Should Athletes Return to Activity After Cryotherapy?

Abstract

Reference/Citation: Bleakley CM, Costello JT, Glasgow PD. Should athletes return to sport after applying ice? A systematic review of the effect of local cooling on functional performance. Sports Med. 2012; 42(1):69-87.Clinical Question: Does local tissue cooling affect immediate functional performance outcomes in a sport situation?Data Sources: Studies were identified by searching MED-LINE, the Cochrane Central Register of Controlled Trials, and EMBASE, each from the earliest available record through April 2011. Combinations of 18 medical subheadings or key words were used to complete the search.Study Selection: This systematic review included only randomized controlled trials and crossover studies published in English that examined human participants who were treated with a local cooling intervention. At least 1 functional performance outcome that was measured before and after a cooling intervention had to be reported. Excluded were studies using whole-body cryotherapy or cold-water immersion above the waist and studies that measured strength or force production during evoked muscle contraction.Data Extraction: Data were extracted by 2 authors using a customized form to evaluate relevant data on study design, eligibility criteria, detailed characteristics of cooling protocols, comparisons, and outcome measures. Disagreement was resolved by consensus or third-party adjudication. To perform an intent-to-treat analysis when possible, data were extracted according to the original allocation groups, and losses to followup were noted. The review authors were not blinded to the study author, institution, or journal. For each study, mean differences or standardized mean differences and 95% confidence intervals were calculated for continuous outcomes using RevMan (version 5.1; The Nordic Cochrane Centre, Copenhagen, Denmark). Treatment effects were based on between-groups comparisons (cryotherapy versus control) using postintervention outcomes or within-group comparisons (precryotherapy versus postcryotherapy). If continuous data were missing standard deviations, other statistics including confidence intervals, standard error, t values, P values, or F values were used to calculate the standard deviation. The Cochrane risk-of-bias tool was used to assess the methodologic quality of included studies. Each study was evaluated for sequence generation, allocation concealment, assessor blinding, and incomplete outcome data. Studies were graded as low or high based on the criteria met, but the risk of bias across the studies was consistently high, so meaningful subgroup classifications were not possible. Differences in study quality and intervention details, including duration of cryotherapy interventions and time periods after intervention before follow-up, were potential sources of bias and considered for a subgroup analysis.Main Results: Using the search criteria, the authors originally identified 1449 studies. Of these, after title and abstract review, 99 studies were deemed potentially relevant and kept for further analys...

Thermoregulation of football players after cryotherapy in thermography

“…[3][4][5]. All intergroup comparisons reveal that mean surface temperature was lower in the group of athletes.…”

“…In a cryochamber, the temperature ranges from -110 to -160°C and the duration of therapy does not exceed three minutes [1]. Review of the research papers, which analyse the use of extremely low temperatures in sports, shows popularity of this physical method in improving regeneration after training effort as well as facilitating and enhancing efficacy of rehabilitation after injuries [2,3]. Studies on the application of cryostimulation treatments proved beneficial effect of extremely low temperatures on trained body of an athlete resulting in increase in pain threshold, reactivation of antioxidants and reduction in inflammation metabolites [4].…”

Exploring the Efficacy of a Safe Cryotherapy Alternative: Physiological Temperature Changes From Cold-Water Immersion Versus Prolonged Cooling of Phase-Change Material

“…Low immersion temperatures may decrease tissue temperatures at a rate that may lead to excessive thermal stress and, if prolonged, are not well tolerated 3 and are limited by individual thermal discomfort and risk of cold-related injury. 4 Further, in practice, repeat treatments are impractical and present logistical challenges, but may be necessary if the goal is to decrease muscle 5 and core 6 temperature.…”

Joint Cooling does not Hinder Athletic Performance during High-intensity Intermittent Exercise

“…Accordingly, bilateral joint cooling may affect dynamic performance differently. Although it is well established that returning to competition immediately post cooling would adversely affect athletic performance in many studies [9,33,38] and reviews [3,35], we still do not know if cold application would result performance deficits when (1) cold application is immediately followed by athletic movements and (2) focal joint cooling, not muscular tissue cooling, is applied to lower extremity joints. Hence, in the present study we evaluated how a 20-min bilateral ankle or knee joint cooling applied before and during high-intensity intermittent exercise lasting 1 h led to alterations in 20-m sprint time and maximal vertical jump heights.…”