Effects of 7 Consecutive Systematic Applications of Cryotherapy With Compression

Postsurgical and acute orthopedic patients are frequently treated with consecutive systematic cryotherapy despite the void of data to support treatment safety or effectiveness. The purpose of this study was to examine the occurrence of frostbite and measure skin temperatures during the systematic application of 2 cryocompression protocols.

A repeated-measures design guided this study.

Nine healthy, college-aged participants (4 men and 5 women; age = 20.7 [1.2] y; height = 174 [11.01] cm; mass = 74 [14] kg) received both cryocompression protocols separated by ≥ 1 week. The static cryocompression protocol consisted of seven 40-minute "on" cycles of cryotherapy (4.4°C) with 45 mm Hg of compression, each followed by a 30-minute "off" cycle (no cryotherapy, compression set at 5 mm Hg). The intermittent cryocompression protocol consisted of seven 40-minute "on" cycles of cryotherapy (4.4°C) with compression alternating between 5 and 45 mm Hg, each followed by a 30-minute "off" cycle (no cryotherapy, compression set at 5 mmHg). At the end of each "on" and "off" cycle, we used a checklist to assess for frostbite, a PT-6 thermocouple to measure skin temperature (in degrees Celsius), and a 10-cm Likert scale to assess comfort.

None of the participants experienced any signs or symptoms of frostbite. There were no differences in skin temperature between the compression conditions over time (F14,112 = 1.43; P = .149) nor were there any differences between the 2 compression conditions (F1,8 = 3.75; P = .087; 1-β = 0.40). The skin temperatures were statistically different over the course of all 7 "on" and "off" cycles (F14,112 = 95.12; P < .001). There was no difference between the skin temperatures produced at the end of each "on" cycle.

The application of 7 consecutive cryotherapy treatments with compression did not result in any signs or symptoms of frostbite and produced similar skin temperatures with each "on" cycle.