Therapeutic Strategies for Developing Neuromuscular Control in the Kinetic Chain

2012 ◽  
pp. 1-36 ◽  
Author(s):  
John Nyland
Keyword(s):  
Neuromuscular Control ◽  
Therapeutic Strategies ◽  
Kinetic Chain

Effect of Closed Kinetic Chain Training on Neuromuscular Control in the Upper Extremity

1999 ◽  
Vol 8 (3) ◽  
pp. 184-194 ◽  
Author(s):  
Mary E. Ubinger ◽  
William E. Prentice ◽  
Kevin M. Guskiewicz
Keyword(s):  
Upper Extremity ◽  
Neuromuscular Control ◽  
Position Sense ◽  
Joint Position Sense ◽  
Kinetic Chain ◽  
Physically Active ◽  
Significant Difference ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Stimulation Of

When the upper extremity is injured, open kinetic chain (OKC) exercises are primarily used to increase strength and restore functional ability—the goals of rehabilitation. It is also imperative, however, that the receptors responsible for static and dynamic stabilization of the joint be trained. This can be done with closed kinetic chain (CKC) exercises. The purposes of this study were to investigate the effect of a 4-week CKC training program on the neuromuscular control of the upper extremity and to determine whether there was a significant difference between skill-dominant limb and nondominant limb stability indices. Thirty-two physically active participants (14 men, 18 women) were tested on the FASTEX 4 weeks apart. The training group's scores significantly improved, whereas the control group's scores remained the same. It was concluded that the CKC training significantly improved the training group's ability to remain stable. The results suggest that CKC training can increase the accuracy of joint position sense because of increased stimulation of the mechanoreceptors.

Functional Training for the Restoration of Dynamic Stability in the PCL-Injured Knee

1999 ◽  
Vol 8 (4) ◽  
pp. 362-378 ◽  
Author(s):  
Paul A. Borsa ◽  
Eric L. Sauers ◽  
Scott M. Lephart
Keyword(s):  
Dynamic Stability ◽  
Management Strategy ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Joint Stability ◽  
Kinetic Chain ◽  
Functional Training ◽  
Rehabilitation Protocols ◽  
Research Findings ◽  
Injured Knee

Functional training for the purpose of restoring dynamic joint stability has received considerable interest in recent years. Contemporary functional training programs are being designed to complement, rather than replace, traditional rehabilitation protocols. The purpose of this clinical commentary is to present a management strategy for restoring dynamic stability in the posterior cruciate ligament (PCL)-injured knee. The strategy presented integrates five key concepts: (a) planned variation of exercise, (b) outcomes-based assessment, (c) kinetic chain exercise, (d) proprioception and neuromuscular control, and (e) specificity of activity. Pertinent research findings and a clinical rationale are provided for using functional training in the restoration of dynamic stability in the PCL-injured knee.

The Physiological Basis for Open and Closed Kinetic Chain Rehabilitation for the Upper Extremity

1996 ◽  
Vol 5 (1) ◽  
pp. 71-87 ◽  
Author(s):  
Scott M. Lephart ◽  
Timothy J. Henry
Keyword(s):  
Upper Extremity ◽  
Classification System ◽  
Neuromuscular Control ◽  
Classification Systems ◽  
Functional Classification ◽  
Kinetic Chain ◽  
Physiological Basis ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Upper Extremity Rehabilitation

The confusion between the termsopen kinetic chainandclosed kinetic chainbecomes even greater with application to the upper extremity. Upper extremity function is very difficult to define, due to the numerous shoulder positions and the great velocities with which the shoulder can move. Classifying exercises for rehabilitation of the upper extremity is very difficult due to the complexity of the joint. Many definitions and classification systems have been proposed; however, none of these entirely encompass rehabilitation of the upper extremity. Using previous classifications we have developed a Functional Classification System that is designed to serve as a template for upper extremity rehabilitation. This system has been designed to restore functional shoulder stability, which is dependent upon proper scapulothoracic and glenohumeral stability, and humeral control; all of these are in part mediated by neuromuscular mechanisms. The objective of our new Functional Classification System is to restore functional stability of the shoulder by reestablishing neuromuscular control for overhead activities.

The Effect of Select Shoulder Exercises on Strength, Active Angle Reproduction, Single-Arm Balance, and Functional Performance

2004 ◽  
Vol 13 (1) ◽  
pp. 75-95 ◽  
Author(s):  
Darin A. Padua ◽  
Kevin M. Guskiewicz ◽  
William E. Prentice ◽  
Robert E. Schneider ◽  
Edgar W. Shields
Keyword(s):  
Dynamic Stability ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Functional Performance ◽  
Neuromuscular Control ◽  
Healthy Individuals ◽  
Kinetic Chain ◽  
Significant Group ◽  
Shoulder Strength ◽  
Post Hoc

Objective:To determine whether select shoulder exercises influence shoulder-rotation strength, active angle reproduction (AAR), single-arm dynamic stability, and functional throwing performance in healthy individuals.Design:Pretest–posttest.Setting:Laboratory.Participants:54, randomly placed in 4 training groups.Intervention:Four 5-week training protocols.Main Outcome Measures:Average shoulder-rotation torque, AAR, single-arm dynamic stability, and functional throwing performance.Results:Repeated-measures ANOVAs revealed a significant group-by-test interaction for average torque (P> .05). Post hoc analyses revealed significantly increased average torque in the open kinetic chain and proprioceptive neuromuscular facilitation (PNF) groups after training. AAR and sway velocity were not affected in any of the groups (P> .05), but functional performance revealed a significant group-by-test interaction (P< .05). Post hoc analysis demonstrated that the PNF group significantly improved after training (P< .05).Conclusions:Shoulder strength can be improved in healthy individuals, but improvements depend on the exercise performed. Shoulder proprioception and neuromuscular control were unchanged in all groups, but functional performance improved in the PNF group

