Cambios en la temperatura intra-articular de la rodilla. Hielo frente a dispositivos de crioterapia.
Todd A. Warren, NP, ATC, Eric C. McCarty, MD, Airron L. Richardson, BA, Todd Michener, MD and Kurt P. Spindler, MD* From the Vanderbilt Sports Medicine Center, Department of Orthopaedics & Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee
* Address correspondence to Kurt P. Spindler, MD, Vanderbilt Sports Medicine Center, 2601 Jess Neely Drive, Nashville, TN 37212.
Background: Cryotherapy is commonly applied without research documenting the intra-articular (IA) temperature changes or subject discomfort between ice and a cryotherapy device.
Hypothesis: The null hypothesis is that no difference would be observed in IA temperature decline or subject tolerance between ice and the cryotherapy device in normal knees.
Study Design: Prospective, within-subject controlled clinical trial.
Methods: Twelve subjects had IA temperature in suprapatellar pouch and skin recorded bilaterally after application of cryotherapy versus ice. Subject tolerance was recorded by 10-cm visual analog scale (VAS). Statistical evaluation was by Spearmans correlation analysis and paired, nonparametric Wilcoxons signed rank test.
Results: Both significantly lowered (P < 0.001) skin and IA temperature with median decreases (ice/cryotherapy) at 30 (3.3°C/2.2°C), 60 (12.8°C/7.1°C), and 90 (15.2°C/9.7°C) minutes. However, ice lowered the IA temperature significantly more than the cryotherapy device (P < 0.001) and was more painful by VAS at 30 and 60 minutes (P < 0.01).
Conclusions: Both methods produced large declines in skin and IA temperatures. However, ice was more effective yet resulted in higher pain scores. The authors hypothesize that IA temperatures below a threshold are associated with increased perceived pain.
Key Words: cryotherapy intra-articular temperature knee ice
The American Journal of Sports Medicine 32:441-445 (2004)