DEEP HEAT AND JOINT MOBILIZATIONS INCREASE RANGE OF MOTION IN TRAUMATIC ELBOW INJURIES
Main Article Content
Abstract
The purpose of this paper is two-fold. First, to report the cases of 9 patients who lacked full range of motion (ROM) in the elbow due to fracture or dislocation and immobilization, and second, the treatment regimen to restore ROM. Nine patients presented with decreased elbow ROM. All were postsurgical, 3 with internal fixation devices. Initial active extension for each patient was 17 °, 23°, 28 °, 25 °, 45 °, 30 °, 26 °, 30 ° and 33 ° respectively (range of 17 – 45 degrees).Treatment regimen consisted of deep heat (pulsed shortwave diathermy for the first 8 patients and ultrasound for the 9th patient). Changes in extension active range of motion (AROM) were assessed before and after each treatment. Treatment consisted of 10-20 minutes of deep heat on the anterior aspect of the elbow, followed by approximately 10 minutes of joint mobilizations. After post-treatment AROM was recorded, ice was applied to the area for 20 minutes. Once the patient achieved full AROM or did not improve on 2 consecutive visits, he or she was discharged from the study. By the 6th treatment, 7 patients achieved full AROM (One took 10 treatments). All returned to normal activity and normal use of their elbow. One month later, 8 maintained full AROM (one lost 5°). A regimen of deep heat and joint mobilizations was effective in restoring AROM to elbows lacking ROM after injury or surgery.
Key Words: rehabilitation, diathermy, ultrasound,
Key Words: rehabilitation, diathermy, ultrasound,
Article Details
How to Cite
DRAPER, David O..
DEEP HEAT AND JOINT MOBILIZATIONS INCREASE RANGE OF MOTION IN TRAUMATIC ELBOW INJURIES.
Medical Research Archives, [S.l.], n. 3, july 2016.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/538>. Date accessed: 27 dec. 2024.
Keywords
rehabilitation, diathermy, ultrasound
Issue
Section
Case Reports
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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Belanger, A.Y. (2015). Therapeutic Electrophysical Agents: Evidence Behind Practice. 3rd edn. Baltimore, Wolters Kluwer Health. Lippincott Williams & Wilkins.
Bender, L.F. (1954). Histologic studies following exposure to bone to ultrasound. Arch of Phys Med and Rehabil, 35, 555.
Boone, D.C. (1978). Reliability of goniometric measurements. Phys Ther, 58(11),1355-1360.
Deforest, R.E., Herrick, J.R., James, J.M. (1953). Effects of ultrasound on growing bone. Arch of Phys Med and Rehabil, 34,21.
Draper, D.O. (2011). Injuries restored to ROM using PSWD and mobilizations. International J of Sports Med, 32(4),281-286.
Draper, D.O. (2014). Facts and Misfits in ultrasound therapy. International J of Phys Med and Rehabil,50, 209-216.
Draper, D.O. (2014). Pulsed shortwave diathermy and joint mobilizations for achieving normal elbow range of motion after injury or surgery with implanted metal: A case series. J Athl Train, 49(6), 851-855.
Draper, D.O., Castel, J.C., Castel, D. (1995). Rate of temperature increase in human muscle during 1Mhz and 3 Mhz continuous ultrasound. JOSPT,22, 142-150.
Draper, D.O., Castel, J.C., Castel, D. (2004). Low-Watt pulsed shortwave diathermy and metal-plate fixation of the elbow. Athl Ther Today, September, 27-31.
15
Draper, D,O., Harris, S.T., Schulthies, S.S., Ricard, M.D., Knight, K.L., Durrant, E. (1998). Hotpack and 1Mhz ultrasound treatments have an additive effect on muscle temperature increase. J Athl Train,33, 21-24.
Draper, D.O., Knight, K.L., Fujiwara, T., Castel, J.C. (1999). Temperature change in human muscle during and after pulsed shortwave diathermy. JOSPT, 29(1), 13-22.
Franson, J., Rigby, J.H., Mitchel, U., Johnson, A.W., Draper, D.O. (2014). Heat penetration into soft tissue with 3Mhz ultrasound. Athl Train and Sports Health Care,6(6), 267-272.
Gajdosik, R.L., Bohannon, R.W. (1987). Clinical measurement of range of motion: review of goniometry emphasizing reliability and validity. Phys Ther, 67(12), 1867-1872.
Garrett, C.L., Draper, D.O., Knight, K.L. (2000). Heat distribution in the lower leg from pulsed shortwave diathermy and ultrasound treatments. J Athl Train, 35(1), 50-55.
Greenman, P.E. (1996). Principles of Manual Medicine 2nd ed. Baltimore. Williams & Wilkins.
