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Kenneth L. Knight, Jody B. Brucker, Paul D. Stoneman and Mack D. Rubley

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Kevin Guskiewicz

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Susan Y. Kwiecien, Malachy P. McHugh, Stuart Goodall, Kirsty M. Hicks, Angus M. Hunter and Glyn Howatson

practical perspective, this cryotherapy modality offers an attractive alternative to CWI, as individuals can resume activities of daily living while simultaneously receiving cryotherapy treatment that maintains a constant temperature for an extended duration. A 6-hour PCM application reduced pain and

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Kavin K.W. Tsang, Barton P. Buxton, W. Kent Guion, A. Barry Joyner and Kathy D. Browder

The purpose of this study was to investigate the differences in skin temperature during ice application through a dry towel and a dry elastic bandage compared to application on bare skin. Nine subjects completed a 30-min treatment session that consisted of 0.68 kg of cubed ice applied under three conditions: through a dry towel, through a dry elastic bandage, and directly on the skin (control). Following the removal of the ice, all subjects were monitored for 20-min for skin temperature (S temp). There was a significant interaction in S temp between the control (12.50 ± 4.39 °C) and dry towel (23.48 ± 2.88 °C) conditions, the control (12.50 ± 4.39 °C) and dry elastic wrap (27.47 ± 2.36 °C) conditions, and the dry towel (23.48 ± 2.88 °C) and dry elastic wrap (27.47 ± 2.36 °C) conditions. The findings indicated that using a barrier (dry towel or dry elastic bandage) limits the temperature-reducing capacity of the ice and therefore its potential physiological effects.

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Susan G. Capps and Mayberry Brook

Edited by Tricia Hubbard

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James G. Snyder, Jatin P. Ambegaonkar and Jason B. Winchester

Edited by Joe J. Piccininni

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Jeffrey A. Borgmeyer, Bradley A. Scott and Jerry L. Mayhew

Context:

The effect of ice massage on muscle-strength performance is equivocal.

Objective:

To determine the effects of ice massage on maximum isokinetic torque produced during a 20-minute interval.

Design:

Participants performed a maximal isokinetic contraction of the right arm at 30°/s every 2 minutes for 20 minutes, once after a 10-minute ice massage over the right biceps brachii muscle belly and once without ice treatment. Sessions were randomized.

Participants:

11 college men.

Measurements:

Torque was measured with a Cybex® II dynamometer. Biceps skinfold was measured with a Harpenden caliper.

Results:

A repeated-measures ANCOVA revealed no significant interaction between time and treatment condition when the effect of skinfold thickness was held constant. A main effect for time indicated that torque production was significantly higher at 4 and 8 minutes and declined thereafter.

Conclusions:

A 10-minute ice massage neither enhanced nor retarded muscle-force output and thus may be used for its pain-reducing effect to allow resistance exercise during the rehabilitation process

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Kyung-Min Kim, Christopher D. Ingersoll and Jay Hertel

Context:

Focal ankle-joint cooling (FAJC) has been shown to increase Hoffmann (H) reflex amplitudes of select leg muscles while subjects lie prone, but it is unknown whether the neurophysiological cooling effects persist in standing.

Objective:

To assess the effects of FAJC on H-reflexes of the soleus and fibularis longus during 3 body positions (prone, bipedal, and unipedal stances) in individuals with and without chronic ankle instability (CAI).

Design:

Crossover.

Setting:

Laboratory.

Participants:

15 young adults with CAI (9 male, 6 female) and 15 healthy controls.

Intervention:

All subjects received both FAJC and sham treatments on separate days in a randomized order. FAJC was accomplished by applying a 1.5-L plastic bag filled with crushed ice to the ankle for 20 min. Sham treatment involved room-temperature candy corn.

Main Outcome Measures:

Maximum amplitudes of H-reflexes and motor (M) waves were recorded while subjects lay prone and then stood in quiet bipedal and unipedal stances before and immediately after each treatment. Primary outcome measures were Hmax:Mmax ratios for the soleus and fibularis longus. Three-factor (group × treatment condition × time) repeated-measures ANOVAs and Fisher LSD tests were performed for statistical analyses.

Results:

Significant interactions of treatment condition by time for prone Hmax:Mmax ratios were found in the soleus (P = .001) and fibularis longus (P = .003). In both muscles, prone Hmax:Mmax ratios moderately increased after FAJC but not after sham treatment. The CAI and healthy groups responded similarly to FAJC. In contrast, there were no significant interactions or main effects in the bipedal and unipedal stances in either muscle (P > .05).

Conclusions:

FAJC moderately increased H-reflex amplitudes of the soleus and fibularis longus while subjects were prone but not during bipedal or unipedal standing. These results were not different between groups with and without CAI.

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Robert Topp, Lee Winchester, Amber M. Mink, Jeremiah S. Kaufman and Dean E. Jacks

Context:

Soft-tissue injuries are commonly treated with ice or menthol gels. Few studies have compared the effects of these treatments on blood flow and muscle strength.

Objective:

To compare blood flow and muscle strength in the forearm after an application of ice or menthol gel or no treatment.

Design:

Repeated-measures design in which blood-flow and muscle-strength data were collected from subjects under 3 treatment conditions.

Setting:

Exercise physiology laboratory.

Participants:

17 healthy adults with no impediment to the blood flow or strength in their right arm, recruited through word of mouth.

Intervention:

Three separate treatment conditions were randomly applied topically to the right forearm: no treatment, 0.5 kg of ice, or 3.5 mL of 3.5% menthol gel. To avoid injury ice was only applied for 20 min.

Main Outcome Measures:

At each data-collection session blood flow (mL/min) of the right radial artery was determined at baseline before any treatment and then at 5, 10, 15, and 20 min after treatment using Doppler ultrasound. Muscle strength was assessed as maximum isokinetic flexion and extension of the wrist at 30°/s 20, 25, and 30 min after treatment.

Results:

The menthol gel reduced (−42%, P < .05) blood flow in the radial artery 5 min after application but not at 10, 15, or 20 min after application. Ice reduced (−48%, P < .05) blood flow in the radial artery only after 20 min of application. After 15 min of the control condition blood flow increased (83%, P < .05) from baseline measures. After the removal of ice, wrist-extension strength did not increase per repeated strength assessment as it did during the control condition (9−11%, P < .05) and menthol-gel intervention (8%, P < .05).

Conclusions:

Menthol has a fast-acting, short-lived effect of reducing blood flow. Ice reduces blood flow after a prolonged duration. Muscle strength appears to be inhibited after ice application.

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Haydee G. Galvan, Amanda J. Tritsch, Richard Tandy and Mack D. Rubley

Context:

Ice-bath temperatures range from 1 to 15ºC; the pain response during treatment might be temperature specific.

Objective:

To determine levels of perceived pain during ice-bath immersion at distinct temperatures.

Design:

2 (sex) × 3 (temperature) × 9 (treatment time).

Setting:

Athletic training research laboratory.

Participants:

32 healthy subjects.

Intervention:

Ankle immersion in 1, 10, and 15°C ice baths for 20 minutes.

Main Outcome Measures:

Discomfort measured by the Borg scale of perceived pain at immersion for 1, 2, 4, 6, 8, 10, 15, and 20 minutes.

Results:

The magnitude of pain felt depended on treatment temperature (F 18,522 = 11.65, P < .0001). Pain ratings were 43% higher for 1ºC than 10ºC and 70% higher than 15ºC, and ratings at 10ºC were 46% higher than at 15ºC.

Conclusions:

Pain depends on treatment temperature. Patients might report inconsistent pain ratings with varying temperature.