Pulsed Shortwave Diathermy and Joint Mobilizations for Achieving Normal Elbow Range of Motion After Injury or Surgery With Implanted Metal: A Case Series

Context: Regaining full, active range of motion (ROM) after trauma to the elbow is difficult. Objective: To report the cases of 6 patients who lacked full ROM in the elbow because of trauma. The treatment regimen was thermal pulsed shortwave diathermy and joint mobilizations. Design: Case series. Setting: University therapeutic modalities laboratory. Patients or Other Participants: Six patients (5 women [83%], 1 man [17%]) lacked a mean active ROM of 24.5° of extension approximately 4.8 years after trauma or surgery. Intervention(s): Treatment consisted of 20 minutes of pulsed shortwave diathermy at 800 pulses per second for 400 microseconds (40–48 W average power, 150 W peak power) applied to the cubital fossa, immediately followed by 7 to 8 minutes of joint mobilizations. After posttreatment ROM was recorded, ice was applied to the area for about 30 minutes. Main Outcomes Measure(s): Changes in extension active ROM were assessed before and after each treatment. Once the patient achieved full, active ROM or failed to improve on 2 consecutive visits, he or she was discharged from the study. Results: By the fifth treatment, 4 participants (67%) achieved normal extension active ROM, and 2 of the 4 (50%) exceeded the norm. Five participants (83%) returned to normal activities and full use of their elbows. One month later, the 5 participants had maintained, on average, (mean ± SD) 92% ± 6% of their final measurements. Conclusions: A combination of thermal pulsed shortwave diathermy and joint mobilizations was effective in restoring active ROM of elbow extension in 5 of the 6 patients (83%) who lacked full ROM after injury or surgery.

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Ultrasound and Joint Mobilizations for Achieving Normal Wrist Range of Motion After Injury or Surgery: A Case Series

Journal of Athletic Training ◽

10.4085/1062-6050-45.5.486 ◽

2010 ◽

Vol 45 (5) ◽

pp. 486-491 ◽

Cited By ~ 12

Author(s):

David O. Draper

Keyword(s):

Range Of Motion ◽

Full Range ◽

Case Series ◽

Average Intensity ◽

Normal Extension ◽

Therapeutic Modalities ◽

Active Range Of Motion ◽

Before And After ◽

The University ◽

Flexion And Extension

Abstract Context: Regaining full, active range of motion (AROM) after trauma to the wrist is difficult. Objective: To report the cases of 6 patients who lacked full range of motion (ROM) in the wrist due to trauma. The treatment regimen was thermal 3-MHz ultrasound and joint mobilizations. Design: Case series. Setting: University therapeutic modalities laboratory. Patients or Other Participants: Six patients (2 women, 4 men) from the university population lacked a mean AROM of 21.7° of flexion and 26.8° of extension approximately 2.1 years after trauma or surgery. Main Outcome Measure(s): I assessed changes in flexion and extension AROM before and after each treatment. Treatment consisted of 6 minutes of 3-MHz continuous ultrasound at an average intensity of 1.4 W/cm2 on the dorsal and volar aspects of the wrist, immediately followed by approximately 10 minutes of joint mobilizations. After posttreatment ROM was recorded, ice was applied to the area for about 20 minutes. Once the patient achieved full AROM or did not improve on 2 consecutive visits, he or she was discharged from the study. Results: By the sixth treatment, 5 participants achieved normal flexion AROM, and 3 exceeded the norm. All 6 achieved normal extension AROM, and 4 exceeded the norm. All returned to normal activities and normal use of their hands. One month later, they had, on average, maintained 93% of their final measurements. Conclusions: A combination of thermal ultrasound and joint mobilizations was effective in restoring AROM to wrists lacking ROM after injury or surgery.

