bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patellar Kinematics, Part I: The Influence of Vastus Muscle Activity in Subjects With and Without Patellofemoral Pain
Authors: Powers Christopher M 
Published: February 2017

Abstract
Background and Purpose. Reduced motor unit activity of the vastus medialis muscle relative to the vastus lateralis muscle has been implicated as a cause of lateral patellar subluxation. The purpose of this study was to assess the influence of vastus muscle motor unit activity on patellar kinematics. Subjects. Twenty-three women (mean age=26.8 years, SD=8.5, range=14–46) with a diagnosis of patellofemoral pain and 12 women (mean age=29.1 years, SD=5.0, range=24–38) without patellofemoral pain participated. Only female subjects were studied because of potential biomechanical differences between sexes. Methods. Patellar kinematics (kinematic magnetic resonance imaging) and vastus muscle electromyographic (EMG) activity using indwelling electrodes were measured during resisted knee extension. Measurements of medial and lateral patellar displacement and tilt obtained from magnetic resonance images were correlated with normalized vastus lateralis:vastus medialis oblique muscle and vastus lateralis:vastus medialis longus muscle EMG ratios at 45, 36, 27, 18, 9, and 0 degrees of knee flexion using a stepwise regression procedure. Results. The vastus lateralis:vastus medialis longus muscle EMG ratio contributed to the prediction of lateral patellar displacement at 27 degrees of knee flexion (r=−.48), with increased vastus medialis longus muscle activity being associated with greater lateral patellar displacement. A similar inverse relationship was evident with lateral patellar tilt at 36, 27, 18, and 9 degrees of knee flexion. Conclusion and Discussion. These results suggest that increased motor unit activity of the vastus medialis muscle appears to be associated with abnormal patellar kinematics in women, but it is not necessarily a cause of abnormal patellar kinematics.
Validation of a Model of Gross Motor Function for Children With Cerebral Palsy
Authors: Palisano Robert J , Hanna Steven E , Rosenbaum Peter L , Russell Dianne J , Walter Stephen D , Wood Ellen P , Raina Parminder S , Galuppi Barbara E 
Published: February 2017

AbstractBackground and Purpose. Development of gross motor function in children with cerebral palsy (CP) has not been documented. The purposes of this study were to examine a model of gross motor function in children with CP and to apply the model to construct gross motor function curves for each of the 5 levels of the Gross Motor Function Classification System (GMFCS). Subjects. A stratified sample of 586 children with CP, 1 to 12 years of age, who reside in Ontario, Canada, and are known to rehabilitation centers participated. Methods. Subjects were classified using the GMFCS, and gross motor function was measured with the Gross Motor Function Measure (GMFM). Four models were examined to construct curves that described the nonlinear relationship between age and gross motor function. Results. The model in which both the limit parameter (maximum GMFM score) and the rate parameter (rate at which the maximum GMFM score is approached) vary for each GMFCS level explained 83% of the variation in GMFM scores. The predicted maximum GMFM scores differed among the 5 curves (level I=96.8, level II=89.3, level III=61.3, level IV=36.1, and level V=12.9). The rate at which children at level II approached their maximum GMFM score was slower than the rates for levels I and III. The correlation between GMFCS levels and GMFM scores was −.91. Logistic regression, used to estimate the probability that children with CP are able to achieve gross motor milestones based on their GMFM total scores, suggests that distinctions between GMFCS levels are clinically meaningful. Conclusion and Discussion. Classification of children with CP based on functional abilities and limitations is predictive of gross motor function, whereas age alone is a poor predictor. Evaluation of gross motor function of children with CP by comparison with children of the same age and GMFCS level has implications for decision making and interpretation of intervention outcomes.
The Effects of Intense Physical Exercise on Secondary Antibody Response in Young and Old Mice
Authors: Kapasi Zoher F , Catlin Pamela A , Joyner Dexter R , Lewis Michelle L , Schwartz Ann L , Townsend Elise L 
Published: February 2017

