The magnitude of tissue cooling during cryotherapy with varied types of compression.
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.
Tomchuk
David
D
Athletic Training Education Program, Missouri Valley College, Marshall, MO 65340, USA. tomchukd@moval.edu
Rubley
Mack D
MD
Holcomb
William R
WR
Guadagnoli
Mark
M
Tarno
Jason M
JM
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
D007053:Ice; D010969:Plastics
Am J Sports Med. 1994 Jul-Aug;22(4):537-40
7943521
Phys Ther. 1987 Jul;67(7):1080-4
3602101
Med Sci Sports Exerc. 1999 Nov;31(11):1516-21
10589851
Med Sci Sports Exerc. 1985 Dec;17(6):710-3
4079745
J Orthop Sports Phys Ther. 1999 Mar;29(3):177-80
10322591
Med Sci Sports Exerc. 2002 Jan;34(1):45-50
11782646
J Athl Train. 1996 Oct;31(4):319-23
16558417
J Athl Train. 2005 Jul-Sep;40(3):207-10
16284643
J Athl Train. 2003 Jun;38(2):113-119
12937521
Arch Phys Med Rehabil. 2001 Jun;82(6):845-50
11387593
J Orthop Sports Phys Ther. 1998 Apr;27(4):301-7
9549714
Arch Phys Med Rehabil. 2002 Nov;83(11):1501-5
12422316
J Athl Train. 2001 Mar;36(1):32-36
12937512
Ann Emerg Med. 1996 Oct;28(4):436-9
8839531
J Athl Train. 2000 Oct;35(4):412-6
16558654
J Athl Train. 1992;27(3):242-9
16558168
Am J Sports Med. 1995 Jan-Feb;23(1):74-6
7726354
J Athl Train. 1994 Dec;29(4):318-22
16558294
J Athl Train. 1996 Apr;31(2):126-9
16558385
J Athl Train. 2003 Mar;38(1):28-33
12937469
J Athl Train. 1993 Fall;28(3):236-45
16558238
J Athl Train. 1998 Jan;33(1):25-9
16558480
J Athl Train. 1997 Jul;32(3):233-7
16558455
Med Sci Sports Exerc. 1980 Spring;12(1):76-80
6771484