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The Influence of High-Voltage Electrical Stimulation on Edema Formation After Acute Injury: A Systematic Review

Alison R. Snyder, April L. Perotti, Kenneth C. Lam, and R. Curtis Bay

Context:

Electrical stimulation is often used to control edema formation after acute injury. However, it is unknown whether its theoretical benefits translate to benefits in clinical practice.

Objectives:

To systematically review the basic-science literature regarding the effects of high-voltage pulsed stimulation (HVPS) for edema control.

Evidence Acquisition:

CINAHL (1982 to February 2010), PubMed (1966 to February 2010), Medline (1966 to February 2010), and SPORTDiscus (1980 to February 2010) databases were searched for relevant studies using the following keywords: edema, electrical stimulation, high-volt electrical stimulation, and combinations of these terms. Reference sections of relevant studies were hand-searched. Included studies investigated HVPS and its effect on acute edema formation and included outcome measures specific to edema. Eleven studies met the inclusion criteria. Methodological quality and level of evidence were assessed for each included study. Effect sizes were calculated for primary edema outcomes.

Evidence Synthesis:

Studies were critiqued by electrical stimulation treatment parameters: mode of stimulation, polarity, frequency, duration of treatment, voltage, intensity, number of treatments, and overall time of treatments. The available evidence indicates that HVPS administered using negative polarity, pulse frequency of 120 pulses/s, and intensity of 90% visual motor contraction may be effective at curbing edema formation. In addition, the evidence suggests that treatment should be administered in either four 30-min treatment sessions (30-min treatment, 30-min rest cycle for 4 h) or a single, continuous180-min session to achieve the edemasuppressing effects.

Conclusions:

These findings suggest that the basic-science literature provides a general list of treatment parameters that have been shown to successfully manage the formation of edema after acute injury in animal subjects. These treatment parameters may facilitate future research related to the effects of HVPS on edema formation in humans and guide practical clinical use.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 19 (2010): Issue 4 (Jan 2010)

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The Effect of Elevation on Intramuscular Tissue Temperatures

Cordial M. Gillette and Mark A. Merrick

as well as structural components of the cell, eventually leading to cellular necrosis. 7 , 18 The use of cryotherapy suppresses the cell’s metabolic demand, allowing it to better survive the hypoxic period. 1 , 13 , 19 Typical acute injury management with cold has 3 components—ice, compression, and

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 27 (2018): Issue 6 (Nov 2018)

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Cold Application Following Acute Injury–How Much Is Enough?

Jennifer A. Stone

Cover International Journal of Athletic Therapy and Training

In International Journal of Athletic Therapy and Training Volume 2 (1997): Issue 5 (Sep 1997)

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Acute Injuries to the Lower Extremities in Pediatric and Adolescent Athletes

Ronald P. Pfeiffer, Kevin G. Shea, Michael J. Curtin, and Peter Apel

Cover International Journal of Athletic Therapy and Training

In International Journal of Athletic Therapy and Training Volume 7 (2002): Issue 6 (Nov 2002)

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Progression of Secondary Injury After Musculoskeletal Trauma—A Window of Opportunity?

Mark A. Merrick and Nicole M. McBrier

Context:

Acute musculoskeletal-injury management largely focuses on inhibiting secondary injury, although the data describing secondary injury and the timeline for its progression are sparse.

Objective:

To describe the timeline and early progression of secondary injury in skeletal muscle over the first 5 h after blunt trauma.

Design:

A controlled laboratory study with 2 independent variables (injury status and postinjury time point) in a 2 × 21 factorial.

Setting:

University research laboratory.

Subjects:

168 male Sprague Dawley rats (250 to 275 g).

Interventions:

Uniform blunt-contusion injury was caused to the right triceps surae using a drop-weight method; the contralateral limb served as an uninjured control. Both triceps surae were excised and flash frozen at 21 intervals across 5 h postinjury (8 animals, each 15 min).

Main Outcome Measures:

Cytochrome-c oxidase activity via reduction of triphenyltetrazolium chloride (TTC) to triphenyl-formazan.

Results:

There was an interaction effect (P = .041) between and main effects for both injury status (P < .0005) and postinjury time point (P = .038). In the first 30 min after injury, uninjured tissues did not differ from injured tissues, and both displayed TTC reduction rates in the vicinity of 7.1 ± 0.94 μg · mg−1 · h−1. Statistical differences between uninjured and injured tissues became evident starting at 30 min. TTC reduction for uninjured tissues did not change, but injured tissues declined in a roughly linear fashion across the entire 5-h period to 4.8 ± 1.04 μg · mg−1 · h−1.

