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Single-Leg Drop Jump Biomechanics After Ankle or Knee Joint Cooling in Healthy Young Adults. J Sport Rehabil 2021; 31:271-278. [PMID: 34853186 DOI: 10.1123/jsr.2020-0529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 08/21/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT It is unclear if lower-extremity joint cooling alters biomechanics during a functional movement. OBJECTIVE To investigate the effects of unilateral lower-extremity cryotherapy on movement alterations during a single-leg drop jump. DESIGN A crossover design. SETTING Laboratory. PATIENTS Twenty healthy subjects (10 males and 10 females; 23 y, 169 cm, 66 kg). INTERVENTION(S) Subjects completed a single-leg drop jump before and after a 20-minute ankle or knee joint cooling on the right leg, or control (seated without cooling) on 3 separate days. MAIN OUTCOME MEASURES Time to peak knee flexion, vertical ground reaction force, lower-extremity joint angular velocity (sagittal plane only), and angle and moment (sagittal and frontal planes) in the involved leg over the entire ground contact (GC; from initial contact to jump-off) during the first landing. Time to peak knee flexion was compared using an analysis of variance; the rest of the outcome measures were analyzed using functional analyses of variance (P < .05). RESULTS Neither joint cooling condition changed the time to peak knee flexion (F2,95 = 0.73, P = .49). Ankle joint cooling reduced vertical ground reaction force (55 N at 4% of GC), knee joint angular velocity (44°/s during 5%-9% of GC), and knee varus moment (181 N·m during 18%-20% of GC). Knee joint cooling resulted in a reduction in knee joint angular velocity (24°/s during 37%-40% of GC) and hip adduction moment (151 N·m during 46%-48% of GC), and an increase in hip joint angular velocity (16°/s during 49%-53% of GC) and plantarflexion angle (1.5° during 11%-29% of GC). CONCLUSION Resuming activity immediately after lower-extremity joint cooling does not seem to predispose an individual to injury during landing because altered mechanics are neither overlapping with the injury time period nor of sufficient magnitude to lead to an injury.
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Furmanek MP, Słomka KJ, Sobiesiak A, Rzepko M, Juras G. The Effects of Cryotherapy on Knee Joint Position Sense and Force Production Sense in Healthy Individuals. J Hum Kinet 2018; 61:39-51. [PMID: 29599858 PMCID: PMC5873335 DOI: 10.1515/hukin-2017-0106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The proprioceptive information received from mechanoreceptors is potentially responsible for controlling the joint position and force differentiation. However, it is unknown whether cryotherapy influences this complex mechanism. Previously reported results are not universally conclusive and sometimes even contradictory. The main objective of this study was to investigate the impact of local cryotherapy on knee joint position sense (JPS) and force production sense (FPS). The study group consisted of 55 healthy participants (age: 21 ± 2 years, body height: 171.2 ± 9 cm, body mass: 63.3 ± 12 kg, BMI: 21.5 ± 2.6). Local cooling was achieved with the use of gel-packs cooled to -2 ± 2.5°C and applied simultaneously over the knee joint and the quadriceps femoris muscle for 20 minutes. JPS and FPS were evaluated using the Biodex System 4 Pro apparatus. Repeated measures analysis of variance (ANOVA) did not show any statistically significant changes of the JPS and FPS under application of cryotherapy for all analyzed variables: the JPS’s absolute error (p = 0.976), its relative error (p = 0.295), and its variable error (p = 0.489); the FPS’s absolute error (p = 0.688), its relative error (p = 0.193), and its variable error (p = 0.123). The results indicate that local cooling does not affect proprioceptive acuity of the healthy knee joint. They also suggest that local limited cooling before physical activity at low velocity did not present health or injury risk in this particular study group.
