Assessment of exercise-induced minor muscle lesions: the accuracy of Cyriax's diagnosis by selective tension paradigm.

The Cyriax selective tension assessment paradigm is commonly used by clinicians for the diagnosis of soft tissue lesions; however, studies have not demonstrated that it is a valid method. The purpose of this study was to examine the construct validity of the active motion, passive motion, resisted movement, and palpation components of the Cyriax selective tension diagnosis paradigm in subjects with an exercise-induced minor hamstring muscle lesion. Nine female subjects with a mean age of 23.6 years (SD = 4.7) and a mass of 57.3 kg (SD = 10.7) performed two sets of 20 maximal eccentric isokinetic knee flexor contractions designed to induce a minor muscle lesion of the hamstrings. Active range of motion, passive range of motion, knee extension end-feel pain relative to resistance sequence, knee flexor isometric strength, pain perception during knee flexor resisted movement testing, and palpation pain of the hamstrings were assessed at 0, 5, 2, 12, 24, 48, and 72 hours postexercise and compared with Cyriax's hypothesized selective tension paradigm results. Consistent with Cyriax's paradigm, passive range of motion remained unchanged, and perceived pain of the hamstrings increased with resistance testing at 12, 24, 48, and 72 hours postexercise when compared with baseline. In addition, palpation pain of the hamstrings was significantly elevated at 48 and 72 hours after exercise (p < 0.05). In contrast of Cyriax's paradigm, active range of motion was significantly reduced over time (p < 0.05), with the least amount of motion compared to baseline (85%) occurring at 48 hours postexercise. Further, resisted movement testing found significant knee flexor isometric strength reductions over time (p < 0.05), with the greatest reductions (33%) occurring at 48 hours postexercise. According to Cyriax, when a minor muscle lesion is tested, it should be strong and painful; however, none of the postexercise time frames exhibited results that were strong and painful. This study suggests that the validity of using Cyriax's selective tension testing for the diagnosis of exercise-induced minor muscle lesions is questionable.

Effects of isokinetic soreness-inducing exercise on blood levels of C-reactive protein and creatine kinase.

This study examined whether acute inflammation was the mechanism underlying delayed muscle soreness (DMS) by assessing the effect of soreness-inducing exercise on blood levels of C-reactive protein (CRP), an acute inflammation marker. Sixteen female college students (= 20.6 +/- 2.6 years) performed three sets of 35 isokinetic contractions of the knee flexors and extensors at 120 degrees /set on a Biodex isokinetic dynamometer. Group 1 (N = 8) exercised eccentrically and Group 2 (N = 8) concentrically at an intensity of 80% of a concentric 120 degrees /set peak torque. Pre-exercise and 1, 24, 48 and 72 hours postexercise, DMS of the quadriceps femoris (QF) and hamstrings (HA) were assessed and blood samples were collected for creatine kinase (CK), an indicator of muscle damage, and CRP, which was measured by a radial immunodiffusion procedure. The mean CK values 72 hours postexercise were 14,856 and 360 IU/L for groups 1 and 2, respectively. No significant elevations of CRP occurred in either group. ANOVAs using a split plot factorial design found Group 1 to have significantly larger logarithmic CK elevations, ranked QF soreness, and ranked HA soreness than Group 2. In contrast to myocardial infarct patients and marathon runner investigations, this study did not demonstrate abnormal elevations of CRP when increases in CK were induced. With high-repetition submaximal isokinetic exercise, eccentric contractions induce higher levels of muscle damage and DMS than concentric contractions. Further, the hamstrings are more susceptible to DMS than the quadriceps femoris when eccentric isokinetic exercise is performed at the same relative intensity. J Orthop Sports Phys Ther 1992;16(5):208-214.

How a hospital and university jointly recruit MTs-to-be.

This state university plugged into the PR program of a nearby hospital to recruit high school students for its undergraduate MT program. The hoped-for result: future laboratorians.

White blood cell response to uphill walking and downhill jogging at similar metabolic loads.

The object of this study was to determine whether leukocytosis would occur in response to eccentric exercise, to concentric exercise, and/or to possible increases in serum cortisol levels. Eight men performed 2 bouts of exercise at 46% VO2max for 40 min. Subjects initially walked up a 10% grade (UW); 2 weeks later they jogged down a 10% grade (DJ), a form of eccentric exercise known to induce delayed onset muscle soreness (DOMS). Venous blood samples were drawn before and after each exercise bout (0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, and 5 h). Total and differential WBCc and serum cortisol levels were assessed. Results were analyzed using repeated measures ANOVA (2 x 11). Subjects experienced severe DOMS after DJ. There was a significant difference in TWBCc (p less than 0.0001) between UW and DJ. Post-hoc testing revealed no significant increase over baseline values for UW; after DJ there was a 46% increase over baseline values (p less than 0.05) initially seen at 1.0 h. These increases in TWBCc were predominantly a reflection of increases in neutrophils which were significant (p less than 0.0001) when compared to baseline values at 1.0, 1.5 and 2.0 h (approximately 60%). No significant neutrophil increases were seen after UW. Cortisol levels were similar for both groups pre-exercise (UW = 367.1 +/- 38.6, DJ = 320.2 +/- 44.16 nmol.L-1 means +/- SE) and decreased similarly for both groups after exercise, and thus were not related to the post-exercise neutrophilia.(ABSTRACT TRUNCATED AT 250 WORDS)