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Effects of 7 Consecutive Systematic Applications of Cryotherapy With Compression

Lisa S. Jutte and Dylan J. Paracka

Context: Postsurgical and acute orthopedic patients are frequently treated with consecutive systematic cryotherapy despite the void of data to support treatment safety or effectiveness. The purpose of this study was to examine the occurrence of frostbite and measure skin temperatures during the systematic application of 2 cryocompression protocols. Design: A repeated-measures design guided this study. Methods: Nine healthy, college-aged participants (4 men and 5 women; age = 20.7 [1.2] y; height = 174 [11.01] cm; mass = 74 [14] kg) received both cryocompression protocols separated by ≥ 1 week. The static cryocompression protocol consisted of seven 40-minute “on” cycles of cryotherapy (4.4°C) with 45 mm Hg of compression, each followed by a 30-minute “off” cycle (no cryotherapy, compression set at 5 mm Hg). The intermittent cryocompression protocol consisted of seven 40-minute “on” cycles of cryotherapy (4.4°C) with compression alternating between 5 and 45 mm Hg, each followed by a 30-minute “off” cycle (no cryotherapy, compression set at 5 mmHg). At the end of each “on” and “off” cycle, we used a checklist to assess for frostbite, a PT-6 thermocouple to measure skin temperature (in degrees Celsius), and a 10-cm Likert scale to assess comfort. Results: None of the participants experienced any signs or symptoms of frostbite. There were no differences in skin temperature between the compression conditions over time (F 14,112 = 1.43; P = .149) nor were there any differences between the 2 compression conditions (F 1,8 = 3.75; P = .087; 1−β = 0.40). The skin temperatures were statistically different over the course of all 7 “on” and “off” cycles (F 14,112 = 95.12; P < .001). There was no difference between the skin temperatures produced at the end of each “on” cycle. Conclusions: The application of 7 consecutive cryotherapy treatments with compression did not result in any signs or symptoms of frostbite and produced similar skin temperatures with each “on” cycle.

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Reliability and Validity of Electrothermometers and Associated Thermocouples

Lisa S. Jutte, Kenneth L. Knight, and Blaine C. Long


Examine thermocouple model uncertainty (reliability + validity).


First, a 3 × 3 repeated measures design with independent variables electrothermometers and thermocouple model. Second, a 1 × 3 repeated measures design with independent variable subprobe.


Three electrothermometers, 3 thermocouple models, a multi-sensor probe and a mercury thermometer measured a stable water bath.

Main Outcome Measures:

Temperature and absolute temperature differences between thermocouples and a mercury thermometer.


Thermocouple uncertainty was greater than manufactures’ claims. For all thermocouple models, validity and reliability were better in the Iso-Themex than the Datalogger, but there were no practical differences between models within an electrothermometers. Validity of multi-sensor probes and thermocouples within a probe were not different but were greater than manufacturers’ claims. Reliability of multiprobes and thermocouples within a probe were within manufacturers claims.


Thermocouple models vary in reliability and validity. Scientists should test and report the uncertainty of their equipment rather than depending on manufactures’ claims.

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EMG Comparison of Selected Ankle Rehabilitation Exercises

Mitchell L. Cordova, Lisa S. Jutte, and J. Ty Hopkins

Many types of rehabilitation exercises are used to reestablish lower extremity neuromuscular function and strength following ankle injuries. It has not been established which exercise induces the greatest leg muscle activity, which might allow patients to recover more quickly from their injuries. The purpose of this investigation was to establish which exercises induce the most muscle activity in the medial gastrocnemius (MG), peroneus longus (PL), and tibialis anterior (TA), as measured by integrated electromyography (I-EMG). Participants (N = 24, age = 22 ± .59, mass = 63.5 ± 2.1 kg, ht = 165.7 ± 1.2 cm) conducted five repetitions of each of four exercise conditions for 30 s: one-legged stance (OLS), OLS on trampoline (OLST), T-Band kicks (TBK), and OLS perturbations (OLSP). It was found that the TBK exercise induces greater I-EMG in all three muscles, the OLST exercise stimulates more I-EMG activity in the MG and TA, and the OLSP exercise induces greater I-EMG activity in the TA.

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Hot-Pack Warming in 4- and 8-Pack Hydrocollator® Units

David A. Kaiser, Kenneth L. Knight, Jeremy M. Huff, Lisa S. Jutte, and Preston Carlson


To determine the time needed to heat hot packs to water temperature (73–75 °C) in 4- and 8-pack Hydrocollator® units.

Design and Setting:

A 2 × 2 factorial design, with heating unit (4- or 8-pack) and number of packs added (1 or 3/7) as independent variables. Dependent variables were hot-pack and Hydrocollator-water temperatures.


Temperatures were measured with type T thermocouples interfaced with a 16-channel Isothermex™. Hydrocollator temperatures were measured with 2 thermocouples, and hot-pack temperatures, with 6 thermocouples inserted in 6 cells of a hydrated, 10- by 12-in Hydrocollator pack. Temperature was measured every 30 s for 5 min before and 45 min after pack immersion.


Packs warmed rapidly from ~18 to 65–68 °C by 10 min and to 72.5–75 °C by 20 min. Heating slowed by ~5% when 7 packs were added to the large unit. Water temperatures decreased ~2 °C (from ~75 °C) after 7 packs were immersed and returned to preimmersion temperatures by 20 min.


Rewarming is quicker than commonly believed (20–150 min) and might be a function of the number of packs being simultaneously warmed.