Isokinetic strength following knee arthroscopy.

This study objectively evaluates recovery of quadriceps and hamstring strength following knee arthroscopy in a group of 43 patients given rehabilitation instructions, but limited supervised rehabilitation. Although the patients did not complain of weakness or functional limitation, isokinetic testing 1, 3, and 8 weeks following surgery revealed persistent weakness in many patients. Incomplete recovery was most apparent when patients were categorized by the degree to which they had recovered normal strength. Results expressed as a mean for the entire group indicated reasonably good recovery and obscured the significant weakness persisting in some patients. Knee extension strength tested at 60 degrees/sec had returned to normal 8 weeks after arthroscopy in only 32% of the subjects. Hamstring strength recovery was better, with 71% having normal strength. Patients may not recognize or report muscular weakness following arthroscopy, yet following 8 weeks of self-supervised rehabilitation many will have objective evidence of persistent weakness. In asymptomatic patients the clinical significance of this weakness is unknown.

The effects of intermittent compression on edema in postacute ankle sprains.

The purpose of this study was to compare the effects of three treatment protocols on pitting edema in patients with first- and second-degree sprained ankles. Thirty subjects with postacute (greater than 24 hours postinjury) ankle sprains and pitting edema but not requiring cast immobilization were randomly assigned to an elastic wrap group (N = 10), an intermittent compression group (N = 10), or an elevated control group (N = 10). Pretreatment and posttreatment volumetric measurements of the subjects' ankles were obtained by the water displacement method. After the pretreatment measurement, the groups were treated for 30 minutes. All subjects' ankles were elevated by raising the foot section of an adjustable table to a 45 degrees angle during treatment. For the first treatment group, the intermittent compression device was set at 40-50 mm Hg, with a 60-second on time and a 15-second off time. For the second treatment group, an elastic wrap was applied from the heads of the metatarsals to 12.7 centimeters above the malleoli. Control group subjects received only the elevated position as their treatment. A three by two repeated measures ANOVA with a follow-up post hoc test revealed that the elevated control group subjects had the least amount of edema (p < .0006). The two compression protocols produced increased edema in the subjects' sprained ankles following treatment. In conclusion, elevation is the most appropriate of the three treatment protocols if the major therapeutic objective is to minimize edema in the postacute phase of rehabilitation. J Orthop Sports Phys Ther 1991;14(2):65-69.

Comparison of three treatment procedures for minimizing ankle sprain swelling.

The purpose of this study was to compare the effects of cold, heat, and contrast bath treatments on the amount of edema in first- and second-degree sprained ankles during the postacute phase of rehabilitation. Thirty subjects with postacute sprained ankles were assigned to a cold (n = 10), heat (n = 10), or contrast bath (n = 10) treatment group. A specially constructed tank was used to take pretreatment and posttreatment volumetric measurements of subjects' sprained ankles. Descriptive statistics, a 3 x 3 two-way analysis of variance for repeated measures, and Tukey's Honestly Significant Difference post hoc test revealed that cold therapy produced the least edema in subjects with sprained ankles (p less than .05). All three treatments (cold, heat, and contrast bath) produced an increase in the amount of edema in the postacute sprained ankles of the subjects. Heat and contrast bath therapy produced almost identical increases in the amount of ankle edema on each of the three days of the study. We concluded that cold therapy is the most appropriate of the three treatments if the therapeutic objective is to minimize edema before rehabilitative exercise during the third, fourth, and fifth days postinjury for first- and second-degree ankle sprains.

Comparison of the Effects of the Anderson Knee Stabler and McDavid Knee Guard on the Kinematics of the Lower Extremity during Gait*.

* This study was completed in partial fulfillment of Ms. Van Horn's master's degree, University of North Carolina at Chapel Hill. The purpose of this study was to compare gait patterns among subjects wearing Anderson Knee Stabler braces, McDavid Knee Guards, and no braces. Fifteen male subjects were filmed while running on a treadmill at 4 mph and 8 mph without a brace, with an Anderson Knee Stabler, and with a McDavid Knee Guard. Fourteen gait variables were measured for each brace and speed condition. Analysis of the variables with multivariate ANOVA indicated that there was an increase in hip and knee flexion and knee angular velocity with and without braces at 8 mph as compared to 4 mph, a decrease in knee extension when either brace was worn, and minimal gait pattern differences with the Anderson Knee Stabler as compared with the McDavid Knee Guard (all results p < 0.05). The results of this study demonstrate that no clear superiority exists between the braces' effect on the gait characteristics measured. Therefore, other parameters should be considered when making brace selections.J Orthop Sports Phys Ther 1988;9(7):254-260.