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Abstract

Flexibility is an intrinsic property of body tissues, which among other factors determines the range of motion (ROM). A decrease in neural activation of the muscle has been linked with greater ROM. Cryotherapy is an effective technique to reduces neural activation. Hence, the aim of the present study was to evaluate if a single session of whole-body cryotherapy (WBC) affects ROM. 60 women and 60 men were divided into two groups (control and experimental). After the initial sit-and-reach test, experimental group performed a 150 s session of WBC, whereas the control group stayed in thermo-neutral environment. Immediately after, both groups performed another sit-and-reach test. A 3-way analysis of variance revealed statistically significant time×group and time × gender interaction. Experimental groups improved sit-and-reach amplitude to a greater extend than the control group. Our results support the hypothesis that ROM is increased immediately after a single session of WBC.

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... The twelve identified studies were categorised into 3 key research areas: physical performance (n = 6) [27][28][29][30][31][32], oxidative stress response (n = 4) [33][34][35][36] and lysosomal enzyme activity (n = 2) [37,38]. Within these categories, three studies used WBC exposure acutely prior to testing or physiological measures being taken [27,29], and five utilised WBC chronically (2-3 exposures per day over a 6-10 training period) [33][34][35]37,38]. ...
... The twelve identified studies were categorised into 3 key research areas: physical performance (n = 6) [27][28][29][30][31][32], oxidative stress response (n = 4) [33][34][35][36] and lysosomal enzyme activity (n = 2) [37,38]. Within these categories, three studies used WBC exposure acutely prior to testing or physiological measures being taken [27,29], and five utilised WBC chronically (2-3 exposures per day over a 6-10 training period) [33][34][35]37,38]. The remaining four studies utilised PBC exposure acutely prior to physical performance measures [28,32,36], with one study misclassifying the cryotherapy modality as WBC, when the correct term is PBC, given the participants' head was out of the chamber [30]. ...
... Most of these studies investigated oxidative stress, and lysosomal enzyme activity with only one study investigating physical performance measures [32]. The five remaining studies used healthy, recreationally active participants to investigate the neuromuscular facilitation response to pre-exercise WBC or PBC exposure [27][28][29][30]. The risk of bias and quality assessment indicated that no studies were of excellent quality, four were good quality (33%), six were fair quality (50%), and two were deemed of poor quality (17%). ...
Article
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Whole- (WBC) and partial-body cryotherapy (PBC) are commonly used sports medicine modalities for the treatment of injury and exercise recovery. Physiological and perceptual effects have the potential to be utilised in a novel application that involves pre-exercise WBC and PBC exposure to improve physical performance. A systematic literature search of multiple databases was conducted in July 2021 to identify and evaluate the effects of pre-exercise exposure of WBC or PBC on physical performance measures, and any potential translational effects. The following inclusion criteria were applied: (1) use of WBC or PBC exposure pre-exercise, (2) use of WBC or PBC in healthy and/or athletic populations, (3) control group was used in the data collection, and (4) investigated physiological, psychosocial or direct physical performance impacts of pre-exercise cryotherapy exposure. A total of 759 titles were identified, with twelve relevant studies satisfying the inclusion criteria after full-text screening. The twelve studies were categorised into three key areas: performance testing (n = 6), oxidative stress response (n = 4) and lysosomal enzyme activity (n = 2). The potential for eliciting favourable physical and physiological responses from pre-exercise WBC or PBC is currently unclear with a paucity of good quality research available. Furthermore, a lack of standardisation of cryotherapy protocols is a current challenge.
... and high-intensity exercise, with favourable results conducive to performance outcomes [11,12]. Pre-exercise WBC has elicited improvements in sit-and-reach scores by ~2 cm in men and ~3 cm in women compared to the control conditions [13]. Furthermore, PBC exposure immediately prior to maximal isometric grip strength tests elicited an improvement by 5% in women and 2% in men compared to the control [14]. ...
