The role rehabilitation plays in the management of patients with lateral epicondylalgia (LE) remains elusive secondary to high recurrence rates. Addressing scapular muscle deficits may be important in the rehabilitation of patients with LE. However, it is unknown if scapular muscle impairments exist in a working population of patients with LE. The purpose of this dissertation was to assess scapular muscle strength and endurance in a working population of patients with LE. Clinical scapular muscle assessment tools are limited in their ability to isolate specific muscles. Rehabilitative ultrasound imaging (RUSI) is a potentially useful tool but few studies have investigated its utility. Absolute muscle thickness measurements were obtained on healthy individuals for the lower trapezius (LT) and serratus anterior (SA) under three conditions (arm at rest, arm elevated with a low load, arm elevated with a high load). For both the LT and SA, a significant distinction could be made in muscle thickness between rest and a loaded condition but not between the two load conditions. Furthermore, excellent reliability was demonstrated for both muscles. It is unknown whether arm dominance plays a role in scapular muscle assessments. Therefore, healthy individuals between the ages of 30 and 65 were recruited to compare the effect of arm dominance on scapular muscle strength, endurance, and change in thickness measured by RUSI. Results indicate that arm dominance does significantly affect some measures of scapular muscle strength and endurance. However, the differences between the dominant and non-dominant limbs were not beyond measurement error. Scapular muscle strength, endurance, and change in muscle thickness of the LT and SA were assessed in 28 patients presenting with signs and symptoms consistent with LE. LT strength, SA strength, middle trapezius strength, endurance, and change in SA thickness were significantly less in patients with LE compared to matched controls. SA and LT strength were significantly less in the involved limb compared to the uninvolved limb in patients with LE. The results suggest that assessing scapular muscle endurance as well as LT and SA strength is indicated when evaluating patients with LE, and the results should be compared to normative data.

The purpose of this study was to examine the influence of self-motivation and several non-psychological variables on injured athletes' adherence to rehabilitation. Twenty-five (17 male, 8 female) injured intercollegiate athletes from several sports (football, gymnastics, diving, swimming, volleyball, cross country/track, baseball, and tennis) participated. After injured athletes reported to the training room for treatment, they were informed of the study by the head athletic trainers. Athletes agreeing to participate were required to complete an injury information form and the Self-Motivation Inventory. The head athletic trainers recorded injury information, attendance to rehabilitation, and made judgments regarding each athletes' adherence to rehabilitation.Adherence was measured four different ways (i.e., attendance rates, trainer judgments, trainer rankings, and a combination of the previous three to create an overall adherence measure). The results of this study are inconclusive, due to the fact that the different adherence measures did not agree for each independent measure. The results, however, suggest that self-motivation and certain non-psychological variables (i.e., academic class, scholarship status, and injury severity) may serve as predictors of injured athletes' adherence to rehabilitation. / Department of Counseling Psychology and Guidance Services

