PURPOSE: The Functional Movement Screen™ (FMS) has been touted as an easily administered 7-test battery that predicts risk of injury in non-specified athletic populations. A cut score of 14 on the 21 point instrument has been cited as a predictor of basic movement pattern dysfunction and related risk of injury. This study tested the predictive validity of the recommend cut score for the FMS in a sample of recreational runners training for a half-marathon. METHODS: Participants for this study were recruited from the 35,000 individuals registered to participate in the 2006 Indianapolis Mini-Marathon. Sixty individuals were evaluated using the FMS as described. The participants then completed a weekly online survey as a means of tracking training and injury status during their preparation and participation in the event. In each survey participants answered questions related to training variables, subjective pain ratings, and symptoms which may have changed training or prompted participants to seek medical attention. Data was collected for a four-month period leading up to the completion of the half-marathon. RESULTS: FMS scores ranged from 11 to 20 on the 21 point instrument. Forty- nine of the 60 participants (82%) completed the weekly questionnaires for the duration of the study. Of these 49 individuals, 12 reported symptoms consistent with overuse injuries, making the total incidence of injury 24.49%. Only 1 of the 12 injured individuals scored below the suggested cut score of 14, which generated 8.3% sensitivity and 94.5% specificity, respectively. A cut score of 20 generated the highest sensitivity (100%), identifying all injured participants but resulting in 27.0% specificity. The cut score with the highest specificity was 11 (97.2%), but it had a sensitivity of 0%. The cut score of 17 showed the highest combination for specificity (41.6%) and sensitivity (56.7%). Neither linear nor logistic regression analyses identified FMS scores as predictors of musculoskeletal injury. CONCLUSIONS: Based on the results of this study, the cut scores on the FMS did not positively predict musculoskeletal injury, indicating this instrument lacks predictive validity in this population of recreational runners. These findings suggest further study is needed to establish the predictive validity of the FMS in athletic populations.
PURPOSE: Several studies have investigated physiological and biomechanical factors which may impact cycling training and performance. However, variables such as neuromuscular efficiency or gross motor performance while cycling have received relatively little attention. Knowledge of performance from this perspective may help scientists understand factors which influence related physiological and biomechanical issues or help coaches optimally apply the principle of specificity in ways which boost performance or lower risk of injury or overtraining. This study investigated the influence of workload on measures of gross motor performance during submaximal cycling. METHODS: Fourteen avid recreational cyclists (47.20 + 11.93 yr, 181.40 + 5.85 cm, 80.58 + 7.67 kg) volunteered for this study. Each completed three submaximal exercise bouts during two separate sessions. Each participant completed three submaximal exercise trials at workload (Watts) to bodyweight (kg) ratios of 1.5:1, 2.0:1, and 2.5:1. The order of the two sessions and three workloads were randomized. Numerous dependent measures of gross motor performance, perceived effort, and physiologic response were collected throughout each trial. RESULTS: A two-way within-subjects analysis of covariance (2 × 3) was conducted to evaluate the effect of workload on dependent variables. Significant differences (p < 0.05) were found for measures of workload (wattage), and gross motor performance (SpinScan™ and average torque angle), and perceived effort (RPE and OMNI). Post-hoc analysis showed subjects demonstrated significantly greater pedaling efficiency as the workload level increased during steady state cycling (p < 0.016). HR responses for the different workloads approached statistical significance (p < 0.05). CONCLUSIONS: This study showed that workload level significantly influenced measures of gross motor performance or pedaling efficiency. These findings suggest that neuromuscular coordination responses contribute greatly to cycling performance and that such responses differ slightly from, and may interact in interesting ways with, the physiological and biomechanical responses seen also during cycling. More study is needed on the relationship between gross motor performance and cycling intensity.
PURPOSE: Studies have investigated a number of physiological and biomechanical variables which can impact cycling training and performance. Time of day (TOD) is a factor believed by many to influence the quality of training and performance, yet this topic has received little attention as it relates to cycling. Understanding the impact of TOD may help scientists better understand factors which influence physiological processes and help coaches develop training programs which improve performance and reduce risk of injury or overtraining. This study investigated the influence of TOD on measures physiology, perceived exertion, or gross motor performance. METHODS: Fourteen avid recreational cyclists (47.20 + 11.93 yr, 181.40 + 5.85 cm, 80.58 + 7.67 kg) volunteered for this study. Each completed three submaximal exercise bouts during two separate sessions, one session starting at 6:00am and the other at 6:00pm. The trials were performed at workload (Watts) to bodyweight (kg) ratios of 1.5:1, 2.0:1, and 2.5:1. The order of the two sessions and three workloads were randomized. Potential confounding variables such as caffeine use were controlled. Dependent measures of heart rate (HR), perceived exertion (RPE and OMNI), and gross motor performance (SpinScan™ and average torque angle) were collected throughout each trial. RESULTS: A two-way within-subjects analysis of covariance (2 x3) was conducted to evaluate the effect of TOD on dependent variables. No significant differences (p <.05) were found for TOD in all dependent measures of HR, perceived effort (RPE and OMNI), or gross motor performance while cycling (SpinScan™ and average torque angle). There also were no significant differences (p < 0.05) found related to the covariate of usual training time (AM vs. PM). CONCLUSIONS: Based on the results of this study, TOD did not significantly affect performance measures during steady state cycling. Thus, the findings did not support the common observation that some individuals are "not morning people“ (or vice versa) as it relates to the quality of performance during physical activities such as cycling. Additional study is needed on factors which may influence perceptions relating to TOD and exercise.
