Muscle Injury Prevention & Rehabilitation in Military Personnel
| Status: | Recruiting |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - 40 |
| Updated: | 5/14/2016 |
| Start Date: | March 2014 |
| End Date: | March 2017 |
| Contact: | Donovan J Lott, PT, PhD |
| Email: | djlottpt@phhp.ufl.edu |
| Phone: | 352-273-9226 |
The overall goal of this study is to establish a new pre-rehabilitation program in the
prevention of muscle injury in the legs of healthy people serving in the military and
injured individuals with muscle wasting following leg injuries. The specific goals include:
1) the amount of exercise that causes injury to healthy muscle in the lower leg of healthy
people; 2) what is the effect of an intervention (pre-rehabilitation program) on decreasing
how easily the muscle of the lower leg can be injured in healthy people; 3a) what amount of
exercise causes injury to muscle that has recently been injured and is recovering and 3b)
the effect of the new pre-rehabilitation program on the muscles of the lower leg when the
muscle has recently been injured and is still recovering.
For the first goal, the investigators will determine how easily the muscle can get injured
from a specific exercise in 6 healthy, conditioned men and women. Participants will perform
different amounts of exercise with the lower leg muscles to see how easily the muscle can be
damaged. Magnetic resonance imaging (MRI) will be used to estimate how much damage occurs
with the different levels of exercise. For the second goal, the investigators will examine
the effect of a new pre-rehabilitation program on decreasing how easily muscle gets damaged
from the exercise we did in the first goal. The investigators will invite healthy people to
participate in this goal. The investigators will use MRI, blood markers, and pain as ways of
assessing muscle damage in 10 people who do the pre-rehabilitation program before exercising
and 10 who do not do the new program. The third goal will focus on a) determining how easily
muscle gets injured that has recently recovered from some trauma (5 people will participate
in this part of the third goal), and b) determining how a pre-rehabilitation program
decreases how easily a muscle that has just recovered from trauma gets injured from exercise
(10 people will participate in this part of the third goal).
prevention of muscle injury in the legs of healthy people serving in the military and
injured individuals with muscle wasting following leg injuries. The specific goals include:
1) the amount of exercise that causes injury to healthy muscle in the lower leg of healthy
people; 2) what is the effect of an intervention (pre-rehabilitation program) on decreasing
how easily the muscle of the lower leg can be injured in healthy people; 3a) what amount of
exercise causes injury to muscle that has recently been injured and is recovering and 3b)
the effect of the new pre-rehabilitation program on the muscles of the lower leg when the
muscle has recently been injured and is still recovering.
For the first goal, the investigators will determine how easily the muscle can get injured
from a specific exercise in 6 healthy, conditioned men and women. Participants will perform
different amounts of exercise with the lower leg muscles to see how easily the muscle can be
damaged. Magnetic resonance imaging (MRI) will be used to estimate how much damage occurs
with the different levels of exercise. For the second goal, the investigators will examine
the effect of a new pre-rehabilitation program on decreasing how easily muscle gets damaged
from the exercise we did in the first goal. The investigators will invite healthy people to
participate in this goal. The investigators will use MRI, blood markers, and pain as ways of
assessing muscle damage in 10 people who do the pre-rehabilitation program before exercising
and 10 who do not do the new program. The third goal will focus on a) determining how easily
muscle gets injured that has recently recovered from some trauma (5 people will participate
in this part of the third goal), and b) determining how a pre-rehabilitation program
decreases how easily a muscle that has just recovered from trauma gets injured from exercise
(10 people will participate in this part of the third goal).
A total of 26 healthy adults and 15 adults who have recently experienced muscle atrophy from
conservative treatment after an orthopedic lower leg/ankle/foot injury that did not require
surgery but did require immobilization will participate.
Magnetic resonance imaging (MRI) will be used to estimate how much damage occurs with the
different levels of exercise. The investigators will be using a T2 MR which has been shown
to be sensitive to injury of muscle damage.
There will be four groups in this protocol as outlined:
Healthy Muscle Group:
Six subjects will be enrolled in this group. MRI measures will be performed at baseline and
48 hours post-exercise, when the largest amount of muscle damage is typically observed. They
will be tested for maximum strength of the dorsiflexors and then undergo an eccentric
exercise protocol for both lower legs on the Biodex with varying loads. Approximately two
days after the exercise protocol, the participants will have another MRI of the lower legs
to assess any change in T2 relaxation time as a construct of muscle edema/damage.
