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Biomedical subjects

L Snyder-Mackler

Publications and source records attributed to L Snyder-Mackler.

14 recordsLinked to original sources
PubMed1991

Comparison of spinal mobility and isometric trunk extensor forces with electromyographic spectral analysis in identifying low back pain.

This study compared conventional clinical measurements with electromyographic (EMG) spectral measurements for identification of individuals with low back pain (LBP). Twenty freshman sweep rowers were subjects for this study. Range-of-motion (ROM) measurements were taken for forward bending (FB), backward bending (BB) (double inclinometers), lateral bending (LB) (tape measure), and rotation (double-arm goniometer). Intratester reliability for ROM was also assessed. The Back Analysis System was used to determine static trunk extensor strength (ie, maximal voluntary contraction [MVC]) and to compute EMG spectral parameters from a paraspinal multi-electrode array. A two-group stepwise discriminant-analysis procedure for the ROM and MVC variables correctly identified 57% of the rowers with LBP and 63% of the rowers without LBP. A similar discriminant-analysis procedure for EMG spectral parameters correctly identified either 88% of the rowers with LBP and 100% of the rowers without LBP or 100% of the rowers with LBP and 88% of the rowers with LBP, depending on whether EMG measurements of recovery were calculated at 1 minute or at 2 minutes into the recovery period. Sensitivity (66%) and specificity (71%) results from the more traditional tests suggest that these techniques may be of limited usefulness for LBP screening or diagnosis.

Adult↗
PubMed1991

Interrater reliability of videotaped observational gait-analysis assessments.

The purpose of this study was to determine the interrater reliability of videotaped observational gait-analysis (VOGA) assessments. Fifty-four licensed physical therapists with varying amounts of clinical experience served as raters. Three patients with rheumatoid arthritis who demonstrated an abnormal gait pattern served as subjects for the videotape. The raters analyzed each patient's most severely involved knee during the four subphases of stance for the kinematic variables of knee flexion and genu valgum. Raters were asked to determine whether these variables were inadequate, normal, or excessive. The temporospatial variables analyzed throughout the entire gait cycle were cadence, step length, stride length, stance time, and step width. Generalized kappa coefficients ranged from .11 to .52. Intraclass correlation coefficients (2,1) and (3,1) were slightly higher. Our results indicate that physical therapists' VOGA assessments are only slightly to moderately reliable and that improved interrater reliability of the assessments of physical therapists utilizing this technique is needed. Our data suggest that there is a need for greater standardization of gait-analysis training.

Adult↗
PubMed1991

Electrical stimulation of the thigh muscles after reconstruction of the anterior cruciate ligament. Effects of electrically elicited contraction of the quadriceps femoris and hamstring muscles on gait and on strength of the thigh muscles.

The effects of neuromuscular electrical stimulation on the strength of the thigh muscles and on gait were examined in ten patients after reconstruction of the anterior cruciate ligament. The patients were randomly assigned to one of two treatment groups: neuromuscular electrical stimulation and volitional exercise, or volitional exercise alone. A four-week course of electrically elicited co-contraction of the thigh muscles resulted in significant attenuation of the characteristic loss of strength of the quadriceps as compared with volitional exercise. There was no significant difference between groups in any measure of performance of the hamstring muscles. In the group that received neuromuscular electrical stimulation, the values for cadence, walking velocity, stance time of the involved limb, and flexion-excursion of the knee during stance were significantly different from those of the volitional exercise group. Flexion-excursion of the knee during stance was directly and significantly correlated with strength of the quadriceps femoris muscle. Flexion of the knee during stance was qualitatively different in the involved extremity as compared with the uninvolved extremity in all patients. There is a rapid flexion of the knee at weight acceptance that is maintained throughout stance and probably reflects stabilization of the joint by muscular coactivation to compensate for weakness of the quadriceps. The patients who received neuromuscular electrical stimulation had stronger quadriceps muscles and more normal gait patterns than those in the volitional exercise group.

Adolescent↗
PubMed1990

Two theories of muscle strength augmentation using percutaneous electrical stimulation.

