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Biomedical subjects

T A Blackburn

Publications and source records attributed to T A Blackburn.

18 recordsLinked to original sources
PubMed2000

Rehabilitation after ligamentous and labral surgery of the shoulder: guiding concepts.

OBJECTIVE: To provide treatment guidelines for rehabilitation after ligamentous and labral surgery of the shoulder. DATA SOURCES: We searched Index Medicus for the last 10 years using the key words "shoulder instability," "shoulder exercises," and "shoulder surgery." DATA SYNTHESIS: Detailed rehabilitation programs for patients with anterior shoulder instability reconstructions can be found in the literature, but many are based on anecdotal evidence and clinical observation. Randomized, prospective outcome studies on these rehabilitation protocols have not been performed. Therefore, we offer a performance- and criteria-based guideline for rehabilitation that is rooted in basic science, surgeons' recommendations, clinical experience, and common sense. CONCLUSIONS/RECOMMENDATIONS: To return an athlete to the preinjury level of function, range of motion, strengthening, proprioception, and functional activities must be used judiciously, keeping healing constraints and arthrokinematics in mind.

Journal Article↗
PubMed1997

The effects of chronic effusion on knee joint proprioception: a case study.

Knee joint effusion has been shown to cause a reflex inhibition of the quadriceps musculature. However, the effect of effusion on knee joint proprioception has not been thoroughly investigated. This issue is further clouded by the debate surrounding the role of the muscle spindle and joint mechanoreceptors in providing afferent feedback to the central nervous system. This case study examines the effects of a chronic effusion on knee joint proprioception. Possible suggestions for the results are discussed, and areas for further study are offered.

Arthroscopy↗
PubMed1997

The effects of "decelerated" rehabilitation following anterior cruciate ligament reconstruction on a hyperelastic female adolescent: a case study.

Current concepts in postoperative anterior cruciate ligament (ACL) reconstruction management include participation in an "accelerated" rehabilitation program. There are no published reports examining the effects of accelerated or conservative rehabilitation on subjects with generalized ligamentous hyperelasticity. The purpose of this case study was to examine the effects of a conservative or "decelerated" rehabilitation program on the functional outcome of a hyperelastic female adolescent athlete following ACL reconstruction. The subject was a 15-year-old female basketball player who sustained a unilateral ACL tear and underwent subsequent ACL reconstruction using a patellar tendon autograft. The subject immediately began participation in a "decelerated" rehabilitation program in which the intensity and rate of progression was decelerated, emphasizing a prolonged period of maximum graft protection. Progress was objectively quantified with a battery of diagnosis-specific tests at scheduled intervals. Results at 52 weeks postoperative revealed normal range of motion, proprioception, balance, knee stability, quadriceps strength, hamstring strength, and subjective assessment values, and only a 4.0% deficit in functional scores. Our results suggest a "decelerated" rehabilitation program may be appropriate for the population with generalized ligamentous hyperelasticity by yielding excellent functional results without compromising the integrity of the graft and, ultimately, knee stability.

Adolescent↗
PubMed1996

The effects of muscle fatigue on and the relationship of arm dominance to shoulder proprioception.

It is hypothesized that proprioceptive information plays an important role in joint stabilization and that muscle fatigue may alter proprioceptive ability. The purpose of this study was to determine what effect shoulder muscle fatigue has on glenohumeral proprioception and to examine the relationship between arm dominance and shoulder proprioception. Eighty subjects without a history of glenohumeral pathology participated. Each was seated on an isokinetic dynamometer with a randomly selected shoulder positioned in 90 degrees of abduction and elbow flexion. With vision blinded, the arm was passively positioned in 75 degrees of external rotation for 10 seconds, then passively returned to the neutral starting position. Three trials each of active and passive repositioning (2 degrees/sec) were recorded. Following a fatigue protocol, both active and passive repositioning were reassessed. Testing order was randomized. A significant difference was detected between pre- and post-fatigue scores. No significant difference was detected between dominant and nondominant extremities. No relationship between arm dominance and shoulder proprioception was established. It is concluded that shoulder proprioception is diminished in the presence of shoulder muscle fatigue, suggesting clinical rehabilitation protocols must emphasize increasing muscular endurance.

Adult↗
PubMed1987

Rehabilitation of the shoulder and elbow after arthroscopy.

Rehabilitation after arthroscopic shoulder and elbow surgery requires an emphasis on flexibility, strength, range of motion, and a return to activity program. Care must be taken to include fitness and conditioning programs for the entire athlete, not just the upper extremity. A thorough program will allow the athlete to return to competition in the best possible condition.

