Int J Sports Med 2006; 27(3): 250-255
DOI: 10.1055/s-2005-865623
Clinical Sciences

© Georg Thieme Verlag KG Stuttgart · New York

Microcirculation of the Ankle after Cryo/Cuff Application in Healthy Volunteers

K. Knobloch1 , 2 , R. Kraemer1 , A. Lichtenberg2 , M. Jagodzinski1 , T. Gosling1 , M. Richter1 , C. Krettek1
  • 1Trauma Department, Hannover Medical School, Hannover, Germany
  • 2Thoracic and Cardiovascular Surgery, Medical School Hannover, Hannover, Germany
Further Information

Publication History

Accepted after revision: March 3, 2005

Publication Date:
02 June 2005 (online)

Abstract

The aim of the study was to assess the combination of compression and cryotherapy (Cryo/Cuff ankle device) on parameters of ankle microcirculation in healthy volunteers over 30 min. In 21 volunteers (12 males, 29 ± 10 years [incl. females], BMI 24 ± 3) the Cryo/Cuff ankle device (AIRCAST, Summit, NJ, USA) was applied with continuous assessment of parameters of ankle microcirculation, such as tissue oxygen saturation (SO2), relative postcapillary venous filling pressures (rHb), and microcirculatory blood flow at 2- and 8-mm tissue depths during 30 min with the Oxygen-to-see System, a laser-Doppler-spectrophotometry-system (LEA Medizintechnik, Gießen, Germany). Superficial tissue oxygen saturation (SO2, 48 ± 19 %) immediately dropped to 23 ± 15 % (- 52 %, p < 0.05) within the first 2 min after Cryo/Cuff activation with a consecutive slow decrease to 32 ± 23 % (- 32 %, p < 0.05 vs. baseline) after 30 min. Deep SO2 (8 mm, 69 ± 5 %) did not change within 30 min of Cryo/Cuff application (70 ± 4 %, n.s.). Superficial postcapillary venous filling pressures (61 ± 17 relative units) showed an immediate and sustained decrease after Cryo/Cuff application within four minutes to 37 ± 18 relative units (- 39 %, p < 0.05). Deep postcapillary venous filling pressures (85 ± 20 relative units) dropped within the first four minutes of Cryo/Cuff application to 68 ± 19 relative units (- 20 %, p < 0.05). Superficial microcirculatory blood flow (21 ± 36 relative units) decreased significantly to 7 ± 5 relative units after 30 min (- 69 %, p < 0.05 vs. baseline). Deep microcirculatory blood flow at 8 mm tissue depth (63 ± 43 relative units) significantly decreased over the 30 min to 39 ± 23 relative units (- 47 %, p < 0.05 vs. baseline). Using the Oxygen-to-see system we could demonstrate significant effects of the Cryo/Cuff device on the ankle level in healthy volunteers with reduced superficial tissue oxygen saturation with preserved deep tissue oxygen saturation, reduced superficial and deep postcapillary venous filling pressures, and reduced superficial and deep microcirculatory blood flow as a function of time. Further clinical studies are mandatory to elucidate the effects of the Cryo/Cuff device on the microcirculatory environment in injured ankles.

References

  • 1 Barlas D, Homann C S, Thode Jr J C. In vivo tissue temperature comparison of cryotherapy with and without external compression.  Ann Emerg Med. 1996;  28 436-439
  • 2 Bassett III F H, Kirkpatrick J S, Engelhardt D L, Malone T R. Cryotherapy-induced nerve injury.  Am J Sport Med. 1992;  20 516-518
  • 4 Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury. A systematic review of randomized controlled trials.  Am J Sport Med. 2004;  32 251-261
  • 5 Cohn B T, Draeger R I, Jackson D W. The effects of cold therapy in the postoperative management of pain in patients undergoing anterior cruciate ligament reconstruction.  Am J Sports Med. 1989;  17 344-349
  • 6 Curl W W, Smith B P, Marr A. et al . The effect of contusion and cryotherapy on skeletal muscle microcirculation.  J Sports Med Phys Fitness. 1997;  37 279-286
  • 7 Draper D O, Schulthies S, Sorvisto P. et al . Temperature changes in deep muscle of humans during ice and ultrasound therapy: An in vivo study.  J Orthop Sports Phys Ther. 1995;  21 153-157
  • 8 Frank K H, Kessler M, Appelaum K, Dümmler W. The Erlangen micro-lightguide spectrophotometer EMPHO I.  Phys Med Biol. 1989;  34 1883-1900
  • 9 Gandjbakhche A H, Bonner R F, Arai A E, Balaban R S. Visible-light photon migration through myocardium in vivo.  Am J Physiol. 1999;  277 698-704
  • 10 Hardy M, Woodall W. Therapeutic effects of heat, cold, and stretch on connective tissue.  J Hand Ther. 1998;  11 148-156
  • 11 Karunakara R G, Lephart S M, Pincivero D M. Changes in forearm blood flow during single and intermittent cold application.  J Orthop Sports Phys Ther. 1999;  29 177-180
  • 12 Knight K L. Cryotherapy: Theory, Technique, and Physiology. Chattanooga, TN; Chattanooga Corp. 1990
  • 13 Knobloch K, Lichtenberg A, Pichlmaier M, Mertsching H, Krug A, Klima U, Haverich A. Microcirculation of the sternum following harvesting of the left internal mammary artery.  Thorac Cardiovasc Surg. 2003;  51 255-259
  • 14 MacAuley D C. Ice therapy: how good is the evidence?.  Int J Sports Med. 2001;  22 379-384
  • 15 McMaster W C, Liddle S, Waugh T R. Laboratory evaluation of various cold therapy modalities.  Am J Sport Med. 1978;  6 291-294
  • 16 Martin S S, Spindler K P, Tarter J W, Detwiler K B. Does cryotherapy affect intraarticular temperature after knee arthroscopy?.  Clin Orthop Res. 2002;  400 184-189
  • 17 Merrick M A, Knight K L, Ingersoll C D. et al . The effects of ice and compression wraps on intramuscular temperature at various depths. J.  Athletic Train. 1993;  28 236-245
  • 18 Olson J E, Stravino V D. A review of cryotherapy.  Phys Ther. 1972;  52 840-853
  • 19 Ohkoshi Y, Ohkoshi M, Nagasaki S. et al . The effect of cryotherapy on intraarticular temperature and postoperative care after anterior cruciate ligament reconstruction.  Am J Sports Med. 1999;  27 357-362
  • 20 O'Toole G, Rayatt S. Frostbite at the gym: A case report of an ice pack bum.  Br J Sport Med. 1999;  33 278-279
  • 3 Purdue G F, Layton T R, Copeland C E. Cold injury complicating burn therapy.  J Trauma. 1985;  25 167-168
  • 21 Swenson C, Swärd L, Karlsson J. Cryotherapy in sports medicine.  Scand J Med Sci Sports. 1996;  6 193-200
  • 22 Taber C, Contryman K, Fahrenbruch J, LaCount K, Cornwall M W. Measurement of reactive vasodilation during cold gel pack application to nontraumatized ankles.  Phys Ther. 1992;  72 294-299
  • 23 Weston M, Taber C, Casagranda L, Cornwall M. Changes in local blood volume during cold gel pack application to traumatized ankles.  J Orthop Sports Phys Ther. 1994;  19 197-199

Dr. K. Knobloch

Trauma Department, Hannover Medical School

Carl-Neuberg-Straße 1

30625 Hannover

Germany

Phone: + 49511532-2181

Fax: + 49 51 15 32 - 58 77

Email: kknobi@yahoo.com

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