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Papers by Shirley Sahrmann

Research paper thumbnail of Figure 1: Cholewicki et al. 2019 JOSPT

Research paper thumbnail of Reciprocal Interaction of Antagonistic Muscles in the Flexion Reflex of the Intact Hindlimb of the Decerebrate Cat

Physical therapy, Apr 1, 1972

Twenty cats were decerebrated by intercollicular section to produce hyperactive stretch reflexes ... more Twenty cats were decerebrated by intercollicular section to produce hyperactive stretch reflexes similar to those found in patients with spasticity. Simultaneous recordings were made of electrical activity from the soleus and tibialis anterior muscles and of ankle joint movement during the flexion response elicited by cutaneous stimulation. Three types of responses were recorded from the antagonistic soleus muscle: I) a short latency twitch elicited by the mechanical stretch from dorsiflexion; 2) a long latency tetanic rebound (120-240 msec post stimulation) initiated by cutaneous afferents, and 3) a twitch coincident with that of the tibialis anterior, for which contributing factors were not delineated. Changing ankle joint position modified these responses. When soleus electrical activity was continuous and intense, the periods of evoked inhibition were markedly reduced. Olinical observation of patients with hyperactive stretch reflexes has raised the question of the influence of these reflexes on voluntary motion. In the patient with spasticity, the lower threshold of the motoneuron may alter reciprocal interaction, Miss Sahrmann is a Ph.D. candidate,

Research paper thumbnail of The Relationship Between Impairments and Use of the Upper Extremity in Patients with Acute Hemiparesis

Journal of Neurologic Physical Therapy, Dec 1, 2004

Research paper thumbnail of Can Biomechanics Research Lead to More Effective Treatment of Low Back Pain? A Point-Counterpoint Debate

Journal of Orthopaedic & Sports Physical Therapy, Jun 1, 2019

SYNOPSIS Although biomechanics plays a role in the development and perhaps the persistent or recu... more SYNOPSIS Although biomechanics plays a role in the development and perhaps the persistent or recurrent nature of low back pain (LBP), whether biomechanics alone can provide the basis for intervention is debated. Biomechanics, which refers to the mechanics of the body, including its neuromuscular control, has been studied extensively in LBP. But, can gains be made in understanding LBP by research focused on this component of biology in the multifactorial biopsychosocial problem of LBP? This commentary considers whether biomechanics research has the potential to advance treatment of LBP, and how likely it is that this research will lead to better treatment strategies. A point-counterpoint format is taken to present both sides of the argument. First, the challenges faced by an approach that considers biomechanics in isolation are presented. Next, we describe 3 models that place substantial emphasis on biomechanical factors. Finally, reactions to each point are presented as a foundation for further research and clinical practice to progress understanding of the place for biomechanics in guiding treatment of LBP. J Orthop Sports Phys Ther 2019;49(6):425-436. Epub 15 May 2019. doi:10.2519/jospt.2019.8825.

Research paper thumbnail of Reduced Hip Adduction Is Associated With Improved Function After Movement-Pattern Training in Young People With Chronic Hip Joint Pain

Journal of Orthopaedic & Sports Physical Therapy, Apr 1, 2018

Study Design-Ancillary analysis, Time-Controlled Randomized Clinical Trial

Research paper thumbnail of Een programma met specifieke oefeningen en houdingscorrectie ter behandeling van cervicogene hoofdpijn: een casusbespreking

