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  • C o m b i n e d S e c t i o n s M e e t i n g

    a58 | january 2017 | volume 47 | number 1 | journal of orthopaedic & sports physical therapy

    C o m b i n e d S e c t i o n s M e e t i n g

    UE grip/pinch strength and axial loading tolerance in all limbs. DISCUSSION: Prior literature suggests that SD can lead to decreased pain in treated limbs; however, changes in untreated painful areas have not been documented. After 10 weeks of SD, this spinal cord injured patient showed notable reductions in pain intensity, distribution, and allodynia in both treated and untreated limbs. Somatosensation in proximal, nonpain- ful areas normalized as pain decreased in more distal areas. These find- ings suggest central neuroplastic changes may occur from SD treatment, perhaps involving normalization of representation of affected and unaf- fected areas in the neuromatrix. REFERENCES: Freedman M, Greis A, Marino L, Sinha A, Henstenburg J. Complex regional pain syndrome: diagnosis and treatment. Phys Med Rehabil Clin N Am. 2014;25:291-303. Barnhoorn KJ, Oostendorp RA, van Dongen RT, et al. The effectiveness and cost evaluation of pain ex- posure physical therapy and conventional therapy in patients with com- plex regional pain syndrome type 1. Rationale and design of a random- ized controlled trial. BMC Musculoskelet Disord. 2012;13:58. Allen RJ, Soterakopoulos C, Fugere KJ, et al. Pain distribution quantification using enhanced ‘rule-of-nines’: reliability and correlations with intensity, sen- sory, affective, and functional pain measures. Physiother. 2011;97:309. Allen R. Multimodal allodynia treated with somatosensory specific de- sensitization in patients with complex regional pain syndrome. Eur J Pain. 2009;13:144-145. Allen R. Physical agents used in the manage- ment of chronic pain by physical therapists. Phys Med Rehabil Clin N Am. 2006;17:315-345. Taub E, Uswatte G, Mark VW, Morris DM. The learned nonuse phenomenon: implications for rehabilitation. Eura Medicophys. 2006;42:241-256.

    OPO2 MANUAL THERAPY INTERVENTIONS FOR ADOLESCENT TO COLLEGIATE-AGED INDIVIDUALS WITH POSTCONCUSSION DISORDER: A RAPID REVIEW Jordan E. Allison, Chris A. Sebelski Department of Physical Therapy and Athletic Training, Saint Louis University, St Louis, Missouri; SLU-SSM Physical Therapy Orthopedic Residency, St Louis, Missouri PURPOSE/HYPOTHESIS: The purpose of this rapid review was to examine current literature related to manual therapy interventions for adolescent to collegiate-aged individuals with postconcussion disorder (PCD) with persistent headache, neck pain, or dizziness. NUMBER OF SUBJECTS: Not applicable. MATERIALS/METHODS: Eligible studies included randomized-controlled

    Orthopaedic Section Abstracts: Poster Presentations

    OPO1-OPO243 The abstracts below are presented as prepared by the authors.

    The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract,

    OPO designates an Orthopaedic Section poster presentation.

