Cold Therapy Clinical Research Overview

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Hart 2014

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Hart JM, Kuenze CM, Diduch DR, Ingersoll CD. Quadriceps muscle function after rehabilitation with cryotherapy in patients with anterior cruciate ligament reconstruction. J Athl Train. 2014 Nov-Dec;49(6):733- 9.

Design: Cross-Sectional Study Subjects: 30 patients with reconstructed ACLs who were at least 6 months post-index surgery and had measurable quadriceps arthrogenic muscle

inhibition (AMI) (central activation ratio less than 90%). Methods: patients were randomly assigned to receive:

• 20 minutes of knee-joint cryotherapy (ice bags),

• 1 hour of therapeutic rehabilitation exercises,

• or cryotherapy followed by exercises. Outcomes included: Quadriceps Hoffmann reflex, Normalized maximal voluntary isometric contraction torque (knee extension), Central activation ratio using the superimposed-burst technique, Patient-reported outcomes. Results: • After the 2-week intervention period, patients who had cryotherapy + exercises had higher normalized maximal voluntary isometric contraction torques (P = .002, Cohen d effect size = 1.4) compared with those who received cryotherapy alone (P = .16, d = 0.58) or performed exercise alone (P = .16, d = 0.30).

Key message: After ACL reconstruction, patients with AMI who received cryotherapy immediately before performing rehabilitation exercises experienced greater strength gains than those who performed cryotherapy or exercises alone.

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