The intimate relationship between the mandibular canal (MC) and the first mandibular molar tooth presents challenges when performing dentoalveolar surgical procedures due to the probability of causing iatrogenic injury to the inferior alveolar neurovascular bundle. Superimposition between the MC and the first molar (M1) tooth roots is often observed on intraoral dental radiographs in small breed dogs. However, due to the radiograph's bidimensional nature, it is impossible to determine the buccal or lingual localization of the first molar roots with respect to the MC. Thus, this study's objective was to determine the localization of the first molar tooth's roots in relation to the position of the MC and their overlapping percentage with the canal in small-bodyweight dogs (<15 kg) using tomographic diagnostic images. For this, cone-beam computed tomography and high-definition computed tomography exams from 103 small breed dogs (under 15 kg) were retrospectively assessed to determine the lingual or buccal localization of the first molar tooth's roots with respect to the MC and the degree of overlap of the roots with the canal. In conclusion, most of the roots of M1 of dogs under 15 kg were located at the MC's lingual aspect (82.7%) with an overall superimposition median with the MC of 100 and 90% for the mesial and distal roots, respectively. Straddle tooth roots were not a common anatomical presentation in the dogs of this study.
Cycling efficiency is dependent upon many factors such as bike set up, body position, and pedaling cadence. These and other factors often have a large influence on both performance and risk of injury. One parameter not fully understood is the influence of available pedal systems on cycling efficiency, and little scientific literature exists on this topic. To determine the effect of different pedal systems on maximal oxygen consumption (o2max) and lactic acid production during direct testing of maximal aerobic power. Nine healthy recreational cyclists (7 males and 2 females; 36.11 ± 7.7 years) volunteered to participate in the study. On average, subjects cycled 3-4 times per week for 1-2 hours at a moderate to high intensity. Subjects performed a maximal bicycle graded exercise test on their own bicycle, using one of three pedal systems on different occasions. Pedal systems included: 1) flat pedals, 2) toe-clip pedals, and 3) clipless pedals, and the order of the pedal systems was randomized. Riding resistance was provided by a computer controlled bicycle ergometer and trainer. Initial resistance was based on a 1:1 power (watts) to individual body weight (kg) ratio and increased 2:1, 3:1, etc. every two minutes until subjects were unable to maintain a pedal cadence of at least 50 revolutions per minute. Gas exchange was analyzed using a portable metabolic system. A portable lactate analyzer was used to measure lactic acid levels prior to the test, upon completion of the test, and at 3, 5 and 7 minutes post-test or until values returned to baseline. A one-way ANOVA with repeated measures was conducted to evaluate the relationship between pedal type and the dependent variables, oxygen consumption and lactic acid production. While there were differences in performance under the three pedal conditions, these differences were not statistically significant for either the oxygen consumption or the lactic acid production. Participants produced higher average o2 values during the clipless condition. Lactic acid accumulation was highest in the flat pedal condition. Lastly, when using the clipless pedals, participants achieved peak lactic acid levels at relatively higher oxygen consumption measures when compared to the flat pedal or toe-clip pedal conditions. Pedal condition did not produce statistically significant differences in maximal oxygen consumption or in lactic acid during a graded exercise test. However, these findings may be clinically meaningful, as statistically significant difference often may not exist within a given group of cyclists, whether the group be performing at a local amateur cycling event or an event such as the Tour de France. Participants produced higher average o2 max values during the clipless condition, suggesting this condition may be more efficient as is commonly believed. Lactic acid accumulation was highest in the flat condition, suggesting participants may have been least efficient when pedaling in this condition. Likewise, the achievement of peak lactic acid levels at relatively higher oxygen consumption further suggests the clipless pedals promote higher performance levels when compared to the flat and toe-clip conditions. Our findings suggesting clipless pedals allow for greater efficiency and result in higher performance. Further study is necessary to investigate these potentially clinically meaningful findings.