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Effects of the Suboccipital Muscle Inhibition Technique on the Range of Motion of the Ankle Joint and Balance According to Its Application Duration: A Randomized Controlled Trial

Healthcare ◽

10.3390/healthcare9060646 ◽

2021 ◽

Vol 9 (6) ◽

pp. 646

Author(s):

Han-Sol Kang ◽

Hyung-Wook Kwon ◽

Di-gud Kim ◽

Kwang-Rak Park ◽

Suk-Chan Hahm ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Range Of Motion ◽

Ankle Joint ◽

Controlled Trial ◽

Balance Test ◽

Randomized Controlled ◽

Active Range Of Motion ◽

Before And After ◽

Muscle Inhibition ◽

Inhibition Technique

This study aimed to investigate the effects of suboccipital muscle inhibition technique (SMIT) on active range of motion (AROM) of the ankle joint, lunge angle (LA), and balance in healthy adults, according to the duration of its application. A total of 80 participants were randomly allocated to the 4-min suboccipital muscle inhibition (SMI) group (SMI_4M, n = 20), 8-min SMI group (n = 20), 4-min sham-SMI (SSMI) group (n = 20), and 8-min SSMI group (n = 20). Accordingly, the SMIT and sham SMIT were applied for 4 min or 8 min in the respective groups. AROM of dorsiflexion and LA were assessed, and a single leg balance test (SLBT) was performed before and after the intervention. AROM (4 min, p < 0.001; 8 min, p < 0.001), LA (4 min, p < 0.001; 8 min, p < 0.001), and SLBT (4 min, p < 0.001; 8 min, p < 0.001) significantly improved after SMI application. Compared with the SSMI group, the SMI group showed a significant increase in AROM (p < 0.001), LA (p < 0.001), and SLBT (p < 0.001). Except for SLBT (p = 0.016), there were no significant interactions between intervention and application duration. The results suggest that the SMIT, at durations of both 4 and 8 min, could be effective tools for improving AROM, LA, and balance.

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Catchlike-inducing train activation of human muscle during isotonic contractions: burst modulation

Journal of Applied Physiology ◽

10.1152/jappl.1999.87.5.1758 ◽

1999 ◽

Vol 87 (5) ◽

pp. 1758-1767 ◽

Cited By ~ 26

Author(s):

Samuel C. K. Lee ◽

Cara N. Becker ◽

Stuart A. Binder-Macleod

Keyword(s):

Isometric Contraction ◽

Peak Power ◽

Average Power ◽

Knee Extension ◽

Human Muscle ◽

Constant Frequency ◽

Maximum Voluntary Isometric Contraction ◽

Before And After ◽

Isotonic Performance ◽

Isotonic Contractions

Stimulation trains that exploit the catchlike property [catchlike-inducing trains (CITs)] produce greater forces and rates of rise of force than do constant-frequency trains (CFTs) during isometric contractions and isovelocity movements. This study examined the effect of CITs during isotonic contractions in healthy subjects. Knee extension was electrically elicited against a load of 10% of maximum voluntary isometric contraction. The stimulation intensity was set to produce 20% of maximum voluntary isometric contraction. The muscle was tested before and after fatigue with a 6-pulse CFT and 6-pulse CITs that contained an initial doublet, triplet, or quadruplet. For prefatigue responses, the greatest isotonic performance was produced by CITs with initial doublets. When the muscles were fatigued, triplet CITs were best. CITs produce greater excursion, work, peak power, and average power than do CFTs, because CITs produced more rapid rates of rise of force. Faster rates of rise of force enabled the preload on the muscle to be exceeded earlier during the stimulation train.

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Effect of Eccentric Strength Training on Elbow Flexor Spasticity and Muscle Weakness in People With Multiple Sclerosis: Proof-of-Concept Single-System Case Series

Physical Therapy ◽

10.1093/ptj/pzaa055 ◽

2020 ◽

Vol 100 (7) ◽

pp. 1142-1152

Author(s):

Andrea Manca ◽

Gianluca Martinez ◽

Elena Aiello ◽

Lucia Ventura ◽

Franca Deriu

Keyword(s):

