Understanding Athletic Trainers’ Knowledge, Intervention, and Barriers Toward Arthrogenic Muscle Inhibition

2021 ◽  
pp. 1-9
Author(s):  
Justin L. Rush ◽  
David A. Sherman ◽  
David M. Bazett-Jones ◽  
Christopher D. Ingersoll ◽  
Grant E. Norte
Keyword(s):  
Electrical Stimulation ◽  
Clinical Practice ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Athletic Trainers ◽  
Neuromuscular Electrical Stimulation ◽  
Current Evidence ◽  
Electrical Nerve Stimulation ◽  
Muscle Inhibition ◽  
Arthrogenic Muscle Inhibition

Context: Arthrogenic muscle inhibition (AMI) is a common neurophysiological response to joint injury. While athletic trainers (ATs) are constantly treating patients with AMI, it is unclear how clinicians are using the available evidence to treat the condition. Objective: To investigate ATs’ general knowledge, clinical practice, and barriers for treating AMI. Methods: A cross-sectional web-based survey was utilized. The survey was distributed to a random sample of 3000 ATs from the National Athletic Trainers’ Association and through social media. 143 board certified ATs (age: 34.6 [10.3] y; experience: 11.7 [9.8] y) from various clinical settings and educational backgrounds were included in the analysis. Results: One hundred one respondents were able to correctly identify the definition of AMI. The majority of these respondents correctly reported that joint effusion (n = 95, 94.1%) and abnormal activity from joint receptors (n = 91, 90.1%) resulted in AMI. Of the 101 respondents, only 58 (57.4%) reported using disinhibitory interventions to treat AMI. The most frequently used evidence supported interventions were transcutaneous electrical nerve stimulation (n = 38, 65.5%), neuromuscular electrical stimulation (n = 33, 56.9%), and focal joint cooling (n = 25, 43.1%). The interventions used correctly most often based on current evidence were neuromuscular electrical stimulation (n = 29/33, 87.9%) and transcutaneous electrical nerve stimulation (n = 26/38, 68.4%). Overall, difficulty quantifying AMI (n = 62, 61.24%) and lack of education (n = 71, 76.2%) were most frequently perceived as barriers. Respondents that did not use disinhibitory interventions perceived lack of experience treating AMI, understanding the terminology, and access to therapeutic modalities more often than the respondents that reported using disinhibitory interventions. Conclusion: Further education about concepts and treatment about AMI is warranted for ATs. Continued understanding of ATs’ clinical practice in regard to AMI may help identify gaps in athletic training clinical education.

scholarly journals Disinhibitory Interventions and Voluntary Quadriceps Activation: A Systematic Review

2014 ◽  
Vol 49 (3) ◽  
pp. 411-421 ◽  
Author(s):  
Matthew S. Harkey ◽  
Phillip A. Gribble ◽  
Brian G. Pietrosimone
Keyword(s):  
Electrical Stimulation ◽  
Transcranial Magnetic Stimulation ◽  
Manual Therapy ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Magnetic Stimulation ◽  
Muscle Activation ◽  
Neuromuscular Electrical Stimulation ◽  
Electrical Nerve Stimulation ◽  
Positive Effects

Objective: To determine the effects of various therapeutic interventions on increasing voluntary quadriceps muscle activation. Background: Decreased voluntary quadriceps activation is commonly associated with knee injury. Recently, research has focused on developing specific disinhibitory interventions to improve voluntary quadriceps activation; yet, it remains unknown which interventions are most effective in promoting this improvement. Data Sources: We searched Web of Science from January 1, 1965 through September 27, 2012, using the key words quadriceps activation and transcutaneous electrical nerve stimulation, transcranial magnetic stimulation, cryotherapy, focal joint cooling, joint mobilization, joint mobilisation, joint manipulation, manual therapy, and neuromuscular electrical stimulation. Study Selection: Studies evaluating the effect of disinhibitory interventions on volitional quadriceps activation were used in our review. Standardized effect sizes (Cohen d) and 95% confidence intervals (CIs) were calculated from voluntary quadriceps activation means and standard deviations measured at baseline and at all available postintervention time points from each study. Data Synthesis: Ten studies were grouped into 5 categories based on intervention type: manual therapy (4 studies), transcutaneous electrical nerve stimulation (2 studies), cryotherapy (2 studies), neuromuscular electrical stimulation (2 studies), and transcranial magnetic stimulation (1 study). Transcutaneous electrical nerve stimulation demonstrated the strongest immediate effects (d = 1.03; 95% CI = 0.06, 1.92) and long-term effects (d = 1.93; 95% CI = 0.91, 2.83). Cryotherapy (d = 0.76; 95% CI = −0.13, 1.59) and transcranial magnetic stimulation (d = 0.54; 95% CI = −0.33, 1.37) had moderate immediate effects in improving voluntary quadriceps activation, whereas manual therapy (d = 0.38; 95% CI = −0.35, 1.09) elicited only weak immediate effects. Neuromuscular electrical stimulation produced weak negative to strong positive effects (range of d values = −0.50 to 1.87) over a period of 3 weeks to 6 months. Conclusions: Transcutaneous electrical nerve stimulation demonstrated the strongest and most consistent effects in increasing voluntary quadriceps activation and may be the best disinhibitory intervention for improving the same.