Background: Altered muscular function of the deep abdominal and back muscles has been implicated as a factor in the development and continuation of low back pain (LBP) and small-scale studies, on specific subgroups of LBP patients, have reported favourable outcomes when these dysfunctions are addressed using specific exercise training. However, these techniques are increasingly being incorporated into treatment packages for non-specific LBP in the UK despite little evidence of their effectiveness in this patient group. A multi-centered, pragmatic, randomized clinical trial, with 12-month follow-up, was therefore designed to investigate the effectiveness of incorporating specific spinal stabilisation exercises within a physiotherapy treatment package in the management of recurrent LBP patients. Methods: Following ethical approval, consenting patients with recurrent LBP, without significant levels of distress (as measured by the distress risk assessment method {DRAM}), were randomized to two groups; 'conventional' physiotherapy and the provision of an advice booklet (Cl) and 'conventional' physiotherapy, the provision of an advice booklet with the addition of specific spinal stabilisation exercises (SSSE). Randomisation was stratified for laterality, duration of symptoms and initial functional disability level {Roland Morris Disability Questionnaire—RMDQ} using a minimization procedure. Functional disability (RMDQ) was the main outcome, and generic, disease-specific and psychological measures were also collected. The trial was powered to detect a 5-point difference between groups using 90% power. A total of 221 patients were screened for entry into the trial and 97 were recruited from three metropolitan physiotherapy departments within the UK between May 1999 and September 2000. Results: All patients were between the ages of 19 and 60 years (mean 38.6, SD: 10.5) and had an average duration of symptoms of 8.7 (8.1) months. Over 30% of the patients screened for entry to the trial were excluded as they showed evidence of psychological distress. Both groups demonstrated improved functioning, reduced pain intensity and an improvement in the physical component of quality of life. Mean change (95% Cl) for RMDQ scores between baseline to 12-month follow-up were —4.5 (-6.2 to —3.6) for the SSSE group and -5.2 (-6.7 to —3.6) for the CT group. No statistically significant differences between the two groups were demonstrated for any of the outcome variables. Patients in the spinal stabilisation group received a slightly greater mean number of treatment sessions over a longer period than the conventional physiotherapy treatment group (7.5 (2.5) over 11 weeks compared to 5.9 (2.3) over 8 weeks respectively). Exploration of the content of each treatment package revealed a combination of treatments was used, most frequently active exercise and manual therapy, with little use of electrotherapy or mechanical lumbar traction. Discussion and Conclusion: This trial represents the largest to date investigating the effects of specific spinal stabilisation exercises, and the first examining their use in a recurrent LBP population. Results indicate that physiotherapy is effective in reducing functional disability and to a lesser extent pain intensity, with improvements maintained at one year following completion of treatment, but that the addition of spinal stabilisation exercises to conventional physiotherapy and an advice booklet, does not provide any obvious additional benefit in terms of functional disability or pain intensity. These findings are of importance as they support the ongoing use of physiotherapy treatment packages in the management of recurrent LBP patients, without significant levels of distress, but challenge the assumption that stabilisation training provides an additional benefit in this particular group of LBP patients.

Tyrimo tikslas – įvertinti kineziterapijos poveikį sergančiųjų depresija psichoemocinei būsenai ir funkcinei būklei. Tyrimo uždaviniai: 1. Įvertinti kineziterapijos poveikį pacientų, sergančių depresija, funkcinei būklei; 2. Įvertinti kineziterapijos poveikį subjektyviam ligonių būklės vertinimui; 3. Įvertinti kineziterapijos poveikį pacientų, sergančių depresija, psichoemocinei būklei. Tyrimo kontingentas: tiriamąją grupę sudarė 24 pacientai kuriems taikyta kineziterapija, kontrolinę grupę - 23 pacientai, gydyti VšĮ Kauno ligoninės padalinio Marių ligoninės depresijų skyriuje. Visiems pacientams buvo diagnozuota klasikinė depresija. Abiejose grupėse buvo vertinta pacientų funkcinė būklė, depresijos sunkumas pagal Hamiltono depresijos skalę; tiriamoji grupė užpildė klausimyną, skirtą jų psichoemocinei būklei vertinti. Tiriamosios grupės pacientams taikyta kineziterapijos programa, susidedanti iš bendrojo lavinimo, atsipalaidavimo pratimų, judriųjų žaidimų ir pratimų, stiprinančių nugaros raumenis. Darbo išvados: 1. Kineziterapija neturėjo įtakos pacientų funkcinės būklės pokyčiams: ŠSD ir AKS pokyčiai nebuvo statistiškai reikšmingi (p>0,05). 2. Kineziterapija turėjo įtakos ligonių subjektyviam būklės vertinimui: pagerėjo miegas, bendravimas, vidinė būsena, fizinė būklė padidėjo noras žiūrėti televizorių. 3. Tiriamosios ir kontrolinės grupių pacientų depresijos sunkumo lygis sumažėjo ir statistiškai reikšmingai tarpusavyje nesiskyrė (p>0,05), t.y. kineziterapija... [toliau žr. visą tekstą] / The aim of the research is to assess the effect of physical therapy on the psycho-emotional state and functional status in persons with depression. Research objectives: 1. to evaluate the effect of physical therapy on the functional status in patients with depression; 2. to evaluate the effect of physical therapy on the subjective assessment of the patients' condition; 3. to evaluate the effect of physical therapy on psycho-emotional state in patients with depression. Research subjects: the research group and the control group included 24 and 23 patients, respectively. All patients were diagnosed with classical depression and they received treatment at the Depression Division of Mariu Hospital, a subdivision of Public Institution Kaunas Hospital. In both groups, the functional status of the patients was assessed and the level of depression was determined using the Hamilton Depression Rating Scale (HAM-D). Furthermore, the research group completed a questionnaire designed to assess their psycho-emotional state. The patients of the research group were enrolled on a physical therapy programme consisting of general training, loosening exercises, and mobile games/exercises to stabilize the spinal muscles. Conclusions: 1. Physical therapy had no impact on changes in the patients' functional status: the changes in the heart rate and arterial blood pressure were not statistically significant (p>0,05). 2. Physical therapy affected the subjective assessment of the patients' condition:... [to full text]

