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176 The rotator cuff functional index
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A c u t e changes in passive stiffness and range of motion post stretching C. Whatman*,A. Knappstein& S. Stanley Auckland UniversityOf Technology
How long an increase in flexibility lasts after a single stretching session is not well documented. The duration of flexibility gain has implications when designing warm-up protocols prior to athletic activity, especially in those activities requiring extreme range of motion (ROM). We investigated the change in passive hamstring stiffness and knee joint ROM following a single bout of passive hamstring stretching with or without active movement post-stretch. Ten asymptomatic subjects participated in the study. Subjects were seated on the Kincom dynamometer and testing involved the dynamometer passively extending the subjects knee joint. Using a safety switch, subjects were instructed to stop the extension when they experienced their "maximum tolerable stretch". Testing involved three trials with average knee joint angle and passive force values recorded. All subjects undertook two interventions. (1) This involved a baseline test, followed by 4 x 20s static stretches of the hamstring muscles and then further testing at 5min intervals for 20min. (2) This involved the same stretching procedure but also included subjects performing active knee flexion and extension between tests over the 20min testing period. Although data is still being collected pre-stretch ROM and/or stiffness will be compared with that immediately after, and 10, 15 and 20 minutes poststretching. Analysis will involve the calculation of a t-statistic from which the probability that any changes in ROM and/or stiffness are practically beneficial, trivial or harmful will be calculated (Hopkins 2002). Hopkins WG (2002). Statistical vs clinical or practical significance [Slideshow]. Sportscience 6, sportsci.orgljoudO2OllStatistical vs clinical.ppt (1507 words)
T h e rotator cuff functional index
176
D. Osbahr & G. Murrell* St George Hospital
Introduction: The objective of this study was to devise and evaluate the utility of a clinical index for predicting rotator cuff tears (RCT) based on handheld dynamometer measurements for shoulder strength testing. Methods: Preoperative handheld dynamometer measurements, including supraspinatus, external rotation, internal rotation, adduction and lift-off were compared in 100 patients with a full-thickness rotator cuff tears greater than 1.0 cm and 100 patients with no rotator cuff pathology (as determined at arthroscopy). Using multiple logistic regression analysis, a rotator cuff functional index (RFI) was formulated. Each patient's RFI was calculated to determine its clinical value in predicting a rotator cuff tear as indicated with a RFI 50. Results: Two handheld dynamometer measurements predicted a rotator cuff tear (p < 0.001; r = 0.53): RFI = 61.6- (1.27 x supraspinatus) + (0.72 x adduction). In predicting a rotator cuff tear, the RFI results had 83% sensitivity, 79% specificity, 80% positive predictive value, 82% negative predictive value, likelihood ratio for a positive test of 3.95, likelihood ratio for a negative test of 0.22, and an accuracy of 81%. Conclusions: The two most useful tests for determining a rotator cuff tear with a handheld dynamometer were power of supraspinatus over power of adduction (as a control). A functional index based on these measurements was able to rule out a rotator cuff tear and predict the presence, but not the size of the tear.
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A c u t e changes in passive stiffness and range of motion post stretching C. Whatman*,A. Knappstein& S. Stanley Auckland UniversityOf Technology
How long an increase in flexibility lasts after a single stretching session is not well documented. The duration of flexibility gain has implications when designing warm-up protocols prior to athletic activity, especially in those activities requiring extreme range of motion (ROM). We investigated the change in passive hamstring stiffness and knee joint ROM following a single bout of passive hamstring stretching with or without active movement post-stretch. Ten asymptomatic subjects participated in the study. Subjects were seated on the Kincom dynamometer and testing involved the dynamometer passively extending the subjects knee joint. Using a safety switch, subjects were instructed to stop the extension when they experienced their "maximum tolerable stretch". Testing involved three trials with average knee joint angle and passive force values recorded. All subjects undertook two interventions. (1) This involved a baseline test, followed by 4 x 20s static stretches of the hamstring muscles and then further testing at 5min intervals for 20min. (2) This involved the same stretching procedure but also included subjects performing active knee flexion and extension between tests over the 20min testing period. Although data is still being collected pre-stretch ROM and/or stiffness will be compared with that immediately after, and 10, 15 and 20 minutes poststretching. Analysis will involve the calculation of a t-statistic from which the probability that any changes in ROM and/or stiffness are practically beneficial, trivial or harmful will be calculated (Hopkins 2002). Hopkins WG (2002). Statistical vs clinical or practical significance [Slideshow]. Sportscience 6, sportsci.orgljoudO2OllStatistical vs clinical.ppt (1507 words)
T h e rotator cuff functional index
176
D. Osbahr & G. Murrell* St George Hospital
Introduction: The objective of this study was to devise and evaluate the utility of a clinical index for predicting rotator cuff tears (RCT) based on handheld dynamometer measurements for shoulder strength testing. Methods: Preoperative handheld dynamometer measurements, including supraspinatus, external rotation, internal rotation, adduction and lift-off were compared in 100 patients with a full-thickness rotator cuff tears greater than 1.0 cm and 100 patients with no rotator cuff pathology (as determined at arthroscopy). Using multiple logistic regression analysis, a rotator cuff functional index (RFI) was formulated. Each patient's RFI was calculated to determine its clinical value in predicting a rotator cuff tear as indicated with a RFI 50. Results: Two handheld dynamometer measurements predicted a rotator cuff tear (p < 0.001; r = 0.53): RFI = 61.6- (1.27 x supraspinatus) + (0.72 x adduction). In predicting a rotator cuff tear, the RFI results had 83% sensitivity, 79% specificity, 80% positive predictive value, 82% negative predictive value, likelihood ratio for a positive test of 3.95, likelihood ratio for a negative test of 0.22, and an accuracy of 81%. Conclusions: The two most useful tests for determining a rotator cuff tear with a handheld dynamometer were power of supraspinatus over power of adduction (as a control). A functional index based on these measurements was able to rule out a rotator cuff tear and predict the presence, but not the size of the tear.
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