Predicting 1 Repetition Maximum Using Handheld Dynamometry

Isometric assessment of muscular function using a handheld dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinicians do not often use 1RM testing, preferring to be cautious with clients who have preexisting impairments. If strength testing using an HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments.

The aim of this study was to establish the relationship and agreement between 1RM and isometric strength scores measured using HHD for the biceps and quadriceps muscle groups and to determine if HHD measurements can be used to predict 1RM. This involved a convenience sample of 50 healthy adults (26 women) aged 19-33 years (mean 23.38 ± 3.11 years) who had their bicep and quads muscle strength tested muscle groups measured by 1RM and isometric maximal voluntary contraction measured using an HHD.

Full story at Physiospot

Rocker bottom shoes help reduce chronic low back pain

A new study confirms that rocker bottom shoes helps strengthen back muscles, improving the spine’s curvature and thus reducing low back pain.

Researchers of the Sports Physiotherapy master’s degree at Valencia’s CEU Cardenal Herrera university have confirmed, in a new study of their research work into back pain, that unstable shoes improve the strength of back muscles in order to maintain balance and stability when walking. This muscular strengthening contributes to reducing low-intensity chronic low back pain, which can be disabling for those who suffer it. The results of this new study, headed by CEU UCH teachers Juan Francisco Lisón and Pablo Salvador, co-authors of the first international study on this matter, have been published in the Q1 edition of scientific magazine Clinical Rehabilitation.

As the coordinator of the CEU UCH master’s degree, Pablo Salvador, explains, “patients with chronic low back pain are usually advised to perform exercises to strengthen the muscles in their back, which improve stability of the spine in the lower back area, although it is always hard to make sure they comply with this type of exercises. What this new study shows is that the use of unstable shoes for several hours during a patient’s day-to-day life, without any other specific exercises, effectively contributes to the muscular strengthening of their back and improves the degree of curvature of the spine in the lumbar area, thus helping to reduce chronic pain.”

Full story at Science Daily

Patients who live alone can safely be sent home after joint replacement

Most patients who live alone can be safely discharged home from the hospital to recover after hip or knee replacement surgery, suggests a study in the January 17, 2018 issue of The Journal of Bone & Joint Surgery.

The results question the belief that patients who live alone should routinely be sent to an inpatient rehabilitation facility after total joint replacement surgery, before going home. “Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty,” write Andrew N. Fleischman, MD, and colleagues from The Rothman Institute, Thomas Jefferson University, Philadelphia.

Similar Outcomes after Joint Replacement for Patients Living Alone

The study included 769 patients who were discharged home after one-sided total hip or knee replacement. Of these, 138 patients were living alone for the first two weeks after surgery. The researchers compared complication rates and other important outcomes for patients who lived alone versus those who lived with others.

Full story at Medical Xpress

In Wake of Nassar Conviction, PT Points to Need for Patient Education on Legitimate Pelvic Physical Therapy

The multiple sexual abuse convictions of former USA Gymnastics doctor Larry Nassar brought an end to Nassar’s monstrous behavior, increased awareness about systemic problems that allowed the abuse to occur, and hopefully even provided a certain sense of closure to the more than 150 victims of his assaults. But in an article written for the HuffPost, APTA member Lora “Lori” Mize, PT, DPT, and certified clinical specialist in women’s health physical therapy, raised concern that the Nassar case also may create a ripple effect that could discourage individuals from seeking legitimate and responsibly delivered pelvic physical therapy.

In her opinion piece titled “Nassar’s Atrocities Stigmatize A Legitimate Medical Treatment,” Mize contrasts Nassar’s horrific actions with the well-established, evidence-based pelvic physical therapist treatments “performed by a highly trained specialist [that] can have a positive impact on a woman’s quality of life.”

Full story at APTA

Shoulder Instability and Joint Position Sense

This is a mini-blog with the intent of giving the user of the Motion Guidance visual feedback productinsight into a researched-based approach to using the product for the diagnosis of shoulder instability.

