The Effect of Ice Immersion of the Elbow on Wrist Proprioception

Proprioception can be defined as the sensory processes responsible for the conscious appreciation of posture and movement. Proprioception is typically measured by testing reproduction joint position sense (RJPS), which is accomplished by testing active reproduction of passive joint repositioning. Research has shown that the application of ice decreases proprioception in the lower extremity. Past studies have applied the ice treatment directly to the joint being tested. Based on the anatomy of the wrist, the muscles that control the wrist originate in the elbow and pass through the wrist. Based in this evidence, it can be assumed that applying ice to the elbow would produce a more profound result of worsened proprioception, thus providing the foundation for this study. The purpose of this study was to determine the effect of cryotherapy (ice immersion) at the elbow on proprioception on proprioception at the wrist. It was hypothesized that the application of the ice to the elbow worsened proprioception at the wrist immediately following the ice treatment. 30 subjects between the ages of 18 and 30 participated in this study (15 male and 15 female). A wrist position sense testing apparatus was used to measure a baseline level of proprioception for each subject via RJPS of various flexion and extension positions. The elbow was then be immersed in a 50° ice bath for 20 minutes. Immediately following the ice bath, each subject then used the testing apparatus again to measure wrist proprioception. 20 total trials were recorded, 10 under each condition. Error scores were determined by calculating the difference between the target angle of wrist flexion or extension and the reproduced angle. Both the absolute (AE) and constant error (CE) was recorded. The average scores between the two conditions (pre-ice application and post-ice application) were compared using an analysis of variance (ANOVA) with an alpha level of .05 to determine any clinical significance. The results showed that no change occurred in the CE or AE of both flexion and extension between the two conditions. No differences were found between genders as well. The results also showed that there was no correlation between body fat percentages and both AE and CE. This study showed that ice immersion of the elbow does not appear to have an effect on proprioception at the wrist in both flexion and extension. These findings support the occurrence of sensory reweighing. More research must be done in order to determine the role of sensory reweighing in the athletic realm