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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.

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Mack D. Rubley, William R. Holcomb, and Mark A. Guadagnoli

Context:

Cryotherapy is initially uncomfortable, but habituation is thought to occur during treatment.

Objective:

To examine pain habituation to ice-bath immersion over 5 consecutive days.

Design:

Mean Borg ratings were analyzed by ANOVA.

Setting:

Athletic training laboratory.

Intervention:

Ankle immersion in a 1 °C ice bath for 20 min.

Participants:

28 healthy individuals.

Main Outcome Measure:

Level of discomfort was rated at immersion; during treatment at 1, 3, 5, 8, 11, 14, 17, and 20 min; and 1 min posttreatment.

Results:

Analysis revealed significant main effects for day and time and a Day × Time interaction. Day 1 had higher pain ratings than days 4 and 5. From min 1 to 11 there was a progressive decline in pain rating; after that there was no significant decline.

Conclusions:

Discomfort was greatest during the first 5 min, and perception of discomfort at initial immersion was consistent across 5 days. In addition, after 3 days of treatments habituation occurred. Taken together, this suggests that treatment habituation is not the result of change in receptor sensitivity.

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Jessica M. Stephens, Ken Sharpe, Christopher Gore, Joanna Miller, Gary J. Slater, Nathan Versey, Jeremiah Peiffer, Rob Duffield, Geoffrey M. Minett, David Crampton, Alan Dunne, Christopher D. Askew, and Shona L. Halson

possible after exercise. 3. Intermittent CWI protocols are effective in reducing T c and can be used when there are a large number of athletes who need to complete CWI with limited resources (eg, 1 ice bath) or when an athlete is uncomfortable with long-duration CWI. 4. Consideration should be given to

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

Purpose: To evaluate the effectiveness between cold-water immersion (CWI) and phase-change-material (PCM) cooling on intramuscular, core, and skin-temperature and cardiovascular responses. Methods: In a randomized, crossover design, 11 men completed 15 min of 15°C CWI to the umbilicus and 2-h recovery or 3 h of 15°C PCM covering the quadriceps and 1 h of recovery, separated by 24 h. Vastus lateralis intramuscular temperature at 1 and 3 cm, core and skin temperature, heart-rate variability, and thermal comfort were recorded at baseline and 15-min intervals throughout treatment and recovery. Results: Intramuscular temperature decreased (P < .001) during and after both treatments. A faster initial effect was observed from 15 min of CWI (Δ: 4.3°C [1.7°C] 1 cm; 5.5°C [2.1°C] 3 cm; P = .01). However, over time (2 h 15 min), greater effects were observed from prolonged PCM treatment (Δ: 4.2°C [1.9°C] 1 cm; 2.2°C [2.2°C] 3 cm; treatment × time, P = .0001). During the first hour of recovery from both treatments, intramuscular temperature was higher from CWI at 1 cm (P = .013) but not 3 cm. Core temperature deceased 0.25° (0.32°) from CWI (P = .001) and 0.28°C (0.27°C) from PCM (P = .0001), whereas heart-rate variability increased during both treatments (P = .001), with no differences between treatments. Conclusions: The magnitude of temperature reduction from CWI was comparable with PCM, but intramuscular temperature was decreased for longer during PCM. PCM cooling packs offer an alternative for delivering prolonged cooling whenever application of CWI is impractical while also exerting a central effect on core temperature and heart rate.

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Stephen J. Kinzey, Mitchell L. Cordova, Kevin J. Gallen, Jason C. Smith, and Justin B. Moore

Objective:

To determine whether a standard 20-min ice-bath (10°C) immersion of the leg alters vertical ground-reaction-force components during a 1 -legged vertical jump.

Design:

A 1 × 5 factorial repeated-measures model was used.

Setting:

The Applied Biomechanics Laboratory at The University of Mississippi.

Participants:

Fifteen healthy and physically active subjects (age = 22.3 ± 2.1 years, height = 177.3 ± 12.2 cm, mass = 76.3 ± 19.1 kg) participated.

Intervention:

Subjects performed 25 one-legged vertical jumps with their preferred extremity before (5 jumps) and after (20 jumps) a 20-min cold whirlpool to the leg. The 25 jumps were reduced into 5 sets of average trials.

Main Outcome Measures:

Normalized peak and average vertical ground-reaction forces, as well as vertical impulse obtained using an instrumented force platform.

Results:

Immediately after cryotherapy (sets 2 and 3), vertical impulse decreased (P = .01); peak vertical ground-reaction force increased (set 2) but then decreased toward baseline measures (P= .02). Average vertical ground-reaction force remained unchanged (P >.05).

Conclusions:

The authors advocate waiting approximately 15 min before engaging in activities that require the production of weight-bearing explosive strength or power.

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Original Research Reports The Relationship between Lower Extremity Isokinetic Work and Single-Leg Functional Hop-Work Test Robert English * Mary Brannock * Wan Ting Chik * Laura S. Eastwood * Tim Uhl * 5 2006 15 2 95 104 10.1123/jsr.15.2.95 Research Pain Perception during Repeated Ice-Bath

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: Preinjury and Postinjury Factors Influencing Psychological Adjustment to Sport Injury Courtney B. Albinson * Trent A. Petrie * 11 2003 12 4 306 322 10.1123/jsr.12.4.306 Time Course of Habituation After Repeated Ice-Bath Immersion of the Ankle Mack D. Rubley * William R. Holcomb * Mark A

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Eurico P. César, Cleito S.R. Júnior, and Raphael N. Francisco

skin surface of working muscle is associated with an increase in exercise intensity. 4 Fonseca et al 5 reported that serum LDH levels were negatively correlated with lower limb power. They submitted 12 highly trained male jiu-jitsu competitors to the CWI condition, immersed in the ice bath to the

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Katie J. Lyman, Michael McCrone, Thomas A. Hanson, Christopher D. Mellinger, and Kara Gange

.1179/174328810X12786297204873 10.1179/174328810X12786297204873 17. Galvan HG , Tritsch AJ , Tandy R , Rubley MD . Pain perception during repeated ice-bath immersion of the ankle at varied temperatures . J Sport Rehabil . 2006 ; 15 ( 2 ): 105 – 115 . doi:10.1123/jsr.15.2.105 10.1123/jsr.15.2.105 18

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Connor A. Burton and Christine A. Lauber

OR endurance cyclists • Intervention: cold water immersion, OR ice immersion, OR cold bath, OR ice bath, AND pre-cooling • Comparison: control • Outcomes: performance, AND core temperature, AND heart rate, AND rate of perceived exertion, AND blood lactate concentration Figure 1 —Summary of search