Cryotherapy influences joint laxity and position sense of the healthy knee joint.
ABSTRACT 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.
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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ABSTRACT: Cryotherapy is commonly used in physical therapy with many known benefits; however several investigations have reported decreased functional performance following therapeutic application thereof. The purpose of this study was to determine the effect of cryotherapy applied to the ankle on static and dynamic standing balance. It was hypothesized that balance would be decreased after cryotherapy application. Twenty individuals (aged 18 to 40 years) participated in this research project. Each participant was tested under two conditions: an experimental condition where subjects received ice water immersion of the foot and ankle for 15 minutes immediately before balance testing and a control condition completed at room temperature. A Biodex® Balance System was used to quantify balance using anterior/posterior (AP), medial/lateral (ML), and overall balance indices. Paired t-tests were used to compare the balance indices for the two conditions with alpha set at 0.05 a priori. Effect size was also calculated to account for the multiple comparisons made. The static balance indices did not display statistically significant differences between the post-cryotherapy and the control conditions with low effect sizes. Dynamic ML indices significantly increased following the cryotherapy application compared to the control exhibiting a moderate effect size indicating decreased balance following cryotherapy application. No differences were noted between experimental and control conditions for the dynamic AP or overall balance indices while a small effect size was noted for both. The results suggest that cryotherapy to the ankle has a negative effect on the ML component of dynamic balance following ice water immersion. Immediate return to play following cryotherapy application is cautioned given the decreased dynamic ML balance and potential for increased injury risk. 3b Case-control study.International journal of sports physical therapy. 02/2013; 8(1):9-14.
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ABSTRACT: Applying ice or other forms of topical cooling is a popular method of treating sports injuries. It is commonplace for athletes to return to competitive activity, shortly or immediately after the application of a cold treatment. In this article, we examine the effect of local tissue cooling on outcomes relating to functional performance and to discuss their relevance to the sporting environment. A computerized literature search, citation tracking and hand search was performed up to April, 2011. Eligible studies were trials involving healthy human participants, describing the effects of cooling on outcomes relating to functional performance. Two reviewers independently assessed the validity of included trials and calculated effect sizes. Thirty five trials met the inclusion criteria; all had a high risk of bias. The mean sample size was 19. Meta-analyses were not undertaken due to clinical heterogeneity. The majority of studies used cooling durations > 20 minutes. Strength (peak torque/force) was reported by 25 studies with approximately 75% recording a decrease in strength immediately following cooling. There was evidence from six studies that cooling adversely affected speed, power and agility-based running tasks; two studies found this was negated with a short rewarming period. There was conflicting evidence on the effect of cooling on isolated muscular endurance. A small number of studies found that cooling decreased upper limb dexterity and accuracy. The current evidence base suggests that athletes will probably be at a performance disadvantage if they return to activity immediately after cooling. This is based on cooling for longer than 20 minutes, which may exceed the durations employed in some sporting environments. In addition, some of the reported changes were clinically small and may only be relevant in elite sport. Until better evidence is available, practitioners should use short cooling applications and/or undertake a progressive warm up prior to returning to play.Sports Medicine 11/2011; 42(1):69-87. · 5.24 Impact Factor
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ABSTRACT: The assessment of skin temperature (Tsk) in athletic therapy and sports medicine research is an extremely important physiological outcome measure. Various methods of recording Tsk, including thermistors, thermocouples and thermocrons are currently being used for research purposes. These techniques are constrained by their wires limiting the freedom of the subject, slow response times, and/or sensors falling off. Furthermore, as these products typically are directly attached to the skin and cover the measurement site, their validity may be questionable. This manuscript addresses the use and potential benefits of using thermal imaging (TI) in sport medicine research. Non-contact infrared TI offers a quick, non-invasive, portable and athlete-friendly method of assessing Tsk. TI is a useful Tsk diagnostic tool that has potential to be an integral part of sport medicine research in the future. Furthermore, as the technique is non-contact it has several advantages over existing methods of recording skin temperature. Keywords: infrared thermal imaging, skin temperature, sports medicine research, core temperature, physiological assessmentINTERNATIONAL SPORTMED JOURNAL 06/2013; 14(2):94-98. · 0.73 Impact Factor