The Journal of orthopaedic and sports physical therapy
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J Orthop Sports Phys Ther · Jun 1998
Case ReportsScapular avulsion fracture of a high school wrestler.
This case study details a rare injury managed conservatively with aggressive therapy with early return to competition. A 17-year-old high school wrestler suffered indirect trauma to the right upper extremity. The patient was forced to the mat where he felt pain in the posterior aspect of his shoulder and was point tender over the inferior pole of his right scapula. ⋯ The patient was able to wrestle in the state tournament 3 weeks after initial injury. At the 6-month follow-up, the patient had no clinical tenderness, full range of motion, and no motor deficits. The outcome resulted in clinical and radiological healing of the fracture and no functional deficits.
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Low back pain is, in large part, a subjective illness. Clinicians must use patient descriptions of the severity and location of low back pain and how it responds to various activities and positions to make diagnostic and treatment decisions. Therefore, it is important to understand how reliably patients describe these aspects of low back pain. ⋯ Reliability of each item on the pain response to activity and position questionnaire was examined by calculating an unweighted Cohen's kappa. Overall, the three pain measures demonstrated fair to good test-retest reliability: 1) visual analogue scale = .66-.93, 2) pain drawing = .58-.94, and 3) pain response to activity and position questionnaire = .46-.89. The results of this study suggest that, although there is some variability in how consistently patients report various aspects of low back pain, the reliability of these pain measures is sufficient to permit their use in making clinical decisions and measuring treatment outcomes.
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J Orthop Sports Phys Ther · Aug 1997
Comparative StudyPostural imbalance and vibratory sensitivity in patients with idiopathic scoliosis: implications for treatment.
Sporadic research reports of decreased proprioception and balance problems have been reported in subjects with idiopathic scoliosis, yet these sensory motor deficits have not been addressed in conservative clinical management programs. The purpose of this study was to compare both balance reactions and vibratory sensitivity (as an estimate of proprioception) in patients with idiopathic scoliosis (N = 24) and age-matched controls (N = 24). Balance was measured by the ability to pass a series of simple static and complex sensory-challenged balance tasks. ⋯ Although vibration sensitivity did not distinguish normal healthy individuals from individuals with idiopathic scoliosis, those with more severe scoliotic curves appear to have a high threshold to vibration. These balance and vibratory differences could either be interpreted as etiologic risk factors or as consequences of spinal asymmetry. In either case, given that curves can continue to progress even into the adult years, improving the ability to right the body with gravity could help maintain the balance of the spine despite structural asymmetry.
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J Orthop Sports Phys Ther · May 1997
Clinical TrialAn objective measurement technique for posterior scapular displacement.
Contemporary shoulder rehabilitation programs emphasize scapular control in the treatment of shoulder pathology. In addition, scapular winging and scapular tipping are often cited as key components to both the evaluative and rehabilitative phase of treatment. However, the lack of objective measurement procedures makes clinical evaluation of these phenomena difficult. ⋯ None of the calculated p values for intratester and intertester reliability were statistically significant (p < 0.05). We conclude that this measurement technique is a reliable method to quantify posterior scapular displacement. Further research utilizing this measurement technique is recommended.