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Biomedical subjects

M Pink

Publications and source records attributed to M Pink.

At least 37 records · Page 2Linked to original sources
PubMed1995

Electromyographic analysis of the hip and knee during the golf swing.

As golf increases in popularity, more golfers seek the proper mechanics necessary for the perfect golf swing. Surprisingly little scientific work has been published on the contribution of the hip and knee muscles during the golf swing even though most professionals have recognized their vital contribution. Recent studies have described the electromyographic (EMG) muscle activity of the shoulder, back, and trunk during the golf swing. The purpose of this study was to describe the electrical muscle activity in seven hip and knee muscles of both the left (lead) and right (trail) leg in competitive golfers while performing the golf swing. Sixteen golfers were studied with indwelling electrodes and high-speed cinematography. The EMG was synchronized with the film to discern five phases of the golf swing. Means, SDs, and t-tests were done. The results revealed that the trail hip extensors and abductors in conjunction with the lead adductor magus initiated pelvic rotation during forward swing. The lead hamstrings maintained a flexed knee and provided a stable base on which pelvic rotation took place. The peak EMG muscle activity recorded in the hips and knees occurred in an earlier phase than that measured previously in the trunk and shoulder. This confirmed the sequential firing pattern of the hip and knee muscles that takes place during the competitive golf swing. Information gained from this study can be used by players and coaches to optimize performance and to minimize injury.

Adult↗
PubMed1994

Non-operative treatment of ruptures of the anterior cruciate ligament in middle-aged patients. Results after long-term follow-up.

We retrospectively reviewed the records of fifty-two patients who had had a rupture of the anterior cruciate ligament between the ages of forty and sixty years, to determine the results of aggressive non-operative treatment. We were able to locate and re-examine thirty of these patients (mean age, forty-six years) after a mean duration of follow-up of seven years (range, five to thirteen years), and to assess the clinical, radiographic, and functional results. The mean score, according to the scale of Lysholm and Gillquist, was 82 points; eight of the eleven patients who had combined ligamentous injuries had a score of less than 84 points (symptoms with daily activities). Thirteen substantial reinjuries had occurred in eleven patients (37 per cent) during the follow-up period. Twenty-nine patients (97 per cent) had a grade-2 or 3 Lachman test, and a positive pivot-shift test was elicited in twenty-five patients (83 per cent). Plain radiographs revealed minimum or no changes in twenty-six patients (87 per cent). Magnetic resonance imaging in nine patients revealed scarring of the remnant of the anterior cruciate ligament to the posterior cruciate ligament in six. The mean difference in anterior-posterior laxity between the injured knee and the normal, contralateral knee, as measured with the KT-1000 arthrometer, was five millimeters at twenty pounds (eighty-nine newtons). Twenty-five (83 per cent) of these thirty middle-aged patients, who had had guided rehabilitation and had modified activity, had a satisfactory outcome without an operation. However, a few patients, who had combined instabilities and who wished to resume competitive sports activity that required pivoting, were dissatisfied. Such patients may need operative reconstruction to achieve their goals.

Adult↗
PubMed1994

Electromyographic analysis of knee rehabilitation exercises.

Many exercises are used to strengthen the knee muscles, yet limited studies that evaluate the exercises exist. The purpose of this study was to describe and compare the muscle firing patterns in five knee muscles during five rehabilitative exercises, which were presumed either to strengthen a specific muscle group or to elicit a cocontraction. During short-arc knee extension, the medial and lateral vasti were significantly more active during the last 15 degrees of extension than during other arcs (p < .05). The short-arc knee extension with hamstring cocontraction demonstrated significantly more activity in the rectus femoris, vastus medialis oblique, and vastus lateralis than the biceps femoris and semimembranosus in the final 15 degrees of extension (p < .05). With isometric knee cocontractions, no significant difference in muscle activity occurred in any of the arcs tested. During squatting, the rectus femoris, vastus medialis oblique, and vastus lateralis were significantly more active than the biceps femoris and semimembranosus during the descending, holding, and arising phases (p < .05). This information offers suggestions in selecting optimal knee rehabilitation exercises.