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Affiliation(s)
- Mariusz P Furmanek
- Jerzy Kukuczka Academy of Physical Education in Katowice, Department of Human Motor Behavior, Katowice, Poland
| | - Kajetan J Słomka
- Jerzy Kukuczka Academy of Physical Education in Katowice, Department of Human Motor Behavior, Katowice, Poland
| | - Andrzej Sobiesiak
- University of Windsor, Department of Mechanical, Automotive & Materials Engineering Windsor, Ontario, Canada
| | - Marian Rzepko
- University of Rzeszow, Faculty of Physical Education, Rzeszow, Poland
| | - Grzegorz Juras
- Jerzy Kukuczka Academy of Physical Education in Katowice, Department of Human Motor Behavior, Katowice, Poland
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Alexander J, Selfe J, Oliver B, Mee D, Carter A, Scott M, Richards J, May K. An exploratory study into the effects of a 20 minute crushed ice application on knee joint position sense during a small knee bend. Phys Ther Sport 2016; 18:21-26. [PMID: 26822165 DOI: 10.1016/j.ptsp.2015.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 05/19/2015] [Accepted: 06/09/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play or activity immediately following cryotherapy application at the knee. The aim of this study was to investigate whether a 20 min application of crushed ice at the knee immediately affects knee joint position sense during a small knee bend. DESIGN Pre- and post-intervention. SETTING University movement analysis laboratory. PARTICIPANTS Eleven healthy male participants. MAIN OUTCOME MEASURES Kinematics of the knee were measured during a weight bearing functional task pre and post cryotherapy intervention using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden). Tissue cooling was measured via a digital thermometer at the knee. RESULTS Results demonstrated significant reductions in the ability to accurately replicate knee joint positioning in both sagittal (P = .035) and coronal (P = .011) planes during the descent phase of a small knee bend following cryotherapy. CONCLUSION In conclusion a 20 min application of crushed ice to the knee has an adverse effect on knee joint repositioning. Team doctors, clinicians, therapists and athletes should consider these findings when deciding to return an athlete to functional weight bearing tasks immediately following ice application at the knee, due to the potential increase risk of injury.
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Affiliation(s)
- Jill Alexander
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom.
| | - James Selfe
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
| | - Ben Oliver
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
| | - Daniel Mee
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
| | - Alexandra Carter
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
| | - Michelle Scott
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
| | - Jim Richards
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
| | - Karen May
- University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire PR1 2HE, United Kingdom
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Tano SS, Fernandes KBP, Moser ADL, Pires-Oliveira DADA, Gil AWO, Oliveira RFD. Effects of cold water immersion on variables of balance in healthy subjects with open and closed eyes. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.003.ao05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractIntroduction Cryotherapy is the use of cold as therapeutic approach. Although often used, its impact on the postural balance is not well-known.Objectives To analyze the effects of cold water immersion in the postural balance on single-leg balance in healthy subjects through the variables of center-of-pressure, velocity anteroposterior and medial-lateral oscillations, comparing conditions open and closed eyes in the moments before, immediately, 20 and 40 minutes after cold water immersion.Material and methods Cross-sectional study with 30 male subjects, cold water immersion at 5 °C during 15 minutes assessed in a force platform, protocol of 3 trials of 30 seconds each with 10 seconds of rest, the average of the 3 trials was used for analysis. The software GraphPad Prisma 5.0 was used for statistical analysis, with the ANOVA test for repeated measures and comparisons with test of Friedman and post-test of Dunn.Results It was observed improvement of the balance by the results of the following variables: in the condition Open Eyes (OE) it was observed significant difference only in the velocity anteroposterior (AP) in the moment before immersion when compared to the 40-minute moment. Significant differences were observed in the condition Closed Eyes (CE) in the following comparisons: in the Center-of-Pressure (COP) only at the immediate moment when compared to the 40-minute moment; in the velocity AP in the moment before when compared to the 40-minute moment, in the immediate moment when compared to the 20-minute and 40-minute moments; and in the medial-lateral velocity (Vel-ML) in two comparisons: in the moment before immersion when compared to the 20-minute and 40-minute moments after cryotherapy. Results show safety in performing activities after cryotherapy.Conclusion Improvement of the postural balance after cold water immersion on the predetermined conditions of this study.
