VIVA Alexis (17) Flashcards
Conduct a hop for distance test for distance for Alexis. (this is prior to
the development of her stress fracture) Explain the procedure and purpose of the
test to Alexis, including what she should experience subjectively and objectively.
Demonstrate the technique.
Purpose - to assess lower limb strength and stability
- Allow a practice trial on each limb, followed by two measured and recorded trials.
- Instruct the athlete to start in a semi-crouched position on the single limb being tested. They must then initiate the hop by swinging the arms forward, simultaneously extending at the hip and knee, and hopping forward as far as possible while being able to land safely on the same limb.
- A stabilized, 1-second landing on the hop limb is required for a successful trial.
- Measure and record the distance to the nearest centimetre on a standard measuring tape
- Record the test using iPad motion analysis app
Subjectively - muscle workings, pain, effort level, confidence
Objectively - measurement of hop, form and technique. Soft landing , stability, use of arms.
Conduct a triple hop test for distance for Alexis. (this is prior to
the development of her stress fracture) Explain the procedure and purpose of the
test to Alexis, including what she should experience subjectively and objectively.
Demonstrate the technique.
Purpose - to assess lower limb strength and stability
- Set up the test with a strip of tape, 15 cm in width and 6 meters long placed perpendicular to the start line.
- Allow a practice trial on each limb, followed by two measured and recorded trials.
- Instruct the athlete to start in a semi-crouched position on the single limb being tested, with the toes behind the start line
- Instruct the athlete to initiate the hop by swinging the arms forward, while hopping forward as far as possible and safely landing on the same limb, and to immediately redirect into 2 subsequent hops, holding the third landing.
- The final landing on the hop limb had to be stabilized and held for 1 second to be recorded as a successful trial
- End distance is measured from where the posterior heel of the last hop lands
- Record test using iPad motion analysis app
Subjectively - muscle workings, pain, effort level, confidence
Objectively - measurement of hop, form and technique. Soft landing , stability, use of arms.
Explain to the examiner why Alexis may be experiencing a drop in lower limb power (think female athlete triad syndrome)
- Malnutrition (calories in < calories out), osteoporosis (low bone density), menstrual dysfunction
- Combination of over training and malnutrition leads to fatigue and muscle weakness results in a loss of power.
Explain to the examiner what is meant by overtraining and female athlete triad
syndrome and specifically how these apply to Alexis.
- Over-training refers to a long-term decline in performance which takes weeks to months for restoration.
- Female triad syndrome occurs when we become malnourished not giving the body adequate calories to calories expended. This causes reduced bone density, weight loss, fatigue and menstrual dysfunction.
- Her busy schedule balancing work, school and training leads to inadequate rest for body to recover properly.
Conduct a cross-over hop test for Alexis. (this is after she has recovered from her stress fracture) Explain the procedure and purpose of the test to Alexis, including what she should experience subjectively and objectively. Demonstrate the technique. Explain to the examiner why Alexis may be experiencing a difference between her left and right sides (think chronic ankle instability and return from injury)
- Test set-up requires two lines of tape 30cm apart
- The subject is instructed to hop laterally, without error, over the two lines of tape 10 times/reps
o Each return to the start position counts as 1 repetition - Each trial is timed and comparison made with the uninjured limb
- A greater time to complete the task is associated with a less functionally stable ankle
Subjectively - muscle workings, pain, effort level, confidence
Objectively - measurement of hop, form and technique. Soft landing , stability, use of arms.
- May have less stability on right side compared to the left due to recent stress fracture
- We can see this with LSI score. Maybe 1.35 (35% slower)
Conduct a Star Excursion Balance test for Alexis. (this is after she has recovered from her stress fracture) Explain the procedure and purpose of the test to Alexis, including what she should experience subjectively and objectively. Demonstrate the technique. Explain to the examiner why Alexis may be experiencing a difference between her left and right sides (think chronic ankle instability and return from injury)
- Star pattern in 8 directions from 0 degrees, 45, 90, 135.
- For forwards movements we have toe behind line and backwards we have heel in front of line.
- Hands on hips, reach as far as you can clockwise and tap with your toes lightly in all 8 directions returning foot back to midline to finish each rep.
- Errors include - heavy touch, rest foot on ground or loses balance, cannot return to starting position under control
- Practice, 3 trials performed and averaged
- Limb Symmetry Index to interpret results
- Subjectively - muscle workings, pain, effort level, confidence
- Objectively - stable technique
- Difference in leg performance due to deconditioning in right leg due to stress fracture, lack of ROM
Briefly explain to examiner what is meant by primary, secondary and tertiary injury prevention and how tertiary injury prevention applies to Alexis returning from her stress fracture.
- Primary prevention aims to stop injuries before they happen. This includes strategies like education, proper technique, and conditioning programs to prevent stress fractures or other injuries in athletes.
- Secondary prevention focuses on early detection and management of an injury to prevent it from worsening. For Alexis, this would involve early recognition of her stress fracture symptoms and appropriate interventions like rest and medical imaging to confirm the diagnosis.
- Tertiary prevention aims to reduce the impact of an already established injury and prevent further complications or recurrence. In Alexis’s case, tertiary prevention would include a structured rehabilitation program to help her safely return to sport without re-injuring her stress fracture. This may involve gradual weight-bearing exercises, strength training, and guidance on modifying her training load to avoid future fractures.
What would be your initial “entry point” for a return to running program for Alexis.
- Assess readiness to run with objective testing with 2/10 or less pain
- Determine current ‘run tolerance’ with 5 minute run tolerance test, check symptoms on day and after
- Plan graded return to achieve patient’s goals - start with run/walk patterns, reduced walk periods, gradually increasing distance over time with no negative symptoms
- Monitor response to training and modify where needed