Aftercare programs allow patients to continue to exercise with supervision following discharge from physical therapy. Although not yet widespread in clinical practice, aftercare programs represent a growing trend following outpatient physical therapy settings in the United States. The purpose of this study was to explore and describe the characteristics, implementation, and impact of contemporary aftercare programs in a selected sample of outpatient physical therapy settings. A purposeful sample of three aftercare program and four clients were interviewed to provide the descriptive data for this study. Each client was also later interviewed at 3–4 months and again at 6 months. A general health outcomes measurement tool (SF-36®) and musculoskeletal regional outcomes tools also were used to measure health status and function. Directors of the three programs cited similar rationales for starting their aftercare programs. However, specific features and goals of the three aftercare programs varied, as did utilization and participation. Clients were generally pleased with their aftercare involvement, and they demonstrated clinically important improvements on outcome measures of function and health-related quality of life in addition to subjective reports of satisfaction. Aftercare programs are an emerging clinical trend following physical therapy, and this study provides an initial description of the development, implementation, and effectiveness of such programs. Future study should investigate a greater variety of aftercare settings and larger samples of participants and should also further examine how well aftercare programs promote health and wellness.
The knee is the most commonly injured joint. The ACL is routinely injured, with risk of injury per exposure 2 to 8 times greater in females than in males. Excessive medial-lateral motion and valgus forces have been shown to be a major contributor to knee injury. While many researchers have studied the influence of knee and hip musculature, less has been studied about the influence of the trunk or "core" musculature on knee kinematics. PURPOSE: To determine the influence of core musculature engagement of females on triplanar motion of the knee during a single leg squat. METHODS: All subjects were evaluated for core strength using Sahrmann's physical therapy evaluation model. Four reflective markers were positioned on the left and right ASIS, right lateral femoral condyle, and right lateral malleolus of 14 female subjects (mean age 22.13 ± 2.87 years). Each subject performed a single leg squat from a six inch step under 2 conditions: core engaged (CORE) and no core engaged (NOCORE). Knee motion was sampled using an APAS motion analysis system. All data were processed using MATLAB. After scaling and time-normalizing, correlation coefficients were determined for knee marker trajectories between individual subjects' CORE trials and the group's mean NOCORE trial. A correlation coefficient of 0.9 was used as a threshold to define similarity between conditions. RESULTS: Similarities were found between CORE and NOCORE conditions in subjects' vertical and anterior-posterior knee motion (CC = 0.952 and 0.941, respectively). In contrast, greater differences were found between CORE and NOCORE conditions in subjects' medial-lateral knee motion (CC = 0.700). Participants showed greater variability in medial-lateral motion during the NOCORE condition. CONCLUSIONS: Core engagement did influence the medial-lateral motion of the knee during single leg squats. This information may have implications for preventing, predicting, and/or rehabilitating knee injuries of females.
Judith Absalon Siddharth Agarwal Jennifer Ahern J. Ahluwahlia Jennifer Alvarez Stacey Anderson Jim Anthony Adolfo Ariza Haroutune Armenian Bob Arnold S. Awasthi Semra Aytur Mary Bassett John Beard Curt Beckwith Leo Beletsky Janice Bell Helen Binns Ricky Bluthenthal Sebastian Bonner Robert Booth Luisa Borrell Sarah Boslaugh J. V. Brady Eric Brown Barry Brown Angela Bucciarelli Jessica Burke K. A. Cagney Jackie Campbell Carol Caton David Celentano Magdalena Cerda Allen Cheadle Ginger Chew John Chin Katherine Christoffel Chuck Cleland Micaela Coady Phil Coffin Deborah Cohen Hannah Cooper David Cooperman Michael Copenhaver Shane Darke Deborah Daro Sherry Deren Robert Derlet Don DesJarlais Pam Deters Kim Dietrich Ana Diez-Roux Charles DiMaggio Gregory Dore Ernest Drucker Arul Earnest Brian Edlin David Eitle Jonathan Ellen Rune Elvik Margaret Ensminger Paul Epstein Julie Fish Julian Ford Jean Ford Jean-Christophe Fotso Bridget Freisthler Nick Freudenberg Linda Fried Sam Friedman Sharon Friel Victoria Frye Crystal Fuller Robert Fullilove Sandro Galea Richard Garfein Lawrence Gartner T. L. Gary Kelly Gebo Don Gemson Robyn Gershon Louisa Gilbert R. Gillum Virginia Gil-Rivas Thomas Glass Nancy Glass Alice Gleghorn Lloyd Goldsamt Andrew Goodman Lauretta Grau Charles Gross Paul Gruenewald Joseph Guydish Perry Halkitis Ted Hammett Beverly Harju Trudy Harpham Douglas Heckathorn Katie Heinrich Terrence Hill King Holmes David Holtgrave E. Hook Don Hoover Paul Hunter Martin Iguchi James Inciardi Ken Inoue Lina Jandorf Mallory Johnson T. Stephen Jones Rhonda Jones-Webb Steen Jorgensen Seth Kalichman Farzana Kapadia Jen Kates Jay Kaufman Peter Kemp George Kent G. L. Khor W. R. Kim Gregory Kirk Tord Kjellstrom Kelly Knight Beryl Koblin Steve Koester Alex Kral Betty Kramer Irene Kuo Naa Oyo Kwate Shenghan Lai Thomas Lambert Kristie Lancaster Sonia Lansky Barbara Laraia Roz Lasker Carl Latkin Mary Leach Joshua Lee Noelle Leonard Jeffrey Levi T. C. Lewis Rebecca Liddicoat M. C. Logsdon Doug Longshore Jennifer Lorvick Anita Loughlin Greg Lucas Duncan Macfarlane Todd Mackenzie Urs Maeder Monica Magadi Kyriakos Markides Morri Markowitz M. Mason Angela Mathee Thomas Matte Karen McDonnell Shruti Mehta Rita Melendez Susan Mercado Lynne Messer Lisa Metsch Marilyn Metzler Latetia Moore
