Contrast Baths Research Articles

Hydrotherapy Application for Women with Polycystic Ovary Syndrome: a Randomized Study

INTRODUCTION. Recently, alternative methods of treating patients with menstrual disorders have become increasingly in demand. One of these methods is hydrotherapy, which has a complex effect on the body. AIM. To evaluate the effectiveness of contrast baths and underwater shower-massage as part of complex treatment of women with polycystic ovary syndrome. MATERIAL AND METHODS. A prospective randomized study was conducted in 120 women with polycystic ovary syndrome, grade 1 obesity, and menstrual irregularities. During the study, 2 groups were allocated by randomization: the first (main) included 60 patients, whose treatment included a special diet and a 24-day course of hydrotherapy, consisting of a single daily intake of fresh water contrast baths (12 days), alternating every other day with underwater shower-massage procedures (12 days). The second group, the control group, was represented by 60 patients who received only a special diet. RESULTS AND DISCUSSION. After treatment, a significantly significant decrease in body mass index was noted in both groups of the study (by 4.9 % in the control group and by 11.3 % in the main group). In women receiving a course of hydrotherapy, there was an improvement in lipid and carbohydrate metabolism with a decrease in the atherogenic index by 36.1 % and an insulin resistance index by 31.0 %, as well as an improvement in indicators of psycho-emotional state, characterized by a decrease in situational anxiety on the Spielberger Hanin scale (p 0.05) and improvement in overall mood on the “Well-being, activity, mood” scale (p 0.05). CONCLUSION. Based on the results of the study, it was proven that the use of hydrotherapy in complex treatment programs for women with polycystic ovary syndrome is an effective and safe method that can be included in standard treatment regimens for this condition.

Hydrotherapy on the Intensity of Neuropathic Pain in Sufferers with Diabetes Mellitus

Background: Neuropathic pain is a type of pain caused by or resulting from a primary injury or dysfunction of the nervous system. Cooperation in nursing care is necessary to reduce the incidence of ambulatory neuropathy. The aim of this study was therefore to evaluate the effectiveness of contrast baths on pain caused by leg neuropathy in diabetic patients. Design: Quasi- experimental design where Pretest Posttest Non- equivalent group design, meeting the inclusion criteria, was selected by non-probability convenience sampling technique. Materials and methods: The study was conducted with 30 patients in the experimental and 30 patients in the control group. Galer Neuropathy A pain assessment tool was used. Results: A comparison of the mean, SD and mean percentage of the control group's pre- and post-test scores shows that in the pre-test the mean score of the control group was (89.4 ± 2.81), which is 89%, while in the post-test the mean score was (68, 1 ± 2.55), which is 68%. It reveals a difference of 21%. Similarly, for the interventional group, the mean score in the pretest was (88.3±2.97), which is 88%, while in the posttest, the mean score was (32.5±2.28), which is 33%. It reveals a distinction of 55%. A contrast bath appeared to be effective in reducing neuropathic pain in patients with diabetes mellitus. Conclusion: The results showed that the interventional group of diabetics experienced a reduction in neuropathic pain after the contrast bath. Therefore, a contrast bath is an effective intervention to reduce neuropathy pain in diabetic patients.

Local alternating heat and cold stimulation affects hemodynamics and oxygenation in fatigued muscle tissue and autonomic nervous activity: a single-arm interventional study

BackgroundLocal alternating heat and cold stimulation as an alternative to contrast bath may cause intermittent vasoconstriction and vasodilation, inducing a vascular pumping effect and consequently promoting increased tissue blood flow and oxygenation. This study aimed to examine the effects of local alternating heat and cold stimulation, using a wearable thermal device, on the hemodynamics of fatigued muscle tissue and autonomic nervous activity.MethodsTwenty healthy individuals experienced fatigue in the periarticular muscles of the shoulder joint due to a typing task. Local alternating heat and cold stimulations were then applied to the upper trapezius muscle. Muscle hardness was measured using a muscle hardness meter, and muscle tissue hemodynamics and oxygenation were evaluated using near-infrared spectroscopy before and after the stimulation. Autonomic nervous activity was also evaluated using heart rate variability.ResultsAlternating heat and cold stimulation decreased muscle hardness of the fatigued trapezius muscle from 1.38 ± 0.15 to 1.31 ± 0.14 N (P < 0.01). The concentration of total hemoglobin in the trapezius muscle tissue increased from − 0.21 ± 1.36 to 2.29 ± 3.42 µmol/l (P < 0.01), and the tissue hemoglobin oxygen saturation also increased from 70.1 ± 5.4 to 71.1 ± 6.0% (P < 0.05). Additionally, the heart rate variability parameter, which is an index of sympathetic nervous activity, increased from 3.82 ± 2.96 to 6.86 ± 3.49 (P < 0.01). A correlation was found between increased tissue hemoglobin oxygen saturation and increased parameters of sympathetic nervous activity (r = 0.50, P < 0.05).ConclusionsLocal alternating heat and cold stimulation affected the hemodynamic response in fatigued muscle tissue and autonomic nervous activity. This stimulation is more efficient than conventional contrast baths in terms of mobility and temperature control and has potential as a new versatile therapeutic intervention for muscle fatigue.Trial registrationUMIN-CTR (UMIN000040087: registered on April 7, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045710. UMIN000040620: registered on June 1, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046359).