Hip-Focused Neuromuscular Exercise Provides Immediate Benefits in Foot Pronation and Dynamic Balance: A Sham-Controlled Cross-Over Study

2021 ◽  
pp. 1-6
Author(s):  
Elif Turgut ◽  
Gozde Yagci ◽  
Volga Bayrakci Tunay
Keyword(s):  
Test Scores ◽  
Dynamic Balance ◽  
Frontal Plane ◽  
Neuromuscular Control ◽  
Kinetic Chain ◽  
Balance Test ◽  
Navicular Drop ◽  
Foot Pronation ◽  
Projection Angle ◽  
Plane Projection

Context: Knowledge on how to utilize a kinetic chain approach in foot and ankle rehabilitation is important. Objective: The aim of this study was to investigate the immediate effects of hip-focused neuromuscular exercise on foot pronation and single-leg neuromuscular control. Design: Cross-over study. Setting: University laboratory. Participants: This cross-over study included 44 asymptomatic volunteers with foot pronation. Interventions: All participants performed (1) a hip-focused neuromuscular exercise and (2) a sham exercise in randomized order. Main Outcome Measures: Foot pronation was assessed by the navicular drop test, and lower-extremity neuromuscular control was assessed by the Modified Star Excursion Balance Test and frontal plane projection angle during single-leg squat before and after the experiments. Results: Navicular drop test scores were significantly lower after the hip-focused neuromuscular exercise than after the sham exercise (mean difference [95% CI] = 2.84 [−1.08 to 6.77], P = .003). Modified Star Excursion Balance Test scores in the anterior (P = .008), posteromedial (P = .04), and posterolateral (P < .001) directions were significantly increased after hip-focused neuromuscular exercise. No statistically significant condition × time interaction was found for the frontal plane projection angle (P > .05). However, a main effect of time (P = .003) indicated that less dynamic knee valgus occurred during single-leg squat after both experiments. Conclusions: Hip-focused neuromuscular exercise produced immediate alterations in foot pronation and dynamic balance. Thus, the hip-focused neuromuscular exercise may be used to control foot posture in foot rehabilitation integrated with a kinetic chain approach and could be an effective prevention and treatment strategy.

Anterior Knee Pain in Children and Adolescents: Overview and Management

2018 ◽  
Vol 31 (05) ◽  
pp. 392-398 ◽  
Author(s):  
Steven Slotkin ◽  
Andrew Thome ◽  
Cassandra Ricketts ◽  
Andrew Georgiadis ◽  
Aristides Cruz ◽  
...  
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Patellofemoral Instability ◽  
Neuromuscular Control ◽  
Kinetic Chain ◽  
Imaging Studies ◽  
Common Causes ◽  
Growth Changes ◽  
Anterior Knee ◽  
Rule Out

AbstractAnterior knee pain (AKP) is a common presenting complaint for pediatricians and orthopaedic surgeons and is often seen in young athletes. AKP is multifactorial and has a broad differential diagnosis. The growth changes, biomechanics, and anatomy around the knee add to the complexity of diagnosis and treatment of AKP. Common causes of AKP include Osgood–Schlatter's disease, patellar tendinitis, and patellofemoral instability. In the diagnosis of AKP, it is important to rule out serious and morbid causes of pain, including infection and tumor. It is crucial to complete a detailed history and physical examination and obtain appropriate imaging studies. In general, the majority of patients will respond to nonoperative measures targeted to correct neuromuscular control and kinetic chain dysfunction.

Functional Anatomy Underlying Pharyngeal Swallowing Mechanics and Swallowing Performance Goals

2019 ◽  
Vol 4 (4) ◽  
pp. 648-655
Author(s):  
William G. Pearson ◽  
Jacline V. Griffeth ◽  
Alexis M. Ennis
Keyword(s):  
Functional Anatomy ◽  
Neuromuscular Control ◽  
Upper Esophageal Sphincter ◽  
Performance Goals ◽  
Laryngeal Elevation ◽  
Port Closure ◽  
Swallowing Dysfunction ◽  
Hyoid Movement ◽  
Pharyngeal Swallowing ◽  
Pharyngeal Constriction

Purpose Rehabilitation of pharyngeal swallowing dysfunction requires a thorough understanding of the functional anatomy underlying the performance goals of pharyngeal swallowing. These goals include the safe and efficient transfer of a bolus through the hypopharynx into the esophagus. Penetration or aspiration of a bolus threatens swallowing safety. Bolus residue indicates swallowing inefficiency. Several primary mechanics, or elements of the swallowing mechanism, underlie these performance goals, with some elements contributing to both goals. These primary mechanics include velopharyngeal port closure, hyoid movement, laryngeal elevation, pharyngeal shortening, tongue base retraction, and pharyngeal constriction. Each element of the swallowing mechanism is under neuromuscular control and is therefore, in principle, a potential target for rehabilitation. Secondary mechanics of pharyngeal swallowing, those movements dependent on primary mechanics, include opening the upper esophageal sphincter and epiglottic inversion. Conclusion Understanding the functional anatomy of pharyngeal swallowing underlying swallowing performance goals will facilitate anatomically informed critical thinking in the rehabilitation of pharyngeal swallowing dysfunction.

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