Int J Sports Med 2014; 35(01): 35-40
DOI: 10.1055/s-0033-1343410
Physiology & Biochemistry
© Georg Thieme Verlag KG Stuttgart · New York

Effects of Whole Body Cryotherapy and Cold Water Immersion on Knee Skin Temperature

J. T. Costello
1   Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
,
A. E. Donnelly
2   Department of Physical Education and Sports Sciences, University of Limerick, Ireland
,
A. Karki
3   Research Services, Satakunta Univeristy of Applied Sciences, Pori, Finland
,
J. Selfe
4   Allied Health Professions Research Unit, University of Central Lancashire, Preston, United Kingdom
› Institutsangaben
Weitere Informationen

Publikationsverlauf



accepted after revision 05. März 2013

Publikationsdatum:
18. Juni 2013 (online)

Abstract

This study sought to a) compare and contrast the effect of 2 commonly used cryotherapy treatments, 4 min of −110°C whole body cryotherapy and 8°C cold water immersion, on knee skin temperature and b) establish whether either protocol was capable of achieving a skin temperature (<13°C) believed to be required for analgesic purposes. After ethics committee approval and written informed consent was obtained, 10 healthy males (26.5±4.9 yr, 183.5±6.0 cm, 90.7±19.9 kg, 26.8±5.0 kg/m2, 23.0±9.3% body fat; mean±SD) participated in this randomised controlled crossover study. Skin temperature around the patellar region was assessed in both knees via non-contact, infrared thermal imaging and recorded pre-, immediately post-treatment and every 10 min thereafter for 60 min. Compared to baseline, average, minimum and maximum skin temperatures were significantly reduced (p<0.001) immediately post-treatment and at 10, 20, 30, 40, 50 and 60 min after both cooling modalities. Average and minimum skin temperatures were lower (p<0.05) immediately after whole body cryotherapy (19.0±0.9°C) compared to cold water immersion (20.5±0.6°C). However, from 10 to 60 min post, the average, minimum and maximum skin temperatures were lower (p<0.05) following the cold water treatment. Finally, neither protocol achieved a skin temperature believed to be required to elicit an analgesic effect.

