Cryotherapy, Sensation, and Isometric-Force Variability.

Abstract

OBJECTIVE: To determine the changes in sensation of pressure, 2-point discrimination, and submaximal isometric-force production variability due to cryotherapy. DESIGN AND SETTING: Sensation was assessed using a 2 x 2 x 2 x 3 repeated-measures factorial design, with treatment (ice immersion or control), limb (right or left), digit (finger or thumb), and sensation test time (baseline, posttreatment, or postisometric-force trials) as independent variables. Dependent variables were changes in sensation of pressure and 2-point discrimination. Isometric-force variability was tested with a 2 x 2 x 3 repeated-measures factorial design. Treatment condition (ice immersion or control), limb (right or left), and percentage (10, 25, or 40) of maximal voluntary isometric contraction (MVIC) were the independent variables. The dependent variables were the precision or variability (the standard deviation of mean isometric force) and the accuracy or targeting error (the root mean square error) of the isometric force for each percentage of MVIC. SUBJECTS: Fifteen volunteer college students (8 men, 7 women; age = 22 +/- 3 years; mass = 72 +/- 21.9 kg; height = 183.4 +/- 11.6 cm). MEASUREMENTS: We measured sensation in the distal palmar aspect of the index finger and thumb. Sensation of pressure and 2-point discrimination were measured before treatment (baseline), after treatment (15 minutes of ice immersion or control), and at the completion of isometric testing (final). Variability (standard deviation of mean isometric force) of the submaximal isometric finger forces was measured by having the subjects exert a pinching force with the thumb and index finger for 30 seconds. Subjects performed the pinching task at the 3 submaximal levels of MVIC (10%, 25%, and 40%), with the order of trials assigned randomly. The subjects were given a target representing the submaximal percentage of MVIC and visual feedback of the force produced as they pinched the testing device. The force exerted was measured using strain gauges mounted on an apparatus built to measure finger forces. RESULTS: Sensation of pressure was less (ie, it took greater pressure to elicit a response) after ice immersion, thumbs were more affected than index fingers, and the decrease was greater in the right limb than the left. Two-point discrimination was not affected by cryotherapy but was higher in the finger than in the thumb under all conditions. Isometric-force variability (standard deviation of mean isometric force) was greater as percentage of force increased from 10% to 40% of MVIC. Targeting accuracy (root mean square error) was decreased at 40% of MVIC. Accuracy and force variability were not affected by cryotherapy. CONCLUSIONS: The application of cryotherapy and reduced sensation of pressure appear to have little effect on motor control of the digits. These results support the hypothesis that the use of cold is not contraindicated for use as an analgesic before submaximal rehabilitative exercise focusing on restoring neuromuscular control to injured tissues.