... However, PBC exposure has been utilised prior to sit-in-reach tests using healthy, non-athletic participants, which elicited significant improvements in reach amplitude in men by ~2 cm and women by ~3 cm compared to the control conditions [13]. In our study using well-trained athletes, PBC yielded moderate improvements in re- of participants, potentially benefitting performance in heavy contact sports [35]. ...
Article
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This study aimed to evaluate the application of a single pre-exercise bout of partial-body cryotherapy (PBC) to augment jump performance, salivary biomarkers and self-reported performance readiness. Twelve male rugby union players (age 20.7 ± 3.2 yr; body mass 93.1 ± 13.9 kg; mean ± SD) were exposed to PBC for 3 min at –140°C or control condition prior to a pre-post series of loaded countermovement jumps (CMJ), salivary biomarker samples and performance readiness questionnaires. PBC elicited a moderately greater improvement in CMJ velocity of +4.7 ± 3.5% (mean ± 90% confidence limits) from baseline to 15 min in comparison with a -1.9 ± 4.8% mean difference in the control condition. The mean change in concentration of salivary α-amylase at 15 min was substantially increased by +131 ± 109% after PBC exposure, compared to a -4.2 ± 42% decrease in the control. Salivary testosterone concentrations were unclear at all timepoints in both the PBC and control interventions. Self-reported perceptions of overall performance readiness indicated small to moderate increases in mental fatigue, mood, muscle soreness and overall questionnaire score after PBC compared to control with a higher score more favourable for performance. The application of pre-exercise PBC can elicit favourable outcomes in controlled physical performance tests and holds promise to be applied to training or competition settings.
... In general, the convective component of heat losses predominates. The measurement of heat fluxes is an integral part of the research and control of most processes that take place in technological apparatuses with the release or absorption of heat [9]. ...
... Approximately 10-15 minutes after the end of the WBC session, the skin temperature returns to its original value. After that, the temperature rises and takes a value 1 degree higher than the initial temperature (Fig. 2, curve 1), which agrees with the experimental data [9]. It also correlates with the sensations of patients who are usually explained by increased blood circulation after WBC [17]. ...
Conference Paper
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Abstract – In this paper, the question of measuring skin integument under the influence of low temperatures is considered. The effect of low temperatures on each layer of the skin was investigated. A model is simulated that allows one to determine the temperature dependence in each layer of the skin from the time of cryochamber and to monitor the temperature change after seance until the temperature field returns to its original state. The dependence of heat flux loss on the degree of cooling of human skin layers is given. The results were obtained using a mathematical model of heat exchange between the flow of a gaseous medium (a pair of liquid nitrogen) and a biological object in a three-dimensional nonstationary formulation. The study was performed using the finite element method in the Comsol Multiphysics application package. The model includes layers of biological tissue and air. Calculations of heat transfer processes in biological tissue were performed using the Bioheat Transfer module. The dependence of heat flux loss on the degree of cooling of human skin layers is given. The results obtained show the effect of the effect of the duration and extent of the cryotherapy effect effect on its further improvement.
... The extreme cold of Whole Body Cryotherapy (WBC) has become an emerging tool for sport and exercise recovery (Lombardi et al., 2017), demonstrating reductions in pain , inflammation , improved muscle strength recovery (Haq et al., 2021) and benefits to range of motion (De Nardi et al., 2015). Despite such effects, there is currently limited research which has identified conclusively the optimum WBC protocol for such purposes. ...