Abstract
Background and Purpose. Based largely on data from young subjects, intense physical exercise is believed to suppress immune function. In addition, immune function, including secondary antibody response, declines with advancing age. Therefore, intense exercise in old subjects may further suppress the secondary antibody response. The purpose of this in vivo study was to investigate the effects of intense physical exercise on secondary antibody response in young (6–8 weeks) and old (22–24 months) C57BL/6 mice. Subjects and Methods. Data were obtained from 22 young and 18 old C57BL/6 mice that were immunized to human serum albumin (HSA) and randomly divided into 3 groups. Two groups were exposed to a single bout of intense exercise to exhaustion and immediately boosted with an injection of HSA. The first group did not exercise further, but the second group continued with daily bouts of intense exercise to exhaustion for 9 days. The third group (control group) did not undergo intense exercise, but received the booster injection of HSA at the same time as the other groups. Ten days after the HSA booster injection, when high level of antibodies are produced in secondary antibody response, serum anti-HSA antibodies were measured by enzyme-linked immunosorbent assay. Results. Young mice did not show suppression of secondary antibody response following intense exercise. However, old mice, exposed to a single bout of intense exercise, had an enhanced response similar to the response seen in young control mice. Conclusion and Discussion. The widely accepted hypothesis of immunosuppression resulting from intense exercise may not be true for old mice.
A Time to Harvest, a Time to Sow: Ethics for a Shifting Landscape
Authors: Purtilo Ruth B 
Published: February 2017

Abstract
Ruth B Purtilo, known to many physical therapist students and clinicians through her numerous publications in the area of ethics, has influenced the delivery of health care nationally and internationally. Throughout her long career, she has educated us about the moral issues and courses of direction that guide us in our daily lives as health care professionals.
Dr Purtilo has been a visiting professor or named lecturer to more than 30 different colleges and universities worldwide. Her publications, primarily on ethics in health care, include 8 books and more than 70 articles and chapters.
In addition to being involved in APTA, Dr Purtilo has served as President of the American Society of Law, Medicine, and Ethics and was a founding member of the Society of Bioethics Consultation. She is a member of many other professional organizations, including the American Association of Bioethics, the American Philosophical Association, the Society for Health and Human Values, and the World Confederation for Physical Therapy.
Dr Purtilo has been recognized by APTA as a recipient of the Golden Pen Award, the Helen Hislop Award for Outstanding Contributions to Professional Literature, and a Catherine Worthingham Fellowship.
Turning Difficulty Characteristics of Adults Aged 65 Years or Older
Authors: Thigpen Mary T , Light Kathye E , Creel Gwenda L , Flynn Sheryl M 
Published: February 2017

Abstract
Background and Purpose. Falls that occur while walking have been associated with an increased risk of hip fracture in elderly people. This study's purpose was to describe movement characteristics in older adults that serve as indicators of difficulty in turning while walking. Subjects. Three groups were assessed: young adults who had no difficulty in turning (age range=20–30 years, n=20) (YNDT group), elderly adults who had no difficulty in turning (age range=65–87 years, n=15) (ENDT group), and elderly adults who had difficulty in turning (age range=69–92 years, n=15) (EDT group). Methods. All subjects were videotaped performing a self-paced 180-degree turn during the Timed “Up & Go” Test. Movement characteristics of each group were identified. Four characteristics were used to identify difficulty in turning: (1) the type of turn, (2) the number of steps taken during the turn, (3) the time taken to accomplish the turn, and (4) staggering during the turn. Results. In general, the EDT group took more steps during the turn and more time to accomplish the turn than the YNDT and ENDT groups did. Although the only turning strategy used by the YNDT group was a pivot type of turn, there was an almost total absence of a pivot type of turn in the EDT group. No differences were found among the groups on the staggering item, yet the EDT group was the only group in which staggering was present. We believe these changes observed in the 4 characteristics only in the EDT group are indicators of difficulty in turning while walking. Conclusion and Discussion. These indicators of difficulty may be useful for the early identification of individuals aged 65 years or older who are having difficulty in turning and may well serve as the basis for the development of a scale for difficulty in turning in older adults. Preliminary findings indicate the need for further study into the reliability, validity, and sensitivity of measurements obtained with such a scale.
End-Range Mobilization Techniques in Adhesive Capsulitis of the Shoulder Joint: A Multiple-Subject Case Report
Authors: Vermeulen Henricus M , Obermann Wim R , Burger Bart J , Kok Gea J , Rozing Piet M , van den Ende Cornelia HM 
Published: February 2017