scholarly journals Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews

2016 ◽  
Vol 96 (7) ◽  
pp. 1039-1048 ◽  
Author(s):  
Peter William Gladwell ◽  
Kathryn Badlan ◽  
Fiona Cramp ◽  
Shea Palmer
Keyword(s):  
Clinical Practice ◽  
Data Analysis ◽  
Musculoskeletal Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Chronic Musculoskeletal Pain ◽  
Pain Clinic ◽  
Electrical Nerve Stimulation ◽  
Primary Data Analysis ◽  
Semistructured Interviews

Abstract Background Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. Objectives The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. Design A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Methods Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Results Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. Conclusions The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice.

scholarly journals Effectiveness of Transcutaneous Electrical Nerve Stimulation with Taping for Stroke Rehabilitation

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Tae-Sung In ◽  
Jin-Hwa Jung ◽  
Kyoung-Sim Jung ◽  
Hwi-Young Cho
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Plantar Flexors ◽  
Stroke Patients ◽  
Noninvasive Methods ◽  
Electrical Nerve Stimulation ◽  
Functional Training ◽  
Long Term Follow Up

Background. Spasticity is a factor that impairs the independent functional ability of stroke patients, and noninvasive methods such as electrical stimulation or taping have been reported to have antispastic effects. The purpose of this study was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) combined with taping on spasticity, muscle strength, and gait ability in stroke patients. Methods. From July to October 2020, 46 stroke patients with moderate spasticity in the plantar flexors participated and were randomly assigned to the TENS group ( n = 23 ) and the TENS+taping group ( n = 23 ). All subjects performed a total of 30 sessions of functional training for 30 min/session, 5 days/week, for 6 weeks. For therapeutic exercise, sit-to-standing, indoor walking, and stair walking were performed for 10 min each. In addition, all participants in both groups received TENS stimulation around the peroneal nerve for 30 min before performing functional training. In the TENS+taping group, taping was additionally applied to the feet, ankles, and shin area after TENS, and the taping was replaced once a day. The composite spasticity score and handheld dynamometer measurements were used to assess the intensity of spasticity and muscle strength, respectively. Gait ability was measured using a 10 m walk test. Results. The spasticity score and muscle strength were significantly improved in the TENS+taping group compared to those in the TENS group ( p < 0.05 ). A significant improvement in gait speed was observed in the TENS+taping group relative to that in the TENS group ( p < 0.05 ). Conclusions. Thus, TENS combined with taping may be useful in improving spasticity, muscle strength, and gait ability in stroke patients. Based on these results, an additional application of taping could be used to enhance the antispastic effect of TENS or other electrical stimulation treatments in the clinic. A long-term follow-up study is needed to determine whether the spasticity relieving effect persists after taping is removed.

Electrical stimulation of peripheral and central pathways for the relief of musculoskeletal pain

1991 ◽  
Vol 69 (5) ◽  
pp. 697-703 ◽  
Author(s):  
M. Catherine Bushnell ◽  
Serge Marchand ◽  
Nicole Tremblay ◽  
Gary H. Duncan
Keyword(s):  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Musculoskeletal Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Dorsal Column ◽  
Electrical Nerve Stimulation ◽  
Dorsal Column Stimulation ◽  
Deep Brain ◽  
Stimulation Of

One method for the treatment of chronic musculoskeletal pain involves stimulation of the peripheral or central nervous system. Such stimulation includes transcutaneous electrical nerve stimulation, dorsal column stimulation, and deep brain stimulation. This review discusses the clinical use of electrical stimulation for the relief of musculoskeletal pain, and describes the results of studies conducted in our laboratory suggesting that such stimulation reduces pain transmission along sensory-discriminative pathways.Key words: pain, nociception, transcutaneous electrical nerve stimulation, dorsal column stimulation, deep brain stimulation.

scholarly journals A Better Way to Decrease Knee Swelling in Patients with Knee Osteoarthritis: A Single-Blind Randomised Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Zübeyir Sari ◽  
Onur Aydoğdu ◽  
İlkşan Demirbüken ◽  
S. Ufuk Yurdalan ◽  
M. Gülden Polat
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Conventional Treatment ◽  
Compression Therapy ◽  
Intermittent Pneumatic Compression ◽  
Electrical Nerve Stimulation ◽  
Cold Pack

Objective. In this study, we compared the effects of intermittent pneumatic compression along with conventional treatment with cold-pack treatment along with conventional treatment on clinical outcomes in patients with knee osteoarthritis.Methods. Eighty-nine patients with knee osteoarthritis participated in this study. One group received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and cold packs. The second group received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and intermittent pneumatic compression. Range of motion, muscle strength, knee swelling, pain intensity, and functional status were measured at baseline and 4th week.Results. We found significant improvements in range of motion, muscle strength, pain intensity, and functional status after the treatment in both groups (p<0.05). When comparing the effects of these two treatment programs, it was observed that the intermittent pneumatic compression treatment group had a better outcome in terms of knee swelling (p=0.028).Conclusions. According to the results, we could report that intermittent pneumatic compression therapy in addition to conventional treatment has significant positive effects on clinical outcomes in patients with knee osteoarthritis. We could also report that intermittent pneumatic compression therapy along with conventional treatment is superior to cold-pack therapy along with conventional treatment in terms of knee swelling in patients with knee osteoarthritis. This trial is registered withNCT03806322.

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