Effects of Neuromuscular Electrical Stimulation on Ankle Swelling

Effects of Neuromuscular Electrical Stimulation on Ankle Swelling in the Early Period After Ankle Sprain Ivy OW Man, Matthew Morrissey, Jozef Cywinski

Purpose l To test the effects of motor-level biphasic ES applied to the gastrocnemius and tibialis anterior muscles on ankle swelling in patients with in 5 days of an ankle sprain injury. Inflammation is the greatest enemy of healing l The goal of early treatment should be to delay or minimize swelling l NMES causes muscle contraction- this compresses the venous and lymphgatic vessels l

Methods l l l 34 subjects 18 to 60 years old Ankle sprain with in 5 days of first scheduled test Invitation Those excluded from experiment: l Diabetics l Peripheral vascular disease or neurovascular deficits l Metal implants in the leg l Injury to other ankle l Open wounds l pacemaker l Three Groups: NMES l Submotor ES l Sham (control) l Randomly assigned l Medical history was documented l

Experimental Protocol Height/ body mass measured l Ankle girth- figure-of-eight tape measuring technique l Blind bilateral girth measurements taken l Volumeter- used to measure swelling l

Continuing l Dried leg and put 4 electrodes Gastrocnemius l Tibialis anterior l Supine l Injured leg elevated l ES pattern for NMES and Submotor group: l 360 cycles l Lasting 5 seconds l 400 pulses each cycle l Frequency- 80 Hz causing a short lasting muscle contraction for 1. 25 sec. (bursts) l Bursts-every 5 sec. frequency of pulses varying from 45 to 120 Hz l Last phase- 77 seconds after starting the machinel Frequencey 2. 68 to 83. 33 Hz l Lasting 40 to 180 microseconds l

The groups l NMESl l Max level of tolerance for 30 minutes Submotor. Intensity increased until muscle flickered and then intensity was reduced very slightly until flicker disappeared l Subject should still have some sensation l l Sham – Same manner as other two l Electrodes attached but no ES was applied l

Results Statistical differences were found, but these findings may not be meaningful because there was a statistically significant difference in ankle girth measurements taken at baseline among the three groups. l P>. 05 for Hughston Clinic Subjective Rating Scale for Ankle Disorders l l l For girth Kruskall-Wallis analyses l Volume

l For graphs see Word

Athletic training- gives us free range to continue to experiment on the best ways to reduce swelling for a particular injury l NMES reduces swelling on the ankle, Different size ankles with NMES is a factor in how fast swelling of an injury is reduces l