Herrera E1, Bacca O1, Reina DC1, Delgado-Díaz DC1, Gonzalez MJ1
1Universidad Industrial de Santander, Physical Therapy, Bucaramanga, Colombia
Background: Cryotherapy is widely used in acute injuries treatment. However, its prescription in balance deficiency conditions as well as in athletic participation is still controversial. There has been conflicting evidence in the literature on whether cryotherapy affects postural sway and/or proprioception (joint position sense-JPS) with some studies observing impaired postural control, while others reporting no effect. Also, the comparison of the effects of different cryotherapy modalities on these variables has not been described.
Purpose: To evaluate the immediate and 30min after effect of two cryotherapy modalities on ankle JPS and static postural sway in healthy individuals.
Methods: Randomized single-blinded experimental study. 75 healthy, physically active males (age: 20.1±1.9y/o; BMI: 22.5±2.7kg/cm2) volunteered to participate. Subjects were randomly distributed into three groups: control (CG) - 20min at rest without cryotherapy; and experimental groups - cryotherapy on calf (15x25cm) of the dominant lower limb (20min), being either ice pack (IP) or ice-massage (IM). Ankle JPS acuity was measured in degrees of error from a preselected target angle, using an isokinetic dynamometer (Humac®-Norm). Postural sway was measured through the center of pressure (COP) oscillation using Humac Balance System, under 4 condition of unipedal standing (10s) on stable and unstable surface with open and closed eyes; COP mean velocity (cm/s) and total path length (cm) were registered. Measurements were performed immediately before, after and 30min post-cryotherapy; skin temperature was measured at each time point. One-way repeated measures ANOVA was used to identify the effect of time intra-group; ANCOVA was applied for the between-groups analysis, considering CG as reference.
Results: Skin temperature significantly decreased in both experimental groups (IP:27.3±1.4°C, p 0,001; IM:25.2±1.6°C, p 0,001), and did reach baseline measurement 30min post-cryotherapy, when adjusted by CG (IP: 2.4±4.6°C, p=0.6; IM:0.6±4.3°C, p=0.8). No differences intra-group or between groups were detected in COP mean velocity and path length in neither group nor condition (p>0.05). Greater JPS error for plantarflexion was detected immediately after IM treatment compared to CG (β=2.0, p=0.02); no further effect of cryotherapy on JPS was detected.
Conclusion(s): The two modalities of cryotherapy demonstrated effect on neither postural sway nor joint position sense on young and healthy men. Our results support previous studies that report no impairment in JPS post-treatment using superficial applications of cryotherapy. It also seems plausible that the modalities applied in the current study did not induce sufficient intramuscular or joint cooling to alter proprioceptive sensitivity.
Implications: IP and IM modalities, as used in the present study, can be safety for the treatment of acute injuries in balance deficiency conditions as well as in athletic participation, considering that small changes in the balance were identified after the cooling application.
Keywords: Cryotherapy, joint position sense, postural sway
Funding acknowledgements: Universidad Industrial de Santander
Purpose: To evaluate the immediate and 30min after effect of two cryotherapy modalities on ankle JPS and static postural sway in healthy individuals.
Methods: Randomized single-blinded experimental study. 75 healthy, physically active males (age: 20.1±1.9y/o; BMI: 22.5±2.7kg/cm2) volunteered to participate. Subjects were randomly distributed into three groups: control (CG) - 20min at rest without cryotherapy; and experimental groups - cryotherapy on calf (15x25cm) of the dominant lower limb (20min), being either ice pack (IP) or ice-massage (IM). Ankle JPS acuity was measured in degrees of error from a preselected target angle, using an isokinetic dynamometer (Humac®-Norm). Postural sway was measured through the center of pressure (COP) oscillation using Humac Balance System, under 4 condition of unipedal standing (10s) on stable and unstable surface with open and closed eyes; COP mean velocity (cm/s) and total path length (cm) were registered. Measurements were performed immediately before, after and 30min post-cryotherapy; skin temperature was measured at each time point. One-way repeated measures ANOVA was used to identify the effect of time intra-group; ANCOVA was applied for the between-groups analysis, considering CG as reference.
Results: Skin temperature significantly decreased in both experimental groups (IP:27.3±1.4°C, p 0,001; IM:25.2±1.6°C, p 0,001), and did reach baseline measurement 30min post-cryotherapy, when adjusted by CG (IP: 2.4±4.6°C, p=0.6; IM:0.6±4.3°C, p=0.8). No differences intra-group or between groups were detected in COP mean velocity and path length in neither group nor condition (p>0.05). Greater JPS error for plantarflexion was detected immediately after IM treatment compared to CG (β=2.0, p=0.02); no further effect of cryotherapy on JPS was detected.
Conclusion(s): The two modalities of cryotherapy demonstrated effect on neither postural sway nor joint position sense on young and healthy men. Our results support previous studies that report no impairment in JPS post-treatment using superficial applications of cryotherapy. It also seems plausible that the modalities applied in the current study did not induce sufficient intramuscular or joint cooling to alter proprioceptive sensitivity.
Implications: IP and IM modalities, as used in the present study, can be safety for the treatment of acute injuries in balance deficiency conditions as well as in athletic participation, considering that small changes in the balance were identified after the cooling application.
Keywords: Cryotherapy, joint position sense, postural sway
Funding acknowledgements: Universidad Industrial de Santander
Topic: Electrophysical & isothermal agents; Sport & sports injuries
Ethics approval required: Yes
Institution: Universidad Industrial de Santander
Ethics committee: CEINCI-UIS
Ethics number: Act number 21; september 22, 2017
All authors, affiliations and abstracts have been published as submitted.