Adult↗
PubMed1993

Biomechanical effects of functional knee bracing. Practical implications.

Bracing of the anterior cruciate-deficient knee remains controversial. Close review of published data has revealed enough common observations about braces that strong suggestive information can be utilised for clinical purposes until more concrete data are provided. Brace function can vary with design. The primary differences noted are between the shell-type and strap-type braces. Shell braces tend to provide more stability to the knee than do the strap braces. Proper hinge placement, rather than type, affects pistoning and overall performance of the brace. Custom braces provide a better fit than off-the-shelf devices, but they can feel more restrictive, especially the shell braces. Static bench-testing data have shown that these braces provide little stability against anterior tibial translation at forces comparable to athletic play. Yet kinematic and force plate data suggest that they may produce some mechanical constraining effect to the entire lower extremity instead of just the knee joint. The literature still supports the philosophy that functional bracing should be considered as part of a comprehensive rehabilitation programme for an anterior cruciate-deficient athlete with significant functional deficits.

Anterior Cruciate Ligament↗
PubMed1993

Classification and treatment of shoulder dysfunction in the overhead athlete.

There are two distinct pathological categories of shoulder injury. In the older population, shoulder injury is generally a result of the degenerative aging process. In the younger population, it is commonly a result of the repetitiousness of an overhead sport. In the latter group, instability is typically the core problem, leading to the continuum of subluxation, impingement, and rotator cuff tear. A classification scheme, proposing four definitive types of shoulder injury, assists in directing an effective management program. Once diagnosed (the first step of treatment) a conservative rehabilitation program that emphasizes strengthening of the glenohumeral protectors, scapulohumeral pivotors, humeral positioners, and power drivers is advised. The surgery of choice, for the small minority who fail to respond to the rehabilitation program, is the anterior capsulolabral reconstruction. A sports medicine team working together with the athlete is instrumental in his/her return to sport.

Adolescent↗
PubMed1993

The normal shoulder during the butterfly swim stroke. An electromyographic and cinematographic analysis of twelve muscles.

This study describes shoulder muscle activity during the butterfly stroke. Upon hand entry, the deltoids and rotator cuff muscles demonstrated activity as the humerus was abducted, extended, and externally rotated. The rhomboids and upper trapezius were also active, retracting and upwardly rotating the scapula, which positioned the glenoid for the humerus. During propulsion, the pectoralis major and latissimus dorsi generated power. The subscapularis and teres minor were active to control humeral rotation. The serratus anterior helped to pull the body over the arm by reversing its origin and insertion. The posterior deltoid completed humeral extension at the end of propulsion and began to lift the arm out of the water. Then, the middle and anterior deltoids fired with the supraspinatus and infraspinatus to abduct and externally rotate the arm. The scapular muscles were also active, retracting the proximal portion of the scapula while protracting and upwardly rotating the distal tip. The glenoid then provided a platform for the humerus. Overall, the serratus anterior and the subscapularis maintained a high level of activation throughout the stroke; thus, these muscles were highly susceptible to fatigue and vulnerable to injury.

Adult↗
PubMed1993

The painful shoulder during the butterfly stroke. An electromyographic and cinematographic analysis of twelve muscles.

This paper compares the muscle firing patterns of 12 shoulder girdle muscles in competitive butterfly swimmers with painful and normal shoulders. Seven of the 12 muscles revealed statistically significant differences between the two populations. The posterior deltoid demonstrated more activity in the painful shoulders during hand entry while the upper trapezius and serratus anterior exhibited less activity. This alteration in muscle firing patterns allowed for the humerus to be positioned for a wider hand entry, which decreased the pain of impingement of the supraspinatus on the coracoacromial arch. Correspondingly, there was significantly less activity in the supraspinatus. The teres minor and serratus anterior revealed significantly less muscle action throughout pulling as they respectively failed to balance the humeral rotation and did not reverse their origins and insertions to pull the body over the arm. Also, the subscapularis and infraspinatus displayed increased activity in the painful shoulders as they depressed the humeral head to avoid impingement. There were no significant differences between the two groups in the rhomboids, pectoralis major, latissimus dorsi, or the anterior and middle deltoids. From this information, accurate preventative and rehabilitative exercise programs for the competitive butterfly swimmer can be developed.

