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Dual-Task Assessment Protocols in Concussion Assessment: A Systematic Literature Review.
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Dual-Task Assessment Protocols in Concussion Assessment: A Systematic Literature Review.

J Orthop Sports Phys Ther. 2017 Nov 07;:1-51

Authors: Kleiner M, Wong L, Dubé A, Wnuk K, Hunter SW, Graham LJ

Abstract
Study Design Systematic review. Background When assessed in isolation, balance and neurocognitive testing may not be sufficiently responsive to capture changes that occur with concussion. Normal daily activities require simultaneous cognitive and physical demands. Therefore, a dual-task assessment paradigm should be considered to identify performance deficits. Objectives To evaluate the literature and identify dual-task testing protocols associated with changes in gait after concussion. Methods A systematic review of articles of individuals with concussion who underwent dual-task testing with a combination of motor and cognitive tasks. AMED, CINAHL, EMBASE, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science databases and grey literature were searched from inception to January 29, 2017. Title and abstract, full-text, quality review and data abstraction were performed by two independent reviewers. Results Twenty-four articles met the inclusion criteria. Eleven articles reported decreased gait velocity and increased medial-lateral displacement for individuals with concussion during dual-task conditions. Overall, included articles were of poor to moderate methodological quality. Fifteen articles used the same participants and datasets creating a threat to validity limiting the ability to make conclusions. Conclusion A deterioration in gait performance during dual-task testing is present among people with concussion. Specific recommendations for a dual-task protocol that may be used in clinical practice to assess individuals with a suspected concussion injury has yet to be determined and merits further research. J Orthop Sports Phys Ther, Epub 7 Nov 2017. doi:10.2519/jospt.2018.7432.

PMID: 29113571 [PubMed - as supplied by publisher]




A Novel Downhill Gait Training Program Following a Total Knee Arthroplasty: A Case Report Highlighting the Impacts of Self-selected Speed on Gait Symmetry.
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A Novel Downhill Gait Training Program Following a Total Knee Arthroplasty: A Case Report Highlighting the Impacts of Self-selected Speed on Gait Symmetry.

J Orthop Sports Phys Ther. 2017 Nov 07;:1-19

Authors: Blue C, Coomes S, Yoshida Y

Abstract
Study Design Case report. Background Walking plays an essential role in activities of daily living that lead to varied health benefits. Studies report gait speed and symmetry are impacted in individuals following TKA. Unfortunately, abnormal gait patterns persistently exist in individuals after TKA. Downhill walking may provide a simple and feasible exercise regimen to improve gait patterns. The purpose of this case report is to describe the application of a downhill treadmill training program and the subsequent changes in gait patterns in an individual following a unilateral TKA. Case Description The participant was a 59-year-old woman following right TKA. Downhill gait training was initiated 1 month post-TKA and completed for 5 weeks. Outcomes were assessed using questionnaires, mobility tests, strength of quadriceps, and gait patterns. The treadmill speed was determined by the participant's self-selected gait speed on a level-surface. Outcomes The participant's eccentric quadriceps strength of the operated limb significantly increased after the gait training. Her physical function recovered to similar level of previous reports. Post-intervention gait analysis was applied for two self-selected speeds due to an increase in her self-selected gait speed between sessions. The participant demonstrated a more symmetrical gait pattern when walking slower, while increased gait asymmetry occurred at the faster speed. Discussion After completion of downhill gait training as a conjunction of therapeutic exercises, the participant showed an increase in quadriceps strength and improved physical function. This case report describes the utilization and potential feasibility of downhill gait training in conjunction with outpatient physical therapy for an individual following unilateral TKA. Level of Evidence Therapy, Level 4. J Orthop Sports Phys Ther, Epub 7 Nov 2017. doi:10.2519/jospt.2018.7374.

PMID: 29113570 [PubMed - as supplied by publisher]




Physical Therapy Rehabilitation of An Adolescent Pre-Professional Dancer Following Os Trigonum Excision: A Case Report.
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Physical Therapy Rehabilitation of An Adolescent Pre-Professional Dancer Following Os Trigonum Excision: A Case Report.

J Orthop Sports Phys Ther. 2017 Nov 07;:1-37

Authors: Filipa A, Barton K

Abstract
Study Design Case report. Background An os trigonum can be a source of pain for dancers due to impingement during repetitive ankle plantarflexion movements. Following excision of an os trigonum, it is important to have a gradual, progressive return-to-dance program for optimal recovery. The purpose of this case report is to describe the post-operative management and return-to-dance progression of an adolescent dancer status post os trigonum excision. Case Description An adolescent pre-professional female dancer had an extensive history of left posterior heel pain beginning at age eight that led to surgical removal of an os trigonum at age fifteen. This case report describes the physical therapy interventions used to help her return to full, unrestricted activity. Outcomes The dancer had a full return of ankle range of motion, strength, and balance, improved patient reported outcome scores, and was able to fully return to dance participation. Discussion Treating a dancer following os trigonum excision should involve a screen for hypermobility, clear communication with the dance instructor, awareness of dance-specific biomechanics, and proper reintegration into dance participation. Level of Evidence Therapy, Level 5. J Orthop Sports Phys Ther, Epub 7 Nov 2017. doi:10.2519/jospt.2018.7508.

PMID: 29113569 [PubMed - as supplied by publisher]