Journal of Orthopaedic & Sports Physical Therapy - Lori Thein Brody, PT, PhD, SCS, ATC

A Comparison of Human Muscle Temperature Increases During 3-MHz Continuous and Pulsed Ultrasound With Equivalent Temporal Average Intensities

Joseph A. Gallo, David O. Draper, Lori Thein Brody, Gilbert W. Fellingham

Study Design: A repeated-measure crossover design was used. The independent variable was the type of ultrasound (pulsed or continuous) and the dependent variable was intramuscular temperature. Objective: To compare changes in intramuscular temperature resulting from the use of pulsed ultrasound versus continuous ultrasound with an equivalent spatial average temporal average (SATA) intensity. Background: There is a lack of research on the heat-generating capabilities of pulsed ultrasound within human muscle. Methods and Measures: The subjects were 16 healthy volunteers (mean age ± SD, 21.3 ± 2.5 years). Each subject was treated with pulsed ultrasound (3 MHz, 1.0 W/cm ₂, 50% duty cycle, for 10 minutes) and continuous ultrasound (3 MHz, 0.5 W/cm ₂, for 10 minutes) during a single testing session. Tissue temperature returned to baseline and stabilized between treatments and treatment order was randomized. Tissue temperature was measured every 30 seconds using a 26-gauge needle microprobe inserted at a depth of 2 cm in the left medial gastrocnemius muscle. Data were analyzed using a linear mixed model. Results: Treatment with continuous ultrasound produced a mean (±SD) temperature increase of 2.8°C ± 0.8°C above baseline. Treatment with pulsed ultrasound produced a mean (±SD) temperature increase of 2.8°C ± 0.7°C above baseline. Statistical analysis revealed no significant differences in either the extent or rate of temperature increases between the 2 modes of ultrasound application. Conclusion: Pulsed ultrasound (3 MHz, 1.0 W/cm ₂, 50% duty cycle, for 10 minutes) produces similar intramuscular temperature increases as continuous ultrasound (3 MHz, 0.5 W/cm₂, for 10 minutes) at a 2-cm depth in the human gastrocnemius. Spatial average temporal average intensity is an important consideration when selecting pulsed ultrasound parameters intended to deliver nonthermal effects.

J Orthop Sports Phys Ther. 2004;34(7):395-401. doi:10.2519/jospt.2004.1363

Key Words: heat, physical agents, spatial average temporal average intensity

Effect of a Static Calf-Stretching Exercise on the Resistive Torque During Passive Ankle Dorsiflexion in Healthy Subjects

Lori Thein Brody, Iain W. Muir, Bert M. Chesworth, Anthony A. Vandervoort
Study Design: A within-subject experimental design was used to measure the effect of calf-stretching exercises on the resistive torque during passive ankle dorsiflexion in a group of 20 healthy men (aged 21 to 40). Objectives: The purpose of this study was to determine if the performance of calf-stretching exercises would produce a decrease in resistive torque during passive ankle dorsiflexion. Background: Calf-stretching exercises are widely used in sporting, fitness, and rehabilitation settings, yet the effects of stretching on the passive mechanics of the ankle joint are not well understood. Methods and Measures: A KIN-COM isokinetic dynamometer was used to measure the passive resistive torque of the ankle while the joint complex was moved through return cycles from 10� plantarflexion to 10� dorsiflexion at a constant velocity of 6�/s. Each subject's right or left ankle was randomly assigned to either a control or an experimental condition. The latter underwent a total of 4 static stretches, each lasting 30 seconds. Results: The main findings of the study were that the calf-stretching exercises did not produce a significant reduction in the resistive torque during ankle dorsiflexion, as measured by the peak-to-peak torque at 10� of ankle dorsiflexion or in the center range of the hysteresis loop at 0� dorsiflexion. Conclusion: Static calf-stretching exercises of short duration did not reduce the passive resistance of the connective tissue within the surrounding muscle and joint structures in the ankles of healthy young men. J Orthop Sports Phys Ther. 1999;29(2):106-115. Key Words: connective tissue, mechanical properties, warm-up

Aquatic-Based Rehabilitation and Training for the Elite Athlete

Jill M. Thein-Nissenbaum, Lori Thein Brody
Elite athletes are competing for longer seasons, training more hours, and taking less time off. This schedule may predispose the elite athlete to overuse injuries. When an injury occurs, aquatic-based rehabilitation may expedite the recovery process, as effective cardiovascular and musculoskeletal training may be accomplished by aquatic exercise. The pool may be used both during rehabilitation and postrecovery as an adjunctive tool. Knowledge of the unique physical properties of water, as well as the physiological responses to immersion both at rest and during exercise, will aid the physical therapist when designing a rehabilitation or training program for the athlete. Understanding the principles of movement in water will provide a foundation for creative use of water's unique properties. J Orthop Sports Phys Ther. 1998;27(1):32-41. Key Words: aquatic, training, rehabilitation

Nonoperative Treatment for Patellofemoral Pain

Jill M. Thein-Nissenbaum, Lori Thein Brody
Patellofemoral pain, often called patellofemoral stress syndrome or patellofemoral joint dysfunction, is a commonly seen knee pain syndrome in patients of all ages. It is often a frustrating problem for both the patient and the clinician, as the source of pain can be elusive, making treatment choices difficult. Strategies have been proposed based upon potential sources of pain, including both operative techniques as well as conservative management. Current nonoperative treatment strategies and techniques in the treatment of patellofemoral pain are reviewed. Recommendations and criteria for progression of rehabilitation and suggestions for future research regarding patellofemoral pain are suggested. J Orthop Sports Phys Ther. 1998;28(5):336-344. Key Words: patellofemoral, knee, athlete, nonoperative treatment