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Specialized Neuromuscular Training to Improve Neuromuscular Function and Biomechanics in a Patient With Quiescent Juvenile Rheumatoid Arthritis

The purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to part... Full description

Journal Title: Physical therapy 2005-08-01, Vol.85 (8), p.791-802
Main Author: Myer, Gregory D
Other Authors: Brunner, Hermine I , Melson, Paula G , Paterno, Mark V , Ford, Kevin R , Hewett, Timothy E
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: American Physical Therapy Association
ID: ISSN: 0031-9023
Link: https://www.ncbi.nlm.nih.gov/pubmed/16048426
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recordid: cdi_proquest_miscellaneous_68086158
title: Specialized Neuromuscular Training to Improve Neuromuscular Function and Biomechanics in a Patient With Quiescent Juvenile Rheumatoid Arthritis
format: Article
creator:
  • Myer, Gregory D
  • Brunner, Hermine I
  • Melson, Paula G
  • Paterno, Mark V
  • Ford, Kevin R
  • Hewett, Timothy E
subjects:
  • Abridged Index Medicus
  • Arthritis, Juvenile - physiopathology
  • Arthritis, Juvenile - rehabilitation
  • Athletic Injuries - prevention & control
  • Biomechanical Phenomena
  • Care and treatment
  • Case studies
  • Child
  • Children & youth
  • Female
  • Health aspects
  • Health risk assessment
  • Humans
  • Juvenile rheumatoid arthritis
  • Knee Injuries - prevention & control
  • Muscle, Skeletal - physiopathology
  • Physical Education and Training - methods
  • Physical therapy
  • Proprioception
  • Range of Motion, Articular
  • Rheumatoid arthritis
  • Rheumatoid arthritis in children
  • Risk Factors
  • Sports
  • Sports - education
  • Therapeutics, Physiological
  • Time Factors
ispartof: Physical therapy, 2005-08-01, Vol.85 (8), p.791-802
description: The purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to participate in soccer and basketball. Range of motion and manual muscle testing of the lower extremity were within normal limits. Neuromuscular testing included kinematic and kinetic testing, isokinetic assessment, and postural stability testing. The patient's gait was near normal; however, she had narrowed step width and increased knee flexion at heel-strike. Landing analysis during a box drop vertical jump task showed increased and imbalanced (right versus left lower extremity) peak impact forces. The testing was followed by specialized neuromuscular training (SNT). Following SNT, heel-strike and step width were within normal limits, peak impact forces on the box drop test decreased by 31%, imbalance decreased by 46%, and vertical jump increased 15%. The isokinetic strength ratio between knee flexors and extensors and the overall balance measures were within normal limits and equal bilaterally. Patients with quiescent JRA may have abnormal biomechanics, which could place them at increased risk for injury or future articular cartilage damage. Specialized neuromuscular training may have helped to decrease the patient's risk for future injury or disease progression.
language: eng
source:
identifier: ISSN: 0031-9023
fulltext: no_fulltext
issn:
  • 0031-9023
  • 1538-6724
url: Link


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titleSpecialized Neuromuscular Training to Improve Neuromuscular Function and Biomechanics in a Patient With Quiescent Juvenile Rheumatoid Arthritis
creatorMyer, Gregory D ; Brunner, Hermine I ; Melson, Paula G ; Paterno, Mark V ; Ford, Kevin R ; Hewett, Timothy E
creatorcontribMyer, Gregory D ; Brunner, Hermine I ; Melson, Paula G ; Paterno, Mark V ; Ford, Kevin R ; Hewett, Timothy E
descriptionThe purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to participate in soccer and basketball. Range of motion and manual muscle testing of the lower extremity were within normal limits. Neuromuscular testing included kinematic and kinetic testing, isokinetic assessment, and postural stability testing. The patient's gait was near normal; however, she had narrowed step width and increased knee flexion at heel-strike. Landing analysis during a box drop vertical jump task showed increased and imbalanced (right versus left lower extremity) peak impact forces. The testing was followed by specialized neuromuscular training (SNT). Following SNT, heel-strike and step width were within normal limits, peak impact forces on the box drop test decreased by 31%, imbalance decreased by 46%, and vertical jump increased 15%. The isokinetic strength ratio between knee flexors and extensors and the overall balance measures were within normal limits and equal bilaterally. Patients with quiescent JRA may have abnormal biomechanics, which could place them at increased risk for injury or future articular cartilage damage. Specialized neuromuscular training may have helped to decrease the patient's risk for future injury or disease progression.
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subjectAbridged Index Medicus ; Arthritis, Juvenile - physiopathology ; Arthritis, Juvenile - rehabilitation ; Athletic Injuries - prevention & control ; Biomechanical Phenomena ; Care and treatment ; Case studies ; Child ; Children & youth ; Female ; Health aspects ; Health risk assessment ; Humans ; Juvenile rheumatoid arthritis ; Knee Injuries - prevention & control ; Muscle, Skeletal - physiopathology ; Physical Education and Training - methods ; Physical therapy ; Proprioception ; Range of Motion, Articular ; Rheumatoid arthritis ; Rheumatoid arthritis in children ; Risk Factors ; Sports ; Sports - education ; Therapeutics, Physiological ; Time Factors
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descriptionThe purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to participate in soccer and basketball. Range of motion and manual muscle testing of the lower extremity were within normal limits. Neuromuscular testing included kinematic and kinetic testing, isokinetic assessment, and postural stability testing. The patient's gait was near normal; however, she had narrowed step width and increased knee flexion at heel-strike. Landing analysis during a box drop vertical jump task showed increased and imbalanced (right versus left lower extremity) peak impact forces. The testing was followed by specialized neuromuscular training (SNT). Following SNT, heel-strike and step width were within normal limits, peak impact forces on the box drop test decreased by 31%, imbalance decreased by 46%, and vertical jump increased 15%. The isokinetic strength ratio between knee flexors and extensors and the overall balance measures were within normal limits and equal bilaterally. Patients with quiescent JRA may have abnormal biomechanics, which could place them at increased risk for injury or future articular cartilage damage. Specialized neuromuscular training may have helped to decrease the patient's risk for future injury or disease progression.
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2Arthritis, Juvenile - rehabilitation
3Athletic Injuries - prevention & control
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9Female
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20Rheumatoid arthritis
21Rheumatoid arthritis in children
22Risk Factors
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25Therapeutics, Physiological
26Time Factors
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authorMyer, Gregory D ; Brunner, Hermine I ; Melson, Paula G ; Paterno, Mark V ; Ford, Kevin R ; Hewett, Timothy E
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abstractThe purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to participate in soccer and basketball. Range of motion and manual muscle testing of the lower extremity were within normal limits. Neuromuscular testing included kinematic and kinetic testing, isokinetic assessment, and postural stability testing. The patient's gait was near normal; however, she had narrowed step width and increased knee flexion at heel-strike. Landing analysis during a box drop vertical jump task showed increased and imbalanced (right versus left lower extremity) peak impact forces. The testing was followed by specialized neuromuscular training (SNT). Following SNT, heel-strike and step width were within normal limits, peak impact forces on the box drop test decreased by 31%, imbalance decreased by 46%, and vertical jump increased 15%. The isokinetic strength ratio between knee flexors and extensors and the overall balance measures were within normal limits and equal bilaterally. Patients with quiescent JRA may have abnormal biomechanics, which could place them at increased risk for injury or future articular cartilage damage. Specialized neuromuscular training may have helped to decrease the patient's risk for future injury or disease progression.
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