Volume 8:5
The Immediate Effects of Two Different Stretching Interventions on Passive Shoulder Internal Rotation in Collegiate Baseball Players
Alexander Brown, SPT; Victor Alfieri, SPT; David Fazulak, SPT; Ayse Ozcan Edeer, PT, PhD; Valerie D. Olson, PT, PhD
Dominican College Doctor of Physical Therapy Program – Orangeburg, NY
ABSTRACT
Objectives: To determine if a modified version of the cross body stretch that incorporates scapular stabilization immediately following a bout of pitching will increase passive shoulder range of motion more than the standard cross body stretch in male collegiate baseball players.
Background: Overhead athletes, mainly baseball players, often exhibit pathologic gross internal rotation deficit (pGIRD) in their dominant arm due to the unique repetitive shoulder motion of throwing. If not addressed, this repetitive motion in combination with pGIRD may lead to future arm injuries over time. Following throwing, immediate stretching intervention may increase passive shoulder range of motion, decrease shoulder tightness, and decrease the risk of future injury.
Methods and Measures: Forty asymptomatic collegiate baseball players were randomly assigned to one of two groups with each group receiving a different intervention of stretching. Using a standard inclinometer, shoulder PROM measures were taken at three intervals: 1) after warm up, 2) immediately after throwing and 3) immediately after assigned intervention. One group received the standard cross-body stretch while the other group received a modified version of the cross-body stretch. The modified version included active stretching with the use of a 4-inch foam roller for scapular stabilization. Examiners taking the shoulder measurements were blinded to the participants’ dominant throwing arm, as well as to which stretch the subjects executed.
Results: A mixed between-within subjects analysis of variance showed that mean throwing shoulder IR, HAD and TROM differed statistically significantly across the three time points (p=.002, p=.007, p=.016 respectively). A test of between-subjects effects showed no significant difference for IR, ER, HAD and TROM when the two groups were compared across the various time points (p=.939, p= .765, p= .763, p=.806 respectively).
Conclusion: Both the modified cross-body stretch and standard cross-body stretch appears to improve passive shoulder internal rotation and total shoulder range of motion in the overhead athlete after an acute bout of throwing.
Reliability of Real Time Motion Analysis System VirtuBalance® as Compared to Traditional Measurement Methods of Functional Reach and Postural Sway
Kyle Dodge, SPT; 1LT Ryan Lynch, SPT; Steven R. Tippett, PhD, PT, SCS
Bradley University, Department of Physical Therapy and Health Science – Peoria, IL
ABSTRACT
Objectives: The study’s objective was to determine the reliability of the VirtuBalance® motion analysis system in measuring the Functional Reach Test and the modified Clinical Test of Sensory Integration on Balance (mCTSIB) in healthy subjects.
Background: VirtuBalance is an infrared three-dimensional motion analysis system that captures movements in real time and stores video and descriptive data of subject performance in a variety of functional tests for the physical therapy client. Utilization of the VirtuBalance to assess balance is becoming more popular in the clinic, however, no reliability studies have been performed on the device to date.
Methods: A total of thirty-one subjects ranging in age from 18 to 65 years were recruited from a sample of convenience. Following informed consent, each subject performed two trials of the mCTSIB standing on a level stable surface and a level foam surface with eyes open and eyes closed. Performance was simultaneously assessed on the AMTITM Forceplate as well as by real time motion analysis via the VirtuBalance system (VirtuSense Technologies). Subjects also performed three trials of the Functional Reach test that were simultaneously assessed via traditional manual measurement and by the VirtuBalance system. Data were collected simultaneously via the VirtuBalance and the AMTITM Forceplate while participants performed two trials of the mCTSIB to determine analysis of sway. Data were also collected simultaneously for three trials of the Traditional Functional Reach test via the VirtuBalance 3d- motion analysis system and visually by a researcher.
Results: All data for the VirtuBalance were normally distributed. No statistically significant differences were found between the VirtuBalance (15.50+2.54; 15.75+2.49; and 16.05+2.73) and Traditional Functional Reach test as measured by an independent examiner (15.83+2.59, 15.74+2.45, and 16.08+2.65). Correlations between the two trials of total sway as measured by the VirtuBalance ranged from r = .594 to r =.736 (p = .01). No statistical significance was found in average or total sway when comparing VirtuBalance to force plate measures.
Conclusion: The VirtuBalance is a reliable tool in assessment of Functional Reach and the modified Clinical Test of Sensory Integration on Balance in normal subjects.
Treating the Psychosocial Implications of Parkinson's Disease Within Physical Therapy: A Case Report
Audrey Hentges, SPT, ATC, LAT
Clarke University - Dubuque, IA
Abstract
Study Design: Single-subject case design.
Background: Parkinson's disease (PD) affects at least 1% of the population over the age of 65. The cardinal signs of PD are the presence of a resting tremor, rigidity, postural instability, and bradykinesia. These physical implications are easily identified and therefore treated appropriately. Unseen to the eye, however, are the psychological issues that accompany PD. These symptoms are often the most debilitating and have the largest effect on the individual's quality of life. The purpose of this case report is to discuss the rehabilitation process of a patient with Parkinson's disease, complicated by psychosocial issues and self-limiting behaviors.
Case Description: The patient was a 69 year-old male with PD referred to PT for the treatment of gait and balance issues. The greatest challenge encountered with this patient was managing the multitude of psychosocial issues, including perfectionistic standards and dependency behaviors.
Outcomes: Specific interventions were aimed at improving the patient's trunk strength, dynamic balance, endurance, and lessening his perception of functional impairments. Improvements in strength and balance were noted in manual muscle testing scores and an improved Berg Balance Score. No statistical change was noted on the Dizziness Handicap Inventory. Upon discharge, the patient reported increased ease with functional activities and a feeling of more control in his life.
Conclusion: This case described the treatment of a patient with Parkinson's disease complicated by psychosocial factors. The importance of employing multimodal treatment strategies is discussed, as is the importance of creating an individualized plan of care based on the specific needs of the patient.
