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Jennifer Ostrowski, Angelina Purchio, Maria Beck and JoLynn Leisinger

(15–75 mm Hg), PowerPlay-ice bag (PP-ice) at 70 mm Hg of compression. The subjects were assigned to their treatment order based on a predetermined order scheme (ABC, ACB, BAC, BCA, CAB, and CBA). Treatment conditions were separated by a minimum of 4 days and a maximum of 7 days to ensure there were no

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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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Hailey N. Love, Kimberly A. Pritchard, Joseph M. Hart and Susan A. Saliba

Context:

Alterations in skin sensations may be responsible for pain reduction provided by cryotherapy, but the exact physiological mechanism is unknown.

Objective:

To investigate perceptions of skin sensations associated with different modes of cryotherapy administration and skin temperature at the point of perceived numbness.

Design:

Repeated measures.

Participants:

30 healthy subjects (12 Male, 18 Female, Age = 21.1±1.9 years).

Interventions:

Crushed ice bag, ice massage, and cold water immersion.

Main Outcome Measures:

Perceptions of sensations during each mode of cryotherapy administration were derived from a Modified McGill Pain Questionnaire. Skin temperature was recorded when numbness was reported for each treatment.

Results:

Participants experienced sensations that included cold, tight, tingling, stinging, and numb. Ice massage sensations transitioned rapidly from cold to numb, whereas cold water immersion and ice bag treatments produced altered sensations for longer duration. Ice massage decreased skin temperature significantly more than the other two modes of cryotherapy administration.

Conclusions:

Ice massage may be the best mode of cryotherapy administration for achievement of anaesthesia as rapidly as possible, whereas cold water immersion and ice bag application may be better for attainment of pain reduction associated with noxious stimulation of skin receptors.

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Christine L. Berg, Joseph M. Hart, Riann Palmieri-Smith, Kevin M. Cross and Christopher D. Ingersoll

Context:

If ankle joint cryotherapy impairs the ability of the ankle musculature to counteract potentially injurious forces, the ankle is left vulnerable to injury.

Objective:

To compare peroneal reaction to sudden inversion following ankle joint cryotherapy.

Design:

Repeated measures design with independent variables, treatment (cryotherapy and control), and time (baseline, immediately post treatment, 15 minutes post treatment, and 30 minutes post treatment).

Setting:

University research laboratory.

Patients or Other Participants:

Twenty-seven healthy volunteers.

Intervention(s):

An ice bag was secured to the lateral ankle joint for 20 minutes.

Main Outcome Measures:

The onset and average root mean square amplitude of EMG activity in the peroneal muscles was calculated following the release of a trap door mechanism causing inversion.

Results:

There was no statistically significant change from baseline for peroneal reaction time or average peroneal muscle activity at any post treatment time.

Conclusions:

Cryotherapy does not affect peroneal muscle reaction following sudden inversion perturbation.

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Jenna K. Cataldi, Kimberly A. Pritchard, Joseph M. Hart and Susan A. Saliba

Context:

Recommended treatment duration for cryotherapy varies, but the primary therapeutic benefit may be related to the amount of time required for changes in cutaneous sensation.

Objective:

To determine the amount of time required to induce numbness for three different modes of cryotherapy administration, and the amount of time that numbness persists after treatment.

Design:

Repeated measures.

Participants:

30 healthy adults (12 males, 18 females, age = 21.1 ± 1.9 years).

Interventions:

Crushed ice bag, ice massage, and cold water immersion.

Main Outcome Measures:

Time required to induce numbness and the amount of time numbness remained after removal of each mode of cryotherapy.

Results:

Ice massage and cold water immersion produced numbness significantly faster than the crushed ice. There were no significant differences in terms of numbness duration.

Conclusions:

Changes in cutaneous sensation can be achieved in a relatively short amount of time (6–12 minutes) with ice massage and cold water immersion. The duration of the treatment effect did not differ among the three modes of cryotherapy administration.

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Amy Mauro and Blaine C. Long

. The purpose of this study, therefore, was to determine if an ice bag or moist heat pack (MHP) application, prior to PNF-CR stretching the hamstring muscle group, improved passive hip flexion ROM more than just PNF-CR stretching or ice bag or MHP alone. We hypothesized that participants assigned to

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

temperature decreases between salted ice bags, Game Ready at high pressure, and PowerPlay with wetted ice bag. 19 Previous research has found that frozen gel packs produce limited decreases in muscular tissue, 10 , 20 yet despite these findings, new cryo-compression units utilizing frozen gel packs continue

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Tyler A. Beauregard, Jade Vaile, Lucas Whitney, Mark Merrick and Valerie Moody

.24 L of crushed ice was placed in a 38- × 51-cm plastic ice bag; and for the saltwater pack, 0.24 L of crushed ice was combined with 0.06 L of noniodized salt in a 38- × 51-cm plastic ice bag. Medco Instant Cold Pack ® was obtained from Medco Sports Medicine (Amherst, NY). Prior to the study, all

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Joseph M. Hart, Jamie L. Leonard and Christopher D. Ingersoll

Context:

Despite recent findings regarding lower extremity function after cryotherapy, little is known of the neuromuscular, kinetic, and kinematic changes that might occur during functional tasks.

Objective:

To evaluate changes in ground-reaction forces, muscle activity, and knee-joint flexion during single-leg landings after 20-minute knee-joint cryotherapy.

Design:

1 × 4 repeated-measures, time-series design.

Setting:

Research laboratory.

Patients or Other Participants:

20 healthy male and female subjects.

Intervention:

Subjects performed 5 single-leg landings before, immediately after, and 15 and 30 minutes after knee-joint cryo-therapy.

Main Outcome Measures:

Ground-reaction force, knee-joint flexion, and muscle activity of the gastrocnemius, hamstrings, quadriceps, and gluteus medius.

Results:

Cryotherapy did not significantly (P > .05) change maximum knee-joint flexion, vertical ground-reaction force, or average muscle activity during a single-leg landing.

Conclusion:

Knee-joint cryotherapy might not place the lower extremity at risk for injury during landing.

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Bonnie L. Van Lunen, Clayton Carroll, Kristen Gratias and Doug Straley

Context:

Rehabilitation.

Objective:

To determine the effects of a 20-min ice treatment on pain tolerance and peak torque.

Design:

A 2 × 2 × 6 factorial with repeated measures on 1 factor.

Setting:

Outpatient rehabilitation clinic.

Participants:

20 men and 15 women.

Intervention:

The participants were randomly assigned to an experimental (ice bag) or control (no ice bag) group.

Main Outcome Measures:

Peak electrical-stimulation output intensity (ESOI) was recorded in mV, and isokinetic peak torque (IPT), in N · m, every 4 min for 20 min.

Results:

ESOI and IPT increased over time. ESOI for the experimental condition was greater than for the control and within the experimental condition at 12, 16, and 20 min. No other differences were found for the IPT measures. There were no differences for ESOI and IPT between genders.

Conclusions:

Cryotherapy enables patients to tolerate greater output intensities but does not result in increased peak torque