    OPO1 EFFECTS OF DESENSITIZATION ON PAIN DISTRIBUTION AND NORMALIZATION OF SOMATOSENSATION IN A PATIENT WITH QUADRILATERAL COMPLEX REGIONAL PAIN SYNDROME Roger J. Allen, Lisa J. Cook, Dullen R. Kristen, Jacob N. Hoffman, Megan A. Vento Physical Therapy, University of Puget Sound, Tacoma, Washington BACKGROUND AND PURPOSE: Complex regional pain syndrome (CRPS) is a chronic condition affecting 1 or more extremities that can develop after injury, involving constant limb pain, allodynia, and hyperpathic autonom- ic and somatic symptoms. Somatosensory desensitization (SD) has long been considered essential in CRPS treatment, yet efficacy evidence re- mains limited. This study’s aim was to assess pain intensity and distribu- tion differences between treated and untreated limbs, as well as potential somatosensory normalization of proximal nonpainful limb regions, fol- lowing 10 weeks of SD in a patient with quadrilateral CRPS. CASE DESCRIPTION: The patient was a 54-year-old male with incomplete C5 SCI. Eighteen months of physical therapy yielded nearly full func- tional unassisted mobility, yet constant searing pain and tactile allodyn- ia developed in all extremities. Prior to seeking SD therapy, the patient experienced constant pain for 5 years following type II CRPS diagnosis. Quadrilateral involvement afforded an opportunity to desensitize 1 up- per and 1 lower limb, allowing outcome assessment of treated and un- treated limbs. During a 10-week treatment, the patient was exposed to progressively coarser materials via self-massage BID with weekly stimu- lus progression. Pain body diagrams (PBD) were completed pre and post SD and at 7-month follow-up. Changes in limb pain extent were quan- tified with pain distribution score (PDS) calculations applied to PBDs. Outcome measures taken weekly and at the 7-month follow-up on each limb included visual analog pain scale (VAS) and allodynia assessments via algometry. Semmes Weinstein monofilaments and 2-point discrimi- nation were used to assess somatosensory changes to affected and unaf- fected limb areas. OUTCOMES: Overall PDS decreased by 23.5%, with reductions of 9.5% for treated and 14.0% for untreated limbs. VAS scores for the treated limbs decreased by 5.5 cm UE and 2.4 cm LE, with reductions of 0.3 cm and 1.2 cm for the untreated UE and LE, respectively. Monofilament and 2-point discrimination testing revealed pretreatment subnormal somatosenso- ry thresholds and acuity of proximal nonpainful limb areas, that subse- quently normalized with corresponding reductions in distal pain. Other posttreatment changes included reduced allodynia and improvements in

    47-01 CSM Ortho Posters.indd 58 12/22/16 5:20 AM

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  • C o m b i n e d S e c t i o n s M e e t i n g

    journal of orthopaedic & sports physical therapy | volume 47 | number 1 | january 2017 | a59

    C o m b i n e d S e c t i o n s M e e t i n g

    trials, meta-analyses, prospective and retrospective comparative co- hort studies, case series, and case reports examining the use of man- ual therapy for treatment in adolescent to collegiate-aged individu- als with PCD. Standardized search terms were used to search PubMed, Scopus, CINAHL Plus with full text, SPORTDiscus with full text and the Cochrane Library. Grey literature included conference, symposium and website data from the American Academy of Orthopaedic Manual Physical Therapists, the North American Institute of Orthopedic Manual Therapy and the Maitland-Australian Physiotherapy Seminars. Inclusion criteria: literature published from 2006 to present, incorporation of man- ual therapy as defined by the American Physical Therapy Association and participants 13 to 26 years old. Exclusion criteria: studies specific to acute concussion management and those not including manual thera- py interventions. Study level of evidence was assessed using criteria from the Centre for Evidence-Based Medicine, for prospective and therapeu- tic studies. RESULTS: Three hundred eighty-three studies were retrieved. After dupli- cates removed, 260 titles/abstracts were reviewed and 30 full-text arti- cles were assessed for eligibility. Five of the 30 studies were eligible, and assessed for level of evidence. Four of the studies were case studies/series (level 4 evidence) and 1 was a randomized controlled trial, (level 1b evi- dence). One of 5 studies evaluated the effects of manual therapy interven- tion in isolation, whereas the remaining 4 studies utilized a multimod- al approach including manual therapy. Based on this rapid review, these studies concluded that integration of manual therapy for management of individuals with PCD improves neck pain, dizziness, and headache, and facilitates a quicker return to athletic competition. CONCLUSIONS: This rapid review included 5 studies of individuals with PCD and the associated symptoms of neck pain, headache and dizziness. A multimodal approach, including manual therapy interventions, is an ef- fective way to decrease neck pain, headache and/or dizziness associated with PCD. There is a paucity of literature available at this time specific to manual therapy interventions for those with PCD. CLINICAL RELEVANCE: Based on the limited evidence available, manual ther- apy interventions are a safe and effective mode of treatment for individu- als suffering from PCD. Further investigation is required to validate this conclusion.

    OPO3 CROSS-CULTURAL ADAPTATION AND PSYCHOMETRIC PROPERTIES TESTING OF THE ARABIC ANTERIOR KNEE PAIN SCALE Abdullah Alshehri Loma Linda University, Riyadh, Saudi Arabia PURPOSE/HYPOTHESIS: The purpose of this study was to translate, develop a cross-cultural adaptation, and examine validity, test-retest reliability and feasibility of the Arabic version of the Anterior Knee Pain Scale (AKPS) in patients with Patellofemoral Pain Syndrome (PFPS). NUMBER OF SUBJECTS: Fo

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