Cryotherapy influences joint laxity and position sense of the healthy knee joint

Department of Orthopaedics, Shimane Medical University, Izumo-shi, Shimane-ken, Japan.
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.57). 01/2003; 84(1):131-5. DOI: 10.1053/apmr.2003.50074
Source: PubMed


To investigate the influences of cryotherapy on the anteroposterior (AP) laxity and the joint position sense of the knee.
University hospital in Japan.
Twenty healthy volunteers (10 men, 10 women; age range, 21-28y) were analyzed.
Not applicable.
A cooling pad was applied to the knee for 15 minutes under the circulating medium at 4 degrees C. The subject's skin temperature over the anteromedial aspect of the knee was measured during the 15 minutes of cooling and again 15 minutes later. The accuracy of the knee joint position sense was evaluated before and after cooling by using a modified Skinner's method. AP displacement and anterior terminal stiffness (ATS) of the knee were obtained with a KT-2000 trade mark knee arthrometer.
Total (AP) laxity and anterior knee laxity decreased by 1.0 and 1.2mm after 15 minutes of cooling (P=.003, P=.017), respectively. ATS and inaccuracy of position sense increased by 21N/mm and 1.7 degrees (P<.001, P=.003), respectively. All parameters had normalized at 15 minutes postcooling.
Cooling for 15 minutes makes the knee joint stiffer and lessens the sensitivity of the position sense. These findings may be significant and should be taken into account for therapeutic programs that involve exercise immediately after a period of cooling.

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    • "Studies on the ankle (Hopper, Whittington & Davis, 1997; La Riviere & Osternig, 1994) and the shoulder (Wassinger, Myers, Gatti, Conley & Lephart, 2007; Dover & Powers, 2004) have also shown conflicting results. Reductions in JPS are commonly assessed clinically to identify proprioceptive deficits these may indicate that an individual is at risk of injury (Uchio et al. 2003; Bleakley, McDonough & MacAuley, 2006; Zazulak, Hewett, Reeves, Goldberg & Cholewicki, 2007; Wassinger et al. 2007; Surenkok et al., 2008; Costello & Donnelly, 2010). It is supported by "
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    ABSTRACT: Objectives The effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play or activity immediately following cryotherapy application at the knee. The aim of this study was to investigate whether a 20 minute application of crushed ice at the knee immediately affects knee joint position sense during a small knee bend. Design Pre and post-intervention. Setting University movement analysis laboratory. Participants Eleven healthy male participants. Main Outcome Measures Kinematics of the knee were measured during a weight bearing functional task pre and post cryotherapy intervention using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden). Tissue cooling was measured via a digital thermometer at the knee. Results Results demonstrated significant reductions in the ability to accurately replicate knee joint positioning in both sagittal (P=.035) and coronal (P=.011) planes during the descent phase of a small knee bend following cryotherapy. Conclusion In conclusion a twenty minute application of crushed ice to the knee has an adverse effect on knee joint repositioning. Team doctors, clinicians, therapists and athletes should consider these findings when deciding to return an athlete to functional weight bearing tasks immediately following ice application at the knee, due to the potential increase risk of injury.
    Physical Therapy in Sport 06/2015; DOI:10.1016/j.ptsp.2015.06.004 · 1.65 Impact Factor
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    • "This research was carried out to earn a PhD degree in Rehabilitation and Functional Performance, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. control is altered (Uchio et al., 2003). For this reason , more discussion on the immediate return to sporting activities is necessary. "
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    ABSTRACT: The purpose of this study was to evaluate the effects of cold-water immersion on the electromyographic (EMG) response of the lower limb and balance during unipodal jump landing. The evaluation comprised 40 individuals (20 basketball players and 20 non-athletes). The EMG response in the lateral gastrocnemius, tibialis anterior, fibular longus, rectus femoris, hamstring and gluteus medius; amplitude and mean speed of the centre of pressure, flight time and ground reaction force (GRF) were analysed. All volunteers remained for 20 min with their ankle immersed in cold-water, and were re-evaluated immediately post and after 10, 20 and 30 min of reheating. The Shapiro-Wilk test, Friedman test and Dunn's post test (P < 0.05) were used. The EMG response values decreased for the lateral gastrocnemius, tibialis anterior, fibular longus and rectus femoris of both athletes and non-athletes (P < 0.05). The comparison between the groups showed that the EMG response was lower for the athletes. Lower jump flight time and GRF, greater amplitude and mean speed of centre of pressure were predominant in the athletes. Cold-water immersion decreased the EMG activity of the lower limb, flight time and GRF and increased the amplitude and mean speed of centre of pressure.
    Journal of Sports Sciences 06/2015; DOI:10.1080/02640414.2015.1054861 · 2.25 Impact Factor
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    • "In physiotherapy clinical practice, it is very common to use thermal agents, such as cryotherapy (CR) and short-wave diathermy (SWD), prior to performing exercises at different levels of muscular contraction. The cryotherapy decreases skin and muscle temperature (Rupp et al., 2012) and when applied before exercises, may result in inadequate peripheral feedback on the position sense and may change biomechanical properties of the joint (Hopper et al., 1997; Uchio et al., 2003). SWD is a deep heat modality, which can reach the muscle tissue (Garret et al., 2000), but its effect on the mechanical function of active musculotendons is not well understood (Mitchell et al., 2008). "
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    ABSTRACT: The objective of this study was to assess electromyographic features of the brachial biceps muscle after the application of cryotherapy and short-wave diathermy. Sixty healthy volunteers participated in the study and were equally divided into three groups: cryotherapy – application of ice packs for 30 minutes; short-wave diathermy for 20 minutes; and control. The thermal agents were applied to the anterior and posterior regions of the non-dominant arm. The electromyographic (EMG) signal from the brachial biceps was recorded before and after the application of thermal agents during flexion of the elbow joint at 25%, 50%, 75% of a maximum voluntary isometric contraction defined at least two days before the actual experiments (MVICbl). The volunteers also were asked to execute a free MVIC before and after the application of the thermal agents (MVICfree). A linear regression model with mixed effects (random and fixed) was used. Intra-group analysis showed a reduction in root mean square (RMS) at MVICfree, with no change in the median frequency of the EMG signal at any contraction level for the short-wave diathermy group. An increase on RMS values and a decrease on median frequencies were found after the application of cryotherapy for all contraction levels. The results imply that cryotherapy plays an important role on changing neuromuscular responses at various levels of muscle contraction. Therapists should be aware of that and carefully consider its use prior to activities in which neuromuscular precision is required.
    Journal of Electromyography and Kinesiology 12/2014; 24(6). DOI:10.1016/j.jelekin.2014.07.013 · 1.65 Impact Factor
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