The effectiveness of contrast bath to reduce joint pain in the elderly

Background: The aging process results in changes in the musculoskeletal system causing a decrease in function of joints, loss of elasticity and limited mobility. This condition also causes joint pain, especially in the joints supporting the body weight, namely the knee. The previous studies discussed the method of reducing pain using a contras bath which was implemented by soaking parts of the body that experience pain alternately with hot and cold water, this was difficult to apply if the pain occurs in the upper body. Modifications in contrast baths using compresses to the knee joint have never been implemented before.Objective: This study aimed to figure out the effect of the contras bath method using compresses to reduce knee joint pain in the elderly.Method: The design of this study was pre-experimental with one group of pretest-posttest. The sample used was 16 elderly who were selected by random sampling at Posyandu (a center for pre- and postnatal health care and information for elderly) in village of Sawit Gantiwarno, Klaten. Contrast bath is applied by giving compresses of warm and cold water alternately with a ratio of three minutes: one minute per-day during 20 minutes, for a week. Pain measurement is performed using the Visual Analog Scale (VAS) instrument.Result: The mean of knee pain before giving a contrast bath was 5.44, whereas after a contrast bath was 3.50. Bivariate analysis used Wilcoxon, it showed p value &lt;0.05 which means there was a significant difference in knee joint pain before and after contrast baths were applied.Conclusion: Administration of contrast bath can reduce knee joint pain in the elderly.

Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy.

Contrast baths (CB) is a thermal treatment modality used in sports medicine, athletic training, and rehabilitation settings. Proposed physiological effects of CB include increasing tissue blood flow and oxygenation and decreasing tissue swelling and edema to promote better healing, improved limb function, and quicker recovery. To investigate the physiological effects of CB on the intramuscular hemodynamics and oxygenation of the lower leg muscles using near-infrared spectroscopy (NIRS), an optical method for monitoring changes in tissue oxygenated (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb) as well as tissue oxygen saturation index (TSI%). Descriptive laboratory study. Ten healthy men and women with a mean age of 29 (range = 17 ± 42) years, mean body mass index of 24.6 ± 3.2, and mean adipose tissue thickness of 6.4 ± 2.2 mm. Conventional CB (10-minute baseline, 4 : 1-minute hot : cold ratio) was applied to the left lower leg. Changes in chromophore concentrations of O2Hb, HHb, tHb, and TSI% of the gastrocnemius muscle were monitored during 10 minutes of baseline measurement, a 30-minute CB protocol, and 10 minutes of recovery using a spatially resolved NIRS. After a 30-minute CB protocol, increases ( P < .05) in tissue O2Hb (7.4 ± 4 μM), tHb (7.6 ± 6.1 μM), and TSI% (3.1% ± 2.3%) were observed as compared with baseline measures. Application of CB induced a transient change in the hemodynamics and oxygenation of the gastrocnemius muscle in healthy individuals. The effect of CB application in improving tissue hemodynamics and oxygenation may, therefore, support the therapeutic benefits of CB in the treatment of muscle injuries.

Fatigue and Recovery in Rugby: A Review.

The physical demands and combative nature of rugby lead to notable levels of muscle damage. In professional rugby, athletes only have a limited timeframe to recover following training sessions and competition. Through the implementation of recovery strategies, sport scientists, practitioners and coaches have sought to reduce the effect of fatigue and allow athletes to recover faster. Although some studies demonstrate that recovery strategies are extensively used by rugby athletes, the research remains equivocal concerning the efficacy of recovery strategies in rugby. Moreover, given the role of inflammation arising from muscle damage in the mediation of protein synthesis mechanisms, some considerations have been raised on the long-term effect of using certain recovery modalities that diminish inflammation. While some studies aimed to understand the effects of recovery modalities during the acute recovery phase (<48h post-match), others investigated the effect of recovery modalities during a more prolonged timeframe (i.e. during a training week). Regarding the acute effectiveness of different recovery modalities, cold water immersion and contrast baths seem to provide a beneficial effect on creatine kinase clearance, neuromuscular performance and delayed onset of muscle soreness. There is support in the literature concerning the effect of compression garments on enhancing recovery from delayed onset of muscle soreness; however, conflicting findings were observed for the restoration of neuromuscular function with the use of this strategy. Using a short-duration active recovery protocol seems to yield little benefit to recovery from rugby training or competition. Given that cold modalities may potentially affect muscle size adaptations from training, their inclusion should be treated with caution and perhaps restricted to certain periods where athlete readiness is more important than increases in muscle size.