Bohn Stafleu van Loghum eBooks, 2006

Opzet van het onderzoek: Casusbespreking.Doel: Een behandeling beschrijven die bestaat uit een sp... more Opzet van het onderzoek: Casusbespreking.Doel: Een behandeling beschrijven die bestaat uit een specifiek programma met actieve oefeningen en verbetering van de houding bij een persoon met cervicogene hoofdpijn.Achtergrond: De patient was een 46-jarige man met een voorgeschiedenis van cervicogene hoofdpijn sinds zeven jaar. Zijn symptomen waren constant met een gemiddelde intensiteit van 5/10 op een visueel analoge schaal waarbij 0 staat voor geen pijn en 10 voor ondraaglijke pijn. De pijnintensiteit in de week voorafgaand aan zijn eerste consult was gemiddeld 3/10 na triggerpointinjecties. De symptomen werden erger bij activiteiten waarbij hij de armen gebruikte en bij langdurig zitten.Methoden en metingen: De patient werd in een periode van drie maanden zeven keer behandeld. Er werden afwijkingen gevonden in de stand, spierfunctie en in de bewegingspatronen van de cervicale, scapulothoracale en lumbale regionen. Uitkomstmaten waren de frequentie en intensiteit van de hoofdpijn en de Neck Disability Index (ndi). De interventies bestonden uit correctie van de houding en van de bewegingspatronen bij actieve bewegingen van de cervicale wervelkolom en van de armen. Ook kreeg de patient functionele instructies ter minimalisering van het effect van het gewicht van de armen op de cervicale wervelkolom.Conclusie: Interventies bestaande uit correctie van de houding in de cervicale, scapulothoracale en lumbale regionen in combinatie met instructie van een specifiek programma met actieve oefeningen gericht op bewegingsafwijkingen in die drie regionen, waren bij deze patient succesvol tegen hoofdpijn en leverden functieverbetering op.

Research paper thumbnail of Curriculum to Prepare Diagnosticians in Physical Therapy

Journal, physical therapy education, 1995

ABSTRACT: The changing nature of health care and the expanding knowledge about diagnoses made by ... more ABSTRACT: The changing nature of health care and the expanding knowledge about diagnoses made by physical therapists require education programs to update their curricula continually. This article describes a curriculum that prepares entry‐level physical therapy students to be diagnosticians. The curriculum is characterized by (1) immediate introduction of students to their roles as diagnosticians, (2) instruction in impairment‐based diagnostic systems, (3) teaching diagnostic process through instruction in content, and (4) a systematic increase in the complexity of learning. An outline of the four‐semester curriculum is provided with brief descriptions of the teaching methods used. Instruments that guide students to make judgments about diagnosis are provided. Examples are given of the classification schemes and diagnoses used for patients with medical‐surgical, musculoskeletal, neurological, and cardiopulmonary problems. Preliminary evidence is provided of the extent to which graduates report using the diagnostic skills they have learned, and suggestions are made for encouraging increased usage. Collaborative research is needed to develop further the content on diagnosis in physical therapy.

Research paper thumbnail of Assessment: Botulinum Neurotoxin for the Treatment of Spasticity (An Evidence-Based Review)

Neurology, Aug 31, 2009

Objective: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin... more Objective: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of movement disorders. Methods: A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and selected movement disorders. Authors reviewed, abstracted, and classified articles based on American Academy of Neurology criteria (Class I-IV). Results: The highest quality literature available for the respective indications was as follows: blepharospasm (two Class II studies); hemifacial spasm (one Class II and one Class III study); cervical dystonia (seven Class I studies); focal upper extremity dystonia (one Class I and three Class II studies); focal lower extremity dystonia (one Class II study); laryngeal dystonia (one Class I study); motor tics (one Class II study); and upper extremity essential tremor (two Class II studies). Recommendations: Botulinum neurotoxin should be offered as a treatment option for the treatment of cervical dystonia (Level A), may be offered for blepharospasm, focal upper extremity dystonia, adductor laryngeal dystonia, and upper extremity essential tremor (Level B), and may be considered for hemifacial spasm, focal lower limb dystonia, and motor tics (Level C). While clinicians' practice may suggest stronger recommendations in some of these indications, evidencebased conclusions are limited by the availability of data.