Guler-Uysal, F., Kozanoglu, E. (2004). Comparison of the early response to two methods of rehabilitation in adhesive capsulitis. Swiss Med Weekly, 134, 353-358.
Hoppenfeld, S. (1976). Physical Examination of the Spine and Extremities. 3rd edn. Norwalk, CT. Appleton Century Crofts.
Jan, M.H., Lai, J.S. (1991). The effects of physiotherapy on osteoarthritic knees of females. J Formosan Med Assoc, 90(10), 1008-1013.
Kaltenborn, F.M. (2003). Manual Mobilization of the Joints: The Kaltenborn Method of Joint Examination and Treatment.vol. 1, 6th edn. Bokhandel, Oslo, Norway.
Knight, K.L., Draper, D.O. (2013). Therapeutic Modalities: The Art and Science. 2nd edn. (2013). Baltimore, MD. Wolters Kluwer/Lippincott Williams & Wilkins.
Leadbetter, W.B., Buckwalter, J.A., Roettger, R.F. (eds). (1990). American Orthopaedic Society for Sports Medicine Symposium. Sports-Induced Inflammation: Clinical and Basic Science Concepts. Park Ridge, IL. American Academy of Orthopeadic Surgeons, 55-101.
Lehmann, J.F., Brunner, G.D., McMillan, J.A. (1959). Comparative study of the efficiency of shortwave, microwave and ultrasonic diathermy in heating of the hip joint. Arch of Phys Med and Rehabil, 40, 510-512.
Lehmann, J.F., DeLateur, B.J. (1990). Therapeutic heat, in Lehmann, J.F. Therapeutic Heat and Cold, 4th edn. Baltimore, MD. Williams & Wilkins.
Lehmann, J. F., Masock, A.J. Warren, C.G, Koblanski, J.N. (1970). Effect of therapeutic temperatures on tendon extensibility. Arch Phys Med Rehabil, 51(8), 481-487.
Lehmann, J.F., McDougall, J.A., Guy, A.W., Warren, C.G., Esselman, P.C. (1983). Heating patterns produced by shortwave diathermy applicators in tissue substitute models. Arch Phys Med Rehabil, 64, 575-577.
Low, J.L. (1976). The reliability of joint measurement. Physiotherapy, 62(7), 227-229.
Magee, D.L. (1992). Orthopedic Physical Assessment. Philadelphia, W.B. Saunders.
Maitland, G.D. (1991). Peripheral Manipulation 3rd end. Oxford. Butterworth-Heinemann.
McCray, R.E., Patton, N.J. (1984). Pain relief at trigger points: a comparison of moist heat and shortwave diathermy. JOSPT, 5(4), 175-178.
Merrick, M.A. (2002). Secondary injury after musculoskeletal trauma: A review and update. J Athl Train, 37, 209-217.
Michlovitz, S., Bellew, J.M., Nolan, T.P. (2012). Modalities for Therapeutic Intervention. 5th edn. Philadelphia, F.A. Davis.
Murray, C.C., Kitchen, S. (2000). Effect of pulse repetition rate on the perception of thermal sensation with pulsed shortwave diathermy. Physiother Res Int,, 5(2), 73-85.
Oosterveld, F.G.J., Rasker, J.J., Jacobs, J.W.G, Overmars, H.J.A. (1992). The effect of local heat and cold therapy on the intraarticular and skin surface temperature of the knee. Arch & Rheum, 35(2), 146-151.
Palmer, L.M., Epler, M.E. (1998). Fundamentals of Musculoskeletal Assessment Techniques. 2nd edn. Philadelphia, Lippincott, Williams & Wilkins.
Reid, R.W., Foley, J.M., Prior, B.M., Weingand, K.W., Meyer, R.A. (1999). Mild topical heat increses popliteal blood flow as measured by MRI. Med Sci Sports Exerc, 31(5), S208.
Rothstein, J.M., Miller, P.J., Roettger, R.F. (1983). Goniometric reliability in a clinical setting: Elbow and knee measurements. Phys Ther, 63(10), 1611-1615.
Ruggera, P. S., Witters, D.M., von Malzahn, G., Bassen, H.I. (2003). In vitro assessment of tissue heating near metallic implants by exposure to pulsed radio frequency diathermy. Phys Med Biol, 48, 2919-2928.
Seiger, C., Draper, D.O. (2006). Use of pulsed shortwave diathermy and joint mobilizations to increase ankle range of motion in the presence of surgical implanted metal: A case series. JOSPT, 36(9), 669-677.