AbstractBackground and Purpose. The purpose of this case report is to describe the use of end-range mobilization techniques in the management of patients with adhesive capsulitis. Case Description. Four men and 3 women (mean age=50.2 years, SD=6.0, range=41–65) with adhesive capsulitis of the glenohumeral joint (mean disease duration=8.4 months, SD=3.3, range= 3–12) were treated with end-range mobilization techniques, twice a week for 3 months. Indexes of pain, joint mobility, and function were measured by the same observer before treatment, after 3 months of treatment, and at the time of a 9-month follow-up. In addition, arthrographic assessment of joint capacity (ie, the amount of fluid the joint can contain) and measurement of range of motion of glenohumeral abduction on a plain radiograph were conducted initially and after 3 months of treatment. Outcomes. After 3 months of treatment, there were increases in active range of motion. Mean abduction increased from 91 degrees (SD=16, range=70–120) to 151 degrees (SD=22, range=110–170), mean flexion in the sagittal plane increased from 113 degrees (SD=17, range=90–145) to 147 degrees (SD=18, range=115–175), and mean lateral rotation increased from 13 degrees (SD=13, range=0–40) to 31 degrees (SD=11, range=15–50). There were also increases in passive range of motion: Mean abduction increased from 96 degrees (SD=18, range=70–125) to 159 degrees (SD=24, range 110–180), mean flexion in the sagittal plane increased from 120 degrees (SD=16, range=95–145) to 154 degrees (SD=19, range=120–180), and mean lateral rotation increased from 21 degrees (SD=11, range=10–45) to 41 degrees (SD=8, range=35–55). The mean capacity of the glenohumeral joint capsule (its ability to contain fluid) increased from 10 cc (SD=3, range=6–15) to 15 cc (SD=3, range=10–20). Four patients rated their improvement in shoulder function as excellent, 2 patients rated it as good, and 1 patient rated it as moderate. All patients maintained their gain in joint mobility at the 9-month follow-up. Discussion. There seems to be a role for intensive mobilization techniques in the treatment of adhesive capsulitis. Controlled studies regarding the effectiveness of end-range mobilization techniques in the treatment of adhesive capsulitis are warranted.
The Efficacy of Perturbation Training in Nonoperative Anterior Cruciate Ligament Rehabilitation Programs for Physically Active Individuals
Authors: Fitzgerald G Kelley , Axe Michael J , Snyder-Mackler Lynn 
Published: February 2017

AbstractBackground and Purpose. Treatment techniques involving perturbations of support surfaces may induce compensatory muscle activity that could improve knee stability and increase the likelihood of returning patients to high-level physical activity. The purpose of this study was to determine the efficacy of augmenting standard nonoperative anterior cruciate ligament (ACL) rehabilitation programs with a perturbation training program. Subjects. Twenty-six patients with an acute ACL injury or ruptures of ACL grafts participated in the study. Subjects had to have a unilateral ACL injury, be free of concomitant multiple ligament or meniscal damage requiring surgical repair, and pass a screening examination designed to identify patients who had the potential to return to high-level physical activity with nonoperative treatments. Subjects also had to be regular participants in level I activities (eg, soccer, football, basketball) or level II activities (eg, racquet sports, skiing, construction work). Methods. Subjects were randomly assigned to either a group that received a standard rehabilitation program (standard group) or a group that received the standard program augmented with a perturbation training program (perturbation group). Treatment outcome was determined from scores on the Knee Outcome Survey's Activities of Daily Living Scale (ADLS) and Sports Activity Scale, a global rating of knee function, scores on a series of single-limb hop tests, measurements of maximum isometric quadriceps femoris muscle force output, and the group frequency of unsuccessful rehabilitation. Unsuccessful rehabilitation was defined as the occurrence of an episode of giving way of the knee or failure to maintain the functional status of a rehabilitation candidate on retesting. Results. More subjects had unsuccessful rehabilitation in the standard group compared with the perturbation group. There was a within-group × time interaction for the ADLS, global rating of knee function, and crossover hop test scores. These scores decreased from posttraining to the 6-month follow-up for the standard group. Conclusion and Discussion. Although both the standard program and the perturbation training program may allow subjects to return to high-level physical activity, the perturbation training program appears to reduce the risk of continued episodes of giving way of the knee during athletic participation, and it allows subjects to maintain their functional status for longer periods.
Effects of Attentional Focus, Self-Control, and Dyad Training on Motor Learning: Implications for Physical Rehabilitation
Authors: McNevin Nancy H , Wulf Gabriele , Carlson Christine 
Published: February 2017

