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The Effect of Elevation on Volumetric Measurements of the Lower Extremity
Abstract
Background: The empirical evidence for the use of RICE (rest, ice, compression, elevation) has been questioned regarding its clinical effectiveness. The component of RICE that has the least literature regarding its effectiveness is elevation. Objective: The objective of this study was to determine if various positions of elevation result in volumetric changes of the lower extremity. Methodology: A randomized crossover design was used to determine the effects of the four following conditions on volumetric changes of the lower extremity: seated at the end of a table (seated), lying supine (flat), lying supine with the foot elevated 12 inches off the table (elevated), and lying prone with the knees bent to 90 degrees (prone). The conditions were randomized using a Latin Square. Each subject completed all conditions with at least 24 hours between each session. Pre and post volumetric measurements were taken using a volumetric tank. The subject was placed in one of the four described testing positions for 30 minutes. The change in weight of the displaced water was the main outcome measure. The data was analyzed using an ANOVA of the pre and post measurements with a Bonferroni post hoc analysis. The level of significance was set at P<.05 for all analyses. Results: The only statistically significant difference was between the gravity dependent position (seated) and all other positions (p <.001). There was no significant difference between lying supine (flat), on a bolster (elevated), or prone with the knees flexed to 90 degrees (prone). Conclusions: From these results, the extent of elevation does not appear to have an effect on changes in low leg volume. Elevation above the heart did not significantly improve reduction in limb volume, but removing the limb from a gravity dependent position might be beneficial.
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Elkins, E. C., Herrick, J. F., Grindlay, J. H., Mann, F. C., & De Forest, R. E. (1953). Effect of various procedures on the flow of lymph. Archives of Physical Medicine and Rehabilitation, 34(1), 31-39.
Greenwood, A., & Gillette, C. (2017). Effect of cold water immersion on metabolic rate in humans. International Journal of Kinesiology and Sports Science, 5(2), 1 - 6. doi:doi:10.7575/aiac.ijkss.v.5n.2p.1
Hargens, A. R. (1983). Fluid shifts in vascular and extravascular spaces during and after simulated weightlessness. Medicine & Science in Sports & Exercise, 15(5), 421-427.
Hirai, M., & Iwata, H. (2004). A comparison of physical methods for prophylaxis of deep vein thrombosis on augmentation of venous flow velocity and reduction of calf volume. Phlebology, 19(2), 72-76. doi:10.1258/026835504323080344
Jutte, L. S., Merrick, M. A., Ingersoll, C. D., & Edwards, J. E. (2001). The relationship between intramuscular temperature, skin temperature, and adipose thickness during cryotherapy and rewarming. Archives of Physical Medicine and Rehabilitation, 82(6), 845-850. doi:http://dx.doi.org/10.1053/apmr.2001.23195
Knight, K. (1995). Cryotherapy in sport injury management. Champaign, IL: Human Kinetics.
Merrick, M. A., Jutte, L. S., & Smith, M. E. (2003). Cold modalities with different thermodynamic properties produce different surface and intramuscular temperatures. Journal of Athletic Training, 38(1), 28-33.
Merrick, M. A., Knight, K. L., Ingersoll, C. D., & Potteiger, J. A. (1993). The effects of ice and compression wraps on intramuscular temperatures at various depths. Journal of Athletic Training, 28(3), 236-245.
Merrick, M. A., & McBrier, N. M. (2010). Progression of secondary injury after musculoskeletal trauma—A window of opportunity? Journal of Sport Rehabilitation, 19, 380-388.
Merrick, M. A., Rankin, J. M., Andres, F. A., & Hinman, C. L. (1999). A preliminary examination of cryotherapy and secondary injury in skeletal muscle. Medicine & Science in Sports & Exercise, 31(11), 1516-1521.
Otte, J. W., Merrick, M. A., Ingersoll, C. D., & Cordova, M. L. (2002). Subcutaneous adipose tissue thickness alters cooling time during cryotherapy. Archives in Physical Medicine and Rehabilitation, 83(11), 1501-1505. doi:http://dx.doi.org/10.1053/apmr.2002.34833
Prentice, W. E. (2009a). Arnheim's Principles of Athletic Training (13 ed.). Boston, MA: McGraw-Hill.
Prentice, W. E. (2009b). Arnheim's Principles of Athletic Training: A Competency-Based Approach (M. Ryan Ed. 13th ed.). New York, NY: McGraw-Hill.
Prentice, W. E. (2009c). Therapeutic Modalities for Sports Medicine and Athletic Training (6th ed.). Boston, MA: McGraw-Hill.
Prentice, W. E. (2011). Rehabilitation Techniques for Sports Medicine and Athletic Training (5th ed.). New York, NY: McGraw Hill.
Prentice, W. E. (2013). Essentials of Athletic Injury Management (10e ed.). New York, NY: McGraw-Hill.
Sims, D. (1986). Effects of positioning on ankle edema. The Journal of Orthopedic and Sports Physical Therapy, 8(1), 30-33.
van den Bekerom, M. P., Struijs, P. A., Blankevoort, L., Welling, L., van Dijk, C. N., & Kerkhoffs, G. M. (2012). What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? Journal of Athletic Training, 47(4), 435-443. doi:10.4085/1062-6050-47.4.14
Warren, P. J., Hardiman, P. J., & Woolf, V. J. (1992). Limb exsanguination. II. The leg: effect of angle of elevation. Annals of the Royal College of the Surgeons of England, 74(5), 323-325.
DOI: https://doi.org/10.7575/aiac.ijkss.v.5n.3p.1
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