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  • Author: Jennifer Ostrowski x
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Jennifer Ostrowski, Angelina Purchio, Maria Beck and JoLynn Leisinger

Context: Rest, ice, compression, and elevation are commonly recommended immediately after injury. Traditionally, ice bag (IB) with elastic wrap compression has been utilized; however, recently intermittent cryocompression units are being used. Limited research has evaluated tissue temperature decreases with intermittent cryocompression units. Objective: Evaluate magnitude of muscle and skin cooling. Design: Repeated-measures counterbalanced study. Setting: University research laboratory. Patients or OtherParticipants: Twelve healthy college-aged participants (4 males and 8 females; age = 23.08 [1.93] y; height = 171.66 [9.47] cm; mass = 73.67 [13.46] kg; subcutaneous thickness = 0.90 [0.35] cm) without compromised circulation or injury. Intervention(s): Salted IB, GameReady (GR), and PowerPlay-ice bag (PP-ice) were applied to the posterior aspect of the nondominant calf for 30 minutes; participants underwent each treatment in counterbalanced order. Main Outcome Measure(s): Muscle temperature measured via 21-gauge catheter thermocouple; skin temperature measured via a surface thermocouple. Temperatures were recorded at baseline and during a 30-minute treatment. Correlations were evaluated between muscle and skin temperatures. Results : Nonsignificant treatment × time interaction and nonsignificant main effect of treatment for intramuscular cooling. Mean Decrease From Baseline : IB, 6.4°C (±2.8); GR, 5.4°C (±1.1); PP-ice, 4.8°C (±2.8). Nonsignificant treatment × time interaction for skin cooling (F 20,200 = 1.440, P = .65, ηp2=.346, and observed β = 0.773), but significant main effect for treatment (F 10,100 = 5.279, P = .03, ηp2=.883, and observed β = 1.00). Mean Decrease From Baseline: IB, 17.0°C; GR, 16.4°C; PP-ice, 14.6°C. No significant correlation between intramuscular and skin temperatures in any condition at any time point. No significant correlation between adipose tissue thickness and maximum temperature decrease with any modality. Conclusions: Salted IB with elastic wrap compression, GR, and PP-ice produced equivalent intramuscular temperature decreases during the treatment period.

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Jennifer L. Stiller and John A. Ostrowski

Edited by James Mensch

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Jennifer Ostrowski, C. Collin Herb, James Scifers, Teraka Gonzalez, Amada Jennings and Danvirg Breton

Background: ThermoStim Probe (TSP) has recently joined the market as a superficial heating modality. Although there is limited research into the intramuscular heating capability of superficial heating modalities in general (moist hot pack [MHP], paraffin, warm whirlpool), no previous research has examined intramuscular heating capability of TSP. Objective: Evaluate rate and magnitude of intramuscular heating via TSP compared with hydrocollator MHP, and determine if TSP can increase tissue temperature 3°C–4°C (vigorous heating range). Design: Repeated-measures counterbalanced study. Setting: Multisite trial; 2 college/university research laboratories. Patients or Other Participants: A total of 18 healthy college-aged participants (11 females and 7 males, age: 23.0 [2.1] y, weight: 74.64 [18.64] kg, height: 168.42 [9.66] cm, subcutaneous adipose: 0.71 [0.17] cm) with calf subcutaneous adipose <1.2 cm. Interventions: MHP and TSP were applied to the posterior aspect of the nondominant calf for 20 minutes; participants underwent each treatment in a counterbalanced order. Main Outcome Measurements: Muscle temperature at a depth of 1.5 cm was measured via 21-gauge catheter thermocouple. Temperatures were recorded at baseline and during the 20-minute treatment. Results: There was a significant treatment-by-time interaction during the treatment period (F 5,85 = 14.149, P < .001), as well as significant main effects for treatment (F 1,17 = 7.264, P = .02) and for time (F 5,85 = 34.028, P < .001). Muscle temperature increased an average of 1.7° (0.9°) for the MHP and 0.6° (1.0°) for the TSP. Pairwise comparisons of the interaction (using least significant difference adjustment for multiple comparisons) indicated that MHP heated faster than TSP at minutes 12 (P = .02), 16 (P = .002), and 20 (P = .001). There was no significant correlation between subcutaneous adipose thickness and maximum temperature increase obtained with either MHP (r = −.033, P = .90) or TSP (r = −.080, P = .75). Conclusions: MHP increased intramuscular temperature significantly more than TSP; however, neither modality was capable of producing a 3°C–4°C temperature increase associated with increased tissue extensibility.

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Jennifer Ostrowski, Angelina Purchio, Maria Beck, JoLynn Leisinger, Mackenzie Tucker and Sarah Hurst

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 (F 10,80 = 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 (F 10,80 = 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.

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Eric J. Hunter, Jennifer Ostrowski, Matthew Donahue, Caitlyn Crowley and Valerie Herzog

Context:

Many researchers have investigated the effectiveness of different cryotherapy agents at decreasing intramuscular tissue temperatures. However, no one has looked at the effectiveness of adding salt to an ice bag.

Objective:

To compare the cooling effectiveness of different ice bags (wetted, salted cubed, and salted crushed) on cutaneous and intramuscular temperatures.

Design:

Repeated-measures counterbalanced design.

Setting:

University research laboratory.

Participants:

24 healthy participants (13 men, 11 women; age 22.46 ± 2.33 y, height 173.25 ± 9.78 cm, mass 74.51 ± 17.32 kg, subcutaneous thickness 0.63 ± 0.27 cm) with no lower-leg injuries, vascular diseases, sensitivity to cold, compromised circulation, or chronic use of NSAIDs.

Interventions:

Ice bags made of wetted ice (2000 mL ice and 300 mL water), salted cubed ice (intervention A; 2000 mL of cubed ice and 1/2 tablespoon of salt), and salted crushed ice (intervention B; 2000 mL of crushed ice and 1/2 tablespoon of salt) were applied to the posterior gastrocnemius for 30 min. Each participant received all conditions with at least 4 d between treatments.

Main Outcome Measure:

Cutaneous and intramuscular (2 cm plus adipose thickness) temperatures of nondominant gastrocnemius were measured during a 10-min baseline period, a 30-min treatment period, and a 45-min rewarming period.

Results:

Differences from baseline were observed for all treatments. The wetted-ice and salted-cubed-ice bags produced significantly lower intramuscular temperatures than the salted-crushed-ice bag. Wetted-ice bags produced the greatest temperature change for cutaneous tissues.

Conclusions:

Wetted- and salted-cubed-ice bags were equally effective at decreasing intramuscular temperature at 2 cm subadipose. Clinical practicality may favor salted-ice bags over wetted-ice bags.