Darbo tikslas: įvertinti pilvo giliųjų ir paviršinių raumenų elektrinį aktyvumą atliekant uždaros ir atviros kinetinės grandinės pratimus. Uždaviniai: 1. Įvertinti pilvo giliųjų ir paviršinių raumenų elektrinį aktyvumą atliekant pratimus ant stabilios atramos. 2. Įvertinti pilvo giliųjų ir paviršinių raumenų elektrinį aktyvumą atliekant pratimus ant nestabilios atramos. 3. Įvertinti pilvo giliųjų ir paviršinių raumenų elektrinį aktyvumą atliekant atviros kinetinės grandinės pratimus. 4. Įvertinti pilvo giliųjų ir paviršinių raumenų elektrinį aktyvumą atliekant uždaros kinetinės grandinės pratimus. 5. Įvertinti skirtingų, pilvo raumenims lavinti skirtų pratimų atlikimo metu gautą pilvo giliųjų ir paviršinių raumenų elektrinį aktyvumą. Tyrimo metodai: Tyrime dalyvavo 20 darbingo amžiaus vyrų, per tris mėnesius neturėjusių nusiskundimų dėl apatinės nugaros dalies skausmo. Tyrimo pradžioje tiriamajam buvo duodama 15 minučių apšilimo programa, po kurios sekė 8 testuojant naudotų pratimų atlikimas. Ant tiriamojo priklijuotais paviršiniais elektrodais, elektromiografu Myotrace 400 buvo registruojamas ir užrašomas raumenų elektrinis aktyvumas. Išvados: 1. Didžiausias raumenų elektrinis aktyvumas buvo atliekant liemens lenkimą kulnais spaudžiant dėžutę sėdmenų link ant stabilios atramos (p<0,05). Didžiausias santykinis giliųjų-paviršinių pilvo raumenų aktyvumas buvo atliekant liemens lenkimo atremtyje ant delnų ir kelių pratimą. 2. Atliekant pratimus ant nestabilios atramos... [toliau žr. visą tekstą] / The aim: to assess deep and superficial abdominal muscles electrical activity during open and closed kinetic chain exercises. Objectives: 1. To evaluate the surface and deep abdominal muscle electrical activity during exercise on a stable support. 2. To evaluate the surface and deep abdominal muscle electrical activity during the exercises on unstable supports. 3. To evaluate the surface and deep abdominal muscle electrical activity during a open kinetic chain exercises. 4. To evaluate the surface and deep abdominal muscle electrical activity during closed kinetic chain exercises. 5. To evaluate the surface and deep abdominal muscle electrical activity in variation of the abdominal exercises. Research metods: A total of 20 working-age men during the three months had no complaints of lower back pain. In the beginning of study the research was given 15 minutes to warm-up program, which was followed by eight testing exercises performance. Electromyograph Myotrace 400 has been registered and recorded muscles electrical activity by glued onto the skin surface electrodes. Conclusions: 1. The maximum muscle electrical activity was during trunk flexion with pressing the box by the heels toward the buttocks on the stable surface (p<0,05). The highest ratio of surface-deep abdominal muscle activity was during trunk flexion facing on the palms and knees. 2. During the exercises on unstable surface the highest muscle electrical activity was in trunk flexion exercise with pressing the... [to full text]

Thesis (MAppSc in Physiotherapy)--University of South Australia, 1996

Thesis (MScFisio)--University of Stellenbosch, 2006. / Bibliography. Also available via the Internet.

Thesis (Ph. D.)--University of Toronto, 2004. / Adviser: Joel Weiss.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.