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Biomedical subjects

J H Gieck

Publications and source records attributed to J H Gieck.

17 recordsLinked to original sources
PubMed2000

Rehabilitation after posterolateral dislocation of the elbow in a collegiate football player: a case report.

OBJECTIVE: To describe a functional rehabilitation program for a football player with a grade 2 posterolateral elbow dislocation to facilitate early return to competition. BACKGROUND: Conservative management of a posterior dislocation of the elbow is common. The elbow is the second most frequently dislocated large joint in adults. Two common mechanisms of dislocation are hyperextension and posterolateral rotation. Prolonged immobilization can be detrimental to regaining full range of motion and function of the elbow, whereas early directed rehabilitation may lead to early return to normal function. DIFFERENTIAL DIAGNOSIS: Elbow dislocation with medial collateral ligament rupture, elbow subluxation, elbow dislocation with neurovascular compromise, or supracondylar fracture. TREATMENT: The athlete received immediate care of reduction and immobilization in a 90 degrees posterior splint followed by a radiologic evaluation. Postreduction treatment included a short immobilization period and early initiation of protected active and resistive range-of-motion exercises. The athlete was able to return to full football activities in 3 weeks. He competed for the rest of the season with the elbow braced and taped, with no recurring incidents of instability. UNIQUENESS: The time to return to full participation was rapid. The medial collateral ligament was intact, as determined by magnetic resonance imaging. The athlete has since been followed for 2 football seasons and has not demonstrated any detrimental effects due to his early return. CONCLUSIONS: Early determination of the status of the medial collateral ligament through physical examination or imaging combined with early directed rehabilitation of a posterolateral elbow instability enabled this athlete to respond well. He regained pain-free full range of motion, strength, and function, allowing full participation in football at the Division I level with no recurring incidence of dislocation.

Journal Article↗
PubMed2000

Clinical Experiences Are Not Predictive of Outcomes on the NATABOC Examination.

OBJECTIVE: To determine the efficacy of the National Athletic Trainers' Association Board of Certification (NATABOC) clinical experience requirements and individual student characteristics to predict candidate outcomes on the NATABOC certification examination. DESIGN AND SETTING: For all subjects, we gathered survey information and examination scores. The survey information included age, sex, route to certification, previous athletic training and allied health experience, and clinical education experiences. SUBJECTS: A total of 269 subjects, 22.25% of all first-time candidates for the June and November 1993 NATABOC examinations, were included in this study. MEASUREMENTS: Data were analyzed for standard descriptive statistics and parametric linear regression and correlational relationships. RESULTS: Total clinical hours, high-risk sport experiences, and previous athletic training experience were not predictive of examination outcomes. Although our results indicated a relationship between previous allied health experience and both outcome on the written section of the examination and age and outcome on the oral/practical section, these characteristics also were not predictive of examination outcomes. CONCLUSIONS: Gaining clinical experience hours in excess of 400 hours beyond the 800-or 1500-hour requirement may yield no greater benefit for an entry-level professional than less time. The quality, rather than the quantity, of clinical experiences should be evaluated. More emphasis should be placed on the achievement of an entry level of clinical competency, rather than on total hour collection. Also, because high-risk sport experiences did not predict outcomes on the NATABOC examination, the emphasis of clinical education should be on students' receiving a more structured clinical experience, in which they are progressively required to assume greater responsibilities integrating both cognitive and psychomotor skills, while working under the supervision of a certified athletic trainer.

Journal Article↗
PubMed1998

Reliability and responsiveness of disablement measures following acute ankle sprains among athletes.

The minimum amount of change which represents clinical improvement following ankle sprains is unknown. This study considers the usefulness of physiological and behavioral measures commonly employed for this purpose in sports rehabilitation settings. Thirteen collegiate athletes of both genders were measured at approximately 3 and 10 days post-grade I or II ankle sprain. Volumetric displacement and sagittal plane ankle range of motion measures were used as impairment indicators. Motor ability scores (activity count) and a perceived athletic ability measure (visual analog scale) were used to indicate functional limitations. Volumetric displacement and both functional limitation measures demonstrated responsiveness to change between two occasions of measurement separated by 1 week. Observed changes in range of motion deficits could not be distinguished from measurement error. The results of this study suggest that behavioral measures of motor activity and perceived athletic ability may be at least as useful as physical measures of organic dysfunction for assessing clinical improvement following acute ankle sprains among athletes.

Acute Disease↗
PubMed1997

A trend analysis of the in vivo quadriceps femoris angle-specific torque-velocity relationship.

