Acute effects of cold therapy on knee skin surface temperature: gel pack versus ice bag

Abstract

BackgroundTo our knowledge there has been no research that has compared the effectiveness of two popular cold therapy modalities applied to healthy human knees, with a surgical dressing, over a 4 h period.HypothesisTo determine whether gel packs are more effective than ice bags at reducing skin surface temperature in humans.Study designThis was a randomised, repeated measures crossover study, which included nine healthy participants.Level of evidenceLevel 2.MethodsTwo cold therapy modalities—a gel pack (DonJoy-Orthopaedic Pty Ltd, Normanhurst, New South Wales, Australia) and an ice bag (ICE'N'EASY, Bokarina, Queensland, Australia)—were applied on top of a surgical dressing, covering the knee. Each participant randomly received two cold therapy treatments, in separate sessions, at least 4 days apart. Each session utilised the time protocol of 20 min application on the hour, for 4 h. Skin surface temperature was recorded throughout the session at 1 min intervals.ResultsIn the first application, the ice bag (5°C±1.7°C) was more effective at reducing skin surface temperature (p<0.04) from baseline than the gel pack (4°C±0.9°C), and had a significantly greater cooling rate (p<0.02). On the subsequent three applications, both modalities were just as effective at reducing skin surface from baseline, and had similar cooling rates.ConclusionsAn ice bag initially was more effective than the gel pack at reducing skin surface temperature of healthy knees, with a surgical dressing. Over a 4 h period both gel packs and ice bags were just as effective at reducing skin surface temperature and at maintaining these lower temperatures.

A Study to Find the Effectiveness of Cryotherapy With Task Oriented Training in Improving Upper Limb Function in Hemiplegic Cerebral Palsy

“…And overall they are satisfied the therapy and want to continue to achieve the remaining component of upper limb function. Ice pack massage techniques may produce few adverse effects such as severe coldness and numbness [13]. But this study not found any adverse reaction oriented information from the therapist and parents.…”

Comparison of Effectiveness of Cryotherapy and Neuromuscular Electrical Stimulation (NMES) on Pain, Range of Motion and Gait Speed in Early Post-Operative Phase in Subjects with Unilateral Total Knee Arthroplasty

“…e) It was applied for about 20 minutes. f) Intermittently, thermometer was placed below patella and above the tibial tuberosity to ensure uniform cooling [21] . g) Care was taken to avoid post ice application skin temperature drop below 18ºC, to avoid patient discomfort NMES application method [10] : iii.…”

Assessment of the Dynamics of Temperature Changes in the Knee Joint Area in Response to Selected Cooling Agents in Thermographic Tests

“…Nowadays the term local cryotherapy is often understood very broadly, covering the use of various cooling agents, various treatment procedures, also including the duration of exposure. Consequently, in publications there are descriptions of the LC methodology in which both various forms of cooling compresses (ice bag (IB), frozen peas, ice towels, ice massage, gel packs, hypothermic blanket) and refrigerant gases (cold air (CA), carbon dioxide microcrystals, liquid nitrogen vapors) [ 5 , 7 , 8 , 9 , 10 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], and cryotherapy units (that can provide a continuous or intermittent circulation of ice water from an insulated container to a pliable cooling pad placed onto the treatment area) [ 31 , 32 ].…”

“…In reports describing the effect of using LC, the number of exposures ranges from 1 to 20, the temperature of C Ag , ranges from 0 °C to −160 °C and the duration of application ranges from 2 to 30 min [ 8 , 9 , 21 , 22 , 23 ]. Despite such a wide variety of LC treatments (methodology, cooling factors), no exhaustive verification of the physiological thermal response (degree and duration of tissue cooling) depending on the parameters used was not carried out.…”