Electrical stimulation of muscle is a commonly used, well-substantiated strategy that physical therapists use to augment strength in patients with muscle weakness. Two distinctly different theories of strength augmentation using percutaneous muscle stimulation are presented. The first theory proposes that augmentation of muscle strength with electrically elicited muscle contractions occurs in a similar manner to augmentation of muscle strength with voluntary exercise. Electrically elicited muscle contractions of relatively high intensity with low numbers of repetitions strengthen muscle proportionally to the external load on the muscle in a manner that is equivalent to voluntary contraction. The second theory proposes that augmentation of muscle strength using percutaneous stimulation is fundamentally different from augmentation of strength with voluntary exercise. This theory uses the physiological differences between electrically elicited and voluntary contractions, such as the reversal of motor unit recruitment order, as a basis for argument. Both theories are partially substantiated using published literature. Strategies for testing both theories are also presented.

Electric Stimulation Therapy↗
PubMed1990

Fatigue, recovery, and low back pain in varsity rowers.

The purpose of this study was to determine whether surface electromyography (EMG) from the erector spinae muscles could correctly identify individuals with low back pain without a population of elite athletes. A similar technique had previously been successful in identifying low back pain patients within a non-athletic population. A Back Analysis System was used to compute the median frequency of the EMG power density spectrum to monitor metabolic changes in back muscles associated with muscle fatigue. Twenty-three members of a men's collegiate varsity crew team consisting of port (N = 13) and starboard (N = 10) rowers were tested in a laboratory during a fatigue-inducing isometric contraction sustained at a relatively high, constant force. Six of the rowers tested were further classified as having low back pain. A brief test contraction was repeated at a fixed interval following the fatiguing contraction to monitor recovery. A two-group discriminant analysis procedure correctly classified 100% of the rowers with low back pain and 93% of the rowers without back pain on the basis of the median frequency data. The median frequency parameters related to recovery were the best discriminators of back pain. A similar analysis correctly classified 100% of the port rowers and 100% of the starboard rowers on the basis of their spectral parameters. The best discriminating variables in this instance were the median frequency parameters relating to both fatigability and recovery. Results from this study demonstrate that low back pain and asymmetrical muscle function in rowers can be assessed on the basis of EMG spectral analysis.

Adult↗
PubMed1990

Muscle stimulators.

Explore the source record for details and available documents.

Electric Stimulation↗
PubMed1989

Effects of helium-neon laser irradiation on skin resistance and pain in patients with trigger points in the neck or back.

The purpose of this double-blind study was to ascertain the effects of helium-neon (He-Ne) laser irradiation on skin resistance and pain in patients with trigger points in the neck or low back. This study entailed a partial replication of a previous study by Snyder-Mackler and associates that determined the use of the He-Ne laser increased skin resistance overlying a trigger point. Twenty-four patients were randomly assigned to either a treatment or a control group and received three 20-second applications of laser irradiation or placebo "stimulation," respectively. Pretreatment and posttreatment skin resistance and pain measurements (via visual analog scale) were taken during each session. Results indicated a statistically significant increase in skin resistance (p less than .001) and a decrease in pain (p less than .005) following laser treatment. There was not a significant correlation between skin resistance and pain across subjects. These data substantiate the previous findings of Snyder-Mackler and associates and demonstrate a reduction in pain. Helium-neon laser treatment, therefore, may be an effective adjunct to conventional physical therapy of these patients.

Double-Blind Method↗
PubMed1989

Bilateral analysis of the knee and ankle during gait: an examination of the relationship between lateral dominance and symmetry.

This study examined the relationship between lower extremity dominance and kinematic symmetry during gait. Fourteen healthy volunteers without any observable gait deviations participated in the study. The subjects (8 male, 6 female) ranged in age from 19 to 56 years. Lower extremity lateral dominance was determined using an assessment method developed by Carol Coogler. Retroreflective spherical markers were placed bilaterally at points over the greater trochanter, the lateral joint line of the knee, the lateral malleolus, and the metatarsal break. A video-based data-acquisition instrument interfaced with a PDP 11/73 computer measured 12 kinematic variables while the subjects walked at self-selected speeds along a 10-m walkway. A multivariate analysis of variance with one repeated measure revealed significant differences between limbs, across subjects, for stance time and maximum knee extension. A within-subject analysis demonstrated significant differences for 10 variables; however, lateral dominance could not be related predictably to these variations. Our results indicate that symmetry cannot be generalized in view of intrasubject variability for these variables. [Valle DR, Gundersen LA, Barr AE, et al: Bilateral analysis of the knee and ankle during gait: An examination of the relationship between lateral dominance and symmetry.

Adult↗
PubMed1989

Rehabilitation of the athlete with low back dysfunction.

