Spring 1982 - Athletic Training History

AbstractsJohn Wells, ATC, PT, PhDMars Hill College"Cryotherapy," John E. Hocutt, Jr., American FamilyPhysician 23: 141-144, March, 1981.For many years, physicians have debated the questionof whether heat or cold should be used in treatment ofmoderate to severe acute traumatic injuries. Today, thereis general agreement that direct application of cold to theinjured area is the treatment of choice in the immediatepost-traumatic period. This period ends when the initialtissue response to trauma is completed or stabilized(usually 24 to 72 hours). The completion of the injuryprocess marks the beginning of the rehabilitation period,which continues until maximum rehabilitation is achieved.The application of ice or equivalent cold to human skinproduces four phases of sensation. In Stage 1, the patienthas a cold feeling, which lasts one to three minutes afterapplication. Two to seven minutes after initiation ofcryotherapy, the patient experiences a burning or achingsensation (Stage 2). In 5 to 12 minutes, local numbness ofanesthesia is achieved, defined by a marked decrease inconductivity of regional nerve fibers (Stage 3). At thispoint, pain and reflex impulses are inhibited and the painspasmcycle is interrupted. Twelve to fifteen minutes ofice exposure produces a reflex deep-tissue vasodilation,without an increase in metabolism (Stage 4). Immediatelyafter the injury, ice should be applied to achieve Stage 3cryotherapy. Once the injury phase has been stabilized,Stage 3 cryotherapy should be combined with mildmovement and/or controlled exercise. As healingprogresses, exercise may become more forceful. Mostathletes are willing to endure the brief burning or achingassociated with cryotherapy. Once injured athletes seethe results and experience the comfortable sensation ofStage 3 and 4 of cryotherapy, maintenance ofrehabilitation is often easy.Linda Murray"Selective Training of the Vastus Medialis Muscle UsingEMG Biofeedback," Barney F. LeVeau and Carol Rogers,Physical Therapy: The Journal of the American PhysicalTherapy Association 60: 1410-1415, November, 1980.The purpose of this study was to determine if, by usingEMG biofeedback, the vastus medialis could be trained tocontract independently of the vastus lateralis. If so, thealignment of the patella could be adjusted by muscle control.Subjects were five male and five female volunteers.Their ages ranged from 22 to 29 years. The instrumentationused for the study was two EMG biofeedbackunits. Daily training sessions were five days a week,one half hour each day. The total training was threeweeks, or seven and one-half hours. The study had twoparts. In part one, subjects were asked to decrease themuscle activity level in the VL while maintaining a percentageof reference activity level in the VM. Training forpart one lasted two weeks. In part two, subjects wereasked to increase the activity of the VM while maintainingthe activity of the VL below a daily determined percentageof the reference activity level. For both parts ofthe investigation the muscle activity reference levels forVL and VM were determined daily from the maximumamounts of weight the subject could hold at 170 degrees ofextension of the dominant leg. During the final week oftesting, emphasis was placed on raising the muscle activitylevel of the VM while keeping that of the VL below afixed level. The success of the training was assessed byusing independent tests designed to compare 1) the activitylevels of the VM and the VL, and 2) the spread betweenthese two activity levels. This study indicates that,by using EMG biofeedback, the VM may be trained to contractindependently of the VL. Implications can be drawnfrom this investigation to knee rehabilitation. If thistechnique can be successfully used with patients, kneedisorders such as hypermobile patella, chondromalacia,progressive lateral subluxation, and degenerative arthritisof the patellofemoral joint may be able to betreated conservatively.Bob and Kathy Doyle"Mandibular Position and Upper Body Strength: AControlled Clinical Trial," Martin S. Greenberg, et. al.,The Journal of the American Dental Association. 103:576-579, October, 1981.An increasing number of clinicians, dentists, and otherspecialists treat various disorders by repositioning themandible with mouthpieces, templates, and bite plates.Because repositioning appliances have received muchpublicity and athletes have purchased them on the basis ofthese claims, it was thought that a controlled trial waswarranted. A total of 14 members of the University ofPennsylvania varsity basketball team participated in thestudy. To structure a blind study, the subjects were toldthey would be part of a study to evaluate two differenttypes of appliances. This allowed testing placebo againstexperimental, and the combined appliance data against noappliance. Shoulder abduction and adduction were testedon the subject's dominant shooting arm with adynamometer (Cybex II Isokinetic Dynamometer). Nosubject tested had clinical or historic evidence of TMJdysfunction, myofacial pain dysfunction syndrome(MPDS), or posterior bite collapse. Results clearlydemonstrate no change in strength while the bite openingappliance is worn. It is likely that reports of increasedstrength are related to a placebo effect rather than to thedirect result of the appliance. The results indicate thatopening the bite will not increase upper body strength ofthe normal subject.John Wells +Athletic Training • Spring 1982 51