Multiple Sclerosis ◽

Strength Training ◽

Range Of Motion ◽

Case Series ◽

Eccentric Contractions ◽

Single System ◽

Group Level ◽

Eccentric Training ◽

Passive Motion ◽

Active Range Of Motion

Abstract Objective To date, no attention has been devoted to the employment of eccentric contractions to manage spasticity in multiple sclerosis. This single-system case series aimed to explore the effects of eccentric training on spasticity-related resistance to passive motion in people with multiple sclerosis with elbow flexor spasticity. Methods Six people with multiple sclerosis (median Expanded Disability Status Scale score = 4.8, range = 2.0–5.5; Modified Ashworth Scale [MAS] score ≤ 3) underwent a 6-week eccentric strength training of the spastic muscles. Before and after the intervention, the following outcomes were assessed: resistive peak torque (RPT), isometric strength, resting limb position, passive range of motion and active range of motion, severity of hypertonia by MAS, and numerical rating scale. At baseline, the primary outcome (RPT) was tested over 3 time points to ensure a stable measurement. The 2-SD method was used to test pre-post training effects at individual level. Group-level analyses were also performed. Results Following the intervention RPT decreased by at least 2 SDs in all participants but 1, with a significant reduction at group level of 41.6 (29.6)%. Four people with multiple sclerosis reported a reduction in perceived spasticity severity. No changes in MAS score were detected. Group-level analyses revealed that maximal strength increased significantly in the trained elbow flexors (+30.9 [9.1]%). Elbow flexion at rest was found to be significantly reduced (−35.5 [12.4]%), whereas passive range of motion (+4.6%) and active range of motion (+11.8%) significantly increased. Conclusion Eccentric training is feasible and safe to manage spasticity in people with multiple sclerosis. Preliminary data showed that this protocol can reduce resistance to passive motion, also improving strength, spasticity-free range of motion, and limb positioning. Impact Patients with multiple sclerosis–related spasticity and moderate-to-severe disability can benefit from adding slow submaximal eccentric contractions to the conventional management of spasticity.

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Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412450651 ◽

2012 ◽

Vol 38 (3) ◽

pp. 288-296 ◽

Cited By ~ 11

Author(s):

S. H. Song ◽

H. Lee ◽

H. Youssef ◽

S. M. Oh ◽

J. H. Park ◽

...

Keyword(s):

Range Of Motion ◽

Functional Status ◽

Corrective Osteotomy ◽

Case Series ◽

Ilizarov Method ◽

Ilizarov Technique ◽

Before And After ◽

The Mean ◽

Multiple Cartilaginous Exostoses

The aim of this study is to evaluate the results of gradual ulnar correction and lengthening using the modified Ilizarov technique for the treatment of forearm deformities in patients with multiple cartilaginous exostoses. We retrospectively reviewed 23 forearms in 16 patients. Three different types of operative procedures were performed: (1) corrective osteotomy and gradual lengthening of the ulna, (2) corrective osteotomy of the radius, and (3) excision of exostoses. We evaluated the radiographs; range of motion of the wrist, forearm, and elbow; and functional status using a questionnaire before and after operation. During the clinical interview, post-operative functional status was significantly improved than pre-operative functional status, 12 patients stated that they had no difficulty in performing daily activities, 11 patients stated that they had no pain, and 11 patients stated that the post-operative appearance of the operated forearm was satisfactory. At time of final follow-up, the mean range of motion of the wrist in ulnar/radial deviation, forearm pronation/supination was significantly improved. Also, the radiographic parameters including radial articular angle, carpal slip, radial bowing, and ulnar variance were significantly improved at time of final follow-up. In conclusion, we achieved successful clinical and radiological outcomes in our patients with forearm deformities after treatment with the modified Ilizarov method. However, there could be a recurrence of ulnar shortening and deformity during growth periods in skeletally immature patients.