Adult↗
PubMed1993

Baseball batting. An electromyographic study.

The muscle firing pattern in 12 muscles throughout the lower extremity, trunk, and upper extremity during the batting swing is described in this study. The two hamstring muscles studied and the gluteal muscle had a similar pattern of high muscle activity during pre-swing and early swing, and then rapidly diminished. The vastus medialis demonstrated peak activity between 95 and 110% maximum muscle test (MMT) throughout the swing phases and follow-through. The erector spinae demonstrated activity from 85 to 185% MMT during the swing phases. The abdominal obliques showed greater than 100% MMT during the swing phases and follow-through. The supraspinatus and serratus anterior showed relatively low muscle activity (less than 40% MMT). These results show that batting is a sequence of coordinated muscle activity, beginning with the hip, followed by the trunk, and terminating with the arms. Power in the swing is initiated in the hip, and therefore exercises that emphasize such strength development are indicated. The maintained, high muscle activity in the trunk muscles indicates a need for back and abdominal stabilization and rotation exercises. The relatively low level of activity in the four scapulohumeral muscles tested indicated that emphasis should be placed on the trunk and hip muscles for a batter's strengthening program.

Abdominal Muscles↗
PubMed1992

Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament.

From September 1974 to December 1987, seventy-one patients were operated on for valgus instability of the elbow. The average length of follow-up of sixty-eight patients (seventy operations) was 6.3 years (range, two to fifteen years). At the operation, a torn or incompetent ulnar collateral ligament was found. Fourteen patients had a direct repair of the ligament, and fifty-six had a reconstruction of the ligament using a free tendon graft. The result was excellent or good in ten patients in the repair group and in forty-five (80 per cent) in the reconstruction group. Seven of the fourteen patients who had a direct repair returned to the previous level of participation in their sport. Of the fifty-six who had a reconstruction, thirty-eight (68 per cent) returned to the previous level of participation. Twelve of the sixteen major-league baseball players who had a reconstruction as the primary operation (no previous operation on the elbow) were able to return to playing major-league baseball, and two of the seven major-league players who had a direct repair returned to playing major-league baseball. Previous operations on the elbow decreased the chance of returning to the previous level of sports participation (p = 0.04). Fifteen patients had postoperative ulnar neuropathy. This was transient in six patients, only one of whom was unable to return to the previous level of sport. The other nine patients had an additional operation for the neuropathy; four were able to return to the previous level of sport.

Adult↗
PubMed1989

Dynamic EMG analysis of torque transfer in professional baseball pitchers.

Fifteen professional baseball pitchers underwent active pitching motion analysis of the abdominal oblique, rectus abdominis, lumbar paraspinous and gluteus maximus muscles bilaterally via surface electrode evaluation. Baseline resting and isometric maximum values were obtained and active data referenced against these for comparison. The muscle activity then was measured during the pitching sequence and analyzed in each of the five pitching phases. The abdominal oblique, lumbar paraspinous and rectus abdominis contralateral to the pitching arm and the ipsilateral gluteus maximus all had increases in activity level of 75 to 100% during the active pitching motion. Using these data indicating specific muscle group patterns with clinical and performance data, we hope to minimize injuries and maximize pitching performance.

Abdominal Muscles↗
PubMed1989

[Diagnosis and therapy of enthesiopathy of the radial humeral condyle].

According to a detailed analysis of the etiology and pathomorphology of the s.c. "tennis elbow" or radial epicondylitis, only the name enthesopathy (disturbances of the tendinous insertion to bone) can be used. The authors describe the detailed diagnostics of the enthesopathy itself, with multifactorial etiology of disturbances in the insertion of the forearm extensors, the joint capsule, synovium and radial head chondropathy; further the second most common cause, the s.c. supinator syndrome as a tunnel syndrome of the interosseous nerve. The complex pharmaceutical and physical therapy of these syndromes is also mentioned, with special reference to operative treatment. In the operative treatment of radial enthesopathy Boyd's modified operation is preferred; in the supinator syndrome a deliberation of the nerve through a partial decision of the supinator muscle. The excellent results of the operations, where in 101 patients in 2 groups there was only 1 recurrence, serve as prove of an exact diagnosis and adequate operative treatment.