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Hart JM, Kuenze CM, Diduch DR, Ingersoll CD. Quadriceps muscle function after rehabilitation with cryotherapy in patients with anterior cruciate ligament reconstruction. J Athl Train 2015; 49:733-9. [PMID: 25299442 DOI: 10.4085/1062-6050-49.3.39] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONTEXT Persistent muscle weakness after anterior cruciate ligament (ACL) reconstruction may be due to underlying activation failure and arthrogenic muscle inhibition (AMI). Knee-joint cryotherapy has been shown to improve quadriceps function transiently in those with AMI, thereby providing an opportunity to improve quadriceps muscle activation and strength in patients with a reconstructed ACL. OBJECTIVE To compare quadriceps muscle function in patients with a reconstructed ACL who completed a 2-week intervention including daily cryotherapy (ice bag), daily exercises, or both. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 30 patients with reconstructed ACLs who were at least 6 months post-index surgery and had measurable quadriceps AMI. INTERVENTION(S) The patients attended 4 supervised visits over a 2-week period. They were randomly assigned to receive 20 minutes of knee-joint cryotherapy, 1 hour of therapeutic rehabilitation exercises, or cryotherapy followed by exercises. MAIN OUTCOME MEASURE(S) We measured quadriceps Hoffmann reflex, normalized maximal voluntary isometric contraction torque, central activation ratio using the superimposed-burst technique, and patient-reported outcomes before and after the intervention period. RESULTS After the 2-week intervention period, patients who performed rehabilitation exercises immediately after cryotherapy had higher normalized maximal voluntary isometric contraction torques (P = .002, Cohen d effect size = 1.4) compared with those who received cryotherapy alone (P = .16, d = 0.58) or performed exercise alone (P = .16, d = 0.30). CONCLUSIONS After ACL reconstruction, patients with AMI who performed rehabilitation exercises immediately after cryotherapy experienced greater strength gains than those who performed cryotherapy or exercises alone.
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Thain PK, Bleakley CM, Mitchell ACS. Muscle Reaction Time During a Simulated Lateral Ankle Sprain After Wet-Ice Application or Cold-Water Immersion. J Athl Train 2015; 50:697-703. [PMID: 26067429 DOI: 10.4085/1062-6050-50.4.05] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Cryotherapy is used widely in sport and exercise medicine to manage acute injuries and facilitate rehabilitation. The analgesic effects of cryotherapy are well established; however, a potential caveat is that cooling tissue negatively affects neuromuscular control through delayed muscle reaction time. This topic is important to investigate because athletes often return to exercise, rehabilitation, or competitive activity immediately or shortly after cryotherapy. OBJECTIVE To compare the effects of wet-ice application, cold-water immersion, and an untreated control condition on peroneus longus and tibialis anterior muscle reaction time during a simulated lateral ankle sprain. DESIGN Randomized controlled clinical trial. SETTING University of Hertfordshire human performance laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 54 physically active individuals (age = 20.1 ± 1.5 years, height = 1.7 ± 0.07 m, mass = 66.7 ± 5.4 kg) who had no injury or history of ankle sprain. INTERVENTION(S) Wet-ice application, cold-water immersion, or an untreated control condition applied to the ankle for 10 minutes. MAIN OUTCOME MEASURE(S) Muscle reaction time and muscle amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain were calculated. The ankle-sprain simulation incorporated a combined inversion and plantar-flexion movement. RESULTS We observed no change in muscle reaction time or muscle amplitude after cryotherapy for either the peroneus longus or tibialis anterior (P > .05). CONCLUSIONS Ten minutes of joint cooling did not adversely affect muscle reaction time or muscle amplitude in response to a simulated lateral ankle sprain. These findings suggested that athletes can safely return to sporting activity immediately after icing. Further evidence showed that ice can be applied before ankle rehabilitation without adversely affecting dynamic neuromuscular control. Investigation in patients with acute ankle sprains is warranted to assess the clinical applicability of these interventions.
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Affiliation(s)
- Peter K Thain
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Christopher M Bleakley
- Faculty of Life and Health Sciences, University of Ulster, Northern Ireland, United Kingdom
| | - Andrew C S Mitchell
- Department of Sport Science & Physical Activity, University of Bedfordshire, Bedford, United Kingdom. Dr Thain is now at Faculty of Health and Social Sciences, University of Bedfordshire, Luton, Bedfordshire, United Kingdom
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The effects of cryotherapy on proprioception system. BIOMED RESEARCH INTERNATIONAL 2014; 2014:696397. [PMID: 25478573 PMCID: PMC4244933 DOI: 10.1155/2014/696397] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/08/2014] [Indexed: 02/04/2023]
Abstract
Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception.