Abstract
In this article, the authors review recent studies on 3 factors that have been shown to affect the learning of motor skills—the performer's attentional focus, self-control, and practice in dyads—and discuss their implications for rehabilitation. Research has shown that directing learners' attention to the effects of their movements can be more beneficial for learning than directing their attention to the details of their own actions. Furthermore, giving learners some control over the training regimen has been found to enhance learning, unlike prescriptive training protocols that dictate when feedback will be delivered, how often, and the order that tasks will be practiced. Finally, not only can practice in dyads (or larger groups) reduce the costs of training, but it can also result in more effective learning than individual practice sessions. The incorporation of these factors into rehabilitation practice can potentially enhance the effectiveness and efficiency of rehabilitation.
Examination and Treatment of a Patient With Hypermobility Syndrome
Authors: Russek Leslie N 
Published: February 2017

AbstractBackground and Purpose. The purpose of this case report is to present the examination, evaluation/diagnosis/prognosis, intervention, and outcome of a patient with hypermobility syndrome (HMS). Hypermobility syndrome has been widely recognized in the rheumatology literature, but it has seldom been discussed in the orthopedic literature and has only recently been described in the physical therapy literature. The signs and symptoms of HMS are common among patients seen in orthopedic physical therapy clinics; however, the HMS may be overlooked while treating individual joints or tissues causing pain. Case Description. The patient was a 28-year-old woman with complaints of chronic, multiple-joint pain. After years without a diagnosis, a rheumatologist had recently diagnosed her as having HMS. Outcomes. Following intervention that emphasized patient education and activity modification, the patient's complaints decreased. Discussion. Recognition of HMS underlying common orthopedic problems may facilitate appropriate patient education and management.
Effectiveness of Wound Care Products in the Transmission of Acoustic Energy
Authors: Klucinec Brian , Scheidler Matthias , Denegar Craig , Domholdt Elizabeth , Burgess Sharon 
Published: February 2017

Abstract
Background and Purpose. Ultrasound is often recommended in the treatment of people with partial and full-thickness wounds. Many treatments are performed over a hydrogel sheet or semipermeable film dressing. The purpose of this in vitro study was to examine the effectiveness of 4 hydrogels (Nu-Gel, ClearSite, Aquasorb Border, and CarraDres) and 4 film dressings (CarraSmart Film, J&J Bioclusive, Tegaderm, and Opsite Flexigrid) in ultrasound transmission. Methods. The amount of sound energy transmitted through each product and interposed pig tissue was measured using an oscilloscope to display the intensity of sound energy delivered by the transducer. Five intensities at a frequency of 3.3 MHz were studied. Results. Results were expressed as the mean (±SD) percentage of voltage transmitted compared with a gel baseline. Nu-Gel was the most efficient hydrogel (77.2%±4.6%), followed by ClearSite (72.0%±2.2%), Aquasorb Border (45.3%±2.1%), and CarraDres (42.8%±5.9%). The 4 film dressings, in order of efficiency, were CarraSmart Film (60.5%±4.4%), J&J Bioclusive (53.2%±2.4%), Tegaderm (47.1%±2.3%), and Opsite Flexi-grid (31.5%±4.0%). Conclusion and Discussion. Transmissivity of wound care products used to deliver acoustic energy during ultrasound treatment of wounds varies greatly among dressing products. We believe that clinicians can use our findings as a part of the clinical reasoning process that they use to select an optimal wound dressing.
Spinal Cord Control of Movement: Implications for Locomotor Rehabilitation Following Spinal Cord Injury
Authors: Field-Fote Edelle Carmen 
Published: February 2017