Arthroscopy↗
PubMed1985

Rehabilitation of anterior cruciate ligament injuries.

The previously outlined exercise program for the knee is for the instability that results from the loss of the anterior cruciate ligament and/or capsular ligaments laterally. Its success depends on communication between surgeon, therapist, and trainer. Each must understand what the other is doing and must follow the biomechanical and healing restraints of the surgery. The understanding of soft tissue healing is ongoing. Research in this field will greatly enhance the rehabilitation programs of the future.

Biocompatible Materials↗
PubMed1980

Knee anatomy: a brief review.

This article provides a basis for understanding the anatomy involved in knee disorders and was directed toward structures of clinical importance. The osseous portions of the knee were discussed in a relation to muscular actions. The soft tissue components about the knee were described in relation to the osseous components that divide the knee into medial and lateral compartments. This article is to serve to introduce this special issue, giving the clinician a greater understanding of the interaction between structure and function rather than a comprehensive view of knee anatomy.

Humans↗
PubMed1980

Classification of knee ligament instabilities.

1) The intactness of the posterior cruciate ligament is a key to the basic classification system of the knee. 2) With an intact posterior cruciate ligament, single or combined rotatory instability may occur. 3) With a tear of the posterior cruciate ligament, straight instability may be found. 4) An intact posterior cruciate ligament limits the instability of the knee in full extension (adduction or abduction stress test). 5) The anterior drawer test is somewhat equivocal. A strongly positive result of the anterior drawer test does suggest that the anterior cruciate ligament is not intact, although a moderately positive result may not implicate this ligament.

Humans↗
PubMed1980

Knee rehabilitation.

Knee rehabilitation is nearly as complex as the knee itself. The general and specific and specific programs and exercises presented are to be used eclectically. Rehabilitation must not be of a cookbook nature but rather individualized to fit the needs of the patient. The emphasis of rehabilitation must be dictated by the demands the individual places upon the knee. Rehabilitation must degenerate into function!

Exercise Therapy↗
PubMedDate not supplied

Surgical reconstruction of chronic anteromedial rotatory instability of knee. A review with computer analysis of 149 cases.

The clinical records were reviewed of 142 men and 7 women (average age 26.8 years; range, 15 to 58 years) who had surgical reconstruction for anteromedial rotatory instability of the knee. All were treated consecutively at the same clinic during a 15-year period (1960 to 1975). Preoperative and postoperative symptoms were rated both subjectively and objectively by devised scales and analyzed by a computer program. Comparison of the three major surgical procedures show that the subjective success rate was 87% for the pes anserinus transfer, 70% for the posterior oblique ligament reconstruction, and 72% for the combination procedure. Of the 149 patients, 130 had been injured in sportive activities and 110 were able to return to some degree of athletics. Accurate and detailed recording of clinical data allowed construction of subjective and objective rating systems for computer analysis in review of a large series over a period of years. This approach enhanced our ability to obtain correlation and objective evaluation of the data. Commercial equipment for evaluating the quadriceps and hamstrings is beneficial in determining that a patient has achieved complete rehabilitation or if there will be a permanent decrease in function after surgical intervention.

Adolescent↗
PubMedDate not supplied

Biomechanics of knee rehabilitation with cycling.

The bicycle provides quadriceps rehabilitation while controlling the stresses to the knee ligaments. With pedaling on the bicycle, forces are applied to the anterior cruciate ligament, the capsular ligaments, and the posterior structures of the knee joint as the tibial plateau is posteriorly tilted. The knee muscles can modify their forces. Therefore, by controlling the mode of cycling with varying seat heights and pedal positions, the ligaments can be relieved from these forces during the initial stages of the rehabilitative process. An exercise program can then be designed to apply controlled stress to these structures to enhance the healing and recovery processes.

Adult↗
PubMedDate not supplied

Valgus extension overload in the pitching elbow.

Five baseball pitchers, three college and two professional, with an average age of 24 years, exhibited pain between the acceleration phase and follow-through phase of the pitching motion. This caused the players to be unable to continue at the level of competition necessary to play. A significant osteophyte on the posteromedial aspect of the olecranon process was identified in all pitchers. This caused impingement with the articular wall of the olecranon fossa and often created an area of chondromalacia. The more commonly identified posterior osteophyte was present in all cases. However, if just this posterior osteophyte is removed, the described lesion will be missed, with resultant persistent disability. Surgical excision of the posteromedial osteophyte through a relatively atraumatic posterolateral approach allowed early return of function without morbidity. With an average follow up of 1 year, all of the pitchers returned for one full season at maximum effectiveness.

Adult↗