Does ice immersion influence ankle joint position sense?

Abstract

The purpose of this study was to determine whether a fifteen minute ice immersion treatment influenced the normal ankle joint position sense at 40% and 80% range of inversion and to establish the length of treatment effect through monitoring the rewarming process. Forty nine healthy volunteers between the ages of 17 and 28 were tested. Subjects were screened to exclude those with a history of ankle injuries. The subject's skin temperature over antero-lateral aspect of the ankle was measured using a thermocouple device during the fifteen minutes ice intervention and thirty minutes post-intervention. Testing of ankle joint position sense using the pedal goniometer was performed before and after a clinical application of ice immersion. The testing required the subject to actively reposition their ankle at 40% and 80% of their total range of inversion. The majority of subjects experienced numbness of the foot and ankle by the fifth or sixth minute during ice immersion. One minute after immersion skin temperatures averaged 15 degrees C + 1.7 degrees C. Skin temperature was seen to rise relatively rapidly for the first ten minutes and then slowed considerably. Subjects had not returned to the pre-test skin temperatures by thirty minutes. A significant difference in ankle joint position sense (p < 0.0499) following fifteen minutes of ice immersion was found. However, the magnitude of this difference (0.5 degree) would not be deemed significant in clinical practice. The research found no significant difference in joint position sense between 40% and 80% of the range of inversion both before and after cryotherapy. These findings suggest that the clinical application of cryotherapy is not deleterious to joint position sense and assuming normal joint integrity patients may resume exercise without increased risk of injury.

Factors Influencing Proprioception: What do They Reveal?

“…The authors found no differences in joint position sense after the ice application, but the results were reported in centimeters of vertical displacement, making those hard to interpret and compare with the literature. The studies (Costello & Donnelly, 2011;D. Hopper, et al, 1997;LaRiviere & Osternig, 1994) using water-immersion cryotherapy protocols found similar results for lower limb proprioception.…”

“…Cryotherapy modalities comprise the application of ice (for instance crushed ice) , cold water immersion (Costello & Donnelly, 2011), commercially available cooling pads, and liquid cooling solutions (Leite & Ribeiro, 2010) aiming to reduce tissue temperature, metabolism, inflammation, pain, vasodilatation, and symptoms of delayed-onset muscle soreness. A number of studies have focused the effects of cryotherapy on proprioception (Costello & Donnelly, 2011;Dover & Powers, 2004;D. Hopper, et al, 1997;LaRiviere & Osternig, 1994;Uchio, et al, 2003;Wassinger, Myers, Gatti, Conley, & Lephart, 2007) and reported conflicting results (Table 2).…”

“…Hopper, et al, 1997;LaRiviere & Osternig, 1994) using water-immersion cryotherapy protocols found similar results for lower limb proprioception. Indeed, despite using different immersion durations (15, 20 and 30 minutes), depths, and water temperatures (14º, 4º, 5º, respectively), and assessing different joints (ankle and knee), they reported no changes in position sense after water immersion (Costello & Donnelly, 2011;LaRiviere & Osternig, 1994) or have questioned the clinical significance of the changes (D. Hopper, et al, 1997). In fact, Hopper et al (1997) questioned if a 0.5° difference in ankle joint position sense following 15 minutes of ice bath immersion would be clinically relevant.…”

“…It can be also assessed using contralateral or ipsilateral matching responses (Bouet & Gahery, 2000). The accuracy of joint position sense has been measured directly, using goniometers, potentiometers and video analysis systems (Figure 1), and indirectly using visual analog scales (Barrett, 1991;Dover & Powers, 2004;D. Hopper, Whittington, & Davies, 1997;Miura, et al, 2004;Ribeiro, Mota, & Oliveira, 2007;Stillman, McMeeken, & Macdonell, 1998;Torres, et al, 2010;Tripp, Boswell, Gansneder, & Shultz, 2004;You, 2005).…”

Análise Do Desempenho Físico E Do Equilíbrio Sob Influência Da Crioterapia Em Atletas De Futsal

“…Hopper et al 29 observaram que a crioterapia não diminui o senso de posição articular, e com isso, exercícios após a crioterapia não ofereceriam riscos ao equilíbrio. Para Wassinger et al 30 , a propriocepção é diminuída após a crioterapia e os fisioterapeutas e treinadores desportivos devem estar atentos aos dé-ficits neuromotores causados pelo resfriamento, pois esta modalidade é comumente utilizada após lesões agudas e durante o processo de reabilitação, quando sobrecargas são impostas às estruturas do sistema musculoesquelético envolvidas após crio.…”