Case 15
Edward Schwarz, Tomos Richards in Cases of a Hollywood Doctor, 2019
Your next patient in your busy GP morning clinic arrives. He introduces himself as Hercules and you are immediately impressed with his size and stature. He reports some heavy lifting over the past few months. Yesterday, this 25 year old lifted a large boulder and developed severe pain in his back. He denies any bladder or bowel disturbances. A full neurological examination is performed, which is normal, and he has some pain on straight leg raise.
The relationship between the functional movement screen, star excursion balance test and the Beighton score in dancers
Published in The Physician and Sportsmedicine, 2020
Objectives: To determine the association between the Functional Movement Screen (FMS), Star Excursion Balance Test (SEBT) and the Beighton Score (BS) in dancers with implications for performance and injury. Methods: The study was of cross-sectional design and included 47 female university dancers (age: 20.4 ± 0.7 years, height: 160.5 ± 5.8 cm; mass: 55.6 ± 4.8 kg). Participants completed the FMS and the anterior, posteromedial and posterolateral reach components of the SEBT and hypermobility was assessed via the BS. Results: A fair significant correlation existed between FMS composite and total BS (r = 0.37, p = 0.01). For individual elements of the screening tools, there were 24 significant correlations between the FMS and the BS, 11 significant correlations between the FMS and SEBT and 4 significant correlations between the SEBT and BS. Conclusion: The FMS and the BS correlations highlighted the importance of the deep squat in functional movement and the relationship between FMS mobility elements and the BS. The significant correlation between the FMS and the BS may suggest that they capture similar information. The active straight leg raise and shoulder mobility measurements should be considered key elements to measure during screening.
Effects of Ankle Dorsiflexion on Vastus Medialis Oblique and Vastus Lateralis Muscle Activity During Straight Leg Raise Exercise with Hip External Rotation in Patellofemoral Pain Syndrome
Published in Journal of Musculoskeletal Pain, 2014
Sil-Ah Choi, Heon-Seock Cynn, Tae-Lim Yoon, Woo-Jeong Choi, Ji-Hyun Lee
Objectives: The purpose of this study was to investigate the effect of combined ankle dorsiflexion [DF] and straight leg raise with hip external rotation [SLRER] on the vastus medialis oblique [VMO] and vastus lateralis [VL] muscle activity and VMO/VL ratio in subjects with patellofemoral pain syndrome [PFPS] and healthy normal control [HNC] subjects. Methods: Twenty-six subjects [13 in the PFPS group and 13 in the HNC group] were recruited and all subjects performed two exercises; SLRER and SLRER with DF [SLRERDF]. Surface electromyography was used to collect data of the VMO and VL muscle activity. A two-way mixed analysis of variance was used to determine the statistical significance of VMO and VL muscle activity and VMO/VL ratio. Results: The VMO muscle activity during SLRERDF was significantly greater than SLRER in both groups and the VL muscle activity during SLRERDF was significantly greater than SLRER in both groups. For the VMO/VL ratio, there were no significant main effect of group and exercise. Conclusions: Although the findings of this study did not demonstrate that SLRERDF is effective for targeting the VMO over VL muscle activity in the PFPS group, SLRERDF could be recommended as activation strategy for subjects with the general quadriceps weakness.
Ultrasound measurement of abdominal muscles during clinical isometric endurance tests in women with and without low back pain
Published in Physiotherapy Theory and Practice, 2019
Shabnam ShahAli, Amir Massoud Arab, Esmaeil Ebrahimi, Shiva ShahAli, Nahid Rahmani, Hossein Negahban, Anoshirvan Kazemnejad, Andia Bahmani
Purpose: The present study investigated group differences between the thickness changes of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles, during performance of the isometric supine chest raise and the supine double leg-straight leg raise tests in women with and without low back pain (LBP). Method: Twenty women with LBP and 20 women without LBP participated in this case-control study. The thickness of the right TrA, IO, and EO muscles was measured using B-mode ultrasound (US) at rest, immediately at the beginning of performing the tests and when participants in both groups self-reported fatigue. The percentage of change in thickness of the abdominal muscles from rest to the initiation and fatigue stages of both tests was measured. Results: The results indicate a statistically significant difference in the pattern of changes in deep (TrA) and superficial (EO) abdominal muscles thickness at the fatigue stage of the supine double straight-leg raise (SDSLR) test between groups (P 0.05). Conclusions: An altered activation pattern in the deep (TrA) and superficial (EO) muscles of LBP participants during fatigue stage of the SDSLR test as compared to controls indicates motor control dysfunction in the LBP group. Comparison of the activity of TrA and EO muscles during fatigue stage of SDSLR test can be used to assess alterations in motor control of abdominal muscles.
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