Theodosopoulos P, Raymer G, Allman B, Luke A, and Marsh G; School of Kinesiology, The University of Western Ontario, and the Lawson Health Research Institute, London, Ontario. Department of Rehabilitation Science, University at Buffalo, The State University of New York, Buffalo, NY pt22@buffalo.edu.

It has been suggested that chronic anterior exertional compartment syndrome (CAECS) is caused by a less distensible fascia preventing the normal increases in muscle size during exercise leading to a raised intramuscular pressure and symptoms associated with compression. We hypothesized that smaller changes in the size of the anterior compartments would occur following exertion of anterior compartment muscles in individuals with CAECS. PURPOSE: To test this hypothesis, MR Imaging was used to investigate the changes in anterior compartment cross-sectional area (CSA) of people with CAECS and healthy controls after a progressive resistive dorsiflexion exercise test. SUBJECTS: Individuals with CAECS (n = 3) and asymptomatic controls (n = 5) were matched according to age, activity and frequency level, and body mass index. METHODS: People with CAECS and controls completed a progressive resistance dorsiflexion exercise and treadmill run test until symptomatic pain or volitional fatigue. Pain and fatigue scores were collected sequentially throughout rest, exercise, and recovery. Magnetic resonance images were collected at rest and at 5 minutes of recovery. A cross-section of the leg was taken using a multi-echo multi-segmented (MEMS) sequence and cross-sectional area for each anterior compartment was manually traced and acquired from Analyze imaging software. ANALYSIS: An independent t-test was used to compare changes in anterior compartment CSA and pain and fatigue scores within and between groups and a Pearson correlation was used to determine the relationship between CAECS intracompartmental pressure measurements and CSA. All intracompartmental measurements were determined by the slit catheter method. RESULTS: Normalized CSA between groups at recovery indicated that the change in anterior compartment CSA in the CAECS group was 44% less compared to the normal group. A negative correlation (r = -0.93) between CAECS intracompartmental measures and CSA pre and post –exercise suggest a less distensible compartment fascia. Furthermore, CAECS pain and fatigue scores were found to be significantly higher after five minutes of recovery compared to the control group (p < 0.05). CONCLUSIONS: The results of this preliminary study indicate that a less distensible fascia is a factor in the development of symptoms of CAECS. FUNDING SOURCE: London Health Sciences.

Copyright 2004 by the American Physical Therapy Association

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