Three randomized studies, comprising patients with predominantly acute or subacute low back pain (LBP), have tested the effects of MDT versus SM in a subgroup of patients that presented with centralization of symptoms or directional preference (favorable response to end range motions) during physical examination [ 10- 12].
Several other studies have reported higher reliability and/or higher sensitivity in detecting movements, in proprioceptive variables close to the end range of motion compared with in the mid range of motion in patients with ACL injury and uninjured subjects [ 18, 29, 33].
In vitro test protocols and finite element models that are validated using only end range of motion data may not accurately reproduce continuous in vivo motion.
Recognizing that the rotator cuff and the glenohumeral ligaments (joint capsule) provide passive stability to the joint at the end range of motion, our cadaveric model does not actively load the joint.
Dynamic stretching, by contrast, involves taking a position at the end range of motion, applying slow, steady pressure to push that boundary and then returning.
Then, the lower extremity was passively lifted to the end range of motion or firm end feel and the measurement recorded in degrees.
Prior to performing the measurement on study subjects they practised together and agreed the criteria for identifying the end range of motion.
Thus, from the results of the present study and those of others [ 18, 29, 33], it can be argued that measurements of TDPM close to the end range of motion are probably the most reliable and sensitive.
Examiners were trained to differentiate between the firm limit caused by structural or joint restriction (true end range of motion) and the soft limit caused by volitional resistance or hypertonicity.
For this reason, we have intentionally limited the scope of our investigation to the end range of glenohumeral motion.