Research paper thumbnail of Review of Length-Associated Changes in Muscle

Physical therapy, Dec 1, 1982

... MARILYN R. GOSSMAN, SHIRLEY A. SAHRMANN, and STEVEN J. ROSE ... The purpose of this article i... more ... MARILYN R. GOSSMAN, SHIRLEY A. SAHRMANN, and STEVEN J. ROSE ... The purpose of this article is to review the literature related to length-associated changes in muscle. ... The length-associated changes may be secondary to the primary problem for which the patient is ...

Research paper thumbnail of Relationship... subjects: Commentary

Research paper thumbnail of Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines

1. Introduction 2. Staging System for Rehabilitation 3. Movement System Syndromes of the Cervical... more 1. Introduction 2. Staging System for Rehabilitation 3. Movement System Syndromes of the Cervical Spine 4. Movement System Syndromes of the Thoracic Spine 5. Movement System Syndromes of the Hand and Wrist 6. Movement System Syndromes of the Elbow 7. Movement System Syndromes of the Knee 8. Movement System Syndromes of the Foot and Ankle

Research paper thumbnail of Diagnosis and Treatment of Movement Impairment Syndromes

Diagnosis and Treatment of Movement Impairment Syndromes is the long-awaited book by Shirley Sahr... more Diagnosis and Treatment of Movement Impairment Syndromes is the long-awaited book by Shirley Sahrmann, who has been considered an expert in movement disorders and the musculoskeletal system. This text examines the effect of normal and abnormal movement patterns and ...

Research paper thumbnail of Reflex responses to passive motion in normal and spastic man

Research paper thumbnail of Clarification of Positioning: The Authors Respond

Physical therapy, Mar 1, 1979

Research paper thumbnail of The kinesiopathological model and mechanical low back pain

Research paper thumbnail of Spasticity, Passive Stretch, and Knee Extension: The Authors Respond

Research paper thumbnail of Applause for Analytic Approach: The Authors Respond

Research paper thumbnail of Movement Science and Physical Therapy

Journal of Physical Therapy Education, 1993

Research paper thumbnail of Author Response

Research paper thumbnail of Postural Adjustments Associated with a Lower Extremity Functional Task

Research paper thumbnail of Figure 1: Cholewicki et al. 2019 JOSPT

Research paper thumbnail of Reciprocal Interaction of Antagonistic Muscles in the Flexion Reflex of the Intact Hindlimb of the Decerebrate Cat

Physical therapy, Apr 1, 1972

Twenty cats were decerebrated by intercollicular section to produce hyperactive stretch reflexes ... more Twenty cats were decerebrated by intercollicular section to produce hyperactive stretch reflexes similar to those found in patients with spasticity. Simultaneous recordings were made of electrical activity from the soleus and tibialis anterior muscles and of ankle joint movement during the flexion response elicited by cutaneous stimulation. Three types of responses were recorded from the antagonistic soleus muscle: I) a short latency twitch elicited by the mechanical stretch from dorsiflexion; 2) a long latency tetanic rebound (120-240 msec post stimulation) initiated by cutaneous afferents, and 3) a twitch coincident with that of the tibialis anterior, for which contributing factors were not delineated. Changing ankle joint position modified these responses. When soleus electrical activity was continuous and intense, the periods of evoked inhibition were markedly reduced. Olinical observation of patients with hyperactive stretch reflexes has raised the question of the influence of these reflexes on voluntary motion. In the patient with spasticity, the lower threshold of the motoneuron may alter reciprocal interaction, Miss Sahrmann is a Ph.D. candidate,

Research paper thumbnail of The Relationship Between Impairments and Use of the Upper Extremity in Patients with Acute Hemiparesis

Journal of Neurologic Physical Therapy, Dec 1, 2004

Research paper thumbnail of Can Biomechanics Research Lead to More Effective Treatment of Low Back Pain? A Point-Counterpoint Debate

