College athletes with syndesmosis benefit more from e-stem or cryokinetics to help reduce pain with movement?
Cryokinetics is the use of alternating cold applications and active graded exercises for rehabilitating acute joint sprains such as syndesmosis. For any therapeutic modality dealing with cold (cryotherapy) the treatment of the application/substance such as: ice, whirlpool, ice massage, or game ready, etc. Should have an overall temperature lower than the body’s temperature for the treatment to be fully effective. The main benefit from cryotherapy is to decrease pain in the involved limb with injury and muscle spasms as well. If syndesmosis is undiagnosed or even mistreated the healing process of any injury would be postponed and/or could leave permanent damage to the affected site. The modality of cryokinetics could potentially be used too vigorous or not vigorously enough, because in doing so as a clinician you could delay the rehabilitation process of the patient. Within the article, “Rehabilitation of Syndesmotic High Ankle Sprains” talks about the anatomy of Syndesmosis and how exactly a patient would injury themselves to the types of special test used to differentiate the complexity of the injury if surgery is needed or not, and how one would carry out the treatment plan for their patients to reduce pain. In the article of, “Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis” its main purpose is to combine many different papers and determine an overview treatment plan for a high ankle sprain.
In the article of, “Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis” a total of 46 papers over strategies for treating ankle sprains were peer reviewed and graded using the AMSTAR. Each paper was graded for pain outcomes, swelling of joint after injury, NSAID, and rehabilitation modalities. High ankle sprains did benefit more from NSAIDS and cryokinetic of the limb to reduce pain, swelling, and gained function back. Although there was no clear statement saying estem or cryokinetics was better or worst at reducing the pain management for patients. There was a greater amount of research on cryokinetics with pain management therefore, at the end cryokinetics is the better modality to use. Although a lot of rehabilitation guidelines on syndesmosis sprains are largely based on clinical experience (Williams and Allen 2010).
The information gathered in both these articles I read will more then benefit in my future profession as a PT. I learned that there is certain special stress test I can perform to determine syndesmosis in a patient such as the squeeze test and external rotation (Kleiger). As I gain clinical experience in the workplace, I will become better at diagnosing my patients and creating rehabilitation plans for each patient that best suits their rehabilitative progress. Some limitations would include from the second article was that only one person gathered all the data, and most of there data they gathered were from the papers dating back to 2000 – 2010 nothing current. My PICO question dealt with college athletes, so that would be another limitation in this peer review none of the articles really focused on college athletes or young adults. In conclusion, both of the articles I read did help me answer my PICO question. Cryokinetics does help reduce the amount of pain with movement and gets the athlete back to play.
Williams, G. N., ; Allen, E. J. (2010). Rehabilitation of Syndesmotic (High) Ankle Sprains.
Sports Health: A Multidisciplinary Approach, 2(6), 460-470. doi:10.1177/1941738110384573
Doherty, C., Bleakley, C., Delahunt, E., ; Holden, S. (2016). Treatment and prevention of acute and
recurrent ankle sprain: An overview of systematic reviews with meta-analysis. British Journal of Sports Medicine, 51(2), 113-125. doi:10.1136/bjsports-2016-096178