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.
SourceAvailable from: Mariusz Paweł Furmanek[Show abstract] [Hide abstract]
ABSTRACT: Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception.BioMed Research International 11/2014; 2014(2014):1-14. DOI:10.1155/2014/696397 · 2.71 Impact Factor
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ABSTRACT: Context : Persistent muscle weakness after anterior cruciate ligament (ACL) reconstruction may be due to underlying activation failure and (AMI). Knee-joint cryotherapy has been shown to improve quadriceps function transiently in those with AMI, thereby providing an opportunity to improve quadriceps muscle activation and strength in patients with a reconstructed ACL. Objectives : To compare quadriceps muscle function in patients with a reconstructed ACL who completed a 2-week intervention including daily cryotherapy (ice bag), daily exercises, or both. Study Design : Cross-sectional study. Methods : A total of 30 patients with reconstructed ACLs who were at least 6 months post-index surgery and had measurable quadriceps AMI (central activation ratio less than 90%) attended 4 supervised visits over a 2-week period. Patients were randomly assigned to receive 20 minutes of knee-joint cryotherapy, 1 hour of therapeutic rehabilitation exercises, or cryotherapy followed by exercises. We measured quadriceps Hoffmann reflex, normalized maximal voluntary isometric contraction torque, central activation ratio using the superimposed-burst technique, and patient-reported outcomes before and after the intervention period. Results : After the 2-week intervention period, patients who performed rehabilitation exercises immediately after cryotherapy had higher normalized maximal voluntary isometric contraction torques (P = .002, Cohen d effect size = 1.4) compared with those who received cryotherapy alone (P = .16, d = 0.58) or performed exercise alone (P = .16, d = 0.30). Conclusions : After ACL reconstruction, patients with AMI who performed rehabilitation exercises immediately after cryotherapy experienced greater strength gains than those who performing cryotherapy or exercises alone.Journal of athletic training 10/2014; 49(6). DOI:10.4085/1062-6050-49.3.39 · 1.51 Impact Factor
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ABSTRACT: Abstract The purpose of this study was to identify the influence of cryotherapy on lower extremity running biomechanics. Twenty-six healthy male volunteers were randomised into two intervention groups: cold water (cold water at ~11°C) or tepid water (tepid water at ~26°C). They were required to run at 4.0 ± 0.2 m · s(-1) before and after they underwent water immersion for 20 min. Differences between pre- and post-intervention were used to compare the influence of water intervention during running. Peak joint angles, peak joint moments, peak ground reaction forces (GRF) and contact time (CT) were calculated using three-dimensional gait analysis. Independent t-tests were applied with a significant alpha level set at 0.05. Decreased peak propulsive and vertical GRF, decreased plantarflexion moments, increased hip flexion angle and longer CT were observed following cold water immersion. Although cold water immersion (cryotherapy) affected the running movement, none of the alterations have been related to running biomechanical patterns associated with injuries. Therefore, our results indicated that cold water immersion appears safe prior to running activities.Journal of Sports Sciences 09/2014; DOI:10.1080/02640414.2014.946952 · 2.10 Impact Factor