PURPOSE: Accurate assessment of exercise intensity is widely accepted as a fundamental tenet of evidence-based exercise prescription, as appropriate dosing of intensity contributes to increased performance and lessens the risk of overreaching and overtraining. Borg's Rating of Perceived Exertion (RPE) scale has been found a valid and reliable method for gauging exercise intensity in a wide variety of activities and populations, and this instrument has been widely used for decades in research, sporting, and clinical scenarios. In contrast, the OMNI scale has emerged in recent years as an alternative method of assessing perceived exertion; this instrument differs from the RPE in that its scale includes both pictorial and verbal descriptors to gauge the level of exertion, but it has been studied less extensively. The purpose of this study was to assess the concurrent validity of the Borg and OMNI scales during submaximal cycling exercise. METHODS: Fourteen recreational cyclists (47.20 + 11.93 yr, 181.40 + 5.85 cm, 80.58 + 7.67 kg) volunteered for this study. Each completed three submaximal exercise bouts on two occasions. During each laboratory session, each subject completed three exercise bouts at workload (watts) to bodyweight (kg) ratios of 1.5:1, 2.0:1, and 2.5:1. The order of laboratory sessions and workloads were randomized. RESULTS: Pearson product correlation coefficients were calculated on HR, RPE scores, and OMNI scores for the physiological workloads included in this study. Correlations between RPE and OMNI were statistically significant (p < 0.01) at each of the workloads, ranging from.774 to.838, respectively. None of the correlations between HR and RPE or HR and OMNI were statistically significant (p < 0.05). CONCLUSIONS: Strong statistical relationships were found between RPE and OMNI scores in this study. These findings suggest that the OMNI has high concurrent validity with the more established RPE for use among experienced recreational cyclists during submaximal exercise. Some studies have suggested the OMNI scale may be used more easily by some individuals than the original Borg scale (6-20) or the Borg CR-10. Thus these findings suggest the OMNI may be a reasonable alternative for use in monitoring exercise intensity during cycling.
Inactivity is a major contributor to lifestyle-associated diseases such as obesity, heart disease, and osteoporosis. Something as simple as walking regularly can lessen the impact of these diseases, if done with sufficient frequency, intensity and duration. Pedometers are commonly used to monitor exercise prescriptions as they have been shown to be accurate and reliable. However, these studies have primarily focused on walking on level surfaces. This presents challenges to generalizing findings to the average adult whom in the course of a day ascends or descends stairs and hills, walks on different surfaces, and wears different footwear. These factors have the capacity to affect gait kinematics and therefore, the accuracy of the pedometer count. To test the ability of the pedometer to correctly measure step count while walking on level, inclined, and declined surfaces while wearing “tennis shoes”, “flip flops”, and no shoes. Nine male and 9 female college students (20.58 + 4.57 yr, 173.92 + 8.44 cm, 71.39 + 11.73 kg) classified as “minimum” risk per ACSM guidelines volunteered for this study. Participants wore an inexpensive, commercially available pedometer on each hip. After a warm up, each walked on a treadmill at 3.3 mph for 3 minutes for each of the experimental conditions, which were randomized for footwear and gradient. Steps for each trial were also tallied using handheld counters. A two-way within-subjects analysis of variance was conducted to evaluate the effect of footwear and grade on pedometer accuracy. No significant differences were found between the pedometer and handheld counts (p < .05). Significant differences were found in step counts between the footwear conditions (p = .002). Post-hoc analysis showed participants took significantly greater steps in the flip flop and barefoot conditions when compared with shoes (p < .016). No significant interactions were found. These results indicate that the pedometer was accurate in assessing step count under footwear and gradient conditions. These findings suggest that a commonly available pedometer possesses the sensitivity to pick up differences in gait kinematics related to a variety of footwear conditions.
