The Effect of Cryotherapy Application to the Knee Joint on Dynamic Postural Stability

in Journal of Sport Rehabilitation
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Context: Decreased postural balance is a primary risk factor for lower-limb injuries. Cryotherapy is commonly utilized by clinicians to provide local analgesia for minor acute knee joint musculoskeletal injuries during breaks in play or at halftime. Its effect on dynamic postural balance remains unclear. Objective: To investigate the acute effects of a 15-minute knee joint cryotherapy application on dynamic postural balance, as assessed primarily via a clinically oriented outcome measure. Design: Experimental study. Setting: University biomechanics laboratory. Patients or Participants: A total of 28 elite-level college male field-sport athletes. Intervention: Participants were tested on the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test both before and after a 15-minute knee joint cryotherapy application. Main Outcome Measure(s): Normalized reach distances, 3-dimensional knee joint kinematics, sagittal plane hip and ankle joint kinematics, as well as fractal dimension of the center-of-pressure path during the performance of the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test. Results: There was a statistically significant decrease in reach distance scores achieved on anterior, posteromedial, and posterolateral directions of the Star Excursion Balance Test from precryotherapy to postcryotherapy (P < .05). None of the decreases in reach distance scores exceeded the reported smallest detectable difference values. No significant differences were observed in hip, knee, or ankle joint kinematics (P > .05). No significant change in fractal dimension was observed for any reach direction following cryotherapy application (P > .05). Conclusions: The results of the present study indicate that dynamic postural balance is unlikely to be adversely affected immediately following cryotherapy application to the knee joint.

Fulllam is with DBC Belfield@UCD, Institute for Sport & Health, Dublin, University College, Dublin, Ireland. Fullam and Delahunt are with Health Sciences Centre, Institute for Sport & Health, School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland. Caulfield is with INSIGHT@ UCD, Insight Centre for Data Analytics, Applied Research for Connected Health (ARCH), Dublin, Ireland. Coughlan is with Physiotherapy, Connacht Rugby, Galway, Ireland. McNulty is with Wayne McNulty Physiotherapy and Sports Massage, Dublin, Ireland. Campbell is with Physiotherapy, Nova International Ltd, Dublin, Ireland.

Fullam (karl.fullam@ucdconnect.ie) is corresponding author.
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