Background: The purpose of this study was to compare the effects of specific neck muscle training and general neck-shoulder exercises on neck proprioception, pain, and disability in patients with chronic non-specific neck pain. Methods: Twenty-five patients with chronic non-specific neck pain were recruited into this preliminary single-blinded randomized clinical trial. They were randomly assigned to either a specific neck exercise (n = 13, mean aged 24 years) or a general neck exercise group (n = 12, mean aged 25 years). Specific neck exercises included eye-head coordination and isometric deep neck muscle exercises. General neck exercises included neck and shoulder free range of motion and shoulder shrug. Pain, disability, and neck proprioception, which was determined using the joint repositioning error, were measured at baseline and after eight weeks of training in both groups. Results: Both training groups showed significant improvements in joint repositioning error (p < 0.001, F = 24.144, ES = 0.8), pain (p < 0.001, F = 61.118, ES = 0.31), and disability (p = 0.015, F = 6.937, ES = 0.60). However, the specific neck exercise group showed larger variability in joint repositioning error (p = 0.006, F = 0.20, F critical = 0.36). Conclusions: Either specific neck exercise or a general neck-shoulder range of motion exercise could be effective in improving neck proprioception. Therefore, exercises could be recommended based on patient comfort and patients’ specific limitations.

Context: Foot-orthosis (FO) intervention to prevent and treat numerous lower extremity injuries is widely accepted clinically. However, the results of quantitative gait analyses have been equivocal. The foot models used, participants receiving intervention, and orthoses used might contribute to the variability. Objective: To investigate the effect of a custom-molded FO intervention on multisegment medial foot kinematics during walking in participants with low-mobile foot posture. Design: Crossover study. Setting: University biomechanics and ergonomics laboratory. Patients or Other Participants: Sixteen participants with low-mobile foot posture (7 men, 9 women) were assigned randomly to 1 of 2 FO groups. Intervention(s): After a 2-week period to break in the FOs, individuals participated in a gait analysis that consisted of 5 successful walking trials (1.3 to 1.4 m/s) during no-FO and FO conditions. Main Outcome Measure(s): Three-dimensional displacements during 4 subphases of stance (loading response, mid-stance, terminal stance, preswing) were computed for each multisegment foot model articulation. Results: Repeated-measures analyses of variance (ANOVAs) revealed that rearfoot complex dorsiflexion displacement during midstance was greater in the FO than the no-FO condition (F_1,14 = 5.24, P = .04, partial η² = 0.27). Terminal stance repeated-measures ANOVA results revealed insert-by-insert condition interactions for the first metatarsophalangeal joint complex (F_1,14 = 7.87, P = .01, partial η² = 0.36). However, additional follow-up analysis did not reveal differences between the no-FO and FO conditions for the balanced traditional orthosis (F_1,14 = 4.32, P = .08, partial η² = 0.38) or full-contact orthosis (F_1,14 = 4.10, P = .08, partial η² = 0.37). Conclusions: Greater rearfoot complex dorsiflexion during midstance associated with FO intervention may represent improved foot kinematics in people with low-mobile foot postures. Furthermore, FO intervention might partially correct dys-functional kinematic patterns associated with low-mobile foot postures.

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to the knee using TK and EK protocols. The purpose of this multi-site study was to examine kinematic outcomes during walking in separate groups of young children in an EK and a TK prosthesis protocol, along with a population of children without lower limb amputations. Eighteen children aged 12 months to five years were recruited for this study at two clinical sites, six in each of the three groups. Children in the two prosthesis groups had unilateral limb loss and had been treated either at one site with the TK protocol or at another with the EK protocol. Children in the EK group achieved swing phase prosthetic knee flexion averaging 59.8±8.4 degrees. Children wearing prosthetic limbs walked slower than age-matched peers. In most instances, walking speed and step length increased with age in the EK group, similar to the control group. However, this trend was not observed in the TK group. Clearance adaptations were present in both limb loss groups. Observed adaptations were twice as prevalent in the TK group versus the EK group; however, the groups differed in age and etiology. Children with limb loss provided with an articulating knee component in their first prosthesis incorporated knee flexion during swing phase and showed fewer gait adaptations than children in the TK protocol.