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Costello JT, Donnelly AE. Cryotherapy and joint position sense in healthy participants: a systematic review. J Athl Train 2011; 45:306-16. [PMID: 20446845 DOI: 10.4085/1062-6050-45.3.306] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To (1) search the English-language literature for original research addressing the effect of cryotherapy on joint position sense (JPS) and (2) make recommendations regarding how soon healthy athletes can safely return to participation after cryotherapy. DATA SOURCES We performed an exhaustive search for original research using the AMED, CINAHL, MEDLINE, and SportDiscus databases from 1973 to 2009 to gather information on cryotherapy and JPS. Key words used were cryotherapy and proprioception, cryotherapy and joint position sense, cryotherapy, and proprioception. STUDY SELECTION The inclusion criteria were (1) the literature was written in English, (2) participants were human, (3) an outcome measure included JPS, (4) participants were healthy, and (5) participants were tested immediately after a cryotherapy application to a joint. DATA EXTRACTION The means and SDs of the JPS outcome measures were extracted and used to estimate the effect size (Cohen d) and associated 95% confidence intervals for comparisons of JPS before and after a cryotherapy treatment. The numbers, ages, and sexes of participants in all 7 selected studies were also extracted. DATA SYNTHESIS The JPS was assessed in 3 joints: ankle (n = 2), knee (n = 3), and shoulder (n = 2). The average effect size for the 7 included studies was modest, with effect sizes ranging from -0.08 to 1.17, with a positive number representing an increase in JPS error. The average methodologic score of the included studies was 5.4/10 (range, 5-6) on the Physiotherapy Evidence Database scale. CONCLUSIONS Limited and equivocal evidence is available to address the effect of cryotherapy on proprioception in the form of JPS. Until further evidence is provided, clinicians should be cautious when returning individuals to tasks requiring components of proprioceptive input immediately after a cryotherapy treatment.
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Affiliation(s)
- Joseph T Costello
- Department of Physical Education and Sport Sciences, University of Limerick, Castletroy, Limerick, Ireland.
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Bleakley CM, O'Connor S, Tully MA, Rocke LG, Macauley DC, McDonough SM. The PRICE study (Protection Rest Ice Compression Elevation): design of a randomised controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain [ISRCTN13903946]. BMC Musculoskelet Disord 2007; 8:125. [PMID: 18093299 PMCID: PMC2228299 DOI: 10.1186/1471-2474-8-125] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Accepted: 12/19/2007] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Cryotherapy (the application of ice for therapeutic purposes) is one of the most common treatment modalities employed in the immediate management of acute soft tissue injury. Despite its widespread clinical use, the precise physiological responses to therapeutic cooling have not been fully elucidated, and effective evidence-based treatment protocols are yet to be established. Intermittent ice applications are thought to exert a significant analgesic effect. This could facilitate earlier therapeutic exercise after injury, potentially allowing for a quicker return to activity. The primary aim of the forthcoming study is therefore to examine the safety and effectiveness of combining intermittent ice applications with periods of therapeutic exercise in the first week after an acute ankle sprain. METHODS/DESIGN The study is a randomised controlled trial. 120 subjects with an acute grade I or grade II ankle sprain will be recruited from Accident & Emergency and a University based Sports Injury Clinic. Subjects will be randomised under strict double-blind conditions to either a standard cryotherapy (intermittent ice applications with compression) or cryokinetic treatment group (intermittent ice applications with compression and therapeutic exercise). After the first week, treatment will be standardised across groups. Assessor blinding will be maintained throughout the trial. Primary outcome will be function, assessed using the Lower Extremity Functional Scale (LEFS). Additional outcomes will include pain (10 cm Visual Analogue Scale), swelling (modified figure-of-eight method) and activity levels (activPALtrade mark physical activity monitor, PAL Technologies, Glasgow, UK). Diagnostic Ultrasound (Episcan-1-200 high frequency ultrasound scanning system, Longport International Ltd, PA) will also be used to assess the degree of soft tissue injury. After baseline assessment subjects will be followed up at 1, 2, 3 & 4 weeks post injury. All data will be analysed using repeated measures analysis of co-variance (ANCOVA). DISCUSSION This paper describes the rationale and design of a randomised controlled trial which will examine the effectiveness of two different cryotherapy protocols in the early management of acute ankle sprain. TRIAL REGISTRATION ISRCTN13903946.
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Affiliation(s)
- Chris M Bleakley
- Health & Rehabilitation Sciences Research Institute, University of Ulster, Jordanstown, Northern Ireland, UK.
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