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.

 

• ...

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...

This transcript includes highlights from the live, interactive session of our Clinical Conversation: Footwork Options for Pregnancy.

If you missed the live webinar, you can read about some of the biomechanical changes during pregnancy, as well as footwork options for 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. 

OUR FEET AS OUR FOUNDATION

•  Pilates sessions traditionally begin with footwork and other strength work to set a foundation for movement.
• By spending time building strength through the feet, you can help to support a stable and dynamic support for standing, and for upright movement.
• This is an incredibly functional place to begin, and it's no different when working with a pregnant body.

 CLINICAL PILATES EMBODIED ANATOMY: FOOTWORK...

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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Age-Related Reduction in Motor Adaptation

Wolpe N, Ingram J, Tsvetanov K, et al. (2020). Age-related reduction in motor adaptation: brain structural correlates and the role of explicit memory. Neurobiology of Aging 90: 13-23.

The authors of this study examined the differences in the brain structure and cognition underlying motor adaptation in a population-based cohort. Results support the hypothesis that sensorimotor adaptation is a composite of multiple learning strategies, which are differentially affected by age, and the authors conclude that "that across the lifespan, motor adaptation declines with age as a result of the deteriorating explicit learning system".

Key Points: Motor Adaptation and Age Related Changes

• ...

This is a brief summary of neuronal plasticity and motor learning, particularly as it pertains to physical activity.

Minino, Roberta, Patrizia Belfiore, Marianna Liparoti (2020): Neuroplasticity and motor learning in sport activity, Journal of Physical Education and Sport; DOI: 10.7752/jpes.2020.s4318.

 KEY POINTS: NEUROPLASTICITY & MOTOR LEARNING IN SPORT

• Motor learning is defined as the ability to acquire new motor actions or new movement patterns.
• Cortical reorganization can be used for motor learning; the process follows a path consisting of two phases: unmasking and strengthening preexisting conditions, and creating new connections.
• In motor learning, the transition from coarse movement to a precise execution has three phases:
  • Cognitive phase: Understanding the purpose of the action to be acquired and how to perform it.
  • Associative phase: Structuring movements and finalizing the motor sequence.
  • Automation phase: Automation of motor...

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...

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.

Brachial Plexus Injury After Shoulder Dislocation: A Literature Review

Olga G et al. Brachial Plexus Injury After Shoulder Dislocation: a literature review. Neurosurgical Review (2020) 43:407–423. https://doi.org/10.1007/s10143-018-1001-x

This literature review examined the neurological implications of shoulder dislocation. The authors analyzed the implications of brachial plexus injury, the incidence of neurological injuries in patients with shoulder dislocation, and proposed the algorithm for management.

Key Points

• Traumatic anterior shoulder dislocation has an incidence estimated of 2% across the population.
• 4-55% incidence of neurological complications after dislocations is reported in the literature.
• Neurological...

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 profile 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...

Integrating neural mobility exercises into functional movements and clinical Pilates practice can have multiple benefits, regardless of whether a client is displaying neural mechanosensitivity: all tissues in the body need to move!

Key Points: Neurodynamics

• Mechanical and physiological events within the nervous system are dynamically interdependent.
• Neurodynamics (ND) is the term used to describe the integration of the morphology,
  biomechanics, and physiology of the nervous system." ¹⁰
  
• In neurodynamics, posture and multi-joint movements are combined to apply force to a nerve.
• Mobilisation triggers a range of responses in nervous tissues, including tension and pressure changes, and positive impacts on nervous impulses, axonal transport, viscoelasticity, microcirculation, and abnormal impulse-generating sites.
• Theoretically, neural mobilisation restores homeostasis in and around the nerve, dispersing intraneural oedema in the nerve root and axon, thereby decreasing...