Self-stress vs manual stress in talar tilt radiography.

BACKGROUND: Radiographic study following inversion ankle sprain commonly is used to determine the presence of anatomic laxity across the talocrural joint. PURPOSE: To compare the degree of talar tilt derived from a radiographic ankle stress exam under 2 conditions: self-stress vs manual stress applied by the clinician. METHODS: Twenty-four subjects seeking medical care following ankle sprain underwent talar tilt stress exams of both ankles. The involved ankle was imaged with self-stress by use of a strap and with the clinician providing manual stress during the imaging exam. Mean talar tilt for the self-stress method was 2.2 degrees, compared with 5.9 degrees for the manual stress method (P < .001). RESULTS: Significantly greater and clinically meaningful differences in talar tilt angle were found when manual stress was provided by the clinician. To avoid false negative findings of anatomic laxity in stress talar tilt studies at the ankle, a standardized procedure in which the clinician provides manual stress may be necessary.

Dabbing the Skin Surface Dry During Ice Massage Augments Rate of Temperature Drop.

While ice massage (IM) is a rapid cooling technique used to facilitate therapeutic movements in the rehabilitation process, evidence of its efficacy over alternative therapeutic protocols is scarce. We determined whether dabbing the skin surface dry during a standard IM treatment would lead to greater rate of skin temperature reduction in comparison to without dabbing; and whether dabbing the skin would lead to an acute change in flexibility. Sixteen healthy volunteers received a "dabbing" and "non-dabbing" 7-minute IM treatment over the surface of each triceps surae muscle. Minute-by-minute temperature change in skin surface was evaluated using an infrared thermometer. Active (AROM) and passive (PROM) range of motion were evaluated via hand-held goniometer and passive stretch force was evaluated with an algometer. Dependent variables (reported as Mean ± SD) were tested with two-way analysis of variance with repeated measures. Skin temperature (°C) was reduced to with dabbing (5.8 ± 1.1) in comparison to without dabbing (6.8 ± 1.4), evoking significantly greater cooling at 1-min of ice massage (group X time interaction, p<0.01). However, after two minutes of IM, each method of application evoked similar surface temperatures. There was no significant difference in AROM, with dabbing (-0.63 ± 2.55°) in comparison to without dabbing (1.18 ± 2.90°), and no significant difference in passive-length tension relations (p>0.05) for either IM group. The dabbing protocol resulted in more rapid rate of temperature drop at 1-minute, however, both IM techniques are sufficient in cooling surface temperature after 2-minutes of IM. Further study is warranted to determine the clinical significance of the dabbing procedure.

Dimensions of the cervical neural foramina in resting and retracted positions using magnetic resonance imaging.

STUDY DESIGN: Prospective within-subject experimental design using a sample of convenience. OBJECTIVES: To describe cervical foraminal dimensions in vivo of nonimpaired, asymptomatic individuals in a neutral cervical spine position using magnetic resonance images, and then to document dimensional changes of the foramina when placing the neck in a retracted position. BACKGROUND: Physical therapists frequently use movement interventions to treat spine dysfunctio The influence of positional changes of the head and neck on the dimensions of the cervical neuiural foramina is not well documented. METHODS AND MEASURES: Twenty asymptomatic subjects (10 men and 10 women), 22 to 25 yearrs of age (mean SD = 23.7 0.8), underwent magnetic resonance imaging of the cervical spine in both neutral and retracted positions. Bilateral measurements were documented in both positions and compared for height, width, and area of each subject's intervertebral foramen from C2-C3to C7-T1. RESULTS: No significant differences (P > 0.004) were found between the 2 neck positions. Withthe single exception of foraminal area at C3-C4, the mean values of height, width, and area in the retracted position were equal to or larger than those of the cervical neutral position. CONCLUSIONS: Therapeutic maneuvers using retraction of the cervical spine do not promote positional stenosis of the intervertebral foramen in the healthy neck.