Article
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Despite several established benefits of Whole Body Cryotherapy (WBC) for post-exercise recovery, there is a scarcity of research which has identified the optimum WBC protocol for this purpose. This study investigated the influence of WBC treatment timing on physiological and functional responses following a downhill running bout. An additional purpose was to compare such responses with those following cold water immersion (CWI), since there is no clear consensus as to which cold modality is more effective for supporting athletic recovery. Thirty-three male participants (mean ± SD age 37.0 ± 13.3 years, height 1.76 ± 0.07 m, body mass 79.5 ± 13.7 kg) completed a 30 min downhill run (15% gradient) at 60% VO 2 max and were then allocated into one of four recovery groups: WBC1 (n = 9) and WBC4 (n = 8) underwent cryotherapy (3 min, −120 • C) 1 and 4 h post-run, respectively; CWI (n = 8) participants were immersed in cold water (10 min, 15 • C) up to the waist 1 h post-run and control (CON, n = 8) participants passively recovered in a controlled environment (20 • C). Maximal isometric leg muscle torque was assessed pre and 24 h post-run. Blood creatine kinase (CK), muscle soreness, femoral artery blood flow, plasma IL-6 and sleep were also assessed pre and post-treatment. There were significant decreases in muscle torque for WBC4 (10.9%, p = 0.04) and CON (11.3% p = 0.00) and no significant decreases for WBC1 (5.6%, p = 0.06) and CWI (5.1%, p = 0.15). There were no significant differences between groups in muscle soreness, CK, IL-6 or sleep. Femoral artery blood flow significantly decreased in CWI (p = 0.02), but did not differ in other groups. WBC treatments within an hour may be preferable for muscle strength recovery compared to delayed treatments; however WBC appears to be no more effective than CWI. Neither cold intervention had an impact on inflammation or sleep.
... Наилучший результат от фи- зиотерапевтического эффекта WBC достигается в том случае, когда температура поверхности объекта прибли- жается к минимально допустимому уровню -2 °С [6]. Однако, воздействие паров азота на биологический объ- ект, сопровождаемое снижением температуры кожных покровов ниже -2 °С, может привести к обморожению и необратимому разрушению тканей [7][8][9]. ...
Article
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The results of numerical modeling the distribution of temperature fi elds and heat fl uxes in the skin of a person during the general therapy action are presented. The results were obtained using a mathematical model of heat exchange between the fl ow of a gaseous medium (liquid nitrogen vapour) and a biological object (a patient of general therapeutic effect) in a three-dimensional nonstationary formulation. The study was carried out using the fi nite element method in the Comsol Multiphysics application package. The model included layers of biological tissue (epidermis, dermis, internal tissue, subcutaneous layer) and air medium (nitrogen vapors). Calculations of heat transfer processes in biological tissue were performed using the Bioheat Transfer module. In the heat equation the heat of human biological tissues was taken into account. The fl ow of gaseous nitrogen was considered to be laminar one. Laminar fl ow calculations were performed in the Laminar Flow module and described by the Navier-Stokes equation. Two modules were combined by Comsol Multiphysics. To check the convergence of the results the model is analyzed by the built-in tools for assessing the quality of elements. In the calculations all materials are assumed to be isotropic. The created non-stationary computer model allows describing the distribution of thermal fi elds in the skin integument during the general therapy ction. The results obtained can be applied when modernizing cryochamber regimes and designing new cryochamber with improved cryotherapy effect without any harm to the patient.
... WBC is carried out in a cryogenic cabin or cryochamber at cryogenic gas temperature (-110 to -140°C), which corresponds to approximately 165-135K, the exposure varies from 1 to 3 minutes depending on the weight, thickness of the skin, the patient's sex [3][4][5][6]. Usually cryochambers have automatic control systems that allow regulating the process conditions, such as: temperature, gas velocity and humidity [7]. It has been shown that cryochambers are more convenient to use and less expensive than cryocabins [8]. ...
... Factors associated with the difference between the sexes should be considered when choosing the operating modes of the cryochamber. The effect of the human sex on the thermoregulatory process after WBC has been studied [11][12][13]. Female participants experienced a more intense decrease in skin temperature than men [12]. However, the mechanisms for measuring the temperature of the human body surface in time for the WBC have not been fully investigated. ...
