Paralysis of the trapezius: a case report.

A patient was referred to physical therapy for exercises to the right shoulder secondary to a peripheral nerve injury involving the spinal accessory nerve. A treatment program was designed to accommodate for lack of upward scapula rotation, which is necessary for elevation of the upper extremity above shoulder level. During the course of two and a half years of care, a variety of associated problems were encountered. There was no apparent nerve regeneration, and the patient was left with limited mobility of the affected upper extremity.

Reliability and validity of goniometric measurements at the knee.

The purposes of this study were to assess the intertester reliability of goniometric measurements at the knee and the validity of the clinical measurements by comparing them to measurements taken from roentgenograms. Thirty healthy subjects between the ages of 20 and 60 years were studied. The subjects were positioned on their right side on a roentgenographic table with their left lower extremity on a stabilizing board that was elevated 15 cm above the table's surface. For standardization of the position, an assistant placed the posterior aspect of the subject's left thigh in contact with two 15-cm pegs, which had been inserted perpendicularly into the stabilizing board. The assistant then moved the left leg to achieve an arbitrary angle of the knee joint and held the limb in that position. Two physical therapists then independently used a standard plastic goniometer to measure the knee joint angle in the sagittal plane using the greater trochanter, the lateral condyle of the femur, the head of the fibula, and the lateral malleolus as bony landmarks. A roentgenogram was taken of the extremity before the subject was moved. Pearson product-moment correlation coefficients (r's) and intraclass correlation coefficients (ICCs) were used to analyze the data. The data analysis revealed that the intertester reliability (r = .98; ICC = .99) and validity (r = .97-.98; ICC = .98-.99) were high. The results of this study indicate that goniometric measurements of the knee joint are both reliable and valid.

The mechanics of pitching.

The mechanical aspects of delivering a baseball pitch are presented. To organize the sequence of events involved in pitching, the kinematics are.explained by the phases the pitcher passes through during the delivery. There are four categories of delivering a pitch. Each type of delivery has its own peculiar trunk actions and results in a definite and distinct axis of motion about which the moment arm rotates to provide torque to the pitched ball. Understanding the factors involved in formation of the moment arm and its relationship to the method of delivery enhances the therapist's ability to deal effectively with the total player when treating injuries from pitching or throwing a ball. J Orthop Sports Phys Ther 1987;9(2):56-69.

Validity and reliability of leg length measurements.

This study was conducted to examine the validity and reliability of the leg length measurements with a tape measure. The purpose of this study was to determine: 1) the validity of the leg length measurements through comparison with x-rays, and 2) the intertester reliability. Thirty healthy subjects between the ages of 18 and 65 were studied. Each subject was positioned supine on an x-ray table. A radiopaque ruler marked in 1 mm increments was placed on the table. Two physical therapists measured the right leg length of each subject from anterior superior iliac supine to medial malleolus with a pliable metal tape measure. X-rays were taken by the slit scanography method. Pearson product-moment and intraclass correlation coefficients (r and ICC, respectively) were used to analyze the data. The value of r for the comparison: 1) between therapists was 0.98, 2) between therapist 1 and x-ray measure was 0.98, and 3) between therapist 2 and x-ray measure was 0.98. The value of ICC for the comparison: 1) between therapists was 0.99, 2) between therapist 1 and x-ray measure was 0.99, and 3) between therapist 2 and x-ray measure was 0.99. The findings of this study indicate that the leg length measurements from anterior superior iliac spine to the medial malleolus with tape measure are valid and reliable. Hence, confidence can be placed in the accuracy of clinical measures. J Orthop Sports Phys Ther 1986;8(4):185-188.