Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

The hyperthermic effect of a distal volar forearm nerve block: a possible treatment of acute digital frostbite injuries?

BACKGROUND: The authors have observed that carpal tunnel surgery nerve blocks consisting of subfascial distal volar forearm injection of 10 cc of 1% lidocaine with epinephrine result in fingers that appear hyperemic, warm, and numb in both median and ulnar nerve distributions. The purposes of this study were to (1) determine whether forearm nerve blocks in patients undergoing carpal tunnel releases result in an objective increase in finger temperature, and (2) document the location and duration of finger anesthesia. METHODS: Thirty-nine patients undergoing unilateral carpal tunnel release were studied prospectively. An infrared thermometer was used to measure the temperature in the fingers of operative and nonoperative hands before and after injection of local anesthetic. The distal volar forearm block was performed using 10 cc of 1% lidocaine with 1:100,000 epinephrine deep to the forearm fascia between the median and ulnar nerves 1 cm proximal to the wrist crease. Before and after carpal tunnel release, bilateral finger temperatures were measured at hourly intervals. Statistical analysis included a one-sample test of proportions. RESULTS: The finger temperature of the operative hand was significantly warmer than the unoperated hand over the first 2 hours after the nerve block. Seventy-four percent of patients had a statistically significant increase in temperature. On average, the nerve block lasted 6.27 hours in the median nerve distribution and 5.78 hours in the ulnar nerve distribution. CONCLUSIONS: Forearm nerve blocks produce a chemical sympathectomy that provides a significant increase in skin temperature as a result of vasodilatation in most patients. They also provide prolonged finger numbness. This could be of clinical benefit in patients with acute finger frostbite injuries.

Immediate effect of transcutaneous electrical nerve stimulation on spasticity in patients with spinal cord injury.

OBJECTIVE: To investigate the immediate effect of transcutaneous electrical nerve stimulation (TENS) on spasticity in patients with spinal cord injury. DESIGN: Randomized controlled trial. SETTING: Extended rehabilitation centre. SUBJECTS AND INTERVENTION: Eighteen subjects with spinal cord injury and symptoms of spasticity over lower limbs were randomly assigned to receive either 60 minutes of active TENS (0.25 ms, 100 Hz, 15 mA) or 60 minutes of placebo non-electrically stimulated TENS over the common peroneal nerve. OUTCOME MEASURES: Composite Spasticity Score was used to assess the spasticity level of ankle plantar flexors immediately before and after TENS application. Composite Spasticity Score consisted of Achilles tendon jerks, resistance to full-range passive ankle dorsiflexion and ankle clonus. Between-group statistical differences of reduction of Composite Spasticity Score, Achilles tendon jerks, resistance to full-range passive ankle dorsiflexion and ankle clonus were calculated using the Mann-Whitney test. Within-group statistical differences of Composite Spasticity Score, Achilles tendon jerks, resistance to full-range passive ankle dorsiflexion and ankle clonus were calculated using the Wilcoxon signed ranks test. RESULTS: Significant reductions were shown in Composite Spasticity Score by 29.5% (p = 0.017), resistance to full-range passive ankle dorsiflexion by 31.0% (p = 0.024) and ankle clonus by 29.6% (p = 0.023) in the TENS group but these reductions were not found in the placebo TENS group. The between-group differences of both Composite Spasticity Score and resistance to full-range passive ankle dorsiflexion were significant (p = 0.027 and p = 0.024, respectively). CONCLUSION: This study showed that a single session of TENS could immediately reduce spasticity.