Conference Paper
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Abstract – The physical processes taking place in the cryochamber during the therapeutic treatment were investigated. The analysis of temperature fields during wholebody-cryotherapy (WBC) in skin integument and volume of cryochamber has been investigated. The analysis was implemented based on the modeling of non-stationary heat transfer through a multilayered object. The study was performed using the finite element method. The calculations were based on the equations of heat transfer process in solids and biological tissue with internal heat source and laminar flow. The modules were combined using Multiphysics interface. Main results. The computer model created allows the calculation of thermal field dynamics in the skin of a patient body during and after WBC. Mathematical model of WBC allows the estimation of such parameters as coolant velocity and temperature, session exposure, cryochamber design and individual features of WBC object. The model performed allows the analysis of WBC parameters and their impact on skin integument temperature.
... PBC consisted of 30 seconds of pre-cooling at −60°C and then 2-minutes cooling at −135°C as used previously. 11,20 Participants entered the cryocabin in shorts and wearing cold-resistant woollen boots. During the procedure, the participants placed both hands on the upper edge of the cabin and were instructed to slowly move as prescribed in the user's manual. ...
Article
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The aim of this study was to compare i) the physiological responses following cold-water immersion (CWI) and partial-body cryotherapy (PBC) and ii) the effects on recovery following a muscle-damaging protocol (5 x 20 drop jumps). Nineteen healthy males were randomly allocated into either a CWI (10 °C for 10 min; n = 9) or a PBC (-60 °C for 30 sec, -135 °C for 2 min; n = 10) group. The physiological variables (thigh muscle oxygen saturation [SmO2 ], cutaneous vascular conductance [CVC], mean-arterial pressure [MAP] and local skin temperature) were assessed immediately prior and up to 60 min post-treatment (10 min intervals). The recovery variables (thigh muscle swelling, maximum voluntary contraction [MVC] of the right knee extensors, vertical-jump performance [VJP] and delayed-onset of muscle soreness [DOMS]) were measured immediately prior and up to 72 h post-treatment (24 h intervals). Compared to PBC values, CVC (at 30 min), SmO2 (at 40 min) and lower extremity-skin temperature (thigh/shin at 60 min) were significantly reduced in the CWI group after the treatment (all p < 0.05). Only lower extremity-skin temperature was significantly reduced in the PBC group directly post-treatment (all p < 0.05). MAP significantly increased in both groups after the treatments (both p < 0.05). DOMS did not differ between groups. MVC and VJP returned to baseline in both groups after 24 h (p > 0.05). CWI had a greater impact on the physiological response compared to PBC. However, both treatments resulted in similar recovery profiles during a 72 h follow-up period. This article is protected by copyright. All rights reserved.
... The PBC exposure immediately before testing (ie, 0-5 min) has previously yielded improvements in isometric grip strength by 2% in men and 5% in women. 21 In addition, sitand-reach flexibility scores improved by ∼2 cm in both men and women immediately post-PBC exposure (0-10 min), 22 indicative of a neuromuscular facilitation response to the cold exposure. The CMJ performance has been shown to be higher in horizontally oriented sports than vertically oriented or power sports. ...
