Predictors of Frontal Plane Knee Excursion during Functional Weight Bearing Tasks in Young Athletes

Ahmed F Elhalawaty, Salwa F Abdelmagid, Ebtessam F Gomaa, Walid R Awadallah

Ahmed F Elhalawaty, Salwa F Abdelmagid, Ebtessam F Gomaa, Walid R Awadallah – Predictors of Frontal Plane Knee Excursion during Functional Weight Bearing Tasks in Young Athletes. Fizjoterapia Polska 2020; 20(1); 106-112

Abstract
Background. The knee joint complex is one of the most commonly injured areas of the body in athletes. Excessive frontal plane displacement of the knee joint is considered a risk factor for multiple knee pathologies such as meniscal, anterior cruciate ligament and patellofemoral joint injuries, however, the biomechanical factors that contribute to this loading pattern need further investigations. Objective. The purpose of this study was to investigate clinical predictors of frontal plane knee excursion during single leg landing tasks. Methods. One hundred and twenty eight (male) football players participated in this study. Their mean age was (14.6 ± 1.7) years, mean BMI was (21.3 ± 2.1)kg/m2. The knee frontal plane projection angle was measured by digital video camera using single leg landing tasks after that clinical predictors affecting knee joint frontal plane projection angle assessed (tibiofemoral angle measured using digital video camera, peak isometric strength of hip and knee muscles strength assessed using portable HHD, static postural balance assessed using biodex balance system, foot posture assessed using foot posture index, knee proprioception assessed through measuring weightbearing joint position sense). Results. Statistical analysis using stepwise multiple regression indicated that of the included variables, only static tibiofemoral alignment, hip external/internal rotators ratio and knee joint position sense absolute error predict the knee frontal plane projection angle during landing tasks (r2 = 0.15, p = 0.00; r2 = −0.089, p = 0.00 and r2 = 0.336, p = 0.00 respectively). Together these variables only explained 30% of the variance in knee frontal plane projection angle. Conclusion. Tibiofemoral angle, knee joint proprioception and hip external/internal rotators ratio were found to play great role in controlling knee frontal plane motion, therefore the design of knee rehabilitation programs should include improving these factors to enable targeted prevention strategies to reduce injury rates.

Key words:
knee injuries, risk factors, kinematics, 2-dimensional motion analysis

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Changes in Rotator Cuff Strength Ratio, Shoulder Pain and Disability after Cervicothoracic Mobilization in Subjects with shoulder impingement syndrome

Ahmed M Elmelhat, Salwa F Abdelmagid, Ebtessam F Gomaa, Ahmed M Gad

Ahmed M Elmelhat, Salwa F Abdelmagid, Ebtessam F Gomaa, Ahmed M Gad – Changes in Rotator Cuff Strength Ratio, Shoulder Pain and Disability after Cervicothoracic Mobilization in Subjects with shoulder impingement syndrome. Fizjoterapia Polska 2020; 20(1); 36-42

Abstract
Background. Shoulder impingement syndrome (SIS) is the most common cause of shoulder pain. Recently, attention has been given to the use of spinal manual therapy to treat shoulder pain. Methods. This study is a Randomized controlled trial. Overall, 35 patients with mean age (32 ± 6.47) years were participated in this study as SIS (stage I and II Neer’s classification) were randomized into 2 equal groups. The control group received only a treatment based on the most evidence-based treatment for SIS (Stretching of the posterior capsule, rotator cuff exercises, and scapular muscle training) while experimental group received Maitland’s rhythmic oscillatory central posteroanterior (PA) and transverse mobilization of cervico-thoracic spine (C7-T4 vertebra) with addition same physiotherapy program received by control group for 4 weeks. All patients in both groups were evaluated pre- and post-treatment with isometric rotator-strength ratio measured by Hand Held Dynamometer (HHD) Device. pain level and shoulder disability were measured by Shoulder Pain and Disability Index (SPADI). Results. Statistical analysis using pre and post treatment design indicated that there’s no significant difference between groups in the isometric rotator-strength ratio. However, a significant difference was found in pain level and shoulder disability index between groups. Conclusions. Cervicothoracic mobilization may be an effective intervention to treat pain and disability associated with shoulder impingement; however, the improvements associated with mobilization are not likely explained by changes in shoulder muscle strength.

Key words:
Manual Therapy, Shoulder Pain, Cervicothoracic, SPADI

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