Cryotherapy and Compression

    Introduction

           In “The Magnitude of Tissue Cooling During Cryotherapy With Varied Types of Compression”, the authors discuss the differences in the use of elastic wrap for compression with cryotherapy versus Flex-i-Wrap for compression with cryotherapy. The question the authors want to answer is whether or not Flex-i-Wrap has the same level of effect on surface and intramuscular temperatures as does elastic wrap when used in conjunction with cryotherapy. The hypothesis is that temperatures associated with the use of elastic wrap will be lower than temperatures associated with Flex-i-Wrap.

Methods

           The study consisted of a 2 (depth) x 3 (compression type) x 13 (time) within-subjects, repeated measures design. The independent variable compression type consisted of no compression, Flex-i-Wrap, and elastic wrap, and the independent variable time consisted of 0,5,10,15,20,25,30,40,50,60,70,80, and 90 minutes. The dependent measures of interest were surface temperature and intramuscular temperature 2 cm below the surface.

           Fourteen college students volunteered to participate. All participants with a skinfold thickness greater than 15 mm of their posterior calf were excluded from the study. All participants provided written informed-consent.

           Surface temperature was taken using 2 PT-6 thermocouples, with mean of these readings used for analysis. Intramuscular temperature was taken using a sterile 23-gauge thermocouple, which was implanted with a 21-gauge disposable needle. The thermocouples were disinfected and the needles were replaced after every use.

           Three treatments were applied to each participant; 1 treatment per day separated by 24-28 hours. Treatments included 30 minute ice-bag applications to the right posterior lower leg with no compression, compressed with Flex-i-Wrap, and compressed with elastic wrap.

Results

           Before ice-bag application, no difference was found among compression types on surface temperature. At 5-10 minutes of ice-bag application, surface temperature were not different between Flex-i-Wrap and no compression, or between elastic wrap and no compression. Differences were found between elastic wrap and no compression from 15 minutes through 80 minutes. No differences were found at any time in surface temperature between no compression and Flex-i-Wrap or between compression with Flex-i-Wrap and elastic wrap.

           Before ice application, no difference was recorded among compression types on intramuscular temperature. At 10 minutes of ice application, both elastic wrap and Flex-i-Wrap provided greater intramuscular temperature reductions than no compression. At 25 minutes of ice application, elastic wrap produced lower intramuscular temperatures than Flex-i-Wrap and the difference persisted throughout.

Discussion

           Ice-bag application with Flex-i-Wrap was not different from ice-bag application with no compression or with an elastic wrap with respect to surface temperature.

           Intramuscular tissue temperature decreased 5.60 degrees Celsius with no compression, 7.87 degrees Celsius with Flex-i-Wrap, and 9.40 degrees Celsius with an elastic wrap at the conclusion of a 30 minute ice-bag application. Lowest temperatures were recorded 10 minutes post-treatment. In the end, the hypothesis was correct, elastic wrap produces lower temperatures with cryotherapy than does Flex-i-Wrap.

REFERENCE

Tomchuck, David, Mack D. Rubley, William R. Holcomb, Mark Guadagnoli, and Jason M. Tarno. "The Magnitude of Tissue Cooling During Cotherapy With Varied Types of Compression." Journal of Athletic Training 45.3 (2010): 230-37. Web.