Journal of Orthopaedic & Sports Physical Therapy, Jun 1, 2019

SYNOPSIS Although biomechanics plays a role in the development and perhaps the persistent or recu... more SYNOPSIS Although biomechanics plays a role in the development and perhaps the persistent or recurrent nature of low back pain (LBP), whether biomechanics alone can provide the basis for intervention is debated. Biomechanics, which refers to the mechanics of the body, including its neuromuscular control, has been studied extensively in LBP. But, can gains be made in understanding LBP by research focused on this component of biology in the multifactorial biopsychosocial problem of LBP? This commentary considers whether biomechanics research has the potential to advance treatment of LBP, and how likely it is that this research will lead to better treatment strategies. A point-counterpoint format is taken to present both sides of the argument. First, the challenges faced by an approach that considers biomechanics in isolation are presented. Next, we describe 3 models that place substantial emphasis on biomechanical factors. Finally, reactions to each point are presented as a foundation for further research and clinical practice to progress understanding of the place for biomechanics in guiding treatment of LBP. J Orthop Sports Phys Ther 2019;49(6):425-436. Epub 15 May 2019. doi:10.2519/jospt.2019.8825.

Research paper thumbnail of Reduced Hip Adduction Is Associated With Improved Function After Movement-Pattern Training in Young People With Chronic Hip Joint Pain

Journal of Orthopaedic & Sports Physical Therapy, Apr 1, 2018

Study Design-Ancillary analysis, Time-Controlled Randomized Clinical Trial

Research paper thumbnail of Een programma met specifieke oefeningen en houdingscorrectie ter behandeling van cervicogene hoofdpijn: een casusbespreking

Bohn Stafleu van Loghum eBooks, 2006

Opzet van het onderzoek: Casusbespreking.Doel: Een behandeling beschrijven die bestaat uit een sp... more Opzet van het onderzoek: Casusbespreking.Doel: Een behandeling beschrijven die bestaat uit een specifiek programma met actieve oefeningen en verbetering van de houding bij een persoon met cervicogene hoofdpijn.Achtergrond: De patient was een 46-jarige man met een voorgeschiedenis van cervicogene hoofdpijn sinds zeven jaar. Zijn symptomen waren constant met een gemiddelde intensiteit van 5/10 op een visueel analoge schaal waarbij 0 staat voor geen pijn en 10 voor ondraaglijke pijn. De pijnintensiteit in de week voorafgaand aan zijn eerste consult was gemiddeld 3/10 na triggerpointinjecties. De symptomen werden erger bij activiteiten waarbij hij de armen gebruikte en bij langdurig zitten.Methoden en metingen: De patient werd in een periode van drie maanden zeven keer behandeld. Er werden afwijkingen gevonden in de stand, spierfunctie en in de bewegingspatronen van de cervicale, scapulothoracale en lumbale regionen. Uitkomstmaten waren de frequentie en intensiteit van de hoofdpijn en de Neck Disability Index (ndi). De interventies bestonden uit correctie van de houding en van de bewegingspatronen bij actieve bewegingen van de cervicale wervelkolom en van de armen. Ook kreeg de patient functionele instructies ter minimalisering van het effect van het gewicht van de armen op de cervicale wervelkolom.Conclusie: Interventies bestaande uit correctie van de houding in de cervicale, scapulothoracale en lumbale regionen in combinatie met instructie van een specifiek programma met actieve oefeningen gericht op bewegingsafwijkingen in die drie regionen, waren bij deze patient succesvol tegen hoofdpijn en leverden functieverbetering op.

Research paper thumbnail of Curriculum to Prepare Diagnosticians in Physical Therapy

Journal, physical therapy education, 1995

ABSTRACT: The changing nature of health care and the expanding knowledge about diagnoses made by ... more ABSTRACT: The changing nature of health care and the expanding knowledge about diagnoses made by physical therapists require education programs to update their curricula continually. This article describes a curriculum that prepares entry‐level physical therapy students to be diagnosticians. The curriculum is characterized by (1) immediate introduction of students to their roles as diagnosticians, (2) instruction in impairment‐based diagnostic systems, (3) teaching diagnostic process through instruction in content, and (4) a systematic increase in the complexity of learning. An outline of the four‐semester curriculum is provided with brief descriptions of the teaching methods used. Instruments that guide students to make judgments about diagnosis are provided. Examples are given of the classification schemes and diagnoses used for patients with medical‐surgical, musculoskeletal, neurological, and cardiopulmonary problems. Preliminary evidence is provided of the extent to which graduates report using the diagnostic skills they have learned, and suggestions are made for encouraging increased usage. Collaborative research is needed to develop further the content on diagnosis in physical therapy.

