Alternate Grips for Upper Limb Rehab (June 2022)

This transcript includes highlights from the live, interactive session of our Clinical Conversation: Alternate Grips for Upper Limb Rehab. 

If you missed the live webinar, you can read about using alternate grips for upper limb rehab in your clinical Pilates practice, below. 

Please join our next live event, where you can participate in our Case Study discussion and Q&A session. 

Check out our upcoming Clinical Conversations here

 

GRIP & GRASP

  • Grip and Grasp Anatomy: The carpals.
    • The carpus is designed to increase the tension in the tendons of the fingers (both extensors and flexors) and optimise these movements.
    • The proximal row are functionally separate from the distal row.
    • Flexion of the wrist initially occurs between these two rows, with the scaphoid acting as a bridge, so that in the final stage of flexion the whole carpus moves as a single unit.
    • The same occurs in...
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Clinical Pilates in Practice: Locomotion & Dynamic Posture (June 2022)

This review article explains the networks that the trunk in vertebrates with limbs, and also how the central nervous system acts dynamically on the musculoskeletal system.

 

Guillaud E, et al. Locomotion and dynamic posture: neuro-evolutionary basis of bipedal gait. Neurophysiologie Clinique/Clinical Neurophysiology (2020),  https://doi.org/10.1016/j.neucli.2020.10.012

 

KEY POINTS: LOCOMOTION & DYNAMIC POSTURE

  • Dynamic control of gait is supported by:
    • Locomotor activity that is produced by specialized rhythmogenic spinal circuits called central pattern generators (CPGs), and which cyclically drive axial and leg muscle activity (p.8)
    • Posture control systems which involve long spinal/supraspinal loops, and the integration of various sensory inputs (e.g. proprioceptive, visual and vestibular) at various supraspinal levels resulting in long latency responses (p.8).

  • Dynamic balance in limbed vertebrates requires proper coordination of all...
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Clinical Pilates in Practice: Knee Joint Biomechanics in Transtibial Amputees (May 2022)

This study looked at knee joint biomechanics in a young, healthy population with no activity restrictions, with a focus on energy storage and return (ESAR)  prostheses. The authors recognise that the study had a small sample size, and discuss potential sources of error for their data collection, but are confident about the clinical application of their findings.

 

Orekhov G, Robinson AM, Hazelwood SJ, Klisch SM (2019) Knee joint biomechanics in transtibial amputees in gait, cycling, and elliptical training. PLoS ONE 14(12): e0226060.

 

KEY POINTS: KNEE BIOMECHANICS FOR TRANSTIBIAL AMPUTEES

  • There is a high prevalence of joint pain and osteoarthritis (OA) in unilateral transtibial and transfemoral amputee populations.
  • Transtibial amputees are more likely to develop OA in the intact knee.

 

Abnormal gait biomechanics include asymmetric ground reaction forces, muscle activation patterns, and knee joint kinetics between limbs.

 

  • ...
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Clinical Pilates in Practice: Migraines (April 2022)

This Masterclass / review article discusses current literature and clinical practice for physiotherapists working with patients with migraines.

 

Carvalho, Gabriela F., Annika Schwarz, Tibor M. Szikszay, Waclaw M. Adamczyk, Débora Bevilaqua-Grossi, and Kerstin Luedtke. "Physical therapy and migraine: musculoskeletal and balance dysfunctions and their relevance for clinical practice." Brazilian Journal of Physical Therapy 24, no. 4 (2020), 306-317. doi:10.1016/j.bjpt.2019.11.001.

 

KEY POINTS: MIGRAINES

  • Migraines are under-diagnosed and under-treated.

  •  Patients may present with episodic, highly frequent, or chronic migraines.

  • Neck pain is common as part of the migraine cycle, and is related to worse clinical presentations.

  • Most patients present with at least three of the following:

    • Increased prevalence of cervical trigger points.
    • Decreased cervical ROM.
    • Decreased cervical flexion and extension strength.
    • Decreased upper...
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Clinical Pilates in Practice: Toe Flexor Strength & Mobility (March 2022)

 

This study sought elucidate the influence that foot posture has on the relationship between toe flexor strength and functional performance in older adults. The authors recognise the study's limitations: the study cohort was limited to women, and did not measure body kinematics or muscle activity.

 

Kusagawa, Y., Kurihara, T., Imai, A., Maeo, S., Sugiyama, T., Kanehisa, H., & Isaka, T. (2020). Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet. Journal of foot and ankle research13(1), 55. https://doi.org/10.1186/s13047-020-00422-y

 

KEY POINTS: TOE FLEXOR STRENGTH & MOBILITY IN OLDER ADULTS

  • Both pronated and supinated foot postures influence rearfoot frontal plane motion, plantar pressure distribution, and muscle activity in the lower limb during gait.
  • Individuals with pronated feet require increased intrinsic muscle activity to stabilize the...
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Clinical Pilates in Practice: Biomechanics & The Formation of Nervous Tissue (August 2021)

 

This review is a critical assessment of recent advances in the utilization of mechanical stimuli towards exploiting nervous tissue growth and formation. The authors discuss current in vitro systems designed to restate the mechanical environment of developing neural tissues, and the advancements made in integrating these systems into the clinical setting.

