The Efficacy of Cryotherapy on Decreasing Swelling: A Critically Appraised Topic

Abstract

Context: Swelling is a major consequence of musculoskeletal conditions and can be a barrier to healing. Cryotherapy has been reported to decrease swelling. How effective is cryotherapy in reducing swelling during rehabilitation? Methods: PubMed was searched in June 2022 using the Boolean phrases: Swelling OR edema AND cryotherapy OR ice, Swelling AND injury AND cryotherapy. Included articles were published during or after 2017, consisted of one or more cryotherapy interventions, and listed swelling as an outcome measure. The PEDro scale was used to assess study validity. Swelling was measured by the figure-of-eight method (in centimeters). Means, SDs, and 95% confidence interval (CI) were calculated. Results: Three articles were screened. Stasinopoulos et al. received a score of 9/10; Sari et al. and Tittley et al. received a score of 10/10. Tittley et al. reported a decrease in swelling from 52.7 (SD = 0.8; 95% CI [52.35, 53.05]) to 52.0 (SD = 0.8; 95% CI [51.65, 52.35]). Stasinopoulos et al. reported decreases from 62.62 (SD = 0.34; 95% CI [62.51, 62.80]) to 61.10 (SD = 0.30; 95% CI [60.98, 61.24]). Sari et al. also found minimal change in swelling from pre- to posttreatment, 38.7 (SD = 2.6; 95% CI [37.83, 39.57]) to 38.2 (SD = 2.4; 95% CI [37.40, 39.00]). Conclusion: There is consistent evidence indicating that cryotherapy applied during rehabilitation does not decrease swelling in a patient with a musculoskeletal condition.