Low back injuries in athletes can be classified into three diagnostic categories: disk problems, hypomobility/hypermobility problems, and muscular problems. Various strategies have been presented for the identification and treatment of these disorders. The translation of rehabilitation procedures to an athletic population including resumption of training and competition have been discussed.

Age Factors↗
PubMed1988

Effect of helium-neon laser irradiation on peripheral sensory nerve latency.

The purpose of this randomized, double-blind study was to determine the effect of a helium-neon (He-Ne) laser on latency of peripheral sensory nerve. Forty healthy subjects with no history of right upper extremity pathological conditions were assigned to either a Laser or a Placebo Group. Six 1-cm2 blocks along a 12-cm segment of the subjects' right superficial radial nerve received 20-second applications of either the He-Ne laser or a placebo. We assessed differences between pretest and posttest latencies with t tests for correlated and independent samples. The Laser Group showed a statistically significant increase in latency that corresponded to a decrease in sensory nerve conduction velocity. Short-duration He-Ne laser application significantly increased the distal latency of the superficial radial nerve. This finding provides information about the mechanism of the reported pain-relieving effect of the He-Ne laser.

Adult↗
PubMed1988

Clinical application of electrotherapeutic modalities.

The purposes of this survey study were 1) to determine the frequency of use of eight forms of electrical stimulation and ultrasound in clinical practice and 2) to determine the factors that influence how and when these forms of electrical stimulation are used. A survey questionnaire was distributed to 490 physical therapists in clinics affiliated with the academic programs of Ithaca College and Temple University. Forty-five percent (221) of the distributed surveys were returned. Descriptive statistics and chi-square calculations were used in the data analysis. Respondents frequently used two forms of pulsed current and rarely used two forms of alternating current. No form of electrical current was used as frequently as ultrasound. The frequency and type of electrical stimulation used depended on the availability of electrical stimulators and the adequacy of entry-level training in electrotherapy. The results of this study suggest the need for additional electrical stimulators in physical therapy clinics, training for physical therapists, and research in electrotherapy.

Electric Stimulation↗
PubMed1986

Effect of helium-neon laser on musculoskeletal trigger points.

Cold lasers have been proposed recently as a therapeutic tool for treating a wide variety of pathological conditions, including wounds, arthritis, orthopedic problems, and pain. These proposed therapeutic effects largely have been unsubstantiated by research. A randomized, double blind study was undertaken to ascertain the effect of a helium-neon (He-Ne) laser on the resistance of areas of skin overlying musculoskeletal trigger points. These areas usually demonstrate decreased skin resistance when compared with the surrounding tissue. Thirty patients with musculoskeletal trigger points were assigned randomly to either an experimental or a placebo group. In addition to standard physical therapy, each patient received three 15-second applications of a He-Ne laser or placebo "stimulation" from an identical unit that did not emit a laser. The results of a two-way analysis of covariance with one repeated measure showed a statistically significant increase (p less than .007) in skin resistance. This increase in an abnormal skin resistance pattern may accompany the resolution of pathological conditions.

Adolescent↗
PubMedDate not supplied

Effect of standard and Aircast tennis elbow bands on integrated electromyography of forearm extensor musculature proximal to the bands.

Classic tennis elbow, or lateral epicondylitis, has been described as an overuse or misuse injury resulting in a tendinitis. The extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) have been implicated as primary culprits in this pathology. Tennis elbow has been treated using a constrictive band placed several centimeters distal to the origin of these two muscles. Aircast (Aircast Inc., Summit, NJ) has developed a new style of band that employs an air-filled bladder as the counterpressure element. This study tested the effect of both standard and Aircast bands on EMG activity of the EDC and ECRB proximal to the band compared to control values. Ten normal subjects, ranging in age from 20 to 43 years, were tested. Right upper extremities were tested in all cases. The subjects' forearms were stabilized in the CYBEX II forearm stabilization V-pad. The ECRB and EDC were then impaled with monopolar EMG needle electrodes. The CYBEX data were recorded using the HUMAC system and the EMG data were recorded and analyzed using the Cadwell 7400. EMG data were recorded at 80% of maximum voluntary isometric contraction (MVIC) with no band, the standard band, and the Aircast band. An analysis of variance (ANOVA) with repeated measures of integrated EMG (IEMG) and Duncan's multiple comparison tests revealed that the Aircast caused a significant reduction in IEMG of the ECRB and EDC when compared with control values and the standard band. The decrease in IEMG with the standard band was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