Examination of Intramuscular and Skin Temperature Decreases Produced by the PowerPlay Intermittent Compression Cryotherapy

in Journal of Sport Rehabilitation
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Context: Previous research has found ice bags are more effective at lowering intramuscular temperature than gel packs. Recent studies have evaluated intramuscular temperature cooling decreases with ice bag versus Game Ready and with the PowerPlay system wetted ice bag inserts; however, intramuscular temperature decreases elicited by PowerPlay with the standard frozen gel pack inserts have not been examined. Objective: Evaluate the rate and magnitude of cooling using PowerPlay with frozen gel pack (PP-gel) option, PowerPlay with wetted ice bag (PP-ice) option, and control (no treatment) on skin and intramuscular temperature (2 cm subadipose). Design: Repeated-measures counterbalanced study. Setting: University research laboratory. Patients or Other Participants: Twelve healthy college-aged participants (4 men and 8 women; age = 23.08 (1.93) y, height = 171.66 (9.47) cm, mass = 73.67 (13.46) kg, and subcutaneous thickness = 0.90 (0.35) cm). Intervention(s): PowerPlay (70 mm Hg) with either wetted ice bag or frozen gel pack was applied to posterior aspect of nondominant calf for 30 minutes; control lay prone for 30 minutes. Participants underwent each treatment in counterbalanced order (minimum 4 d, maximum 10 d between). Main Outcome Measure(s): Muscle temperature was measured via 21-gauge catheter thermocouple (IT-21; Physitemp Instruments, Inc). Skin temperature was measured via surface thermocouple (SST-1; Physitemp Instruments, Inc). Results: Significant treatment-by-time interaction for muscle cooling (F10,80 = 11.262, P = .01, ηp2=.585, observed β = 0.905) was observed. PP-ice cooled faster than both PP-gel and control from minutes 12 to 30 (all Ps < .05); PP-gel cooled faster than control from minutes 18 to 30 (all Ps < .05). Mean decreases from baseline: PP-ice = 4.8°C (2.8°C), PP-gel = 2.3°C (0.8°C), and control = 1.1°C (0.4°C). Significant treatment-by-time interaction for skin cooling (F10,80 = 23.920, P = .001, ηp2=.857, observed β = 0.998) was observed. PP-ice cooled faster than both PP-gel and control from minutes 6 to 30 (all Ps < .05); PP-gel cooled faster than control from minutes 12 to 30 (all Ps < .05). Mean decreases from baseline: PP-ice = 14.6°C (4.8°C), PP-gel = 4.0°C (0.9°C), and control = 1.0°C (1.0°C). Conclusions: PP-ice produces clinically and statistically greater muscle and skin cooling compared with PP-gel and control.

Ostrowski is with Sports Medicine & Rehabilitation Center, Moravian College, Bethlehem, PA. Purchio is with Branham High School, San Jose, CA. Beck is with Twin Cities Orthopedics, Minneapolis, MN. Leisinger is with Seattle Children’s Hospital, Seattle, WA. Tucker and Hurst are with Weber State University, Ogden, UT.

Ostrowski (ostrowskij@moravian.edu) is corresponding author.
  • 1.

    Seiyama A, Shiga T, Maeda N. Temperature effect on oxygenation and metabolism of perfused rat hindlimb muscle. Adv Exp Med Biol. 1990;277:541–547. PubMed

  • 2.

    Abramson D, Kahn A, Tuck S, Turman G, Rejal H, Fleischer C. Relationship between a range of tissue temperature and local oxygen uptake in the human forearm. Lab Clin Med. 1957;50:789–793.

    • Search Google Scholar
    • Export Citation
  • 3.

    Gregson W, Black M, Jones H, et al. Influence of cold water immersion on limb and cutaneous blood flow at rest. Am J Sports Med. 2011;39(6):1316–1323. PubMed doi:10.1177/0363546510395497

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Selkow N, Day C, Liu Z, Hart J, Hertel J, Saliba S. Microvascular perfusion and intramuscular temperature of the calf during cooling. Med Sci Sports Exerc. 2012;44(5):850–856. doi:10.1249/MSS.0b013e31823bced9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Schwartz D, Kaplin K, Schwartz S. Hemostasis, surgical bleeding, and transfusion. In: Charles Brunicardi F, ed. Principles of Surgery. Vol 8. 2nd ed. New York, NY: McGraw-Hill Book Co; 2005.

    • Search Google Scholar
    • Export Citation
  • 6.

    Deal D, Tipton J, Rosencrance E, Curl W, Smith T. Ice reduces edema. A study of microvascular permeability in rats. J Bone Joint Surg Am. 2002;84A(9):1573–1578. doi:10.2106/00004623-200209000-00009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Merrick M. Secondary injury after musculoskeletal trauma: a review and update. J Athl Train. 2002;37(2):209–217. PubMed

  • 8.