Sekins, K.M., Lenmann, J.F., Esselman, P., Dundore, D., Emery, A.F., deLateur, B.J., Nelp, W.B. (1984). Local muscle blood flow and temperature responses to 915 Mhz diathermy as simultaneously measured and numerically predicted. Arch Phys Med Rehabil, 65, 1-7.
Shields, N., O’Hare, H., Gormley, J. (2004). Contra-indications to shortwave diathermy: survey of Irish physiotherapists. Physiotherapy, 90, 42-53.
Starkey, C., Ryan, J. (2010). Evaluation of Orthopedic and Athletic Injuries. 3rd edn. Philadelphia, F.A. Davis.
Talaat, A.M., El-Dibany, M.M., El-Garf, A. (1986). Physical therapy in the management of myofascial pain dysfunction syndrome. Ann Otol Rhinol Laryngol, 95, 225-228.
Wagstaff, P., Wagstaff, S., Downey, M. (1986). Apilot study to compare the efficacy of continuous and pulsed magnetic energy [shortwave diathermy] on the relief of low back pain. Physiotherapy, 72(11), 563-566.
Belanger, A.Y. (2015). Therapeutic Electrophysical Agents: Evidence Behind Practice. 3rd edn. Baltimore, Wolters Kluwer Health. Lippincott Williams & Wilkins.
Bender, L.F. (1954). Histologic studies following exposure to bone to ultrasound. Arch of Phys Med and Rehabil, 35, 555.
Boone, D.C. (1978). Reliability of goniometric measurements. Phys Ther, 58(11),1355-1360.
Deforest, R.E., Herrick, J.R., James, J.M. (1953). Effects of ultrasound on growing bone. Arch of Phys Med and Rehabil, 34,21.
Draper, D.O. (2011). Injuries restored to ROM using PSWD and mobilizations. International J of Sports Med, 32(4),281-286.
Draper, D.O. (2014). Facts and Misfits in ultrasound therapy. International J of Phys Med and Rehabil,50, 209-216.
Draper, D.O. (2014). Pulsed shortwave diathermy and joint mobilizations for achieving normal elbow range of motion after injury or surgery with implanted metal: A case series. J Athl Train, 49(6), 851-855.
Draper, D.O., Castel, J.C., Castel, D. (1995). Rate of temperature increase in human muscle during 1Mhz and 3 Mhz continuous ultrasound. JOSPT,22, 142-150.
Draper, D.O., Castel, J.C., Castel, D. (2004). Low-Watt pulsed shortwave diathermy and metal-plate fixation of the elbow. Athl Ther Today, September, 27-31.
15
Draper, D,O., Harris, S.T., Schulthies, S.S., Ricard, M.D., Knight, K.L., Durrant, E. (1998). Hotpack and 1Mhz ultrasound treatments have an additive effect on muscle temperature increase. J Athl Train,33, 21-24.
Draper, D.O., Knight, K.L., Fujiwara, T., Castel, J.C. (1999). Temperature change in human muscle during and after pulsed shortwave diathermy. JOSPT, 29(1), 13-22.
Franson, J., Rigby, J.H., Mitchel, U., Johnson, A.W., Draper, D.O. (2014). Heat penetration into soft tissue with 3Mhz ultrasound. Athl Train and Sports Health Care,6(6), 267-272.
Gajdosik, R.L., Bohannon, R.W. (1987). Clinical measurement of range of motion: review of goniometry emphasizing reliability and validity. Phys Ther, 67(12), 1867-1872.
Garrett, C.L., Draper, D.O., Knight, K.L. (2000). Heat distribution in the lower leg from pulsed shortwave diathermy and ultrasound treatments. J Athl Train, 35(1), 50-55.
Greenman, P.E. (1996). Principles of Manual Medicine 2nd ed. Baltimore. Williams & Wilkins.
Guler-Uysal, F., Kozanoglu, E. (2004). Comparison of the early response to two methods of rehabilitation in adhesive capsulitis. Swiss Med Weekly, 134, 353-358.
Hoppenfeld, S. (1976). Physical Examination of the Spine and Extremities. 3rd edn. Norwalk, CT. Appleton Century Crofts.
Jan, M.H., Lai, J.S. (1991). The effects of physiotherapy on osteoarthritic knees of females. J Formosan Med Assoc, 90(10), 1008-1013.
Kaltenborn, F.M. (2003). Manual Mobilization of the Joints: The Kaltenborn Method of Joint Examination and Treatment.vol. 1, 6th edn. Bokhandel, Oslo, Norway.
Knight, K.L., Draper, D.O. (2013). Therapeutic Modalities: The Art and Science. 2nd edn. (2013). Baltimore, MD. Wolters Kluwer/Lippincott Williams & Wilkins.
