ASSESSMENT OF EXERCISE-INDUCED MINOR MUSCLE LESIONS - THE ACCURACY OFCYRIAXS DIAGNOSIS BY SELECTIVE TENSION PARADIGM

The Cyriax selective tension assessment paradigm is commonly used by c linicians for the diagnosis of soft tissue lesions; however, studies h ave not demonstrated that it is a valid method. The purpose of this st udy was to examine the construct validity of the active motion, passiv e motion, resisted movement and palpation components of the Cyriax sel ective tension diagnosis paradigm in subjects with an exercise-induced minor hamstring muscle lesion, Nine female subjects with a mean age o f 23.6 years (SD = 4.7) and a mass of 57.3 kg (SD = 10.7) performed tw o sets of 20 maximal eccentric isokinetic knee flexor contractions des igned to induce a minor muscle lesion of the hamstrings. Active range of motion, passive range of motion, knee extension end-feel pain relat ive io resistance sequence, knee flexor isometric strength, pain perce ption during knee flexor resisted movement testing, and palpation pain of the hamstrings Mere assessed at 0,.5, 2, 12, 24, 48, and 72 hours postexercise and compared with Cyriax's hypothesized selective tension paradigm results. Consistent with Cyriax's paradigm, passive range of motion remained unchanged, and perceived pain oi the hamstrings incre ased with resistance testing at 12, 24, 48, and 72 hours postexercise when compared with baseline. In addition. palpation pain of the hamstr ings was significantly elevated at 48 and 12 hours after exercise (p < 0.05). In contrast to Cyriax's paradigm, active range of motion was s ignificantly reduced over time (p < 0.05), with the least amount of mo tion compared to baseline (85%) occurring al 48 hours postexercise. Fu rther, resisted movement testing found significant knee flexor isometr ic strength reductions over time (p < 0.05), with the greatest reducti ons (33%) occurring at 48 hours postexercise. According to Cyriax, whe n a minor muscle lesion is tested, it should be strong and painful; ho wever, none of the postexercise time frames exhibited results that wer e strong and painful. This study suggests that the validity of using C yriax's selective tension testing for the diagnosis of exercise-induce d minor muscle lesions is questionable.