http://www.fysiotherapie-lucas.nl/selectie3.pdf

Inter-rater reliability for measurement of passive physiological range of motion of upper extremity joints is better if instruments are used: a systematic review

Cuboid subluxation is a common but poorly recognized condition. Its symptoms include lateral midfoot pain and an inability to "work through the foot." In addition, pressing on the plantar surface of the cuboid in a dorsal direction produces pain. The normal dorsal/plantar joint play is reduced or absent when compared to the uninjured side, and subtle forefoot valgus is present. Frequently, there is a shallow depression on the dorsal surface of the foot and palpable fullness on the plantar aspect of the cuboid. Documentation by radiograph, CT scan, or magnetic resonance imaging is difficult because of the normal variations found in the relationship between the cuboid and its surrounding structures. The diagnosis is primarily subjective, and must be made on the basis of the patient's history and physical findings. Treatment requires recognition of the condition, manual reduction by a therapist or physician familiar with the condition, and follow-up to be certain that the cuboid remains in place. Therapists and orthopaedists involved in the care of dancers should be alert to the possibility of cuboid subluxation and be able to recognize it when it occurs.

Cuboid subluxation in ballet dancers

Study Design Descriptive. Objectives Examine the intrarater and interrater reliability of end-feel and pain/resistance sequence for patients with painful shoulders and knees. Background Clinicians make diagnostic and intervention decisions based on end-feel and pain/resistance sequence, but few studies have examined agreement within and between physical therapists when assessing subjects with pathology. Methods and Measures Subjects with unilateral knee pain (18 men and 22 women with a mean age of 31.8 ± 9.5 years) or shoulder pain (21 men and 25 women with a mean age of 34.3 ± 12.9 years) were examined twice. Two physical therapists used standardized positions to evaluate 2 knee motions and 5 shoulder motions. Evaluators did not interview subjects and were blinded to previous test results. Evaluators applied overpressure and noted the end-feel while subjects identified the moment their pain was reproduced. Following testing, subjects rated their pain intensity. Analyses included: percentage of agreement;...

Reliability of Assessing End-Feel and Pain and Resistance Sequence in Subjects With Painful Shoulders and Knees

Examination of the elbow: linking diagnosis, prognosis, and outcomes as a framework for maximizing therapy interventions.

Background and Purpose: In orthopaedic manual physical therapy, passive intervertebral joint testing of the upper cervical spine is widely used for clinical assessment. However, the test position has not been standardized and tester reliability has not been well established. The purpose of this study is to determine whether patient positioning affects the degree of reliability of passive motion testing and end-feel assessment when passively testing craniovertebral sidebending.Subjects: Ten subjects participated in both the radiographic and clinical assessment portion of this study with mean age of 32.5 +/− 6.9 years.Methods: Open-mouth position radiographs were used to measure passive craniovertebral sidebending at the “erect” neutral and the “physiological” neutral positions. Intertester and intratester reliability were determined on the same group of subjects using six physical therapists to assess end-feel and mobility grades for passive craniovertebral sidebending in five positions.Results: Th...

Radiographic Assessment and Reliability Study of the Craniovertebral Sidebending Test

Identification of the anatomic and pathoanatomic structure which limits the range of motion of a joint help to determine the need for and type of treatment approach. The purpose of this study was to determine the interrater and intrarater reliability of two experienced physical therapists in the identification of the type of end feel for elbow flexion and extension when using the Paris classification system of normal end feel. Four trials of flexion end feel and four trials of extension end feel were conducted for each of the twenty subjects by each blindfolded examiner. A total of 160 movements were performed by each examiner. The intertester Kappa value for interrater reliability for flexion was .40 and for extension was .73 with a significance of p < .0001 for both flexion and extension. Intrarater agreement was measured by percent comparison. Examiner A demonstrated 80% agreement for flexion and 79% for extension. Examiner B showed 75% agreement for flexion and 78% for extension. This study d...

Reliability of Interpretation of The Paris Classification of Normal End Feel for Elbow Flexion and Extension

The purpose of this case report is to relate an episode of movement impairment at the cuboid calcaneal articulation leading to symptoms of iliotibial band (ITB) syndrome. An explanation of the etiology and clinical diagnosis in relation to the differential diagnosis, treatment techniques, and patient outcomes are described. The 24-year-old female tri-athlete reported pain at Gerdy's tubercle and lateral femoral condyle areas occurring within 2 miles of a run. VAS score was 6/10 for the running activity and the lower extremity functional scale (LEFS) score was 93% (74/80). Over the previous 2 years, the ITB symptoms had failed to resolve with extensive conservative treatment at the knee. On weight bearing, the patient demonstrated pain free limitation of active midtarsal pronation more than supination, which correlated with a decrease in passive internal rotation of the cuboid. Symptoms resolved after one cuboid whip manipulation and the patient was able to run pain free. Post-manipulation treatment consisted of two more sessions, which included motor retraining for weight bearing active midtarsal pronation and supination. LEFS was 100% (80/80) and VAS 0/10 with running greater than 10 miles. While causality cannot be inferred from a single case, this report may foster further investigation regarding the differential diagnosis and treatment of a hypomobile cuboid.

/pdf/differential-diagnosis-and-treatment-of-iliotibial-band-pain-a12ozagvmv.pdf

Catherine E. Patla

Papers

Reliability of Interpretation of The Paris Classification of Normal End Feel for Elbow Flexion and Extension

Differential diagnosis and treatment of iliotibial band pain secondary to a hypomobile cuboid in a 24-year-old female tri-athlete