To adequately assess isokinetic human muscle performance, it is important for clinicians to understand how the muscle functions across a range of velocities. Thus, the purpose of this study was to re-examine the in vivo quadriceps torque-velocity relationship using trend analysis. Twelve uninjured university-age females performed three concentric and eccentric contractions at velocities of 0, 25, 50, 75, 100, 125, 150, 175, and 200 degrees/sec on the Kin-Com isokinetic dynamometer. A trend analysis was performed on the angle-specific torques at 30, 60, and 75 degrees of knee flexion. The results indicated that the concentric and eccentric relationships at 30 degrees and the concentric relationship at 60 degrees were represented by a third-order polynomial, and a linear relationship was found for concentric contractions at 75 degrees. There were no significant trends for the eccentric relationship at 60 and 75 degrees, suggesting that they were best described by the grand mean. These results suggest that muscular torque production varies across velocities and contraction modes and that this relationship varies depending on the joint angle of torque measurement.

Adult↗
PubMed1993

Effect of preload and range of motion on isokinetic torque in women.

The purposes of this study were to compare the effects of two preload settings (0 N, 75 N) and two ranges of motion (5-90 degrees ROM, 25-70 degrees ROM) on torque output of the knee musculature. Twenty females were randomly assessed for isokinetic concentric (CON) and eccentric (ECC) torque of the knee extensor (EXT) and flexor (FLEX) musculature at a velocity of 1.62 rads.s-1. Two four-way ANOVAs (muscle x mode x range of motion x preload) revealed significant differences in average torque between the preload and range of motion conditions (CONEXT: 5-90 degrees ROM, 75 N = 74.3 +/- 17.2 Nm; 5-90 degrees ROM, 0 N = 68.3 +/- 17.2 Nm; 25-70 degrees ROM, 75 N = 79.0 +/- 13.0 Nm; 25-70 degrees ROM, 0 N = 71.5 +/- 20.8 Nm) (ECCEXT: 5-90 degrees ROM, 75 N = 85.6 +/- 28.6 Nm; 5-90 degrees ROM, 0 N = 82.8 +/- 27.8 Nm; 25-70 degrees ROM, 75 N = 97.7 +/- 23.4 Nm; 25-70 degrees ROM, 0 N = 93.6 +/- 26.5 Nm) (CONFLEX: 5-90 degrees ROM, 75 N = 43.5 +/- 9.2 Nm; 5-90 degrees ROM, 0 N = 43.1 +/- 5.6 Nm; 25-70 degrees ROM, 75 N = 44.2 +/- 8.9 Nm; 25-70 degrees ROM, 0 N = 41.2 +/- 8.9 Nm) (ECCFLEX: 5-90 degrees ROM, 75 N = 56.7 +/- 16.3 Nm; 5-90 degrees ROM, 0 N = 55.6 +/- 17.8 Nm; 25-70 degrees ROM, 75 N = 57.3 +/- 14.0 Nm; 25-70 degrees ROM, 0 N = 51.8 +/- 14.0 Nm) (P < 0.05). No differences in peak torque values were observed. Based on the findings of this study, preload and range of motion should remain constant between and among subjects if average torque is used as a criterion measure.

Adult↗
PubMed1992

Motivational congruency and discrepancy of hawaiian athletic trainers.

Motivation is an integral part of an effective organizational management scheme. In March 1992, we sent a survey designed to assess motivational preference to all certified athletic trainers in the State of Hawaii. The population included: 6 high school athletic trainers, 10 university athletic trainers, and 9 clinic athletic trainers. The surveys were completed and returned by 80% of the population. With the exception of being an integral part of a work team (p<.05), athletic trainers in the State of Hawaii showed little discrepancy in terms of motivation. Further, there are differences among the three groups of athletic trainers in rating the importance of motivators concerning being appreciated, receiving raises, and being an integral part of a team (p< .05) Differences in motivational factors among these three groups could be influenced by the organizational structure in which the athletic trainers operate. Further investigation should include a mainland population that includes athletic trainers in professional sports and the industrial setting.

Journal Article↗
PubMed1987

Application of modalities in overuse syndromes.

Improper techniques are often the cause of overuse syndromes. Unless the technique is corrected, the patient is doomed to recurrence. The same is true of improper posture, especially in the lower extremity and trunk areas. The pitcher or tennis player should have his or her style analyzed for proper form. The runner should have his or her muscular imbalances corrected by exercise and orthotic appliances. As with all other modalities used for treating painful conditions, proper evaluation of the etiology and the rectification of the cause is important. When athletes are underway in their sports seasons, it is often difficult to convince them to accept the ideal healing conditions needed to eliminate the problem. Management of the condition with any modality while maintaining an active lifestyle often brings about ethical scrutiny. However, it is the belief of the authors that noninvasive modalities do not provide the pain relief that would enable the athlete to tolerate activity beyond a significant injurious stress level. The modalities allow the athlete to regain the criteria for return, strength, and range of motion more successfully. Short-term goal setting is imperative to proper return. Several plateaus should be successfully completed before full return to activity is allowed. Tennis elbow, for example, may be allowed an initial period of 5 minutes on alternate days, gradually increasing to full activity every other day. Patients are often so anxious to return to activity that they overdo, leading to a decrease in function with a rapid return to the results of inflammation. The goals of successful rehabilitation of the overuse syndrome are pain-free range of motion, strength, and endurance. The use of cold, heat, electrotherapy, and exercise allow the athlete to reach his or her goal of returning to activity more quickly with a reduced risk of reinjury.

