were greater than those on the dominant side (48.0 ± 12.58) (p = 0.002). There was no difference when GHIR values were compared by sex (p = 0.327) and a significant interaction between UE dominance and sex was not apparent (p = 0.693).
Conclusions:
In a healthy college age population, these preliminary data suggest GHIR values are statistically greater on the non‐dominant side and that sex does not significantly affect GHIR measures in a sidelying position.
Level of Evidence:
Level 3c
PMCID: PMC3867072  PMID: 24377065
Digital inclinometer; range of motion; shoulder internal rotation; sleeper stretch
3.  RELIABILITY AND VALIDITY OF FUNCTIONAL PERFORMANCE TESTS IN DANCERS WITH HIP DYSFUNCTION 
Study Design:
Quasi-experimental, repeated measures.
Purpose/Background:
Functional performance tests that identify hip joint impairments and assess the effect of intervention have not been adequately described for dancers. The purpose of this study was to examine the reliability and validity of hop and balance tests among a group of dancers with musculoskeletal pain in the hip region.
Methods:
Nineteen female dancers (age: 18.90±1.11 years; height: 164.85±6.95 cm; weight: 60.37±8.29 kg) with unilateral hip pain were assessed utilizing the cross-over reach, medial triple hop, lateral triple hop, and cross-over hop tests on two occasions, 2 days apart. Test-retest reliability and comparisons between the involved and uninvolved side for each respective test were determined.
Results:
Intra-class correlation coefficients for the functional performance tests ranged from 0.89-0.96. The cross-over reach test had a SEM of 2.79 cm and a MDC of 7.73 cm. The medial and lateral triple hop tests had SEM values of 7.51 cm and 8.17 cm, and MDC values of 20.81 cm and 22.62 cm, respectively. The SEM was 0.15 seconds and the MDC was 0.42 seconds for the cross-over hop test. Performance on the medial triple hop test was significantly less on the involved side (370.21±38.26 cm) compared to the uninvolved side (388.05±41.49 cm); t(18) = −4.33, p<0.01. The side-to-side comparisons of the cross-over reach test (involved mean=61.68±10.9 cm; uninvolved mean=61.69±8.63 cm); t(18) = −0.004, p=0.99, lateral triple hop test (involved mean=306.92±35.79 cm; uninvolved mean=310.68±24.49 cm); t(18) = −0.55, p=0.59, and cross-over hop test (involved mean=2.49±0.34 seconds; uninvolved mean= 2.61±0.42 seconds; t(18) = −1.84, p=0.08) were not statistically different between sides.
Conclusion:
The functional performance tests used in this study can be reliably performed on dancers with unilateral hip pain. The medial triple hop test was the only functional performance test with evidence of validity in side-to-side comparisons. These results suggest that the medial triple hop test may be a reliable and valid functional performance test to assess impairments related to hip pain among dancers.
Level of Evidence:
3b. Non-consecutive cohort study
PMCID: PMC3812843  PMID: 24175123
Hop test; reach test; reliability; validity
4.  THE INFLUENCE OF HEEL HEIGHT ON VERTICAL GROUND REACTION FORCE DURING LANDING TASKS IN RECREATIONALLY ACTIVE AND ATHLETIC COLLEGIATE FEMALES 
Purpose:
To determine if heel height alters vertical ground reaction forces (vGRF) when landing from a forward hop or drop landing.
Background:
Increased vGRF during landing are theorized to increase ACL injury risk in female athletes.
Methods:
Fifty collegiate females performed two single‐limb landing tasks while wearing heel lifts of three different sizes (0, 12 & 24 mm) attached to the bottom of a athletic shoe. Using a force plate, peak vGRF at landing was examined. Repeated measures ANOVAs were used to determine the influence of heel height on the dependent measures.
Results:
Forward hop task‐ Peak vGRF (normalized for body mass) with 0 mm, 12 mm, and 24 mm lifts were 2.613±0.498, 2.616±0.497 and 2.495±0.518% BW, respectively. Significant differences were noted between 0 and 24 mm lift (p<.001) and 12 and 24 mm lifts (p=.004), but not between the 0 and 12 mm conditions (p=.927). Jump‐landing task‐ No significant differences were found in peak vGRF (p=.192) between any of the heel lift conditions.
