[Cryotherapy. Behavior of joint temperature during ice application-- a basis for practical use]

Changes of intraarticular temperature were measured in ten young animals during long-term cryotherapy. The use of cold packs of -23 degrees C and an application time of 30 minutes resulted in a decrease of intraarticular temperature of means = 6.56 +/- 1.04 degrees C. The original temperature was reached again after an average of 215 minutes. With cryotherapy there is an initial reflex increase in temperature is the primary object of therapy, all movements commencement of application. Since movements of a joint result in the mixing of synovia of various temperatures, we recommend the following procedures in cryotherapy: 1. during the application of cold (cooling phase) the patient is ask to move his joint from time to time, in order to attain a faster and more effective decrease in temperature in the joint. 2. But in this cases, in which an intraarticular decrease in temperature is the primary object of therapy, all movements should be avoided during the phase of rewarming. The effect of long-term cryotherapy (Kern, 1980) is a decrease in temperature of sufficient magnitude and duration resulting in a reduction of joint metabolism, thereby of the activity of cartilage degrading enzymes. Accordingly, long-term cryotherapy can be recommended using cold packs of -20 to -23 degrees C for 30 minutes every 5 to 6 hours in acute rheumatic arthritis, posttraumatic oedema and in the acute therapy of sports injuries. A thin towel or blotting tissue is used to avoid local freezing. Slight exercise during the cooling phase can improve the results of cryotherapy.