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  • Author: Kimberly A. Pritchard x
  • Athletic Training, Therapy, and Rehabilitation x
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Alyssa Muething, Shellie Acocello, Kimberly A. Pritchard, Stephen F. Brockmeier, Susan A. Saliba and Joseph M. Hart

Context:

Understanding how muscles activate in a population with a previous glenohumeral-joint (GH) injury may help clinicians understand how to build a conservative treatment plan to strengthen or activate the specific muscles in an attempt to reduce recurrent shoulder injury and development of GH laxity.

Objective:

To investigate muscle-activation differences between the previously injured limb of individuals with a history of GH-joint injury and healthy matched controls during functional isometric contractions.

Design:

Case control.

Setting:

University research laboratory.

Participants:

17 individuals (8 women, 9 men; age 22.3 ± 2.6 y, height 172.4 ± 8.8 cm, mass 75.4 ± 16.5 kg) with previous unilateral shoulder pain and 17 (8 women, 9 men; age 22.9 ± 3.9 y, height 170.9 ± 11.3 cm, mass 73.6 ± 22.9 kg) with no history of shoulder pain or injury.

Intervention(s):

Diagnostic ultrasound measurements of the supraspinatus were completed in both resting and contracted states to assess changes in muscle thickness. Manual muscle tests (anterior deltoid, upper trapezius, infraspinatus, lower trapezius, serratus anterior) and functional isometric contractions (forward flexion, scaption, abduction) were measured using electromyography.

Main Outcome Measures:

Peak, normalized activation of each muscle and supraspinatus thickness activation ratio were compared between groups and bilaterally within groups using separate ANOVAs.

Results:

The anterior deltoid was significantly less activated during all functional isometric tasks in previously injured subjects than in healthy subjects (P = .024). In previously injured subjects, the involved limb-lower trapezius was significantly less activated during scaption and abduction tasks than the contralateral side (P = .022 and P = .031, respectively).

Conclusions:

There were decreases in muscle activation in the anterior deltoid between previously injured and healthy people, as well as in the lower trapezius, in previously injured subjects. Understanding the source of muscle-activation deficits can help clinicians focus rehabilitation exercises on specific muscles.

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Hailey N. Love, Kimberly A. Pritchard, Joseph M. Hart and Susan A. Saliba

Context:

Alterations in skin sensations may be responsible for pain reduction provided by cryotherapy, but the exact physiological mechanism is unknown.

Objective:

To investigate perceptions of skin sensations associated with different modes of cryotherapy administration and skin temperature at the point of perceived numbness.

Design:

Repeated measures.

Participants:

30 healthy subjects (12 Male, 18 Female, Age = 21.1±1.9 years).

Interventions:

Crushed ice bag, ice massage, and cold water immersion.

Main Outcome Measures:

Perceptions of sensations during each mode of cryotherapy administration were derived from a Modified McGill Pain Questionnaire. Skin temperature was recorded when numbness was reported for each treatment.

Results:

Participants experienced sensations that included cold, tight, tingling, stinging, and numb. Ice massage sensations transitioned rapidly from cold to numb, whereas cold water immersion and ice bag treatments produced altered sensations for longer duration. Ice massage decreased skin temperature significantly more than the other two modes of cryotherapy administration.

Conclusions:

Ice massage may be the best mode of cryotherapy administration for achievement of anaesthesia as rapidly as possible, whereas cold water immersion and ice bag application may be better for attainment of pain reduction associated with noxious stimulation of skin receptors.

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Jenna K. Cataldi, Kimberly A. Pritchard, Joseph M. Hart and Susan A. Saliba

Context:

Recommended treatment duration for cryotherapy varies, but the primary therapeutic benefit may be related to the amount of time required for changes in cutaneous sensation.

Objective:

To determine the amount of time required to induce numbness for three different modes of cryotherapy administration, and the amount of time that numbness persists after treatment.

Design:

Repeated measures.

Participants:

30 healthy adults (12 males, 18 females, age = 21.1 ± 1.9 years).

Interventions:

Crushed ice bag, ice massage, and cold water immersion.

Main Outcome Measures:

Time required to induce numbness and the amount of time numbness remained after removal of each mode of cryotherapy.

Results:

Ice massage and cold water immersion produced numbness significantly faster than the crushed ice. There were no significant differences in terms of numbness duration.

Conclusions:

Changes in cutaneous sensation can be achieved in a relatively short amount of time (6–12 minutes) with ice massage and cold water immersion. The duration of the treatment effect did not differ among the three modes of cryotherapy administration.