Cold Therapy Clinical Research Overview

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Knobloch 2008

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Knobloch K, Grasemann R, Spies M, Vogt PM. Midportion achilles tendon microcirculation after intermittent combined cryotherapy and compression compared with cryotherapy alone: a randomized trial. Am J Sports Med. 2008 Nov;36(11):2128-38.

Design: Randomized in vivo laboratory study.

Subjects: 60 subjects were randomized for either combined cryotherapy/compression ( Cryo/Cuff , n = 30) or cryotherapy alone (KoldBlue, n = 30;) with intermittent 3 × 10-minute application. Methods: Midportion Achilles tendon microcirculation was determined. This cryotherapy application was scheduled with the intention to create a sort of preconditioning. Ischemic preconditioning is the cyclic change of ischemia followed by reperfusion, which has been shown to protect the tissue from further ischemic damage

Results:

• Capillary bloodflow: both Cryo/Cuff and KoldBlue significantly reduced superficial and deep capillary tendon blood flow within the first minute of application without a significant difference throughout all 3 applications. However, during recovery, superficial and deep capillary blood flow was reestablished significantly faster using Cryo/Cuff .

Key message: Combined cryotherapy and compression (Cryo/Cuff) is superior to cryotherapy alone regarding the Achilles tendon microcirculation.

• Tendon oxygen saturation was reduced in both groups significantly within the first 3 minutes

of application, with significantly stronger effects using Cryo/Cuff. Cryo/Cuff led to significantly higher tendon oxygenation in superficial and deep tissue compared with KoldBlue during all recoveries ("preconditioning"). • Postcapillary venous filling pressures were significantly reduced in both groups during application; however, Cryo/Cuff led to significantly, but marginally, lower pressures. • Complications: none of the 60 enrolled participants had any skin burns or nerve palsies, such as paresthesias or paresis, caused by either device during or after application.

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