Study Design: A time series design was used, with the dependent variable being gastrocnemius muscle temperature at a depth of 3 cm. Objectives: To determine the rate of temperature rise and the rate of post-treatment temperature decline in skeletal muscle following the application of pulsed short-wave diathermy (PSWD). Background: Data on PSWD rate and longevity of heating are 20 years old and outdated. With the recent introduction of advanced diathermy equipment, results of our study would provide clinicians with much needed information regarding treatment duration. Methods and Measures: A 23-gauge thermistor was inserted into the center of the medial head of the anesthetized gastrocnemius muscle, 3 cm below the skin's surface of 20 subjects. The PSWD (27.12 MHz frequency) was applied using the following parameters: 800 bursts per second; 400 usecond burst duration; 850 usecond interburst interval; with a peak root mean square (RMS) amplitude of 150 W per burst and an average RMS output of 48 W. Temperature changes were documented every 5 minutes during the treatment and additionally at 5 and 10 minutes following treatment. Results: The average baseline and peak temperatures were 35.84 ± 0.93°C and 39.80 ± 0.83°C, respectively. Mean temperature increases were: 1.36 ± 0.90°C (5 min); 2.87 ± 1.44°C (10 min); 3.78 ± 1.19°C (15 min); 3.49 ± 1.13°C (20 min). After the treatment terminated, intramuscular temperature dropped 0.97 ± 0.68°C in 5 minutes and 1.78 ± 0.69° in 10 minutes. Conclusions: PSWD is an effective modality if temperature elevation of deep tissue over a large area is the clinical objective.

J Orthop Sports Phys Ther. 1999;29(1):13-22.

Key Words: diathermy, heat, ultrasound

Shoulder pain and dysfunction with overhead activities resulting from subacromial impingement syndrome is common. Subacromial impingement syndrome has generally been classified as primary or secondary. A thorough history and physical examination are essential to identifying the etiology of the subacromial impingement syndrome and to direct treatment. Primary subacromial impingement syndrome, resulting from mechanical encroachment into the subacromial space usually by an acromial hook or spurs, occurs in middle age. Individuals with primary subacromial impingement syndrome have symptoms of shoulder pain and weakness with overhead activities. Impingement tests (eg, Neer, Hawkins) are positive. Typically, external rotation, flexion, and abduction of the shoulder are weak and painful. Night pain, usually an inability to sleep on the painful shoulder, is a common symptom of the full-thickness rotator cuff tears that can also occur in this age group. Trauma is usually the mechanism of injury. Persons with secondary subacromial impingement syndrome also have symptoms of pain and weakness with overhead activities. These individuals are usually young and often participate in sports that require repetitive overhead motion (eg, baseball, swimming, volleyball). Symptoms with secondary impingement are attributed to rotator cuff tendinitis. These symptoms are thought to result from overuse of the rotator cuff tendons to compensate for subtle anterior or multidirectional glenohumeral instability. More recently, scapulothoracic muscle weakness has been identified as a cause of secondary subacromial impingement syndrome. Here, the lack of scapular stability is thought to contribute to secondary subacromial impingement syndrome.

J Orthop Sports Phys Ther. 1999;29(1):31-38.

Key Words: shoulder pain, subacromial, tendinitis

Study Design: Single group repeated measures with multiple raters. Objectives: To determine the interrater reliability of KT-1000 measurements of novice and experienced raters and to provide error estimates for these raters. Background: The KT-1000 arthrometer is often used clinically to quantify anterior tibial displacement. Few data have been documented, however, about the relative reliability of KT-1000 measurements obtained by novice compared with experienced users. Methods and Measures: Two novice and two experienced KT-1000 users performed measurements on 29 knees of 25 patients after anterior cruciate ligament (ACL) reconstruction or with a diagnosis of ACL deficiency. Measurements were performed at 131 N. Interrater and intertrial reliability coefficients (interclass correlation coefficient; ICC) and the standard error of measurement were calculated for expert and novice raters. Results: The interrater ICC for novices was 0.65 and the interrater error was ±3.52 mm (90% confidence interval [CI]). The interrater ICC for experts was 0.79 and the interrater error was ±2.94 mm (90% CI). Conclusions: These results suggest that experience in using the KT-1000 is related to the interrater error of measurements and that training is an important consideration when using the KT-1000 arthrometer.

J Orthop Sports Phys Ther. 1999;29(1):49-55.

Key Words: Standard error of measurement, reliability, testing