Contrast Therapy and Heat Therapy in Subacute Stage of Grade I and II Lateral Ankle Sprains.

UNLABELLED: Objective This study was conducted to determine the most effective thermal modality; heat or contrast therapy-in reducing pain, reducing swelling, and increasing range of movement (ROM) of the grade I and II lateral ankle sprain in the prechronic stage of the subacute phase. Design Randomized control trail. Methods One hundred and fifteen participants of both genders who were diagnosed as having grade I or II lateral ankle sprain were randomly assigned to the study on the fifth day of injury. Pain, volume, and ROM were recorded before and after treatment continuously for 3 days. Results Effects were evaluated as "Immediately after application" and "3 days after continuous application." Immediately after application, there was no difference between the 2 modalities on ankle ROM; heat reduced pain over contrast therapy, and both modalities increased swelling. When considering the effects after continuous application for 3 days, no difference was found between the 2 modalities on ROM and the reduction of pain. Contrast therapy reduced swelling while heat caused increased swelling even after 3 days. Conclusion The use of different thermal modalities during the transition from the acute to chronic phase of injury can be suggested as effective treatment options according to the objectives of injury management: pain reduction, improve ROM, and swelling management. LEVELS OF EVIDENCE: Therapeutic, Level II: Randomized clinical trial.

Prevalence of behavioral and emotional problems among seven to eleven year old children in selected schools in Kandy District, Sri Lanka.

BACKGROUND: Behavioral and emotional problems comprising internalizing, externalizing and mixed disorders consist of psychiatric disorders in childhood and adolescents. Prevalence rates of 8.3% for preschoolers, 12.2% for preadolescents and 15.0% for adolescents have been reported from around the world. This study aimed to measure the prevalence of emotional and behavioral disorders in 7-11 year-old school children studying in Kandy District Sri Lanka which was a first for the geographic area. METHOD: This was a community based study at the primary section of the selected schools. The questionnaire, Child behavior Checklist-Sinhala (CBCL-S) was administered in a group setting to the main caregiver of 562 subjects selected randomly. The questionnaire identified problems in 8 subscales under three main sub categories : internalizing, externalizing and other. Data were analyzed using The Syndrome Scales for Boys and Girls developed for analyzing the questionnaire CBCL. RESULTS: Indicated a prevalence of 13.8% of emotional and behavioral problems in the study population. 8.8% of children showed internalizing problems and 8.8% externalizing problems. These findings are in line with the prevailing rates from previous studies of the world. Children in school types 1AB and 1C had less emotional and behavioral problems compared to type 2 and 3 schools. LIMITATIONS: Only 20 schools in KEZ and Sinhala speaking population of the Kandy were studied. CONCLUSIONS: This study showed the extent of childhood emotional and behavioral problems and also confirms that the schools with advanced level classes have lesser problems amongst primary children.