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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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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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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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B. Andrew Krause., J. Ty Hopkins, Christopher D. Ingersoll, Mitchell L. Cordova and Jeffrey E. Edwards

Objective:

Correlate skin temperature and motoneuron-pool recruitment during cooling and rewarming.

Design:

Within-subjects, correlational analysis. H reflex was correlated to ankle-skin temperature over time using a Pearson product-moment correlation coefficient and a coefficient of determination (R2).

Subjects:

Ten healthy, physically active college students.

Measurements:

Soleus H reflex and ankle-skin interface temperature were measured during ice application and rewarming. Electrical stimulation was delivered to produce 75% of each subject's maximum H reflex.

Results:

Ankle cooling (r = −.95, P < .05) exhibited a strong inverse relationship with soleus H reflex. A positive correlation was observed between rewarming (r = .74, P < .05) and soleus H reflex.

Conclusions:

Temperature accounts for nearly 90% (R2 = .90) of the variability in the soleus H reflex during cooling and 55% (R2 = .55) during rewarming, suggesting that more motoneurons are recruited as temperature decreases. These interactions appear to involve both local and central nervous system functions.

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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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Eric Winters, Steven Doty and Sean Newell

Objective:

To explore changes in bovine Achilles-tendon elasticity relative to 3 thermal conditions.

Design and Setting:

Posttest-only design with assignment by convenience. Manufactured-apparatus-clamped excised tendon, delivered tensile stress, and provided strain measures. Stress was increased at 1-minute intervals. Strain was observed for each level of stress. Before testing, cold-group tendons were submerged in cold water for 20 minutes. Heat-group tendons were tested in the presence of an ultraviolet lamp. A third group of tendons was tested at room temperature.

Subjects:

Frozen bovine Achilles tendons provided by a meat-rendering factory and segmented into 3 longitudinal strips.

Measurements:

Stress and strain were sequentially measured. Elastic region was identified, elastic-region Young's modulus determined, and elastic limit calculated.

Results:

Young's modulus for cold was 0.956 gigapascal (GPa; ± 0.0621); room temperature, 0.753 GPa (± 0.0624); and heat group, 0.487 GPa (± 0.0407). Significant differences were identified between each of the 3 conditions.

Conclusions:

A direct relationship was observed between imposed thermal energy and tendon elasticity. Thermal energy does not affect the elastic limit.

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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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Stephanie J. Guzzo, Susan W. Yeargin, Jeffery S. Carr, Timothy J. Demchak and Jeffrey E. Edwards

Context:

Many athletic trainers use “ice to go” to treat their athletes. However, researchers have reported that icing a working muscle may negate intramuscular (IM) cooling.

Objective:

The purpose of our study was to determine the length of time needed to cool the gastrocnemius while walking followed by rest.

Design:

A randomized crossover study design was used.

Setting:

Exercise Physiology Laboratory.

Patients or Other Participants:

Nine healthy, physically active males and females (males 5, females 4; age 24.0 ± 2.0 years; height 174.0 ± 8.0 cm; weight 86.3 ± 6.5 kg; skinfold taken at center of gastrocnemius greatest girth, R leg 20.3 ± 4.4 mm, L leg 19.6 ± 4.1 mm) without lower extremity injury or cold allergy volunteered to complete the study.

Intervention:

Participants randomly experienced three treatment conditions on separate days: rest (R), walk for 15 minutes followed by rest (W15R), or walk for 30 minutes followed by rest (W30R). During each treatment, participants wore a 1 kg ice bag secured to their right gastrocnemius muscle. Participants walked at a 4.5km/hr pace on a treadmill during the W15R and W30R trials.

Main Outcome Measures:

A 1 × 3 within groups ANOVA was used to determine the effect of activity on cooling time needed for the gastrocnemius temperature to decrease 6 °C below baseline.

Results:

The R condition cooled faster (25.9 ± 5.5 min) than both W15R (33.7 ± 9.3 min; P = .002) and W30R (49.4 ± 8.4 min; P < .001). Average time to decrease 6 °C after W15R was 18.7 ± 9.3 minutes and after W30R was 19.4 ± 8.4 minutes.

Conclusions:

Clinicians should instruct their patients to stay and ice or to keep the ice on for an additional 20 minutes after they stop walking and begin to rest.

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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.