Abstracts 169
Marked differences occurred in ultimate loads, deflection and
energy absorbed as a consequence of differences in femoral-
tibia1 orientation. The mode of structural failure. as
determined by post-test examination, also varied markedly as
a function of femoral-tibia1 orientation. It is concluded that
differences both in measured mechanical properties and
observed failure details are a consequence of varying the
loading pattern of the fiber bundles across the finite breadth
of the ligament.
Figgie HE III. Bahniuk EH. Heiple KG and Davy DT
J Biomech 1986: IY: 89-91
A biomechanical analog of curve progression and
orthotic stabilization in idiopathic scoliosis
A biomechanical analog of curve progression and orthotic
stabilization in idiopathic scoliosis has been developed using
the classical theory of curved beam-columns. The interaction
of the spinal musculature and other supporting structures is
incorporated in the model using an equivalent flexural
rigidity. The stability of a given scoliotic curve relative to a
normal spine is described in terms of the so-called critical load
ratio (P,iP,.). This dimensionless quantity appears in the exact
solution of the governing differential equation and boundary
conditions. It is defined as the ratio of the load bearing
capacity of a scoliotic spine (P,.) to that of a normal spine
where the load bearing capacity of a normal spine is defined
as Euler’s buckling load (P,.). The computation of P,/P,. is
based upon a maximum allowable moment criterion. This
model is used to study the effect of the degree of initial
curvature and curve pattern in the frontal plane on the
stability of untreated idiopathic scoliosis. Although restricted
to two-dimensions. the model appears to demonstrate the
synergistic effects of end support. transverse loading. and
curve correction on improvement in relative stability of an
orthotically supported scoliotic curve. The results of this
study are in qualitative agreement with clinical tindin!> that
are based on long-term studies of natural history of rdmpathic
\coliosis and of patients undergoing orthotic management for
\coliosis.
Patwardhan AG. Bunch WH. Meadr KP. Vanderhy R Jr and
Knight GW. J. Biomech 1986; 19: 103-17
Evaluation of lumbar lordosis. A prospective and
retrospective study
Two lordotic angles were measured on roentgenograms of
Y73 adults in a prospective and retrospective review. The
majority of the films were taken because of lumbar
complaints. The mean lumbosacral (LS) angle (LZ-Sacrum)
was 4S~OS”fX?‘. The mean lumbolumbar (LL) angle (LZ-LS)
was 29Y6”+.74”. Only minor differences were found between
a standardized (prospective) and a nonstandardized
(retrospective) group. There was a statistically significant
difference between men and women with both LS and LL
angles, but no racial differences were observed. A ‘routine’
supine lateral lumbar spine roentgenogram is a very accurate
means of measuring lordotic angles. A lordotic angle of less
than 23” defines hypolordosis and more than 68”.
hyperlordosis.
Fernand R and Fox DE. Spine 1985; 10: 799-803
SPORTS MEDICINE
Manipulation in the treatment of tennis elbow
With the increasing popularity of tennis there has been an
increasing interest in the etiology and treatment of lateral
epicondylitis. The current pathophysiology is assumed to be
related to repeated wrist extension origin with an ultimate
change in the histology of the area. Treatment involves
exercise. the use of many modalities to treat the area locally,
and more specifically when tennis is the etiology a whole
variety. of functional adaptations as well as a modification
of eqmpment. Specifically. manipulation of the elbow
has played a large role in the treatment of resistant tennis
elbow and the large number of different named
maneuvers has led to a certain amount of confusion. The
second half of the paper attempts to review these
manipulations including that described by Mills, Cyriax.
Kaltenborn. Mennell. and Stoddard. These manipulations
seem to fall into two basic varieties: those that seek full
extension and those that will produce a varus thrust. The
manipulations done with the elbow in extension and the
forearm in pronation have the greatest chance of affecting the
contractile elements whereas those performed with a varus
thrust at the elbow seem to act primarily on the capsular
structures causing gapping and restoring joint play. While
manipulation may be effective it always must be used in
conjunction with a total treatment regime including exercise,
modalities, and modification of the activities involved in the
etiology.
Kushner S and Reid DC. J Orthop Sports Phys Ther 1986;
7: 264-72
Strength relationship of the knee musculature: effects of
gravity and sport
The purposes of this study were to examine the effects of
gravity and sport on the hamstrings-quadriceps strength
relationship. The peak torques at four speeds of isokinetic
exercise (60. 180. 24().300”/sec) were determined for 20 male
college track athletes. including 10 sprinters and 10 distance
runners. The runners were tested on a Cybex@ 11 isokinetic
dynamometer. Peak torque measurements were corrected for
the effects of gravity. Results of the present study showed
that: 1) the effects of gravity significantly alters the
hamstrings to quadriceps ratio at all velocities, and 2) there is
no statistically significant difference in tire hamstrings-
quadriceps strength ratios between the two groups of athletes
except at 3()o”/sec. At that speed, sprinters had a higher ratio
than distance runners.
Appen L and Duncan PW. J Orthop Sports Phys Ther 1986;
7: 237-5
Injury prediction in female gymnasts
In order to identify injury-proneness in female competitive
gymnasts, 20 measures of flexibility, hypermobility. spinal
posture and anthropometry were performed on 40
competitive gymnasts and injury scores were derived from the
severity and extent of previous gymnastic injury and inherent
hypermobility traits. Results were compared between
contrasting groups of ‘low’ and ‘high’ injury gymnasts
respectively (both N= 10). Nine variables demonstrated
significant differences between the ‘low’ and ‘high’ injury risk
statusgroups namely. weight (p<O.OOl). height (p<O~OOl),
age (~<O~Ool). mesomorphy b<O-01). Quetelet Index
(p<O.Ol). shoulder flexion (p<O.OS) and lumbar extension
@<O%). standing lumbar curvature and total peripheral
flexibility score (bothpcO@5).