title: The magnitude of tissue cooling during cryotherapy with varied types of compression.
abstract: BACKGROUND
  Certified athletic trainers can choose different types of external compression (none, Flex-i-Wrap, and elastic wrap) when applying an ice bag to the body. However, which type facilitates the greatest magnitude of tissue cooling is unclear.
  
  
  OBJECTIVE
  To compare the effects of 2 common types of external compression on the magnitude of surface and intramuscular cooling during an ice-bag treatment.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  University research laboratory.
  
  
  METHODS
  Fourteen college students (10 women, 4 men; age = 22.4 +/- 1.8 years, height = 169.1 +/- 8.2 cm, mass = 73.3 +/- 18.5 kg, skinfold = 13.14 +/- 1.61 mm) with previous cryotherapy experience and a posterior lower leg skinfold equal to or less than 15 mm.
  
  
  METHODS
  On 3 different days separated by 24 to 48 hours, an ice bag was applied to the posterior lower leg surface of each participant for 30 minutes with no compression, with elastic wrap, or with Flex-i-Wrap.
  
  
  METHODS
  Posterior lower leg surface and intramuscular (2 cm) temperatures were recorded for 95 minutes.
  
  
  RESULTS
  At 15 minutes, the elastic wrap produced greater surface temperature reduction than no compression (P = .03); this difference remained throughout the protocol (P range, .03 to .04). At 30 minutes, surface temperatures were 14.95 degrees C, 11.55 degrees C, and 9.49 degrees C when an ice bag was applied with no external compression, Flex-i-Wrap, and elastic wrap, respectively. Surface temperatures between Flex-i-Wrap and elastic wrap and between Flex-i-Wrap and no compression were never different. At 10 minutes, Flex-i-Wrap (P = .006) and elastic wrap (P < .001) produced greater intramuscular temperature reduction than no compression produced; these differences remained throughout the protocol. At 10 minutes, no compression, Flex-i-Wrap, and elastic wrap decreased intramuscular temperature by 1.34 degrees C, 2.46 degrees C, and 2.73 degrees C, respectively. At 25 minutes, elastic wrap (8.03 degrees C) produced greater temperature reduction than Flex-i-Wrap (6.65 degrees C) (P = .03) or no compression (4.63 degrees C) (P < .001 ). These differences remained throughout ice application and until 50 minutes after ice-bag removal.
  
  
  CONCLUSIONS
  During an ice-bag application, external compression with elastic wrap was more effective than Flex-i-Wrap at reducing intramuscular tissue temperature. Elastic wraps should be used for acute injury care.
authors.affiliation: Athletic Training Education Program, Missouri Valley College, Marshall, MO 65340, USA. tomchukd@moval.edu
authors.forename: David
authors.initials: D
authors.lastname: Tomchuk
authors.forename: Mack D
authors.initials: MD
authors.lastname: Rubley
authors.forename: William R
authors.initials: WR
authors.lastname: Holcomb
authors.forename: Mark
authors.initials: M
authors.lastname: Guadagnoli
authors.forename: Jason M
authors.initials: JM
authors.lastname: Tarno
mesh_terms: D000704:Analysis of Variance; D001265:Athletic Injuries / Q000628:therapy; D001833:Body Temperature Regulation; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007053:Ice; D007866:Leg; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries*; D026741:Physical Therapy Modalities; D010969:Plastics; D012039:Regional Blood Flow; D012885:Skinfold Thickness; D013178:Sports Medicine; D055815:Young Adult
chemical_list: D007053:Ice; D010969:Plastics
references.citation: Am J Sports Med. 1994 Jul-Aug;22(4):537-40
references.pmid: 7943521
references.citation: Phys Ther. 1987 Jul;67(7):1080-4
references.pmid: 3602101
references.citation: Med Sci Sports Exerc. 1999 Nov;31(11):1516-21
references.pmid: 10589851
references.citation: Med Sci Sports Exerc. 1985 Dec;17(6):710-3
references.pmid: 4079745
references.citation: J Orthop Sports Phys Ther. 1999 Mar;29(3):177-80
references.pmid: 10322591
references.citation: Med Sci Sports Exerc. 2002 Jan;34(1):45-50
references.pmid: 11782646
references.citation: J Athl Train. 1996 Oct;31(4):319-23
references.pmid: 16558417
references.citation: J Athl Train. 2005 Jul-Sep;40(3):207-10
references.pmid: 16284643
references.citation: J Athl Train. 2003 Jun;38(2):113-119
references.pmid: 12937521
references.citation: Arch Phys Med Rehabil. 2001 Jun;82(6):845-50
references.pmid: 11387593
references.citation: J Orthop Sports Phys Ther. 1998 Apr;27(4):301-7
references.pmid: 9549714
references.citation: Arch Phys Med Rehabil. 2002 Nov;83(11):1501-5
references.pmid: 12422316
references.citation: J Athl Train. 2001 Mar;36(1):32-36
references.pmid: 12937512
references.citation: Ann Emerg Med. 1996 Oct;28(4):436-9
references.pmid: 8839531
references.citation: J Athl Train. 2000 Oct;35(4):412-6
references.pmid: 16558654
references.citation: J Athl Train. 1992;27(3):242-9
references.pmid: 16558168
references.citation: Am J Sports Med. 1995 Jan-Feb;23(1):74-6
references.pmid: 7726354
references.citation: J Athl Train. 1994 Dec;29(4):318-22
references.pmid: 16558294
references.citation: J Athl Train. 1996 Apr;31(2):126-9
references.pmid: 16558385
references.citation: J Athl Train. 2003 Mar;38(1):28-33
references.pmid: 12937469
references.citation: J Athl Train. 1993 Fall;28(3):236-45
references.pmid: 16558238
references.citation: J Athl Train. 1998 Jan;33(1):25-9
references.pmid: 16558480
references.citation: J Athl Train. 1997 Jul;32(3):233-7
references.pmid: 16558455
references.citation: Med Sci Sports Exerc. 1980 Spring;12(1):76-80
references.pmid: 6771484