Abstract
In recent years, our understanding of the spinal cord's role in movement control has been greatly advanced. Research suggests that body weight support (BWS) walking and functional electrical stimulation (FES), techniques that are used by physical therapists, have potential to improve walking function in individuals with spinal cord injury (SCI), perhaps long after the stage of spontaneous recovery. Walking is one of the most desired goals of people with SCI; however, we are obligated to be judicious in our claims of locomotor recovery. There are few controlled studies that compare outcomes of BWS training or FES with those of conventional interventions, and access to services using BWS training or FES may be restricted under managed care.
Effects of Squat Lift Training and Free Weight Muscle Training on Maximum Lifting Load and Isokinetic Peak Torque of Young Adults Without Impairments
Authors: Yeung Simon SM , Ng Gabriel YF 
Published: February 2017

Abstract
Background and Purpose. Manual lifting is a frequent cause of back injury, and there is no evidence as to which training mode can provide the best training effect for lifting performance and muscle force. The purpose of this study was to examine the effects of a squat lift training and a free weight muscle training program on the maximum lifting load and isokinetic peak torque in subjects without known neuro-muscular or musculoskeletal impairments. Subjects. Thirty-six adults (20 male, 16 female) without known neuromuscular or musculoskeletal impairments participated. The subjects' mean age was 21.25 years (SD=1.16, range=20–24). Methods. Subjects were divided into 3 groups. Subjects in group 1 (n=12) performed squat lift training. Subjects in group 2 (n=12) participated in free weight resistance training of their shoulder abductors, elbow flexors, knee extensors and trunk extensors. Subjects in group 3 (n=12) served as controls. The maximum lifting load and isokinetic peak torques of the trunk extensors, knee extensors, elbow flexors, and shoulder abductors of each subject were measured before and after the study. Training was conducted on alternate days for 4 weeks, with an initial load of 80% of each subject's maximum capacity and with the load increased by 5% weekly. Results. All groups were comparable for all measured variables before the study. After 4 weeks, subjects in groups 1 and 2 demonstrated more improvement in maximum lifting load and isokinetic peak torque of the back extensors compared with the subjects in group 3, but the 2 training groups were not different. Conclusion and Discussion. The findings demonstrate that both squat lift and free weight resistance training are equally effective in improving the lifting load and isokinetic back extension performance of individuals without impairments.
A Multivariate Model of Determinants of Motor Change for Children With Cerebral Palsy
Authors: Bartlett Doreen J , Palisano Robert J 
Published: February 2017

AbstractThe purpose of this article is to describe the development of a theory-and data-based model of determinants of motor change for children with cerebral palsy. The dimensions of human functioning proposed by the World Health Organization, general systems theory, theories of human ecology, and a philosophical approach incorporating family-centered care provide the conceptual framework for the model. The model focuses on relationships among child characteristics (eg, primary and secondary impairments, personality), family ecology (eg, dynamics of family function), and health care services (eg, availability, access, intervention options). Clarification of the complex multivariate and interactive relationships among the multiple child and family determinants, using statistical methods such as structural equation modeling, is necessary before determining how physical therapy intervention can optimize motor outcomes of children with cerebral palsy. We propose that the development and testing of multivariate models is also useful in physical therapy research and in the management of complex chronic conditions other than cerebral palsy. Testing of similar models could provide physical therapists with support for: (1) prognostic discussions with clients and their families, (2) establishment of realistic and attainable goals, and (3) interventions to enhance outcomes for individual clients with a variety of prognostic attributes.