Movement joint positionsense is most likely to be impaired after shoulder injury involving post-traumatic instability when compared to the contralateral shoulder and to controls, while deficits for Active JPS and Passive JPS are more likely to be evident compared to the contralateral shoulder in participants with glenohumeral musculoskeletal disorders. This has been shown in a 2011 study by Balke. A link can be found here. Balke was able to demonstrate that angle reproduction capability was worst below shoulder level (55°) in all groups. Best results were achieved at shoulder level (90°). Healthy controls showed overall better results than patients with instability. Patients after surgical stabilization had better results in 55° and 90° abduction compared to instability patients before surgery. Balke quantified measurements by attaching a laser pointer to the wrist of the subject and then asked them to reproduce anlges at 55°, 90°, and 125° of shoulder in flexion and abduction.

Full story at The Manual Therapist

Augmented reality system allows medical images to be displayed directly on the patient’s body

New technology is bringing the power of augmented reality into clinical practice.

The system, called ProjectDR, allows medical images such as CT scans and MRI data to be displayed directly on a patient’s body in a way that moves as the patient does.

“We wanted to create a system that would show clinicians a patient’s internal anatomy within the context of the body,” explained Ian Watts, a computing science graduate student and the developer of ProjectDR.

Full story at News Medical

What is iliotibial band syndrome and how is it treated?

People who exercise regularly, particularly runners, are prone to experience pain in the outer part of the knee. When this occurs, iliotibial band syndrome may be the cause.

Iliotibial (IT) band syndrome is often caused by repetitively bending the knee during physical activities, such as running, cycling, swimming, and climbing.

The IT band is a group of fibers that run the length of the upper leg, from the hip to the top of the shin.

Full story at Medical New Today

Flex: New CEU Courses

TOTAL KNEE ARTHROPLASTY REHABILITATION CONSIDERATIONS

The major objectives of rehabilitation after total knee arthroplasty (TKA) are the early regain of range of motion (ROM) and mobilization of the patient.  The goals of this CEU course are to investigate the effect of the knee position during wound closure on early knee function recovery after TKA and the validity and effectiveness of rehabilitation techniques and physical therapies before and after TKA.

POST-PARTUM COCCYDYNIA MUSCLE ENERGY TECHNIQUES

Coccydynia is a painful and incapacitating condition in the early post-partum period.  The goal of this CEU course is to determine the effect of Muscle Energy Technique (MET) in treating post-partum coccydynia. This course is based off of an open access article from the Journal of Physical Therapy and Rehabilitation.

For more on these new courses and many more, visit our CEU home page!

Slowing bone loss with weight-bearing exercise

As with loss of muscle mass, bone strength starts to decline earlier than you might imagine, slipping at an average rate of 1% per year after age 40. About 10.2 million Americans have osteoporosis, which is defined by weak and porous bones, and another 43 million are at risk for it.

Numerous studies have shown that weight-bearing exercise can help to slow bone loss, and several show it can even build bone. Activities that put stress on bones stimulate extra deposits of calcium and nudge bone-forming cells into action. The tugging and pushing on bone that occur during strength and power training provide the stress. The result is stronger, denser bones.

Full story at Harvard Health Edu

APTA Physical Therapy Outcomes Registry Again Receives CMS Designation for MIPS Reporting

APTA’s Physical Therapy Outcomes Registry (Registry) has been approved again by the US Centers for Medicare and Medicaid Services (CMS) as a qualified clinical data registry (QCDR). The designation for 2018 means that physical therapists (PTs) who participate in the Merit-based Incentive Payment System (MIPS) program can submit their data directly from the Registry, but the CMS approval is also an acknowledgment that APTA offers a robust, reliable system for tracking and benchmarking patient outcomes.

Although voluntary for now, PT participation in MIPS could be mandatory as early as 2019, making it important to become familiar with the system (APTA encourages eligible PTs to voluntarily participate in MIPS now).The Registry’s QCDR status will be particularly helpful for practices whose electronic health records (EHRs) do not have the capability to report directly to MIPS.

According to Heather Smith, PT, MPH, APTA’s director of quality, the value of the Registry goes well beyond MIPS data submission.

Full story at APTA