Conclusions:

Cytochrome-c oxidase activity, an indicator of oxidative phosphorylation and mitochondrial viability, is diminished by events that follow muscle trauma. Loss of this enzymatic activity becomes statistically evident at 30 min postinjury and continues linearly for at least 5 h. This suggests that secondary injury is a slowly developing problem of more than 5 h duration. A window of opportunity for intervention may lie somewhere within the first 30 min after injury.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 19 (2010): Issue 4 (Jan 2010)

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“Be Mindful Even Though It Hurts”: A Single-Case Study Testing the Effects of a Mindfulness- and Acceptance-Based Intervention on Injured Athletes’ Mental Health

Karin Moesch, Andreas Ivarsson, and Urban Johnson

Injury is a serious setback for athletes and might jeopardize mental health. The aim of this study is to investigate if a mindfulness- and acceptance-based intervention can improve mindfulness (nonreactivity and acting with awareness), acceptance, and well-being, and decrease the level of symptoms of anxiety and depression. A single-case design with multiple, staggered, and nonconcurrent baselines was used. Six seriously injured athletes took part in an 8-week intervention and repeatedly completed questionnaires on all variables for the duration of the study. The results showed that, on average, there were significant clinical changes between phases in nonreactivity, well-being, and acceptance. No effect was seen in the two remaining scales. On an individual level, two participants showed effects in all scales, two participants in some of the scales, and two participants in the scale nonreactivity. Results are discussed in light of existing research, and implications for practitioners’ clinical methods are presented.

Cover Journal of Clinical Sport Psychology

In Journal of Clinical Sport Psychology Volume 14 (2020): Issue 4 (Dec 2020)

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Relationship Between Pain Catastrophizing and 6-Month Outcomes Following Anterior Cruciate Ligament Reconstruction

Kate N. Jochimsen, Margaret R. Pelton, Carl G. Mattacola, Laura J. Huston, Emily K. Reinke, Kurt P. Spindler, Christian Lattermann, and Cale A. Jacobs

postoperative self-reported pain and functional outcomes in acute injury populations is poorly understood. In examining the effect of preoperative PCS scores on immediate postoperative pain, Pavlin et al 13 found that preoperative PCS scores were related with immediate postoperative pain (while in the

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 29 (2020): Issue 6 (Aug 2020)

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An Interdisciplinary Approach to a Well-Rounded Campus Healthcare Delivery System

Shari D. Bartz-Smith and Amy Campbell

An injury care clinic (ICC) as part of a comprehensive campus-wide healthcare system is a cost-effective way to optimize the flow of patient care utilizing a collaborative model of healthcare in a time of physician shortage. Services include: basic first aid, injury evaluation, acute injury care, basic rehabilitation, preventative techniques including taping and stretching, and professional referrals. The ICC provides care to previously underserved campus community members, focusing on: club sport and intramural athletes, recreation center users, and the general student body, in addition to faculty and staff, going beyond the varsity athlete. The ICC functions through the efforts of athletic trainers, physicians, fitness specialists, administrators, faculty, and students across disciplines. After 3 years, the clinic has serviced more than 2,500 unique patients exceeding 4,800 patient encounters, demonstrating outcomes that access to affordable healthcare options with a licensed healthcare provider are warranted and needed.

Cover Kinesiology Review

In Kinesiology Review Volume 6 (2017): Issue 4 (Jan 2017)

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Loss of Motion Following ACL Reconstruction: A Second Look

James J. Irrgang, Christopher D. Harner, Freddie H. Fu, Mark B. Silbey, and Robbie DiGiacomo

The purpose of this study was to determine the effects of preoperative, intraoperative, and postoperative intervention on the incidence of loss of motion (LOM) following ACL reconstruction. A retrospective review of patients undergoing ACL reconstruction between 1990 and 1991 was conducted to identify those with LOM. Factors potentially related to loss of motion were recorded. The results were compared to the findings of a similar group of patients who underwent ACL reconstruction between 1987 and 1989. In 1990 to 1991, less concomitant ligament surgery was performed, the incidence of loss of extension was significantly reduced, and the incidence of loss of flexion was significantly increased. It appears the risk for loss of extension can be minimized by delaying surgery following acute injury, performing less concomitant ligament surgery, paying meticulous attention to notchplasty and anatomic placement of the graft, and placing early emphasis on restoration of full extension following surgery.

Cover Journal of Sport Rehabilitation

In Journal of Sport Rehabilitation Volume 6 (1997): Issue 3 (Jan 1997)

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Narratives of Chronic Pain in Sport

Emily R. Hunt and Melissa C. Day

Sports injury research has predominantly focused on acute injuries, often overlooking the complexities that may be associated with chronic injury. Consequently, the aim of the present study was to understand the experiences of individuals who continued to take part in sport with a chronic injury. Using a narrative methodology, 10 athletes who had experienced chronic pain for at least one year took part in interviews which asked them to narrate their story of pain. Results identify the imprisonment narrative used to describe chronic injury and consider that the causes of this “imprisonment” may be both physical and environmental. Further, this study illustrates how athletes have coped with chronic pain, emphasizing the body-self relationship and the difficulties associated with adapted sport. These findings have important implications for practitioners working with injured athletes, emphasizing that the experiences of athletes in chronic pain may differ considerably from those in acute pain.

Cover Journal of Clinical Sport Psychology

In Journal of Clinical Sport Psychology Volume 13 (2019): Issue 1 (Mar 2019)