No abstract

Study Design: Single-group repeated measures design pre-and postintervention. Objectives: To determine if the modified low-Dye medial longitudinal arch (MLA) taping procedure places the subtalar joint into the neutral position and maintains the subtalar joint neutral (STJN) position following 10 minutes of walking. Background: Subtalar malalignment in excessive pronation is commonly accepted as a contributing factor to a variety of musculoskeletal pathologies. The modified low-Dye MLA taping procedure is often used on the plantar surface of the foot as a short-term corrective tool for excessive foot pronation. However, research that evaluates the efficacy of this taping technique during light exercise is lacking. Measurement of navicular height is commonly used as a measure of subtalar position. Methods and Measures: Prior to the study, one tester-established reliability in the navicular drop technique measurement by initially practicing the measurements on 400 feet, followed by a reliability study performed on 29 subjects. In this study, a screening procedure excluded subjects with ankle or foot pathology, supinated feet, or neutral feet, and included only subjects with pronated feet. The study, which included 40 subjects, involved four steps: (1) measuring navicular height in the relaxed position; (2) measuring navicular height in the STJN position; (3) measuring navicular height after application of the modified low-Dye MLA taping procedure; and (4) measuring navicular height after subjects had walked for 10 minutes with the taping. Results: Results indicated an intrarater intraclass correlation coefficient (ICC) for measuring navicular height of 0.96 for the right foot and 0.94 for the left foot. Repeated measures ANOVA revealed that significant differences existed (P Ͻ 0.05) among the 4 measures. A Bonferroni post hoc analysis showed a difference between relaxed stance measurements and all other measurements, and between taped-prewalking measurements and taped-postwalking measurements. In addition, no significant difference was observed between navicular height measured in STJN and the taped-prewalking and taped-postwalking conditions. The average navicular height for the taped-prewalking condition was 1.6 mm higher than that for the STJN position. For the taped-postwalking condition, the average height of the navicular was 1.2 mm lower than that of the STJN position. Arkansas, Physical Therapy Center, Room 319, 201 Donaghey Avenue, Conway, AR 72035-0001. E-mail: holmesc@mail.uca.edu Conclusion: These results demonstrate that the modified low-Dye MLA taping procedure places the subtalar joint near the neutral position. Despite a significant reduction in the height of the navicular after the subjects walked for 10 minutes with the tape on, the height of the navicular was still not significantly different than that of the STJN position.

Stretching is performed in rehabilitation and sports conditioning programs. It is not known how often during a week stretching needs to be performed to maintain flexibility. Therefore, the purpose of this study was to determine the influence of intermittent stretching (i.e., 2-3 days/week) on hip range of motion (ROM) following a 4-week, daily stretching program. This study used a randomized, single-blind, test-retest design. Healthy adult subjects, age 18 to 50 years, were randomly assigned to 1 of 2 static stretching protocols: (a) standard protocol or (b) intermittent protocol. All subjects stretched their hamstrings daily for the first 4 weeks. The standard group discontinued all stretching after 4 weeks. The intermittent group continued to stretch 2 to 3 days per week for an additional 4 weeks. All subjects were measured for hip ROM weekly for the full 8 weeks. Thirty-two subjects completed the study (standard group = 14; intermittent group = 18, mean age 24.6 years). Mean hip ROM increased (p < 0.05) for both groups from before protocol (PRE) to Week 4 (standard group gain from 71.4 +/- 18.5 degrees to 90.6 +/- 20.5 degrees and intermittent group gain from 68.6 +/- 15.7 degrees to 89.1 +/- 16.8 degrees). During the final 4 weeks, mean hip ROM decreased (p < 0.05) for the standard group from 90.6 +/- 20.5 degrees to 83.9 +/- 20.3 degrees. Mean hip ROM for the intermittent group did not decrease during the final 4 weeks of the study (89.1 +/- 16.8 degrees to 93.2 +/- 14.9 degrees, p > 0.05). Intermittent stretching (i.e., 2 or 3 days/week) is sufficient to maintain ROM gains acquired from a prior static stretching program. Clinicians and trainers may educate their clients of the benefits of intermittent stretching to maintain flexibility.

No abstract

No abstract

Cane users might have better stability than walker users in the forward direction and in the direction toward the side holding the cane. This study may provide guide for clinicians including nurses for selecting appropriate rehabilitative interventions for older adults using walkers and canes.

No abstract

Introduction Increasing evidence suggests that plantar shear forces and related stresses play a major role in diabetic foot ulcerations. Several orthotic devices are commercially available to reduce plantar shear forces within the shoe. The biomechanical efficacy of these devices was not tested in vivo. To measure spatiotemporal characteristics of gait to assess the efficacy of such shear-reducing insoles (SRIs), control insoles were also tested for comparison purposes. Material and Methods Eighteen healthy volunteers walked along a 30.5-m line while wearing three types of insoles in randomized order. Spatiotemporal parameters of gait were quantified. Statistical comparisons between the control and SRIs were conducted using repeated measures analysis of variance. Intraclass correlation coefficients (ICCs) were also calculated to reveal the repeatability of the trials. Step length, gait speed, and cadence of the subjects remained similar regardless of the insole type. Results No significant difference was observed in any variable. The ICC values revealed excellent repeatability. Conclusions The lack of changes in gait parameters in these results suggest that shear-reducing diabetic inserts did not decrease plantar shear forces as intended. This might be caused by unrealistic in vitro testing conditions during the prototype development. Future designs should also consider friction at the lateral walls of the inserts, an increase in step repetition that accompanies a decrease in gait speed and/or step length, and a possible temperature increase within the shoe. We conclude that the future SRIs need to be redesigned based on comprehensive biomechanical guidelines.