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

ArticleinArchives of Physical Medicine and Rehabilitation 84(1):131-5 · January 2003with34 Reads
DOI: 10.1053/apmr.2003.50074 · Source: PubMed
Abstract
To investigate the influences of cryotherapy on the anteroposterior (AP) laxity and the joint position sense of the knee. Experimental. 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.
    • "Just as with knee extension, subjects performed contractions more explosively between 0-30 ms under warm environmental conditions , which is confirmed by a significant within-subject contrast (r = 0.99, p = 0.037). Uchio, et al., 2003). At the same time, the warm clothing provided to insulate the head and torso helped to keep body core temperature relatively constant (see Table 1). "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives This study aimed to investigate temperature-related changes in different neuro-muscular parameters, to elucidate the reasons for the increased likeliness of injuries of the anterior cruciate ligament under cold environmental conditions. Design Repeated measures study design. Methods To induce peripheral cooling of the knee joint and thigh muscles, ten healthy, female subjects underwent 30 min of exposure to a cold environment. Both knee extensor and flexor muscles were examined for electromyographic activity, maximum voluntary contraction strength, rate of force development and force sense. Measures of knee laxity were obtained by computerized arthrometry. Results Following cold exposure, rate of force development of the knee flexor muscles was significantly reduced (p = 0.016). Left-shifts of electromyography power spectra indicated changes in neural drive to the medial and lateral head of the vastus muscle. Maximum strength, force sense and knee laxity were not affected by the intervention. Conclusion The reduced capacity of cold knee flexor muscles to explosively generate force may limit the hamstrings' capability to counter strong and fast contractions of the knee extensor muscles that cause anterior shear force on the tibia and, thus, strain the anterior cruciate ligament.
    Article · Jul 2016
    • "Soğuk uygulama ile ilgili dört çalışma farklı farklı eklemlerle ilgili yapılmıştır, bunlardan ikisi diz (Uchio et al., 2003; Ozmun et al., 1996), biri omuz (Dover & Powers, 2004), bir tanesi ayak bileği eklemi (Hopper et al., 1997) ile ilgilidir. Ortaya çıkan sonuç soğuk uygulamanın üç çalışmada herhangi bir şekilde propriosepsiyona etkisi olmadığı yönünde iken, bir çalışmada soğuk uygulamanın propriosepsiyonu kötüleştirici bir etkisi olduğu ifade edilmiştir (Uchio et al., 2003). Celal Bayar Üniversitesinde yapılan iki tezde sıcak uygulamanın hem normal bireylerde hem hasta bireylerde propriosepsiyona etkisi değerlendirilmiş ve olumlu etkileri olduğu gözlemlenmiştir (Özer, 2007; Akaya, 2009). "
    [Show abstract] [Hide abstract] ABSTRACT: Spor yaralanmalarıyla ilgilenen bilim dallarında propriosepsiyon kavramının önemi her geçen gün biraz daha fazla anlaşılmaktadır. Proprioseptif egzersizlerle tedavi sonuçları daha iyi hale getirilebilmekte, yeniden yaralanma riski azaltılabilmektedir. Ayrıca yaralanma öncesi proprioseptif eğitimle, yaralanma sıklığının da azaltılabildiğine inanılmaktadır. Bandajlama, breysleme, kas yorgunluğu, egzersiz ya da cerrahi tedavi gibi birçok faktörün propriosepsiyonu etkilediği gösterilmiştir. Sportif rehabilitasyonda sık kullanılan sıcak ya da soğuk uygulamalarının propriosepsiyona etkileri ise yeterince bilinmemektedir. Bu çalışmanın amacı, sıcak ve soğuk uygulamanın eklemlerde propriosepsiyonu etkileyip etkilemediğini ortaya koymaktır. Sıcak uygulama sonrasında propriosepsiyon düzeyinin arttığı, soğuk uygulama ile propriosepsiyonun kötüleştiği saptanmıştır. Bu bulgular umut verici görünmektedir ve gelecekteki başka çalışmalarla da desteklenirse spor yaralanmalarının önlenmesi ya da tedavisinde yararlı olabilir. / Importance of proprioception in the treatment and prevention of sports injuries has become increasingly clear. Outcome of treatments are increased through proprioceptive rehabilitation, and re-injury risk is reduced. It is also believed that incidence of injury may be reduced by using pre-injury proprioceptive education. Bracing, muscle fatigue, exercises and surgery has been shown to affect proprioception level. Little is known about the effect of heat and cold application on proprioceptive capability which is the most commonly used treatment modalities on sportive rehabilitation. Purpose of this study was to investigate the effects of cold and heat application on joints proprioception. In this study it has been identified that proprioception increased after hot application and it decreased after cold application. These findings seem to be promising and may be useful in prevention and treatment of sports injuries, if supported by future studies.
    Full-text · Article · Jul 2015 · Physical Therapy in Sport
    • "Despite concerns regarding neuromuscular function following cryotherapy interventions, literature is vague as to how JPS is affected, immediately post cryotherapy application. The study's findings demonstrate a significant change (P=.035) in the ability to reproduce knee joint flexion in the sagittal plane and a significant lack of varus control (P=.011) with a subsequent valgus shift in the coronal plane, during the eccentric loading phase of the SKB, in line with previous research (Ribeiro et al., 2013; Watanabe et al., 2013; Uchio et al., 2003; and Surenkok et al., 2008). Analysis revealed no significant changes in the angular velocity of this movement. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Jun 2015
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