Semin Musculoskelet Radiol 2020; 24(S 01): S1-S8
DOI: 10.1055/s-0040-1709547
Scientific Presentations and Posters
Georg Thieme Verlag KG Stuttgart · New York

Evaluation of Intramuscular Tissue Perfusion in PRICE Therapy using Contrast-Enhanced Ultrasound

Rafael Heiss
1   Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
,
Matthias W. Hoppe
2   Institute of Movement and Training Science I, University of Leipzig, Leipzig, Germany
,
Christoph Lutter
3   Department of Orthopedics, University Medical Center Rostock, Rostock, Germany
,
Raimund Forst
4   Department of Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
,
Jürgen Freiwald
5   Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
,
Michael Uder
1   Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
,
Martin Engelhardt
6   Department of Orthopedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrück GmbH, Klinikum Osnabrück, Osnabrück, Germany
,
Casper Grim
6   Department of Orthopedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrück GmbH, Klinikum Osnabrück, Osnabrück, Germany
,
Thilo Hotfiel
4   Department of Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
6   Department of Orthopedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrück GmbH, Klinikum Osnabrück, Osnabrück, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
25 March 2020 (online)

 
 

    Introduction To investigate intramuscular tissue perfusion (ITP) in athletes before, during, and after protection, rest, ice, compression, elevation (PRICE) therapy in sport-specific conditions and to prove the hypothesis of reactive hyperemia after PRICE therapy.

    Material and Methods Twenty healthy athletes (11 women, 9 men; mean ± SD age: 25 ± 3; range: 21–30 years; body mass index: 23 ± 3 kg/m2) were randomized to PRICE or a control group. Quantifiable contrast-enhanced ultrasound was assessed to analyze microvascular blood flow of the anterior thigh (rectus femoris muscle [RF] and vastus intermedius muscle [VI]). Baseline perfusion measurements (t0) were compared with exercise (cycling, t1), intervention (PRICE or control [rest], t2), and a 60-minute follow-up (t3). PRICE included rest, cryotherapy (3°C), compression (35 mm Hg), and elevation.

    Results After cycling, an upregulation of ITP was observed in the VI and RF for both groups. The PRICE measurements revealed a decrease of ITP, corresponding to a 47% and 53% decrease in the VI (wash-in area under the curve, peak enhancement [WiAUC, PE]; p = 0.01, not significant [NS]) and a 50% and 72% decrease in the RF (p = 0.037; p = 0.002). In contrast, an increase of ITP was observed for the control group at t1 and t2. At t3 the superficial RF (PRICE) revealed a persistent decrease of 15% and 50% (NS; p = 0.003), whereas the RF (control) and VI (both groups) showed no significant changes to baseline conditions.

    Conclusion Our study highlights the fundamental impact of PRICE on ITP. PRICE applied after exercise leads to a downregulation of microvascular blood flow in superficial as well as deep muscle layers. The termination of PRICE is not associated with a reactive hyperemia.


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    No conflict of interest has been declared by the author(s).