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Use of functional bandages in patients with stroke

Fisioterapia em Movimento ◽

10.1590/0103-5150.027.003.ao03 ◽

2014 ◽

Vol 27 (3) ◽

pp. 329-336 ◽

Cited By ~ 1

Author(s):

Dreyzialle Vila Nova Mota ◽

Lícia Vasconcelos Carvalho da Silva

Keyword(s):

Physical Therapy ◽

Range Of Motion ◽

Scientific Evidence ◽

Functional Improvement ◽

Neurological Sequelae ◽

Active Range Of Motion ◽

Extensor Muscles ◽

Flexor Muscles ◽

Elbow Flexor Muscles ◽

Before And After

Introduction Functional bandages have been used in physiotherapeutic practice with the purpose of minimizing disabilities and favoring functional improvement. However, there is still a shortage of research regarding the use of these devices in patients with neurological sequelae, especially those resulting from stroke. Objective To report the motor evolution of patients living with sequelae of stroke, who have been submitted to the use of functional bandages associated with conventional physical therapy. Materials and methods We assessed the active range of motion, strength and degree of spasticity in the flexor and extensor muscles of the wrist and elbow joints, and functionality of the upper limb during the performance of daily activities at the first and the twentieth session of conventional physical therapy associated with the use of functional bandages. Results There was an increase in range of motion and muscle strength of patients, and reduction in spasticity of the wrist and elbow flexor muscles. Conversely, the functionality scores remained similar before and after treatment. Conclusion The subjects of this study showed a good evolution in the aspects studied. Thus, the use of functional bandages associated with conventional physical therapy seems to contribute to the rehabilitation of patients with stroke sequelae. Further research needs to be conducted in order to increase the scientific evidence regarding the effectiveness of functional bandages in the treatment of patients with stroke sequelae.

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Use of Pulsed Shortwave Diathermy and Joint Mobilization to Increase Ankle Range of Motion in the Presence of Surgical Implanted Metal: A Case Series

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2006.2198 ◽

2006 ◽

Vol 36 (9) ◽

pp. 669-677 ◽

Cited By ~ 28

Author(s):

Cindy Seiger ◽

David O. Draper

Keyword(s):

Range Of Motion ◽

Case Series ◽

Joint Mobilization ◽

Shortwave Diathermy

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Pulsed Shortwave Diathermy and Joint Mobilizations for Achieving Normal Elbow Range of Motion After Injury or Surgery With Implanted Metal: A Case Series

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.45 ◽

2014 ◽

Author(s):

David O. Draper

Keyword(s):

Range Of Motion ◽

Case Series ◽

Shortwave Diathermy

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A Single Institution Experience with Standardized Objective and Subjective Scar Evaluation While Undergoing Fractional Ablative Carbon Dioxide Laser Treatment

Journal of Burn Care & Research ◽

10.1093/jbcr/irab132 ◽

2021 ◽

Author(s):

Taryn E Travis ◽

Rebekah A Allely ◽

Laura S Johnson ◽

Jeffrey W Shupp

Keyword(s):

Carbon Dioxide ◽

Range Of Motion ◽

Laser Treatment ◽

Carbon Dioxide Laser ◽

Burn Scar ◽

Scar Revision ◽

Scar Assessment ◽

Active Range Of Motion ◽

Before And After ◽

Baseline Evaluation

Abstract Laser treatment of burn scar has increased in recent years. Standard components of scar evaluation during laser scar revision have yet to be established. Patients who began laser scar revision from January 2018-2020, underwent at least three treatments, and completed evaluations for each treatment were included. Patients underwent fractional ablative carbon dioxide laser scar revision and pre- and post-procedure scar evaluations by a burn rehabilitation therapist, including Patient and Observer Scar Assessment Scale, Vancouver Scar Scale, our institutional scar comparison scale, durometry, and active range of motion measurements. Twenty-nine patients began laser scar revision and underwent at least three treatments with evaluations before and after each intervention. All patients improved in at least one scar assessment metric after a single laser treatment. After second and third treatments, all patients improved in at least three scar assessment metrics. Range of motion was the most frequently improved. Durometry significantly improved after a third treatment. Patients and observers showed some agreement in their assessment of scar, but observers rated overall scar scores better than patients. Patients acknowledged substantial scar improvement on our institutional scar comparison scale. Burn scar improves with fractional ablative laser therapy in a range of scar ages and skin types, as early as the first session. Improvements continue as additional sessions are performed. This work suggests baseline evaluation components for patients undergoing laser, and a timeline for expected clinical improvements which may inform conversations between patients and providers when considering laser for symptomatic hypertrophic scar.

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