 
  • References

  • 1 Ammer K. Temperature of the human knee – A review. Therm Int 2012; 22: 137-151
  • 2 Arnoldi C. The Patellar Pain Syndrome. Acta Orthop Scand 1991; 62: 1-29
  • 3 Banfi G, Lombardi G, Colombini A, Melegati G. Whole-body cryotherapy in athletes. Sports Med 2010; 40: 509-517
  • 4 Becher C, Springer J, Feil S, Cerulli G, Paessler H. Intra-articular temperatures of the knee in sports – An in-vivo study of jogging and alpine skiing. BMC Musculoskelet Disord 2008; 9: 46
  • 5 Bjorkstrom S, Goldie I. A study of the arterial supply of the patella in the normal state, in chondromalacia patellae and in osteoarthrosis. Acta Orthop Scand 1980; 51: 63-70
  • 6 Bleakley CM, Costello JT. Do thermal agents affect range of movement and mechanical properties in soft tissues? A systematic review. Arch Phys Med Rehabil 2013; 94: 149-163
  • 7 Bleakley CM, Costello JT, Glasgow PD. Should athletes return to sport after applying ice? A systematic review of the effect of local cooling on functional performance. Sports Med 2012; 42: 69-87
  • 8 Bleakley CM, Hopkins TJ. Is it possible to achieve optimal levels of tissue cooling in cryotherapy?. Phys Ther Rev 2010; 15: 344-351
  • 9 Cholewka A, Stanek A, Sieron A, Drzazga Z. Thermography study of skin response due to whole-body cryotherapy. Skin Res Technol 2012; 18: 180-187
  • 10 Costello JT, Algar LA, Donnelly AE. Effects of whole body cryotherapy (− 110°C) on proprioception and indices of muscle damage. Scand J Med Sci Sports 2012; 22: 190-198
  • 11 Costello JT, McNamara P, O’Connell M, Algar LA, Leahy M, Donnelly AE. Tissue viability imaging of skin microcirculation following exposure to cold Air (−110°C) and cold water (8°C). Arch Exerc Health Dis 2012; in press
  • 12 Costello JT, Culligan K, Selfe J, Donnelly AE. Muscle, skin and core temperature after −110°C cold air and 8°C water treatment. PLoS ONE 2012; 7: e48190 DOI: 48110.41371/journal.pone.0048190.
  • 13 Costello JT, Donnelly AE. Cryotherapy and joint position sense in healthy participants: A systematic review. J Athl Train 2010; 45: 306-316
  • 14 Costello JT, Donnelly AE. Effects of cold water immersion on knee joint position sense in healthy volunteers. J Sports Sci 2011; 29: 449-456
  • 15 Costello JT, McInerney CD, Bleakley CM, Selfe J, Donnelly AE. The use of thermal imaging in assessing skin temperature following cryotherapy: a review. J Therm Biol 2012; 37: 103-110
  • 16 Dahlstedt L, Samuelson P, Dalen N. Cryotherapy after cruciate knee surgery – Skin, subcutaneous and articular temperatures in 8 patients. Acta Orthop Scand 1996; 67: 255-257
  • 17 Denoble AE, Hall N, Pieper CF, Kraus VB. Patellar skin surface temperature by thermography reflects knee osteoarthritis severity. Clin Med Insights Arthritis Musuloskelet Disord 2010; 3: 69-75
  • 18 Gregson W, Black MA, Jones H, Milson J, Morton J, Dawson B, Atkinson G, Green D. Influence of cold water immersion on limb and cutaneous blood flow at rest. Am J Sports Med 2011; 39: 1316-1323
  • 19 Harriss DJ, Atkinson G. Update – ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
  • 20 Hildebrandt C, Raschner C. An intra-examiner reliability study of knee temperature patterns with medical infrared thermal imaging. Therm Int 2009; 19: 73-77
  • 21 Jutte L, Hawkins J, Miller K, Long B, Knight K. Skinfold thickness at 8 common cryotherapy sites in various athletic populations. J Athl Train 2012; 47: 170-177
  • 22 Jutte L, Merrick M, Ingersoll C, Edwards J. The relationship between intramuscular temperature, skin temperature, and adipose thickness during cryotherapy and rewarming. Arch Phys Med Rehabil 2001; 82: 845-850
  • 23 Karki A, Karppi P, Ekberg J, Selfe J. A thermographic investigation of skin temperature changes in response to a thermal washout of the knee in healthy young adults. Therm Int 2004; 14: 137-141
  • 24 Kim Y, Baek S, Choi K, Lee S, Park S. The effect of cold air application on intra-articular and skin temperatures in the knee. Yonsei Med J 2002; 43: 621-626
  • 25 Klimek AT, Lubkowska A, Szyguła Z, Frączek B, Chudecka M. The influence of single whole body cryostimulation treatment on the dynamics and the level of maximal anaerobic power. Int J Occup Med Environ Health 2011; 24: 184-191
  • 26 Knight KL. Cryotherapy in sport injury management. Champaign, IL: Human Kinetics; 1995
  • 27 Lovisatti L, Mora L, Pistolesi G. Thermographic patterns of lower limb arterial disease. Bibl Radiol 1975; 6: 107-114
  • 28 Mayr H. Thermographic evaluation after knee surgery. In: Ammer K, Ring E. (eds.). The Thermal Image in Medicine and Biology. Uhlen-Verlag, Wien: Uhlen; 1995
  • 29 Myrer JW, Myrer KA, Measom GJ, Fellingham GW, Evers SL. Muscle temperature is affected by overlying adipose when cryotherapy is administered. J Athl Train 2001; 36: 32-36
  • 30 Oosterveld F, Rasker J. Effects of local heat and cold treatment on surface and articular temperature of arthritic knees. Arthritis Rheum 1994; 37: 1578-1582
  • 31 Ring E, Ammer K. The technique of infrared imaging in medicine. Thermol Int 2000; 10: 7-14
  • 32 Salisbury RS, Parr G, De Silva M, Hazleman BL, Page-Thomas DP. Heat distribution over normal and abnormal joints: thermal pattern and quantification. Ann Rheum Dis 1983; 42: 494-499
  • 33 Scapinelli R. Studies on the vasculature of the human knee joint. Acta Anat 1986; 70: 305-331
  • 34 Selfe J, Hardaker N, Thewlis D, Karki A. A valid and reliable method of data analysis in thermal imaging of the anterior knee. Arch Phys Med Rehabil 2006; 87: 1630-1635
  • 35 Selfe J, Sutton C, Hardaker NJ, Greenhalgh S, Karki A, Dey P. Anterior knee pain and cold knees: a possible association in women. Knee 2010; 17: 319-323
  • 36 Selfe J, Whitaker J, Hardaker N. A narrative literature review identifying the minimum clinically important difference for skin temperature asymmetry at the knee. Thermol Int 2008; 18: 41-44
  • 37 Uchio Y, Ochi M, Fujihara A, Adachi N, Iwasa J, Sakai Y. Cryotherapy influences joint laxity and position sense of the healthy knee joint. Arch Phys Med Rehabil 2003; 84: 131-135
  • 38 Warren TA, McCarty EC, Richardson AL, Michener T, Spindler KP. Intra-articular knee temperature changes – Ice versus cryotherapy device. Am J Sports Med 2004; 32: 441-445
  • 39 Webb P. Heat storage and body temperature during cooling and rewarming. Eur J Appl Physiol Occup Physiol 1993; 66: 18-24
  • 40 Wilcock IM, Cronin JB, Hing WA. Water immersion: Does it enhance recovery from exercise?. Int J Sports Physiol Perform 2006; 1: 195-206
  • 41 Zhang H, Huizinga C, Arens E, Yu T. Considering individual physiological differences in a human thermal model. J Therm Biol 2001; 26: 401-408