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Biomedical subjects

T R Malone

Publications and source records attributed to T R Malone.

10 recordsLinked to original sources

Intrarater reliability of selected clinical outcome measures following anterior cruciate ligament reconstruction.

STUDY DESIGN: Single group repeated measures following anterior cruciate ligament (ACL) reconstruction. OBJECTIVES: The purpose of this study was to evaluate the intrarater reliability of selected clinical outcome measures in patients having ACL reconstruction. BACKGROUND: Several investigations have reported the reliability of isokinetic testing and knee ligament arthrometry. Fewer studies have examined the reliability of lower extremity functional tests, with most of these studies evaluating normal subjects. METHODS AND MEASURES: Fifteen physically active males with unilateral ACL-reconstructed knees were evaluated with the KT-1000, Biodex isokinetic dynamometer, and 3 functional hop tests on 5 occasions. RESULTS: Intraclass correlation coefficients (ICCs) revealed good to high intrarater reliability (ICC > 0.80) of the functional hop tests and isokinetic peak torque values ICCs were higher for the involved limb than the uninvolved limb using the scores from the KT-1000 Manual Maximum Test. CONCLUSIONS: The outcome measures examined in this investigation have been shown to be reliable in patients with ACL reconstructions, and support previous investigations in nonimpaired populations. Further research is needed to examine the validity of these postoperative outcome measures in patients with ACL reconstructions.

Adolescent↗

Patellofemoral disorders: a classification system and clinical guidelines for nonoperative rehabilitation.

Patellofemoral disorders are among the most common clinical conditions managed in the orthopaedic and sports medicine setting. Nonoperative intervention is typically the initial form of treatment for patellofemoral disorders; however, there is no consensus on the most effective method of treatment. Although numerous treatment options exist for patellofemoral patients, the indications and contraindications of each approach have not been well established. Additionally, there is no generally accepted classification scheme for patellofemoral disorders. In this paper, we will discuss a classification system to be used as the foundation for developing treatment strategies and interventions in the nonsurgical management of patients with patellofemoral pain and/or dysfunction. The classification system divides the patellofemoral disorders into eight groups, including: 1) patellar compression syndromes, 2) patellar instability, 3) biomechanical dysfunction, 4) direct patellar trauma, 5) soft tissue lesions, 6) overuse syndromes, 7) osteochondritis diseases, and 8) neurologic disorders. Treatment suggestions for each of the eight patellofemoral dysfunction categories will be briefly discussed.

Femur↗

The effect of quadriceps femoris, hamstring, and placebo eccentric fatigue on knee and ankle dynamics during crossover cutting.

This study attempted to determine the effect of eccentric quadriceps femoris, hamstring, and placebo fatigue on stance limb dynamics during the plant-and-cut phase of a crossover cut. Twenty female college students (task trained) were tested. Hamstring fatigue resulted in decreased peak impact knee flexion moments (p < or = .01), increased internal tibial rotation at peak knee flexion (p < or = .05), and decreased peak ankle dorisflexion (p < or = .05). Quadriceps fatigue resulted in increased peak ankle dorsiflexion moments (p < .01), decreased peak posterior braking forces (p < or .01), decreased peak knee extension moments (p < or = .01), delayed peak knee flexion (p < or = .01), delayed peak propulsive forces (p < .01), and delayed subtalar peak inversion moments (p < or = .05). Fatigue of either muscle group produced earlier peak ankle plantar flexion moments (p < = .05) and decreased peak propulsive knee flexion moments (p < or = .05). Variables requiring further study (p < or = .1) provide discussion data. Soleus, gastrocnemius, tibialis anterior, and deep posterior compartment calf muscles serve as dynamic impact force attenuators, compensating for fatigued proximal muscles.

Adult↗

Injury to the lateral ligaments of the ankle.

Ankle sprains are common and often are treated inadequately. Unstable lateral ankle ligaments cause abnormal ankle motion and can lead to degenerative changes. Arthrography is the superior radiographic study in acutely injured ankles. Stress tests are useful if positive; however, because false-negative tests are common, general anesthesia should be considered. Chronic injuries may be evaluated well with stress testing. Conservative treatment (that is, mobilization) with aggressive rehabilitation is probably the best treatment for all lateral ligament injuries, unless certain mechanical stability is of paramount importance. Finally, the results of late reconstruction equal those of early repair.

Ankle Injuries↗

Evaluating research literature: the educated clinician.

The purpose of this article is to present a framework for reader evaluation of research literature. The elements of a research article are outlined by citing examples from the January 1984 issue of Physical Therapy. We present concrete suggestions that clinicians can use to develop competence in evaluating research literature and include an annotated bibliography of research references. Better patient care and increased professional growth will result when clinicians learn to evaluate and make use of the research literature.

Bibliographies as Topic↗

Knee disorders.

To clinicians, treatment of knee disorders is an important concern. This article presents the etiology, natural course, and general treatment of common clinical disorders of the knee. The material is presented to serve as an introduction. Clinicians are urged to investigate specific conditions further through the use of the suggested reading list.

Adolescent↗

Long-term functional results in patients with anterolateral rotatory instability treated by iliotibial band transfer.

The purpose of this paper is to define the use of the extraarticular, lateral reconstruction in the spectrum of patients with cruciate deficiency. A review was conducted of 112 consecutive patients with a MacIntosh-type iliotibial band transfer done between 1972 and 1986. Fifty-six of the patients had a partial or complete meniscectomy, and 24% had failed a previous extraarticular procedure. Eighty-one percent were men, with a mean age of 23. Twenty-five percent of the patients had radiographic degenerative changes at the knee at the outset. Ninety-eight percent had an anterior drawer of 1+ or greater; 97% had a pivot shift greater than trace. All patients had symptomatic knee instability. Seventy-seven of the 112 patients (69%) were available for followup (range, 24 months to 15.5 years; median, 7.6). Twenty-three patients (21%) returned for examination, KT-1000 and Cybex testing, and radiographs. An additional 54 patients (48%) were seen by their local physicians or returned a detailed questionnaire that included the Cincinnati knee rating scale. At final followup, 38% complained of some knee instability, 36% had recurrent effusions, 61% had intermittent pain, 79% had radiographic gonarthrosis, and 25% had undergone additional surgery. Forty-two percent had a positive Lachman after surgery, and only 15% had a pivot shift. The mean knee score was 81.1. Previous extraarticular anterior cruciate ligament reconstruction, meniscectomy, and generalized ligamentous laxity were associated with a significant decrement in the knee rating (P = 0.05). Ligamentous laxity strongly correlated with symptoms of giving way.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Cryotherapy-induced nerve injury.

Cryotherapy is a frequently used therapeutic modality in the treatment of athletic injuries. Peripheral nerve injury can result from the use of cryotherapy and cause temporary disability for the athlete. Six cases of peripheral nerve injury are reviewed. All cases resolved spontaneously. To avoid this complication, one should consider the location of major peripheral nerves, the thickness of the overlying subcutaneous fat, and the duration of tissue cooling.

Adult↗