 

Pfister, Bryan J., Jonathan M. Grasman, and Joseph R. Loverde. "Exploiting biomechanics to direct the formation of nervous tissue." Current Opinion in Biomedical Engineering 14 (2020), 59-66. doi:10.1016/j.cobme.2020.05.009.

 

KEY POINTS: BIOMECHANICS & THE FORMATION OF NERVOUS TISSUE

  • Mechanics can be used to guide and accelerate neuronal expansion.
  • The central nervous system plays a key role in initiating the autonomic functions and coordinated actions of every being.
  • The peripheral nervous system coordinates signal transmission between the central nervous systems...
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Clinical Pilates in Practice: Shoulder Kinematics & Subacromial Impingement (June 2021)

 

This literature review examines the relationship between shoulder kinematics and the aetiology of rotator cuff pathology.

 

Lawrence, Rebekah L., Jonathan P. Braman, and Paula M. Ludewig. "Shoulder kinematics impact subacromial proximities: a review of the literature." Brazilian Journal of Physical Therapy 24, no. 3 (2020), 219-230. doi:10.1016/j.bjpt.2019.07.009.

 

KEY POINTS: SHOULDER KINEMATICS & SUBACROMIAL IMPINGEMENT

  • Subacromial compression is unlikely a contributing factor to rotator cuff pathologies.
  • There are limitations to 2D measurements when trying to quantify 3D relationships.
  • 3D techniques are not as broadly available.
  • There are extreme variations in metrics for quantifying the subacromial space.
    • The most common metric is the minimum distance; it quantifies the smallest distance between two structures.
  • A ‘‘painful arc’’ of motion between 700 and 1200 humerothoracic elevation...
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Clinical Pilates in Practice: Is T9-T12 the Thoracolumbar Transition Zone? (April 2021)

 

The authors of this retrospective review study hypothesised that the true thoracolumbar junction is T10-11.

 

Murphy, J. et al. “Is T9-11 the true thoracolumbar transition zone?” Journal of clinical orthopaedics and trauma 11 5 (2020): 891-895.

 

KEY POINTS

  • For clinical purposes, the thoracolumbar transition zone is considered to be T11-L2 for due to the variation in the location of the caudal end of the cord, as well as the biomechanical weakness of false ribs at T11.

The point of transition from floating to false ribs resulting in increased mobility at T10-11.

  • Articulation between thoracic vertebrae and ribs plays an active role in stability and load-bearing of the thoracic spine, along with the ligaments and facet joint capsules.
  • The lumbar spine is relatively more mobile. 
  • Mean age in the patient cohort was 25.3 years; 300 MRIs were reviewed.
  • Disc degeneration was most frequent and most severe at T8-9 and T9-10, followed by...
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Clinical Pilates in Practice: Biokinetic Analysis of the Foot & Ankle (February 2021)

 

This literature review argues that clinically we need to observe functional - rather than conventional - biomechanics at the ankle and foot. Functional biomechanics observes that all segments in a joint can be simultaneously mobile. The authors suggest that:

 "The reader should be able to understand how the 3-dimensional biokinetic analysis of the ankle and foot can contribute along with imaging examinations to the clinical setting, thus allowing the construction of a more complete proļ¬le of the patient."

 

Metsavaht L, Leporace G. Current trends for the biokinetic analysis of the foot and ankle. J Foot Ankle. 2020;14(2):191-6.

 

KEY POINTS: BIOKINETIC ANALYSIS OF THE FOOT & ANKLE

  • The central nervous system works as the generator of complex movement patterns based on muscular synergies; the control of active joint stability is coordinated by the neuromuscular system and not by isolated muscle strength or range of motion.
  • Functional...
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Research Roundup: December 2020

 

Interested in keeping up to date with research relevant to your clinical practice?

The Calibrate Pilates team rounds this up so that you can integrate new information into your evidence-informed practice: join our newsletter now.

 

Multiple Processes Independently Predict Motor Learning

Perry et al. J Neuro Engineering Rehabil (2020) 17:151 https://doi.org/10.1186/s12984-020-00766-3. 

The authors of this paper used an ethological approach to test the hypothesis that practice-related refinements of multiple behavioural features would be independently predictive of motor learning.

 

Key Points

  • Motor learning results from neural adaptations that produce refinements of behavioural features of motor tasks.

  • Motor learning can induce changes in visual processing that are associated with the refinements of skilled limb movement.
  • The interactions between skilled limb movements and visual search lead to coordinated patterns of the eyes and limbs (ie., hand-eye...
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