Effects of cold modality application with static and intermittent pneumatic compression on tissue temperature and systemic cardiovascular responses

Abstract

Background: In the therapeutic setting, cryotherapy with varying levels of intermittent cyclical compression often replaces an ice bag and elastic wrap. However, little is known about the cardiovascular strain and tissue temperature decreases associated with cooling and intermittent compression.

Hypothesis: The authors hypothesized that higher levels of intermittent compression will result in greater reductions of tissue temperature and that all cold modalities will cause acute increases in cardiovascular strain.

Design: Experimental crossover repeated measure design.

Methods: Ten healthy subjects (23 ± 3 years) volunteered for 4 cryotherapy sessions (30-minute treatments with 30-minute passive recovery). Treatments included ice with elastic wrap and Game Ready (GR) with no, medium (5-50 mmHg), and high compression (5-75 mmHg). Throughout the experiment, oral, skin surface, and intramuscular quadriceps temperatures were measured along with mean arterial pressure, heart rate, rate pressure product, forearm blood flow, and forearm vascular conductance.

Results: Mean arterial pressure increased up to 5 minutes (P < 0.05). Forearm blood flow and forearm vascular conductance decreased after baseline (P < 0.05), but there were no differences between treatments. Peak intramuscular changes from baseline were -14 ± 2°C (ice), -11 ± 6°C (GRHIGH), -10 ± 5°C (GRMED), and -7 ± 3°C (GRNO). Ice cooled the muscle the most, while GR with medium and high compression cooled more than GR without compression (P < 0.05).

Conclusions: The application of cold and intermittent pneumatic compression using GR did not produce acute cardiovascular strain that exceeded the strain produced by standard ice bags/elastic wrap treatment. Greater temperature decreases are achieved with medium- and high-pressure settings when using the GR system.

Clinical relevance: Type of cold and amount of compression affect tissue cooling in healthy lean subjects. All tested cold modalities caused acute increases in cardiovascular strain; however, these increases are no more than what healthy subjects experience with the onset of exercise.

Keywords: blood flow; blood pressure; cryotherapy.

Figure 1.

Intramuscular temperature during cooling and passive recovery [mean ± SE]. ^aGR_NO produced significantly less muscle cooling than ice bags, GRMED, and GRHIGH from 10 to 40 minutes (P < 0.05). ^bIce bags provided greater muscle cooling from time points 10 to 45 minutes when compared to GRMED and GRHIGH (P < 0.05). ^cIce bags provided greater muscle cooling than GRMED at time points 50 and 55 minutes (P < 0.05). ^dIce bags provided greater muscle cooling than GR_NO at 5 minutes and 45 to 60 minutes (P < 0.05).

Figure 2.

Skin surface temperature during cooling and passive recovery [mean ± SE]. ^aIce bags provided greater skin surface cooling from 30 seconds to 35 minutes when compared to all Game Ready conditions (P < 0.05). ^bIce bags also provided greater skin surface cooling than GRNO at 40 and 45 minutes (P < 0.05). ^cAll cold conditions exhibited an immediate warming of the skin after removal of cold modality. Time point 30 minutes was significantly different from 35 minutes (P < 0.05).