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Biomedical subjects

M C Morrissey

Publications and source records attributed to M C Morrissey.

23 records · Page 2Linked to original sources

Development of a clinical physical therapy research program.

Clinical physical therapy research is important for the continued growth of the physical therapy profession. Such research results in improved patient care and heightens the professional standing of the physical therapy field. One of the major barriers to clinical physical therapy research is unfamiliarity with the research process by practicing physical therapists. The purpose of this article is to present a model for developing a clinical physical therapy research program that may assist novice investigators interested in initiating clinical physical therapy research at their facility.

Models, Theoretical↗

Open and closed kinetic chain exercises in the early period after anterior cruciate ligament reconstruction. Improvements in level walking, stair ascent, and stair descent.

Thirty-seven patients who had undergone anterior cruciate ligament reconstruction were tested in a gait analysis laboratory at 2 and 6 weeks after surgery. Between test sessions, patients were randomly assigned to a course of either closed or open kinetic chain resistance exercises (3 sessions per week for 4 weeks). Gait analysis consisted of bilateral calculations of knee joint angle, moment, and power during level walking, stair ascent, and stair descent. An analysis of variance on the effects of training group and test session indicated that the only variable to be significantly affected by the type of exercise program was the amount of knee flexion at the beginning of step-up (P < 0.05). All other measures of knee angle, moment, and power (16 total variables) showed no significant difference between the exercise groups. All variables measured on the injured side showed significant improvement from test 1 to test 2 (P < 0.05), but the injured leg remained functionally deficient when compared with the uninjured leg. These data suggest that there are no clinically significant differences in the functional improvement resulting from the choice of open or closed kinetic chain exercises in the early period after this surgery.

Analysis of Variance↗

The effects of electrical stimulation on the quadriceps during postoperative knee immobilization.

Immobilization of the knee after anterior cruciate ligament (ACL) reconstruction results in marked thigh atrophy and decrease in quadriceps strength that may prolong the rehabilitation program of the injured athlete. Fifteen male volunteers undergoing ACL reconstruction were divided into two groups, stimulation (during immobilization) and nonstimulation. Measurements of thigh circumference and isometric quadriceps strength were tested preoperatively, immediately after cessation of cast immobilization (6 weeks), and at 9 and 12 weeks postoperatively. The changes in circumference and strength between the first preoperative test and all subsequent tests were compared for statistical significance (Student's t-test, P less than 0.5) between the two groups. The decrease in quadriceps strength of the stimulation group during immobilization was significantly less than that of the nonstimulation group, although later differences between the two groups were not significant. There were no significant differences in thigh atrophy between the two groups. In conclusion, isometric quadriceps torque decreases resulting from immobilization can be significantly lessened by application of electrical stimulation during immobilization. Electrical stimulation to the quadriceps does not significantly alter thigh circumference changes that occur during immobilization.

Adolescent↗

Assessment of quadriceps/hamstring strength, knee ligament stability, functional and sports activity levels five years after anterior cruciate ligament reconstruction.

The purpose of this study was to examine individuals 5 years after ACL reconstruction and analyze changes involving strength, stability, function, and sports activities. Nineteen males and six females, mean age = 31.4 +/- 7.31 years, participated in this study. Fifteen subjects had received extraarticular and ten subjects had received intraarticular ACL reconstructions. Subjects completed a 100 point subjective functional activity questionnaire and a sports participation survey. Knee ligament stability was assessed during an objective knee examination. Isokinetic quadriceps and hamstring muscle strength were tested at 240 and 120 deg/sec using the Cybex II dynamometer. Anterolateral rotatory instability and positive Lachman were elicited on the operated leg for 80% of the subjects. No significant relationship was found between objective instability and the functional activity score. For the intraarticular group, a significant correlation (P less than 0.05) was found between increased quadriceps and hamstring strength on the operated leg and return to functional activities. Subjects' functional activity score was positively correlated (P less than 0.001) with their ability to participate in sports. Subjects participating in sports involving cutting and twisting motions were less successful in returning to their preinjury participation levels and reported more subjective complaints of pain, swelling, and/or instability. These results indicate that long-term progressive rehabilitation emphasizing increased quadriceps and hamstring strength to approximate the nonoperated leg may enhance successful return to functional and sports activities after ACL reconstruction.

Adult↗

Early phase differential effects of slow and fast barbell squat training.

To examine the importance of resistance training movement speed, two groups of women (24 +/- 4 years, 162 +/- 5 cm, 59 +/- 7 kg) squatted repeatedly at 1) 2 seconds up, 2 seconds down (slow, N = 11); or 2) 1 second up, 1 second down (fast, N = 10), doing three warm-up sets and three eight-repetition maximum sets, three times per week for 7 weeks. Tests included force platform and video analysis of the vertical jump, long jump, and maximum squat, and isometric and isokinetic knee extensor testing at speeds from 25 to 125 deg/sec. The groups improved similarly in many variables with training but also showed some differences. In the long jump, the fast group was superior in numerous variables including knee peak velocity and total-body vertical and absolute power. In the vertical jump, fast training affected the ankle and hip more (e.g., average power), and slow training mostly affected the knee (average torque). In isokinetic testing, the fast group improved strength most at the faster velocities, while the slow group strength changes were consistent across the velocities tested. Although both slow and fast training improved performance, faster training showed some advantages in quantity and magnitude of training effects.

Adult↗