Quantitative Evaluation of the Thermal Heterogeneity on the Surface of Cryotherapy Cooling Pads

Khoshnevis, Sepideh; Nordhauser, Jennifer E.; Craik, Natalie K.; Diller, Kenneth R.

doi:10.1115/1.4027270

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…An earlier set of experiments showed no significant difference in the extent of reduction in tissue perfusion using different CTUs [22]. The Arctic Ice CTU was used since its pad had a greater surface temperature uniformity compared to other CTUs [23]. Intermittent blood pressure measurements were obtained every 15 min by auscultation of the brachial artery with an electrosphygmomanometer (SunTech, Raleigh, NC), and mean arterial blood pressure was calculated as one-third of pulse pressure plus diastolic pressure.…”

Section: Methodsmentioning

confidence: 99%

Cryotherapy-Induced Persistent Vasoconstriction After Cutaneous Cooling: Hysteresis Between Skin Temperature and Blood Perfusion

Khoshnevis

Craik

Diller

2016

Journal of Biomechanical Engineering

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The goal of this study was to investigate the persistence of cold-induced vasoconstriction following cessation of active skin-surface cooling. This study demonstrates a hysteresis effect that develops between skin temperature and blood perfusion during the cooling and subsequent rewarming period. An Arctic Ice cryotherapy unit (CTU) was applied to the knee region of six healthy subjects for 60 min of active cooling followed by 120 min of passive rewarming. Multiple laser Doppler flowmetry perfusion probes were used to measure skin blood flow (expressed as cutaneous vascular conductance (CVC)). Skin surface cooling produced a significant reduction in CVC (P < 0.001) that persisted throughout the duration of the rewarming period. In addition, there was a hysteresis effect between CVC and skin temperature during the cooling and subsequent rewarming cycle (P < 0.01). Mixed model regression (MMR) showed a significant difference in the slopes of the CVC-skin temperature curves during cooling and rewarming (P < 0.001). Piecewise regression was used to investigate the temperature thresholds for acceleration of CVC during the cooling and rewarming periods. The two thresholds were shown to be significantly different (P = 0.003). The results show that localized cooling causes significant vasoconstriction that continues beyond the active cooling period despite skin temperatures returning toward baseline values. The significant and persistent reduction in skin perfusion may contribute to nonfreezing cold injury (NFCI) associated with cryotherapy.

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Section: Methodsmentioning

confidence: 99%

Cryotherapy-Induced Persistent Vasoconstriction After Cutaneous Cooling: Hysteresis Between Skin Temperature and Blood Perfusion

Khoshnevis

Craik

Diller

2016

Journal of Biomechanical Engineering

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“…In actuality, depending on the spatial and temporal patterns of ice water circulation through a cooling bladder, there may be very large lateral gradients in temperature applied to the skin. Infrared thermography has been applied to measure and characterize the magnitude and distribution of cooling bladder temperature gradients for many commercial CTUs [82]. There are substantial differences in the magnitude, range, and distribution of temperatures over a bladder surface among CTU/bladder combinations.…”

Section: Local Temperature Therapy To Aid Healing Of Superficial Tissmentioning

confidence: 99%

Heat Transfer in Health and Healing1

Diller

2015

Journal of Heat Transfer

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1Our bodies depend on an exquisitely sensitive and refined temperature control system to maintain a state of health and homeostasis. The exceptionally broad range of physical activities that humans engage in and the diverse array of environmental conditions we face require remarkable strategies and mechanisms for regulating internal and external heat transfer processes. On the occasions for which the body suffers trauma, therapeutic temperature modulation is often the approach of choice for reversing injury and inflammation and launching a cascade of healing. The focus of human thermoregulation is maintenance of the body core temperature within a tight range of values, even as internal rates of energy generation may vary over an order of magnitude, environmental convection, and radiation heat loads may undergo large changes in the absence of any significant personal control, surface insulation may be added or removed, all occurring while the body's internal thermostat follows a diurnal circadian cycle that may be altered by illness and anesthetic agents. An advanced level of understanding of the complex physiological function and control of the human body may be combined with skill in heat transfer analysis and design to develop life-saving and injury-healing medical devices. This paper will describe some of the challenges and conquests the author has experienced related to the practice of heat transfer for maintenance of health and enhancement of healing processes.

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“…A well-known feature of cryotherapy systems that embody chilled water circulated through a flexible bladder placed at the treatment site is that there are often large spatial variations in the applied temperature [9]. Since the applied temperature dictates the conditions of therapy, inconsistent temperatures may be problematic in achieving desired outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Local tissue temperatures produced by the application of a cryotherapy device are on the order of 15 C, although there can be a considerable variation under a single cryotherapy bladder [9]. Also, there is a considerable variation in the thermal performance among different cryotherapy devices [10,11].…”

Section: Introductionmentioning

confidence: 99%

An On-Site Thermoelectric Cooling Device for Cryotherapy and Control of Skin Blood Flow

Mejía

Dedow

Nguy

et al. 2015

Journal of Medical Devices

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Cryotherapy involves the surface application of low temperatures to enhance the healing of soft tissue injuries. Typical devices embody a remote source of chilled water that is pumped through a circulation bladder placed on the treatment site. In contrast, the present device uses thermoelectric refrigeration modules to bring the cooling source directly to the tissue to be treated, thereby achieving significant improvements in control of therapeutic temperature while having a reduced size and weight. A prototype system was applied to test an oscillating cooling and heating protocol for efficacy in regulating skin blood perfusion in the treatment area. Data on 12 human subjects indicate that thermoelectric coolers (TECs) delivered significant and sustainable changes in perfusion for both heating (increase by (6SE) 173.0 6 66.0%, P< 0.005) and cooling (decrease by (6SE) 57.7 6 4.2%, P < 0.0005), thus supporting the feasibility of a TEC-based device for cryotherapy with local temperature regulation.

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Quantitative Evaluation of the Thermal Heterogeneity on the Surface of Cryotherapy Cooling Pads

Cited by 6 publications

References 16 publications

Cryotherapy-Induced Persistent Vasoconstriction After Cutaneous Cooling: Hysteresis Between Skin Temperature and Blood Perfusion

Cryotherapy-Induced Persistent Vasoconstriction After Cutaneous Cooling: Hysteresis Between Skin Temperature and Blood Perfusion

Heat Transfer in Health and Healing1

An On-Site Thermoelectric Cooling Device for Cryotherapy and Control of Skin Blood Flow

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