Stretch-Contract Pre-rehabilitation Group All subjects will be tested initially with an MRI,
blood work for creatine kinase levels (CK), subjective report of pain, range of motion (ROM)
of the lower leg/ankle, and maximum strength of the dorsiflexors. They will also receive the
"stretch-contract" protocol on one leg consisting of the following: a 5 second passive
stretch of the dorsiflexors, followed immediately by a 5 second active isometric contraction
of the dorsiflexors, and a 5 second rest/relaxation period. This cycle will continue for a
duration of ~5 minutes.
Stretch-Contract Control Group All subjects will be tested initially with an MRI, blood work
for creatine kinase levels (CK), subjective report of pain, range of motion (ROM) of the
lower leg/ankle, and maximum strength of the dorsiflexors. This group will not receive the
"stretch-contract" protocol.
Muscle Atrophy These subjects will undergo MRI and strength testing at baseline and will
also be assessed for CK levels, pain report, and ROM. They will then receive an eccentric
loading paradigm for the dorsiflexor muscles of the involved leg using an isokinetic
dynamometer with varying loads.
All exercise testing will be performed on an isokinetic dynamometer by a physical therapist
who has received extensive training for this piece of exercise equipment.
conservative treatment after an orthopedic lower leg/ankle/foot injury that did not require
surgery but did require immobilization will participate.
Magnetic resonance imaging (MRI) will be used to estimate how much damage occurs with the
different levels of exercise. The investigators will be using a T2 MR which has been shown
to be sensitive to injury of muscle damage.
There will be four groups in this protocol as outlined:
Healthy Muscle Group:
Six subjects will be enrolled in this group. MRI measures will be performed at baseline and
48 hours post-exercise, when the largest amount of muscle damage is typically observed. They
will be tested for maximum strength of the dorsiflexors and then undergo an eccentric
exercise protocol for both lower legs on the Biodex with varying loads. Approximately two
days after the exercise protocol, the participants will have another MRI of the lower legs
to assess any change in T2 relaxation time as a construct of muscle edema/damage.
Stretch-Contract Pre-rehabilitation Group All subjects will be tested initially with an MRI,
blood work for creatine kinase levels (CK), subjective report of pain, range of motion (ROM)
of the lower leg/ankle, and maximum strength of the dorsiflexors. They will also receive the
"stretch-contract" protocol on one leg consisting of the following: a 5 second passive
stretch of the dorsiflexors, followed immediately by a 5 second active isometric contraction
of the dorsiflexors, and a 5 second rest/relaxation period. This cycle will continue for a
duration of ~5 minutes.
Stretch-Contract Control Group All subjects will be tested initially with an MRI, blood work
for creatine kinase levels (CK), subjective report of pain, range of motion (ROM) of the
lower leg/ankle, and maximum strength of the dorsiflexors. This group will not receive the
"stretch-contract" protocol.
Muscle Atrophy These subjects will undergo MRI and strength testing at baseline and will
also be assessed for CK levels, pain report, and ROM. They will then receive an eccentric
loading paradigm for the dorsiflexor muscles of the involved leg using an isokinetic
dynamometer with varying loads.
All exercise testing will be performed on an isokinetic dynamometer by a physical therapist
who has received extensive training for this piece of exercise equipment.
Inclusion Criteria:
Inclusion criteria for control subjects [primary target being Reserve Officer Training
Corps (ROTC) personnel]: 1) healthy individuals ages 18-40 years; and 2) ankle range of
motion for the leg to be tested from 0 degrees of plantarflexion to 30 degrees of
plantarflexion.
Exclusion criteria for control subjects (primary target being ROTC personnel): 1) previous
history of trauma and/or surgery to the lower extremities that may limit function; 2)
neurological, vascular, or cardiac problems that may limit function; 3) diabetes; 4)
previous traumatic head injury or post-traumatic stress disorder; 5) a contraindication to
MRI e.g.: pacemakers, metal implants which are not MRI compatible, pregnancy, and severe
claustrophobia; and 6) currently performing an exercise program that specifically targets
the dorsiflexor muscles.
Inclusion criteria for subjects with muscle atrophy: 1) individuals ages 18-40 years with
an injury to the lower leg requiring immobilization but no surgical intervention; and 2)
ankle range of motion for the leg to be tested from 0 degrees of plantarflexion to 30
degrees of plantarflexion.
Exclusion criteria for subjects with muscle atrophy: 1) previous history of trauma and/or
surgery to the lower extremities, other than the injury for being immobilized, that may
limit function; 2) neurological, vascular, or cardiac problems that may limit function; 3)
orthopedic conditions affecting the contralateral, uninvolved lower extremity that may
limit function; 4) diabetes; 5) previous traumatic head injury or post-traumatic stress
disorder; and 6) a contraindication to MRI e.g.: pacemakers, metal implants which are not
MRI compatible, pregnancy, and severe claustrophobia.
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