Conclusions:
The addition of a 24 mm heel lift to the bottom of a sneaker significantly alters peak vGRF upon landing from a unilateral forward hop but not from a jumping maneuver.
PMCID: PMC3578428  PMID: 23439490
ACL; heel lift; ground reaction force; landing
5.  THE INFLUENCE OF HEEL HEIGHT ON SAGITTAL PLANE KNEE KINEMATICS DURING LANDING TASKS IN RECREATIONALLY ACTIVE AND ATHLETIC COLLEGIATE FEMALES 
Purpose:
To determine if heel height alters sagittal plane knee kinematics when landing from a forward hop or drop landing.
Background:
Knee angles close to extension during landing are theorized to increase ACL injury risk in female athletes.
Methods:
Fifty collegiate females performed two single-limb landing tasks while wearing heel lifts of three different sizes (0, 12 & 24 mm) attached to the bottom of a sneaker. Using an electrogoniometer, sagittal plane kinematics (initial contact [KAIC], peak flexion [KAPeak], and rate of excursion [RE]) were examined. Repeated measures ANOVAs were used to determine the influence of heel height on the dependent measures.
Results:
Forward hop task- KAIC with 0 mm, 12 mm, and 24 mm lifts were 8.88±6.5, 9.38±5.8 and 11.28±7.0, respectively. Significant differences were noted between 0 and 24 mm lift (p<.001) and 12 and 24 mm lifts (p=.003), but not between the 0 and 12 mm conditions (p=.423). KAPeak with 0 mm, 12 mm, and 24 mm lifts were 47.08±10.9, 48.18±10.3 and 48.88±9.7, respectively. A significant difference was noted between 0 and 24 mm lift (p=.004), but not between the 0 and 12 mm or 12 and 24 mm conditions (p=.071 and p=.282, respectively). The RE decreased significantly from 2128/sec±52 with the 12 mm lift to 1958/sec±55 with the 24 mm lift (p=.004). RE did not differ from 0 to 12 or 0 to 24 mm lift conditions (p=.351 and p=.086, respectively). Jump-landing task- No significant differences were found in KAIC (p=.531), KAPeak (p=.741), or the RE (p=.190) between any of the heel lift conditions.
Conclusions:
The addition of a 24 mm heel lift to the bottom of a sneaker significantly alters sagittal plane knee kinematics upon landing from a unilateral forward hop but not from a drop jump.
PMCID: PMC3163998  PMID: 21904697
ACL; heel lift; kinematics; landing
6.  THE RELATIONSHIP BETWEEN LOWER EXTREMITY CLOSED KINETIC CHAIN STRENGTH & SAGITTAL PLANE LANDING KINEMATICS IN FEMALE ATHLETES 
Background:
Female athletes continue to injure their anterior cruciate ligaments at a greater rate than males in comparable sports. During landing activities, females exhibit several different kinematic and kinetic traits when compared to their male counterparts including decreased knee flexion angles as well as decreased lower extremity (LE) strength. While open kinetic chain strength measures have not been related to landing kinematics, given the closer replication of movement patterns that occur during closed kinetic chain (CKC) activity, it is possible that lower extremity strength if measured in this fashion will be related to landing kinematics.
Purpose:
To determine if unilateral isometric CKC lower extremity (LE) strength was related to sagittal plane tibiofemoral kinematics during a single leg landing task in competitive female athletes. We hypothesized females who demonstrated lesser CKC LE strength would exhibit decreased sagittal plane angles during landing.
Methods:
20 competitive female athletes (age = 16.0 ± 1.8 yrs; height = 166.5 ± 8.3 cm; weight = 59.7 ± 10.2 kg) completed CKC LE strength testing followed by 5 unilateral drop landings on the dominant LE during one test session at an outpatient physical therapy clinic. Closed kinetic chain LE strength was measured on a computerized leg press with an integrated load cell while sagittal plane tibiofemoral kinematics were quantified with an electrogoniometer.
Results:
No significant relationships between absolute or normalized isometric CKC strength and sagittal plane landing kinematics were identified.
Conclusions:
Closed kinetic chain lower extremity isometric strength tested at 25 degrees of knee flexion is not related to sagittal plane landing kinematics in adolescent competitive female athletes.
Levels of Evidence: Analytic, Observational
PMCID: PMC3105369  PMID: 21655453
ACL; Closed Kinetic Chain; Female; Kinematics; Strength

Results 1-6 (6)