Leadbetter, W.B., Buckwalter, J.A., Roettger, R.F. (eds). (1990). American Orthopaedic Society for Sports Medicine Symposium. Sports-Induced Inflammation: Clinical and Basic Science Concepts. Park Ridge, IL. American Academy of Orthopeadic Surgeons, 55-101.
Lehmann, J.F., Brunner, G.D., McMillan, J.A. (1959). Comparative study of the efficiency of shortwave, microwave and ultrasonic diathermy in heating of the hip joint. Arch of Phys Med and Rehabil, 40, 510-512.
Lehmann, J.F., DeLateur, B.J. (1990). Therapeutic heat, in Lehmann, J.F. Therapeutic Heat and Cold, 4th edn. Baltimore, MD. Williams & Wilkins.
Lehmann, J. F., Masock, A.J. Warren, C.G, Koblanski, J.N. (1970). Effect of therapeutic temperatures on tendon extensibility. Arch Phys Med Rehabil, 51(8), 481-487.
Lehmann, J.F., McDougall, J.A., Guy, A.W., Warren, C.G., Esselman, P.C. (1983). Heating patterns produced by shortwave diathermy applicators in tissue substitute models. Arch Phys Med Rehabil, 64, 575-577.
Low, J.L. (1976). The reliability of joint measurement. Physiotherapy, 62(7), 227-229.
Magee, D.L. (1992). Orthopedic Physical Assessment. Philadelphia, W.B. Saunders.
Maitland, G.D. (1991). Peripheral Manipulation 3rd end. Oxford. Butterworth-Heinemann.
McCray, R.E., Patton, N.J. (1984). Pain relief at trigger points: a comparison of moist heat and shortwave diathermy. JOSPT, 5(4), 175-178.
Merrick, M.A. (2002). Secondary injury after musculoskeletal trauma: A review and update. J Athl Train, 37, 209-217.
Michlovitz, S., Bellew, J.M., Nolan, T.P. (2012). Modalities for Therapeutic Intervention. 5th edn. Philadelphia, F.A. Davis.
Murray, C.C., Kitchen, S. (2000). Effect of pulse repetition rate on the perception of thermal sensation with pulsed shortwave diathermy. Physiother Res Int,, 5(2), 73-85.
Oosterveld, F.G.J., Rasker, J.J., Jacobs, J.W.G, Overmars, H.J.A. (1992). The effect of local heat and cold therapy on the intraarticular and skin surface temperature of the knee. Arch & Rheum, 35(2), 146-151.
Palmer, L.M., Epler, M.E. (1998). Fundamentals of Musculoskeletal Assessment Techniques. 2nd edn. Philadelphia, Lippincott, Williams & Wilkins.
Reid, R.W., Foley, J.M., Prior, B.M., Weingand, K.W., Meyer, R.A. (1999). Mild topical heat increses popliteal blood flow as measured by MRI. Med Sci Sports Exerc, 31(5), S208.
Rothstein, J.M., Miller, P.J., Roettger, R.F. (1983). Goniometric reliability in a clinical setting: Elbow and knee measurements. Phys Ther, 63(10), 1611-1615.
Ruggera, P. S., Witters, D.M., von Malzahn, G., Bassen, H.I. (2003). In vitro assessment of tissue heating near metallic implants by exposure to pulsed radio frequency diathermy. Phys Med Biol, 48, 2919-2928.
Seiger, C., Draper, D.O. (2006). Use of pulsed shortwave diathermy and joint mobilizations to increase ankle range of motion in the presence of surgical implanted metal: A case series. JOSPT, 36(9), 669-677.
Sekins, K.M., Lenmann, J.F., Esselman, P., Dundore, D., Emery, A.F., deLateur, B.J., Nelp, W.B. (1984). Local muscle blood flow and temperature responses to 915 Mhz diathermy as simultaneously measured and numerically predicted. Arch Phys Med Rehabil, 65, 1-7.
Shields, N., O’Hare, H., Gormley, J. (2004). Contra-indications to shortwave diathermy: survey of Irish physiotherapists. Physiotherapy, 90, 42-53.
Starkey, C., Ryan, J. (2010). Evaluation of Orthopedic and Athletic Injuries. 3rd edn. Philadelphia, F.A. Davis.
Talaat, A.M., El-Dibany, M.M., El-Garf, A. (1986). Physical therapy in the management of myofascial pain dysfunction syndrome. Ann Otol Rhinol Laryngol, 95, 225-228.
Wagstaff, P., Wagstaff, S., Downey, M. (1986). Apilot study to compare the efficacy of continuous and pulsed magnetic energy [shortwave diathermy] on the relief of low back pain. Physiotherapy, 72(11), 563-566.