Article
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Purpose: This study evaluated the effect of partial-body cryotherapy (PBC) exposure 1, 2, or 3 hours before maximal-effort jump performance, salivary enzyme concentration, perceived readiness, and well-being. Methods: Male team-sport players (N = 27; 24.2 [3.6] y; 91.5 [13.2] kg) were exposed to a blinded bout of PBC (-135°C [6°C]) and control (-59°C [17°C]) either 1, 2, or 3 hours prior to countermovement jumps. Passive saliva samples were collected to determine α-amylase concentration. Self-reported performance readiness and well-being questionnaires were completed using a 1-5 Likert scale. Results: Differences in the change in mean countermovement jump velocity and absolute power between PBC and control were unclear at 1 hour (+1.9% [5.3%], P = .149; +0.7% [10.6%], P = .919; mean difference [90% confidence limits]), 2 hours (+3.3% [2.7%], P = .196; +7.8% [7.4%], P = .169), and 3 hours postexposure (+3.1% [3.3%], P = .467; +0.7% [4.8%], P = .327). Salivary α-amylase concentration was elevated 15 minutes postexposure in the 1-hour (+61% [14%], P = .008) and 2-hour groups (+55% [12%], P = .013). The increase in self-reported performance readiness was higher after PBC (+2.4 [1.2] units, P = .046) in the 2-hour group and by 1.4 (1.1) units (P = .023) after 3 hours. Mental fatigue was favorably decreased 2 hours after PBC exposure (+0.5 [0.1], P = .041). Conclusions: An acute exposure of PBC elicits potentially favorable but unclear changes in countermovement jump performance. The PBC enhances salivary α-amylase concentration and perceived performance readiness, reduces mental fatigue, and could be useful in sport-specific training or competitions.
Article
Several types of routines and methods have been experimented to gain neuro/muscular advantages, in terms of overall range of motion, in athletes and fitness enthusiasts. The aim of the present study was to evaluate the impact of different routines on trunk- and lower limbs flexibility in a sample of young women. In a randomized-crossover fashion, eleven subjects underwent to: hamstrings stretching [S]; hamstrings stretching plus whole-body vibration [S+WBV]; partial-body cryotherapy [Cryo]; rest [Control]. Standing hamstrings stretch performance and sit-and-reach amplitude resulted to be improved with [S+WBV] compared to all other protocols (p<0.05). [Cryo] ameliorated the active knee extension performance with respect to all other interventions (p<0.05). These flexibility improvements were obtained without a loss in the trunk position sense proprioception. These results represent the first evidence that a single session of either vibration or cryotherapy can ameliorate flexibility without losing the trunk position sense proprioception in young women.
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Introduction: Cryotherapy has been a widely used thermotherapy modality in sports injuries. The main focus of research on cryotherapy was to find out its effects on functional performance measures of the players. Cryotherapy is known to dampen the stretch reflex and reduce muscle temperature which might indirectly influence the flexibility and power which are the important components of any performance. Hence, it becomes necessary to study the changes, if any, on the flexibility and power post cryotherapy application. Aim: To determine the effects of cryotherapy on lower limb flexibility and power in adult recreational players. Materials and Methods: The present study was an experimental study conducted on 40 recreational players of either gender, between the age range of 18-25 years, who played various forms of recreational sports and had hamstrings and calf muscle tightness were included in the study. Hamstring tightness was assessed by Active Knee Extension Test (AKET) and calf muscle tightness by Weight Bearing Lunge test (WBLT), while power was assessed by vertical jump test. Both the limbs were given cold pack on bilateral calf and hamstrings for 20 minutes for three days. Outcomes were measured on 3rd day and paired t-test was used to analyse the pre and post-treatment difference, p-value less than 0.05 was considered as significant. Results: A total of 40 recreational players were included in the study with the mean age of 22.15±1.36 years, of which 20 were males and 20 were females with mean Body Mass Index (BMI) of 23.07±3.36 kg/m2 . The right calf muscle flex (pretreatment=13.7 cm to post-treatment=14.71 cm, p
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Recovery after exercise is a crucial key in preventing muscle injures and in speeding up processes to return at the homeostasis level. There are several ways of developing a recovery strategy with the use of different kinds of traditional and up-to date techniques. The use of cold has traditionally been used after physical exercise for recovery purposes. In the recent years, the use of whole-body cryotherapy/cryostimulation (an extreme cold stimulation lasting 1-4 min and given in a cold room at a temperature comprised from -60 to -195°C) has tremendously increased for such purposes. However, there are controversies about the benefits that the use of this technique may provide. Therefore, this paper describes what is whole body cryotherapy/cryostimulation, reviews and debates the benefits that its use may provide, presents practical considerations and applications, and emphasizes the need of customization depending on the context, the purpose, and the subject characteristics. This review is written by international experts from the working group on whole body cryotherapy/cryostimulation from the International Institute of Refrigeration.