Humans↗
PubMed1984

Physical therapy work schedules.

The purpose of this article is to describe the results of a survey sent to the directors of 200 hospital physical therapy departments to determine the work schedules of physical therapists. The results indicated that 26 percent of the inpatient units and 76 percent of the outpatient units had work schedules of eight-hour days, Monday through Friday (Schedule A); 61 percent of the inpatient units and 22 percent of the outpatient units had work schedules of eight-hour days and weekends (Schedule B); and 13 percent of the inpatient units and 2 percent of the outpatient units had work schedules other than Schedules A or B (Schedule C). Thirty-three percent of the inpatient units and 64 percent of the outpatient units with Schedule A perceived that schedule as adequate. Seventy-seven percent of the inpatient units and 85 percent of the outpatient units with Schedule B perceived that schedule as adequate. The inpatient and outpatient units with Schedule C unanimously perceived it as adequate.

Hospital Bed Capacity, 100 to 299↗
PubMed1981

Contralateral effects of upper extremity proprioceptive neuromuscular facilitation patterns.

Electromyography was used to determine the presence of electrical activity in the nonexercised latissimus dorsi, infraspinatus, and pectoralis major muscles while the contralateral limb underwent the proprioceptive neuromuscular facilitation pattern of flexion, abduction, external rotation with elbow straight and extension, adduction, internal rotation with elbow straight. Activity was present in all of these muscles during both components of the pattern. There was no significant difference in activity for the pectoralis major muscle during the flexor as compared to extensor component. The infraspinatus was more active during the flexor component, while the latissimus dorsi was more active during the extensor component. These results could be used in planning a treatment program for patients who are unable to exercise one of their upper extremities and who could benefit from the contralateral effects of upper extremity proprioceptive neuromuscular facilitation patterns.

Adult↗
PubMedDate not supplied

The athlete's shoulder.

Throughout the ages, instability has been noted to be the underlying problem in shoulder dysfunction of the young, overhand-throwing athlete. Impingement and rotator cuff tears are progressive symptoms of this instability. The classic theory of impingement describes a mechanism for "outside impingement," which is most often seen in the older, nonathletic population. The mechanism for "inside impingement" in the younger, athletic population is a pinching of the cuff undersurface on the posterosuperior glenoid labrum. In this younger group, the first treatment of choice is rehabilitation. If that fails, the surgical procedure with successful outcome is the ACLR coupled with a progressive rehabilitation program.

Arthroscopy↗
PubMedDate not supplied

Dynamic stability of the elbow: electromyographic analysis of the flexor pronator group and the extensor group in pitchers with valgus instability.

The medical collateral ligament is a common site of injury in baseball pitchers, causing substantial morbidity and loss of pitching time. Twenty-six skilled baseball pitchers with medial collateral ligament insufficiency were studied before surgery with high-speed cinematography and fine-wire electromyography of eight muscles around the elbow. Data from the pitchers with injured elbows were compared with data obtained from uninjured pitchers. The flexor carpi radialis muscle in the pitchers with medial collateral ligament deficiencies revealed significantly decreased firing during the acceleration and deceleration phase of the fastball when compared with that of the pitchers with normal elbows, and the flexor carpi radialis muscle was significantly depressed during the early cocking and deceleration phases. The extensor muscles revealed slightly increased activity in the injured elbows; however, this was not statistically significant. Although the muscles of the flexor pronator group (especially the flexor carpi ulnaris muscle and the flexor digitorum superficialis muscles) are anatomically positioned to provide dynamic stability of the elbow, they did not demonstrate increased electrical activity in pitchers with medial collateral ligament deficiencies. This finding suggests that the muscles on the medial side of the elbow do not supplant the role of the medial collateral ligament during the fastball pitch.

Baseball↗