Examining Rewarming Trends Following Cryokinetics Using Different Cooling Modalities on Ankle Skin Surface Temperature

Context: Cryotherapy is the most common modality used after acute injury to reduce edema. One of the most beneficial uses of cold is for its analgesic effects. Typically, following the application of cold, exercises are completed as part of the rehabilitation plan, a technique termed “cryokinetics”. Current literature reveals that exercise immediately following cold application leads to rapid rewarming, reducing the overall effectiveness of the treatment. However, there are no studies examining the rewarming trends of different cooling modalities. Purpose: The purpose of this study was to examine the rewarming trends of ankle skin surface temperature following a cryokinetics protocol consisting of one of three cryotherapy modalities combined with rehabilitative ankle exercises. By comparing the results, we hope to determine if one modality is more effective than the others for use with cryokinetics. Participants: Eleven college aged University of Montana students (age 18-35) participated in this study. Methods: A repeated measures design was used for this study whereby all participants underwent three 15 minute trials consisting of cold whirlpool, ice pack, and an ice water immersion treatments. Following each cryotherapy treatment, participants completed a series of rehabilitative ankle exercises. The temperature of the dominant ankle was measured at the anterior talofibular ligament (ATFL) prior to treatment, immediately post-treatment, and immediately post exercise. Results: A 3X3 repeated measures ANOVA revealed statistical significance between the cooling modalities and ankle surface temperature (p= 0.05). Pairwise comparisons revealed statistical significance among the different cooling modalities immediately after treatment and immediately after exercise. Ice water immersion cooled the ankle the most and for the longest duration. Conclusion: Ice pack and ice water immersion produced more cooling than cold whirlpool. Ice water immersion provided slightly greater cooling when compared to an ice pack, which suggests that it is the most effective modality for use in cryokinetics