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Whole body cryotherapy is a state-of-the-art method that uses cold for treatment and prevention of diseases. The process implies the impact of cryogenic gas on a human body that implements in a special cryochamber. The temperature field in the chamber is of great importance since local integument over-cooling may occur. Numerical simulation of WBC has been carried out. Chamber design modification has been proposed in order to increase the uniformity of the internal temperature field. The results have been compared with the ones obtained for a standard chamber design. The value of temperature gradient formed in the chamber containing curved wall with certain height has been decreased almost twice in comparison with the results obtained for the standard design. The modification proposed may increase both safety and comfort of cryotherapy.
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The purpose of the present study was to examine musculotendinous stiffness (MTS) and ankle joint range of motion (ROM) in men and women after an acute bout of passive stretching. Thirteen men (mean ± SD age = 21 ± 2 years; body mass = 79 ± 15 kg; and height = 177 ± 7 cm) and 19 women (21 ± 3 years; 61 ± 9 kg; 165 ± 8 cm) completed stretch tolerance tests to determine MTS and ROM before and after a stretching protocol that consisted of 9 repetitions of passive, constant-torque stretching. The women were all tested during menses. Each repetition was held for 135 seconds. The results indicated that ROM increased after the stretching for the women (means ± SD pre to post: 109.39° ± 10.16° to 116.63° ± 9.63°; p ≤ 0.05) but not for the men (111.79° ± 6.84° to 113.93° ± 8.15°; p > 0.05). There were no stretching-induced changes in MTS (women's pre to postchange in MTS: -0.35 ± 0.38; men's MTS: +0.17 ± 0.40; p > 0.05), but MTS was higher for the men than for the women (MTS: 1.34 ± 0.41 vs. 0.97 ± 0.38; p ≤ 0.05). electromyographic amplitude for the soleus and medial gastrocnemius during the stretching tests was unchanged from pre to poststretching (p > 0.05); however, it increased with joint angle during the passive movements (p ≤ 0.05). Passively stretching the calf muscles increased stretch tolerance in women but not in men. But the stretching may not have affected the viscoelastic properties of the muscles. Practitioners may want to consider the possible gender differences in passive stretching responses and that increases in ROM may not always reflect decreases in MTS.
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To (1) search the English-language literature for original research addressing the effect of cryotherapy on joint position sense (JPS) and (2) make recommendations regarding how soon healthy athletes can safely return to participation after cryotherapy. We performed an exhaustive search for original research using the AMED, CINAHL, MEDLINE, and SportDiscus databases from 1973 to 2009 to gather information on cryotherapy and JPS. Key words used were cryotherapy and proprioception, cryotherapy and joint position sense, cryotherapy, and proprioception. The inclusion criteria were (1) the literature was written in English, (2) participants were human, (3) an outcome measure included JPS, (4) participants were healthy, and (5) participants were tested immediately after a cryotherapy application to a joint. The means and SDs of the JPS outcome measures were extracted and used to estimate the effect size (Cohen d) and associated 95% confidence intervals for comparisons of JPS before and after a cryotherapy treatment. The numbers, ages, and sexes of participants in all 7 selected studies were also extracted. The JPS was assessed in 3 joints: ankle (n = 2), knee (n = 3), and shoulder (n = 2). The average effect size for the 7 included studies was modest, with effect sizes ranging from -0.08 to 1.17, with a positive number representing an increase in JPS error. The average methodologic score of the included studies was 5.4/10 (range, 5-6) on the Physiotherapy Evidence Database scale. Limited and equivocal evidence is available to address the effect of cryotherapy on proprioception in the form of JPS. Until further evidence is provided, clinicians should be cautious when returning individuals to tasks requiring components of proprioceptive input immediately after a cryotherapy treatment.