    Kehrer J. Free radicals as mediators of tissue injury and diseases. Crit Rev Toxicol. 1993;23(1):21–48. PubMed doi:10.3109/10408449309104073

  • 9.

    Oliveira N, Rainero E, Salvini T. Three intermittent sessions of cryotherapy reduce the secondary muscle injury in skeletal muscle of rat. J Sport Sci Med. 2006;5:228–234. PubMed

    • Search Google Scholar
    • Export Citation
  • 10.

    Merrick M, Jutte L, Smith M. Cold modalities with different thermodynamic properties produce different surface and intramuscular temperatures. J Athl Train. 2003;38(1):28–33. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Dykstra J, Hill H, Miller M, Cheatham C, Michael T, Baker R. Comparisons of cubed ice, crushed ice, and wetted ice on intramuscular and surface temperature changes. J Athl Train. 2009;44(2):136–141. PubMed doi:10.4085/1062-6050-44.2.136

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hunter E, Ostrowski J, Donahue M, Crowley C, Herzog V. Effect of salted ice bags on surface and intramuscular tissue cooling and rewarming rates. J Sport Rehabil. 2016;25(1):70–76. PubMed doi:10.1123/jsr.2014-0289

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Bleakley C, Hopkins JT. Is it possible to achieve optimal levels of tissue cooling in cryotherapy? Phys Ther Rev. 2010;15(4):344–350. doi:10.1179/174328810X12786297204873

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Sapega A, Heppenstall R, Sokolow D. The bioenergetics of preservation of limbs before replantation. The rationale for intermediate hypothermia. J Bone Joint Surg Am. 1988;70(10):1500–1513. PubMed doi:10.2106/00004623-198870100-00010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Tomchuk D, Rubley M, Holcomb W, Guadagnoli M, Tarno J. The magnitude of tissue cooling during cryotherapy with varied typed of compression. J Athl Train. 2010;45(3):230–237. PubMed doi:10.4085/1062-6050-45.3.230

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Knight K, Draper D. Therapeutic Modalities: The Art and Science. 2nd ed. Baltimore, MD:  Lippincott Williams & Wilkins;2013.

  • 17.

    Holwerda S, Trowbridge C, Womochel K, Keller D. Effects of cold modality application with static and intermittent pneumatic compression on tissue temperature and systemic cardiovascular responses. Sports Health. 2013;5(1):27–33. PubMed doi:10.1177/1941738112450863

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Hawkins J, Shurtz J, Spears C. Traditional cryotherapy treatments are more effective than Game Ready® on medium setting at decreasing sinus tarsi tissue temperatures in uninjured subjects. J Athl Enhancement. 2012;1(2):1–5. doi:10.4172/2324-9080.1000101

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Ostrowski J, Bartoletti M, Purchio A, Leisinger J. Effectiveness of salted ice bag versus cryo-compression on decreasing intramuscular and skin temperature. J Sport Rehabil. doi:10.1123/jsr.2017-0173

    • Search Google Scholar
    • Export Citation
  • 20.

    Enwemeka C, Allen C, Avila P, Bina J, Konrade J, Munns S. Soft tissue thermodynamics before, during, and after cold pack therapy. Med Sci Sports Exerc. 2002;34(1):45–50. PubMed doi:10.1097/00005768-200201000-00008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Jutte L, Knight K, Long B. Reliability and validity of electrothermometers and associated thermocouples. J Sport Rehabil. 2008;17(1):50–59. PubMed doi:10.1123/jsr.17.1.50

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Long B, Jutte L, Knight K. Response of thermocouples interfaced to electrothermometers when immersed in 5 water bath temperatures. J Athl Train. 2010;45(4):338–343. PubMed doi:10.4085/1062-6050-45.4.338

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Janwantanakul P. Different rate of cooling time and magnitude of cooling temperature during ice bag treatment with and without damp towel wrap. Phys Ther Sport. 2004;5(3):156–161. doi:10.1016/j.ptsp.2004.02.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Chesterton L, Foster N, Ross L, Dip G. Skin temperature response to cryotherapy. Arch Phys Med Rehabil. 2002;83(4):543–549. PubMed doi:10.1053/apmr.2002.30926

  • 25.

    Algafly A, George K. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med. 2007;41(6):365–369. PubMed doi:10.1136/bjsm.2006.031237

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Jutte L, Merrick M, Intersoll D, Edwards J. The relationship between intramuscular temperature, skin temperature, and adipose thickness during cryotherapy and rewarming. Arch Phys Med Rehabil. 2001;82:845–850. PubMed doi:10.1053/apmr.2001.23195

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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