Publications

Scholarly Journals--Published

  • Lohman E B 3rd, Balan Sackiriyas K S, & Swen R W. (2011). A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod, and minimally supported running as compared to walking. Phys Ther Sport, 12(4), 151-63. Recreational running has many proven benefits which include increased cardiovascular, physical and mental health. It is no surprise that Running USA reported over 10 million individuals completed running road races in 2009 not to mention recreational joggers who do not wish to compete in organized events. Unfortunately there are numerous risks associated with running, the most common being musculoskeletal injuries attributed to incorrect shoe choice, training errors and excessive shoe wear or other biomechanical factors associated with ground reaction forces. Approximately 65% of chronic injuries in distance runners are related to routine high mileage, rapid increases in mileage, increased intensity, hills or irregular surface running, and surface firmness. Humans have been running barefooted or wearing minimally supportive footwear such as moccasins or sandals since the beginning of time while modernized running shoes were not invented until the 1970s. However, the current trend is that many runners are moving back to barefoot running or running in "minimal" shoes. The goal of this masterclass article is to examine the similarities and differences between shod and unshod (barefoot or minimally supportive running shoes) runners by examining spatiotemporal parameters, energetics, and biomechanics. These running parameters will be compared and contrasted with walking. The most obvious difference between the walking and running gait cycle is the elimination of the double limb support phase of walking gait in exchange for a float (no limb support) phase. The biggest difference between barefoot and shod runners is at the initial contact phase of gait where the barefoot and minimally supported runner initiates contact with their forefoot or midfoot instead of the rearfoot. As movement science experts, physical therapists are often called upon to assess the gait of a running athlete, their choice of footwear, and training regime. With a clearer understanding of running and its complexities, the physical therapist will be able to better identify faults and create informed treatment plans while rehabilitating patients who are experiencing musculoskeletal injuries due to running. (11/2011) (link)

Abstract

  • (NON-PEER REVIEWED) Matt Adams, Sergio Florian, Troy Kurtz, Mike Martinez, R. Wesley Swen, Gail Polvoorde.  The Effects of Aging on the Scapulohumeral Reflex of Older Adults.  Doctor of Physical Therapy Research Reports 2006; Loma Linda University School of Allied Health Professions. Background and Purpose.  The purpose of this study was to document the occurrence rate of the scapulohumeral reflex for normal subjects between 40 and 80 years of age.  We hypothesized that reflexes would diminish as the age of the subjects increased.  Subjects.  Subjects were recruited from senior centers, fitness clubs, convalescent homes, and the community.  Subjects were between 40 and 80 years old.  They were divided into four groups of 10.  Group 1 ranged in age from 40-49 years, group 2 from 50-59, group 3 from 60-69, and group 4 from 70-79 years.  Subjects were free of cervical and shoulder musculoskeletal or neural pathologies. Gender was not a factor in subject selection.  Methods.  Each subject’s right upper extremity reflexes (C5, C6, and C7) were tested along with his/her scapulohumeral reflex (C4).  The subjects were placed sitting with arms resting at their sides.  Six taps were administered with a Babinski/Rabiner reflex hammer and the resulting reflex was classified into one of four reflex grades.  Shoulder elevation and abduction of any grade except 0 was considered to be a positive response for scapulohumeral reflex.  Results.  Scapulohumeral reflex was present in 35 of our 40 subjects (878.5%).  In the 70-79 year old age group, scapulohumeral reflex was present in only 80% of the subjects.  There was not a significant correlation between age and scapulohumeral reflex grade (r=-.21, p=.20).  A Chi-square test also showed no significant association between age group and scapulohumeral reflex grade (p=.57).  Discussion and Conclusion.  Our hypothesis stated that reflexes would diminish with age among the elderly population, however, there was not a significant correlation between age and scapuloumeral reflex grade.  The occurrence rate of the scaulohumeral reflex was greater than that of the triceps reflex, which is used in standard clinical neurological testing.  Clinically, the scapulohumeral reflex may be reliable, along with the biceps, brachioradialis, and triceps reflex, as an evaluation to assess upper extremity neurological integrity. (06/2004 - 06/2006)
  • (NON-PEER REVIEWED) Ruby Bajaj, Charlie Chen, Dharmesh Gordham, R. Wesley Swen, Jeannine Sturat Mendes;  Comparison of the Effectiveness of Dexamethasone and Ketoprofen delivered via Iontophoresis to Patients with Epicondylitis.  Doctor of Physical Therapy Research Reports 2005 Loma Linda University School of Allied Health Professions. Background and Purpose.  The purpose of this study was to compare the effectiveness of two medications, Dexamethasone (DEX-P) and Ketoprofen, delivered to patients with epicondylitis using iontophoresis.  Subjects.  Subjects (n=10) were included in the study if they had a physician''s prescription for physical therapy with a diagnosis of lateral epicondylitis.  Methods.  Physical therapists performed a strength assessment of bilateral musculature, measured passive range of motion (PROM) and active range of motion (AROM) of the elbow and wrist, the Lateral Epicondylitis Test (LET), grip strength of the bilateral upper extremities using a hand dynamometer, and conducted a subjective measurement of pain using a visual analog scale (VAS).  Results.  Subjects who received Dexamethasone treatment (n=4) had a significantly higher mean for wrist extension AROM (p=.04), and wrist extension PROM (p=.02), than subjects receiving Ketoprofen (n=6).  The medications were not significantly different in reducint the report of pain (p=.76).  Discussion and Conclusion.  There is no added benefit to using Ketoprofen instead of Dexamethasone for the reduction of inflammation for patients with lateral epicondylitis. (06/2003 - 06/2005)
  • (NON-PEER REVIEWED) Joseph S. Kim, R. Wesley Swen, Everett B. Lohman III; Electromyographic Activity:  Measuring the Effect of Foot Position in Weight-Bearing Activities.  Doctor of Physical Therapy Research  Reports 2003 Loma Linda University School of Allied Health Professions. Background and Purpose.  Orthotics are used to correct structural abnormalities in the foot.  We hypothesized that the calcaneus rectus position while doing a partial squat would decrease muscle surgace electromyographic (sEMG) activity or change recruitment patterns for muscles of the lower extremity.  Subjects.  The sample consisted of 30 volunteers, ages 21-35 years with rearfoot eversion greater than 2 degrees in a weight-bearing stance.  Methods.  We used sEMG to measure the difference in muscle recruitment between rearfoot eversion and calcaneus rectus during a partial squat.  The Pro-Wedge-ItTM was used to position the foot into calcaneus rectus.  Results.  There were no significant differences in sEMG activity between the foot positions (p>.05) and the muscle recruitment pattern did not change.  Discussion and Conclusion.  Although no significant difference was found, there was a trend for decreased sEMG activity during the partial squat when the foot waas positioned into calcaneus rectus, while standing on the Pro-Wedge-ItTM (06/2001 - 06/2003)