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Vapocoolants have been documented clinically to increase range of motion limited by pain, but only one research study has been undertaken to investigate these observations. The purposes of this study were twofold: to replicate one existing quantitative study on Fluori-Methane Spray and to examine the effects of other brief, cold stimuli (ethyl chloride and isopropyl alcohol) to increase passive hip flexion in healthy adults. Three experimental groups and a control group were used; each subject served as his own control. Pretest and posttest measurements of passive hip flexion were measured in a gravity-minimized position. A specially designed table to ensure trunk stabilization was used. Brief, cold stimuli applied to the posterior region of the thigh were found ineffective in increasing passive hip flexion in healthy adults. The rationale for the findings is described in terms of the effects of brief, cold stimuli on a quiescent CNS as opposed to a CNS demonstrating heightened excitability in the pain-spasm-pain cycle.
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To determine the impact of the application of cryotherapy on nerve conduction velocity (NCV), pain threshold (PTH) and pain tolerance (PTO). A within-subject experimental design; treatment ankle (cryotherapy) and control ankle (no cryotherapy). Hospital-based physiotherapy laboratory. A convenience sample of adult male sports players (n = 23). NCV of the tibial nerve via electromyogram as well as PTH and PTO via pressure algometer. All outcome measures were assessed at two sites served by the tibial nerve: one receiving cryotherapy and one not receiving cryotherapy. In the control ankle, NCV, PTH and PTO did not alter when reassessed. In the ankle receiving cryotherapy, NCV was significantly and progressively reduced as ankle skin temperature was reduced to 10 degrees C by a cumulative total of 32.8% (p<0.05). Cryotherapy led to an increased PTH and PTO at both assessment sites (p<0.05). The changes in PTH (89% and 71%) and PTO (76% and 56%) were not different between the iced and non-iced sites. The data suggest that cryotherapy can increase PTH and PTO at the ankle and this was associated with a significant decrease in NCV. Reduced NCV at the ankle may be a mechanism by which cryotherapy achieves its clinical goals.
Article
Flexibility, which is the ability to move freely through a full range of motion (ROM), is desired to enhance performance and decrease the likelihood of muscle injury. There are different techniques used to increase ROM and cryotherapy techniques to facilitation flexibility gains. However, the combination of stretching and type of cryotherapy agents are still confounding. The purpose was to determine which type of cryotherapy, crushed or wetted ice, would produce the greatest gains in hamstring ROM when followed by proprioceptive neuromuscular facilitation (PNF) stretching. Fifteen healthy subjects underwent three treatment conditions: crushed ice bag (crushed ice), wetted ice bag (wetted ice) and no ice bag (no ice). Subject's hamstring ROM was measured at baseline, then again after a twenty-minute cryotherapy treatment session. Subjects were then stretched using a slow-reversal-hold-relax PNF technique followed by a final ROM measurement. A repeated measures analysis of variance (RM-ANOVA) showed significant differences between cryotherapy and measurement conditions. Post hoc testing indicated that no ice (75.49° ± 12.19°) was significantly different than wetted ice (81.73° ± 10.34°) and crushed ice (81.62° ± 13.19°) at the end of the treatment session and that no ice (85.27° ± 13.83°) was significantly different than wetted ice (89.44° ± 11.31°) and crushed ice (89.16° ± 13.78°) after the stretching session. However, there were no differences between wetted ice and crushed ice. Results indicate that Strength and Conditioning Specialists can increase ROM with both forms of ice in combination with PNF stretching more so than when using no ice at all.
