Objective The purpose of this study was to determine the effects of lower extremity motor control exercises on knee proprioception, muscle strength, and functional level in patients with anterior cruciate ligament reconstruction (ACL-R). Materials and Methods Thirty-two of the 57 patients with ACL-R using tibialis anterior allografts were divided into two groups. Group I: lower extremity motor control exercises were added to the standard rehabilitation program. Group II: standard rehabilitation program was applied. Effects of lower extremity motor control exercises on quadriceps and hamstring muscles strength, knee joint position sense, and hop test were evaluated. Results There were no differences in muscle strength and endurance of the quadriceps and hamstring between the operative and nonoperative sides in Group I (p > 0.05) while there were significant differences in strength of the quadriceps and hamstring between the operative and nonoperative sides in Group II (p < 0.05). There were significant differences in the endurance of the quadriceps and hamstring and knee joint position sense at 15°, 45°, and 75° between the operative sides of the patients in both groups (p < 0.05). Conclusions The neuromuscular control exercises program was found to be more effective in reducing the difference in strength while the standard program was found to be more effective in reducing the difference in endurance between the operated knee and the other knee. This study revealed that neuromuscular control exercises should also be used to improve knee proprioception sense following ACL-R.

Purpose To compare the active joint position sense (JPS), muscle strength, and knee functions in individuals who had anterior cruciate ligament (ACL) reconstruction with quadriceps tendon autograft, hamstring tendon autograft, tibialis anterior allograft and healthy individuals. It was hypothesized that when compared to an age and gender‐matched healthy control group, subjects who were post‐ACL reconstruction would display impaired active joint position sense, knee extensor and flexor strength symmetry and knee function at 1 year post‐surgery. A secondary hypothesis was that differences would exist between the quadriceps tendon autograft, hamstring tendon autograft and tibialis anterior allograft groups. Methods Sixty‐seven patients with ACL reconstruction and 20 healthy individuals were included. Active JPS reproduction was measured at 15°, 45° and 75° of knee flexion. International Knee Documentation Committee (IKDC) subjective score and one‐leg hop test were used to assess the functional status of the patients. Results The JPS detection was different at the 15° target angle between groups (F3.86 = 24.56, p < 0.001). A significantly higher proportion of quadriceps tendon autograft group patients failed to identify the 15° active JPS assessment position compared to the other groups (p < 0.0001). The quadriceps index was lower in patients compared to healthy individuals (p < 0.001), while the hamstring index was similar (n.s.). The knee functional outcomes were similar between ACL reconstructed groups and healthy controls (n.s.). Conclusion Knee proprioception deficits and impaired muscle strength were evident among patients at a mean 13.5 months post‐ACL reconstruction compared with healthy controls. Patients who underwent ACL reconstruction using a quadriceps tendon autograft may be more likely to actively over‐estimate knee position near terminal extension. Physiotherapists may need to focus greater attention on terminal knee extension proprioceptive awareness among this patient group. Level of evidence III.

The purpose of this study was to investigate the effects of kinesiophobia on early functional outcomes in patients following total knee arthroplasty (TKA) and how kinesiophobia is related to functional outcomes and pain. The Tampa Scale for Kinesiophobia (TSK), 2-minute walk test (2-MWT), and the timed up and go test (TUG) were used to assess 46 TKA patients on discharge day. The pain levels and active knee flexion range of motion (ROM) were recorded. Patients were divided into two groups as high kinesiophobia (Group I, n = 22) and low kinesiophobia (Group II, n = 24) based on the TSK levels. The TUG results were similar between groups (p = 0.826). 2-MWT results (p < 0.001), pain levels (p = 0.003), and knee flexion ROM (p = 0.025) scores were better in Group II when compared to Group I. The TSK scores were significantly correlated with 2-MWT results (r = -0.40; p = 0.003), pain levels (r = 0.80; p < 0.001), and knee flexion ROM (r = -0.47; p = 0.001). The regression analysis revealed that 41% of 2-MWT score, 47% of knee flexion ROM, and 60% of pain level changes could be explained by kinesiophobia level. The results suggest that early outcomes following TKA were affected by the pain-related fear of movement. The clinicians need to consider the interrelationships between fear of movement and functional outcomes when designing, implementing, and monitoring daily therapeutic exercise programs.

As GIRD has an adverse effect on functional ratio of the shoulder-rotator muscles, interventions for adolescent overhead athletes should include improving GH-rotation range of motion.

Results: Thirty participants were recruited (mean age 57 SD 27.8; BMI 27.8 SD 4.2); 17 were females. Four patients had non-usable data. Main analysis used paired t tests comparing within subject patellar position with and without brace.For bisect offset index, patellar tilt and patellar height ratio there were no significant differences between the brace and no brace conditions. However, the brace increased lateral facet contact area (p =.04) and decreased lateral patellofemoral separation (p = .03). For bisect offset index, patellar tilt and patellar height ratio there were no significant 22 differences between the brace and no brace conditions. However, the brace increased 23 lateral facet contact area (p =.04) and decreased lateral patellofemoral separation (p = 24 .03).

No abstract

Although lower extremity joint position sense did not differ between groups, the PFPS group displayed a target-trajectory muscular coordination deficit, decreased muscular endurance, and decreased muscular strength compared to control group subjects. Pain level directly related to motor control performance while joint position sense scores did not. Knee pain and impaired strength related more to functional performance impairment than joint position sense scores in patients with PFPS.

Objective: To investigate shoulder-rotator strength, internalrotation (IR) and external-rotation (ER) range of motion (ROM), and acromiohumeral distance (AHD) in asymptomatic adolescent volleyball attackers to determine if they have risk factors for injury.Design: Cross-sectional study. Setting: University laboratory. Participants: Thirty-nine adolescent high school-aged volleyball attackers (22 boys, 17 girls; age ¼ 16.0 6 1.4 years, height ¼ 179.2 6 9.0 cm, mass ¼ 67.1 6 10.9 kg, body mass index ¼ 20.7 6 2.6 kg/m 2 ). Main Outcome Measure(s): Shoulder IR and ER ROM, total-rotation ROM, glenohumeral IR deficit, AHD, and concentric and eccentric strength of the shoulder internal and external rotators were tested bilaterally.Results: External-rotation ROM was greater (t 38 ¼ 4.92, P , .001), but IR ROM (t 38 ¼ À8.61, P , .001) and total ROM (t 38 ¼ À3.55, P ¼ .01) were less in the dominant shoulder, and 15 athletes had a glenohumeral IR deficit (IR ROM loss . 188). We observed greater concentric internal-rotator (t 38 ¼ 2.89, P ¼ .006) and eccentric external-rotator (t 38 ¼ 2.65, P ¼ .01) strength in the dominant than in the nondominant shoulder. The AHD was less in the dominant shoulder (t 38 ¼ À3.60, P , .001).Conclusions: Adolescent volleyball attackers demonstrated decreased IR ROM, total ROM, and AHD and increased ER ROM in their dominant shoulder. Therefore, routine screening of adolescent athletes and designing training programs for hazardous adaptive changes could be important in preventing shoulder injuries.Key Words: ultrasonography, sports, glenohumeral joint, muscle strength Key PointsAsymptomatic adolescent volleyball attackers demonstrated less internal-rotation range of motion (ROM), total ROM, and acromiohumeral distance and more external-rotation ROM in the dominant than in the nondominant shoulder, which might put them at risk for shoulder injuries. Routinely screening adolescent athletes and designing training programs to address hazardous adaptive changes could help prevent shoulder injuries.