Athletic Injuries↗
PubMed1986

Rehabilitation of hand injuries in athletes.

This article outlines and stresses the importance of proper rehabilitation of hand injuries in athletes. Rationale for guidelines in splinting, modalities, and appropriate progression of various types of exercise is discussed.

Athletic Injuries↗
PubMed1986

Protective splinting for the hand and wrist.

Providing adequate protection is a very important component of proper treatment of athletic injuries of the upper extremity. This article reviews the anatomic considerations involved in fabricating splints for various joints of the hand and wrist that will allow the athlete to compete as early as possible while preventing reinjury or permanent disability.

Athletic Injuries↗
PubMedDate not supplied

The coach's finger.

Explore the source record for details and available documents.

Athletic Injuries↗
PubMedDate not supplied

Tennis injuries: prevention and treatment. A review.

When players are engaged in the sport of tennis, injuries may occur to the eyes, in the neck, to the shoulder and back, arm and elbow, wrist and hand, and feet. The key to prevention and treatment of these injuries is good coaching and a formal stretching and strengthening program. The drooped "tennis shoulder" of professionals and senior tennis players is a natural response to heavy use. Shoulder elevating exercises are useful when soreness is associated. The treatment of tennis elbow includes wrist extensor stretching, isometrics, and light weightlifting. When a player follows this program, injections or counterforce braces are rarely needed. It is important for the player to bring his racket to the examination so that his stroke mechanics and grip can be checked. Wrist soreness in a tennis player may denote a hamate hook fracture. Special radiographic views are needed to discern the fracture and it is treated with a short arm cast and little finger extension splint. Nonunion of a hamate hook requires excision. The calf pain prodrome of "tennis leg" requires rest and then a stretching program. Tennis shoes should have rolled heels and large toe boxes with reinforced toe bumpers. The physician may have to fashion soft inserts for the tennis shoes; arch supports may be insufficient.

Athletic Injuries↗
PubMedDate not supplied

Hand and wrist injuries in the athlete.

Injuries to the hand and wrist are probably among the most common injuries incurred by the athlete. Neglect of such injuries may result in irreparable damage to the hand or wrist. This summary of the more common injuries to these areas seen in the athlete, with a description of the recognition and treatment, gives the reader insight into the multiple considerations the athlete and coach must have. Even seemingly minor injuries must be carefully evaluated and treated by a physician. Early diagnosis, accurate precise treatment, and proper rehabilitation are extremely important to regain optimal function after these injuries. They may have a significant impact not only in athletic competition but also in the athlete's selection of an occupation. It is psychologically important also that the participant be returned to his particular sport as soon as possible. Most of the injuries can be controlled by conservative means. However, when surgical repair is indicated, it is important for the surgeon to be trained and familiar with the anatomy and techniques of surgery of the hand and wrist.

Athletic Injuries↗
PubMedDate not supplied

The biophysical effects of ultrasound on median nerve distal latencies.

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The analyses and conclusions were reached, despite only one study incorporating pulsed ultrasound. The purpose of this study was to determine the biophysical effects of continuous wave (CW) and pulsed wave (PW) ultrasound on median nerve motor and sensory latencies using common frequencies of 1.0 and 3.0 MHz. SUBJECTS: Fifteen healthy subjects (8 males, 7 females, age = 23.5 + 4.44 yrs, height = 171.2 + 10.7 cm, weight = 67.5 + 7.9 kg) without a history of neurological or musculoskeletal injury to their non-dominant arm volunteered for testing. METHODS AND MATERIALS: Subjects were exposed in counterbalanced order to five ultrasound treatment conditions: (1) 1 MHz, 1.0 W/cm2, 8 min., (2) 1 MHz, 1.0 W/cm2, 50% PW, 8 min., (3) 3.0 MHz, 1.0 W/cm2, CW, 8 min., (4) 3.0 MHz, 1.0 W/cm2, 50% PW, 8 min., (5) placebo, 0.0 W/cm2, 8 min. Dependent measures for motor and sensory latencies, and subcutaneous temperatures were taken pretreatment, at 2, 4 and 6 minutes during treatment, and immediately post-treatment. Separate two within repeated measures ANOVA were used for each dependent measure. RESULTS: Analysis revealed significant interactions for motor latencies [F (16,224) = 52.77, p < .001], sensory latencies [F (16,224) = 41.10, p < .001], and subcutaneous temperatures [F (16,224) = 52.77, p < .001]. Tukey's HSD post hoc analyses confirmed that nerve latencies responded similarly to subcutaneous temperature changes during and after ultrasound treatment. CONCLUSIONS: Alterations in nerve latencies from ultrasound on healthy nerves appeared to be related to temperature changes induced by ultrasound's thermal effects, and not by non-thermal or mechanical effects.

Adult↗