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Objectives: To examine the effect of thermal agents on the range of movement (ROM) and mechanical properties in soft tissue and to discuss their clinical relevance. Data sources: Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE) were searched from their earliest available record up to May 2011 using Medical Subjects Headings and key words. We also undertook related articles searches and read reference lists of all incoming articles. Study selection: Studies involving human participants describing the effects of thermal interventions on ROM and/or mechanical properties in soft tissue. Two reviewers independently screened studies against eligibility criteria. Data extraction: Data were extracted independently by 2 review authors using a customized form. Methodologic quality was also assessed by 2 authors independently, using the Cochrane risk of bias tool. Data synthesis: Thirty-six studies, comprising a total of 1301 healthy participants, satisfied the inclusion criteria. There was a high risk of bias across all studies. Meta-analyses were not undertaken because of clinical heterogeneity; however, effect sizes were calculated. There were conflicting data on the effect of cold on joint ROM, accessory joint movement, and passive stiffness. There was limited evidence to determine whether acute cold applications enhance the effects of stretching, and further evidence is required. There was evidence that heat increases ROM, and a combination of heat and stretching is more effective than stretching alone. Conclusions: Heat is an effective adjunct to developmental and therapeutic stretching techniques and should be the treatment of choice for enhancing ROM in a clinical or sporting setting. The effects of heat or ice on other important mechanical properties (eg, passive stiffness) remain equivocal and should be the focus of future study.
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To determine the contributions of neural and mechanical mechanisms to the limits in the range of motion (ROM) about a joint, we studied the effects of 30 sessions of static stretch training on the characteristics of the plantar-flexor muscles in 12 subjects. Changes in the maximal ankle dorsiflexion and the torque produced during passive stretching at various ankle angles, as well as maximal voluntary contraction (MVC) and electrically induced contractions, were recorded after 10, 20, and 30 sessions, and 1 month after the end of the training program. Reflex activities were tested by recording the Hoffmann reflex (H reflex) and tendon reflex (T reflex) in the soleus muscle. Training caused a 30.8% (P < 0.01) increase in the maximal ankle dorsiflexion. This improved flexibility was associated (r(2) = 0.88; P < 0.001) with a decrease in muscle passive stiffness and, after the first 10 sessions only, with a small increase in passive torque at maximal dorsiflexion. Furthermore, both the H- and T-reflex amplitudes were reduced after training, especially the latter (-36% vs. -14%; P < 0.05). The MVC torque and the maximal rate of torque development were not affected by training. Although the changes in flexibility and passive stiffness were partially maintained 1 month after the end of the training program, reflex activities had already returned to control levels. It is concluded that the increased flexibility results mainly from reduced passive stiffness of the muscle-tendon unit and tonic reflex activity. The underlying neural and mechanical adaptation mechanisms, however, showed different time courses.
Article
Eighteen healthy subjects (13 females and 5 males) were pretested and posttested under two treatment conditions in order to compare the effects of cryotherapy and thermotherapy on supine, extended-leg, hip flexion measurements. Cryotherapy treatments consisted of crushed ice bags secured to the posterior thigh for 20 minutes. On a separate day, thermotherapy treatment of moist heat pads were applied to the posterior thigh for 20 minutes. For pretest and posttest measurements, the subject's extended leg was taken to the end feel of passive hip flexion as maximum range of motion was assessed using a goniometer. Both cryotherapy and thermotherapy significantly improved immediate range of motion; however, there were no differences between the two treatment conditions. These results suggest that athletes wishing to obtain maximum range of motion immediately after treatment may select either ice or heat modalities. Individual conditions and preferences can be used to dictate treatment selection.
Gender differences in musculotendinous stiffness and range of motion after an acute bout of stretching
  • K M Hoge
  • E D Ryan
  • P B Costa
  • T J Herda
  • A A Walter
  • J R Stout
K.M. Hoge, E.D. Ryan, P.B. Costa, T.J. Herda, A.A. Walter, J.R. Stout, et al., Gender differences in musculotendinous stiffness and range of motion after an acute bout of stretching, J. Strength Cond. Res. 24 (2010) 2618e2626.