Research paper thumbnail of Assessment: Botulinum Neurotoxin for the Treatment of Spasticity (An Evidence-Based Review)

Neurology, Aug 31, 2009

Objective: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin... more Objective: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of movement disorders. Methods: A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and selected movement disorders. Authors reviewed, abstracted, and classified articles based on American Academy of Neurology criteria (Class I-IV). Results: The highest quality literature available for the respective indications was as follows: blepharospasm (two Class II studies); hemifacial spasm (one Class II and one Class III study); cervical dystonia (seven Class I studies); focal upper extremity dystonia (one Class I and three Class II studies); focal lower extremity dystonia (one Class II study); laryngeal dystonia (one Class I study); motor tics (one Class II study); and upper extremity essential tremor (two Class II studies). Recommendations: Botulinum neurotoxin should be offered as a treatment option for the treatment of cervical dystonia (Level A), may be offered for blepharospasm, focal upper extremity dystonia, adductor laryngeal dystonia, and upper extremity essential tremor (Level B), and may be considered for hemifacial spasm, focal lower limb dystonia, and motor tics (Level C). While clinicians' practice may suggest stronger recommendations in some of these indications, evidencebased conclusions are limited by the availability of data.

Research paper thumbnail of Review of Length-Associated Changes in Muscle

Physical therapy, Dec 1, 1982

... MARILYN R. GOSSMAN, SHIRLEY A. SAHRMANN, and STEVEN J. ROSE ... The purpose of this article i... more ... MARILYN R. GOSSMAN, SHIRLEY A. SAHRMANN, and STEVEN J. ROSE ... The purpose of this article is to review the literature related to length-associated changes in muscle. ... The length-associated changes may be secondary to the primary problem for which the patient is ...

Research paper thumbnail of Relationship... subjects: Commentary

Research paper thumbnail of Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines

1. Introduction 2. Staging System for Rehabilitation 3. Movement System Syndromes of the Cervical... more 1. Introduction 2. Staging System for Rehabilitation 3. Movement System Syndromes of the Cervical Spine 4. Movement System Syndromes of the Thoracic Spine 5. Movement System Syndromes of the Hand and Wrist 6. Movement System Syndromes of the Elbow 7. Movement System Syndromes of the Knee 8. Movement System Syndromes of the Foot and Ankle

Research paper thumbnail of Diagnosis and Treatment of Movement Impairment Syndromes

Diagnosis and Treatment of Movement Impairment Syndromes is the long-awaited book by Shirley Sahr... more Diagnosis and Treatment of Movement Impairment Syndromes is the long-awaited book by Shirley Sahrmann, who has been considered an expert in movement disorders and the musculoskeletal system. This text examines the effect of normal and abnormal movement patterns and ...

Research paper thumbnail of Reflex responses to passive motion in normal and spastic man

Research paper thumbnail of Clarification of Positioning: The Authors Respond

Physical therapy, Mar 1, 1979

Research paper thumbnail of The kinesiopathological model and mechanical low back pain

Research paper thumbnail of Spasticity, Passive Stretch, and Knee Extension: The Authors Respond

Research paper thumbnail of Applause for Analytic Approach: The Authors Respond

Research paper thumbnail of Movement Science and Physical Therapy

Journal of Physical Therapy Education, 1993

Research paper thumbnail of Author Response

Research paper thumbnail of Postural Adjustments Associated with a Lower Extremity Functional Task