Cryotherapy impairs knee joint position sense and balance

Abstract

This study sought to assess knee joint position sense(JPS) and static balance after application of cold-packs and spray. Fifteen healthy basketball players volunteered to participate. Each subject underwent testing first after cold pack application and then 1-week later cold spray application. JPS, around-the-knee pain threshold, and 1-leg static balance were assessed in all patients before and after cryotherapy. JPS was measured with an isokinetic dynamometer. Static balance was assessed using a kinesthetic ability trainer. A pressure algometer was used to measure pressure pain thresholds. Knees were tested using continuous passive motion (CPM). Flexion and extension ranged from 0 to 90 degrees; passive movement was maintained at a velocity of 5 degrees per second. Knee movement in both directions was stopped by pressing a button at the mid point (45°) as a reference point. Regarding 1-leg static balance scores, significant differences were found before and after cold pack application and between knee JPS and pain scores. Significant differences also were found for JPS before and after cold spray application and between JPS scores and pain; however, results on the 1-leg balance tests showed no significant differences. No significant differences were found for 1-leg static balance scores at 5 minutes after cryotherapy application. In this study, we showed that JPS deficits occurred, and postural control was adversely affected, with cryotherapy, and caution should be observed when athletes immediately return to their chosen sport after cryotherapy application.