Painless Complex Regional Pain Syndrome in an Old Man

Address for Correspondence/ Yaz›flma Adresi: Fatih Bagcier MD, Ataturk University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Erzurum, Turkey Phone: +90 442 344 70 87 E-mail: bagcier_42@hotmail.com Received/Gelis Tarihi: 21.07.2015 Accepted/Kabul Tarihi: 24.07.2015 To the Editor; A 62-year-old man presented to our outpatient clinic with the complaints of swelling and restriction of finger and wrist movements of his left hand. He provided history of distal radius fracture on his left hand two months prior to presentation to the our clinic. Following the trauma, the patient had been treated by immobilization in a cast for six weeks. He had no pain. On examination of the skin of the affected hand; wrist was swollen (non-pitting), hot, and was not tender to touch (Figure 1a). There was no hyperhidrosis, tremor, allodynia and hyperalgesia. Range of motion was restricted at the wrist and fingers. X-ray of the hand showed demineralization of the bones of the hand. A bone scan was performed and there was milder non-specific diffuse increased uptake in the remaining left wrist region (Figure 2a, 2b). Based on these findings, the patient was diagnosed as complex regional pain syndrome (CRPS) type 1 according to Zyluk scoring system (1). Physical therapy modalities and medical treatment was planned. In the physiotherapy program; range of motion exercises, contrast baths (four cycles over a 20 minute period), whirlpool bath (15 minutes), retrograde massage, pulse ultrasound (1 watt/cm2) was performed. The patient was administered intravenous methylprednisolone 30 mg/day pozology for a week. After the 20 sessions of physical therapy and medical treatment, the patient’s signs and symptoms markedly improved as compared to the initial examination (Figure 1b). Active and passive wrist flexion was full and he did not report any pain at the control visits. According to the International Association for the Study of Pain criteria of 1994, pain, evidence of change in blood flow or abnormal sudomotor activity and the absence of conditions that would otherwise account for symptoms are essential diagnostic entities of CRPS type 1 (2,3). Eisenberg and Melamed (4) reported a series of five patients with various foot pathologies who had presented with all of the criteria of CRPS except pain. Ayhan Kul, Fatih Bagcier, Mahir Ugur Yasli Bir Hastada Agrisiz Kompleks Bolgesel Agri Sendromu Painless Complex Regional Pain Syndrome in an Old Man DOI: 10.4274/tod.84856 Turk J Osteoporos 2016;22:67-8 Letter to Editor / Editore Mektup

Comparative Study of: Non-Invasive Conservative Treatments with Local Steroid Injection in the Management of Planter Fasciitis.

Planter Fasciitis is an annoying and painful condition that limits function. There is pain and tenderness in the sole of the foot, mostly under the heel, with standing or walking and is considered a self limiting condition. Symptoms resolve in 80% to 90% of cases within ten months. However, this long interval is frustrating for both patients and clinicians. This study was undertaken to compare the two different modalities of non operative treatment: Non- invasive conservative methods: NSAID's, Soft Insoles, Stretching, Ultrasound therapy and Contrast baths versus local Steroid injection therapy. Patients by random sampling were divided in two groups. Group A as: Conservative group and Group B as Local Steroid Injections group, 100 patients in each. Patients were assessed as per Visual Analogue Scale (VAS) at the start of treatment and then after 4 wk and 8 wk duration on follow up. SPSS for Windows (version 10.0) by the Chi-Square test. The difference in the distribution of subjects belonging to either of the treatment modalities regarding the treatment outcome at four and eight week was found to be statistically insignificant. As both treatment modalities are at par on comparison of their treatment outcome it is better to go for conservative approach because this can save the patients from the complications of steroid therapy.

Acute Response to Hydrotherapy After a Simulated Game of Rugby

Despite lacking clear scientific evidence, hydrotherapies (water treatments) are accepted techniques to help team sport athletes recover from the physical effects of games. The purpose of this study was to assess the comparative effectiveness of cold water immersions (CWIs) and hot-and-cold contrast baths on athletes' recovery after a simulated game of rugby union. Twenty-four experienced, well-trained, male rugby union players were divided into 3 groups to receive recovery interventions: CWI for 1 group, contrast baths for a second group, and passive recovery for a third (control) group. Pregame and postgame measurements included a countermovement jump (normalized as a ratio to body weight), a sit-and-stretch flexibility test (centimeters), thigh circumference (to detect swelling; centimeters), and participants' perception of delayed-onset muscular soreness (DOMS, 100-mm visual analog scale). Statistical analysis included analysis of variance, and the calculation of omnibus effect sizes for each group ((Equation is included in full-text article.)) and the magnitudes of change within and between groups (Cohen's d). The participants in the contrast bath group reported statistically significantly greater measures of DOMS than participants in the control group did at 1 hour postintervention (p = 0.05, control group: d = 1.80; contrast bath: d = 4.75), and than participants in the CWI group did at 48 hours postintervention (p = 0.02, CWI: d = 1.17; contrast bath: d = 1.97). These findings provide modest evidence that contrast baths are a less effective strategy for recovery from rugby union than are CWI or passive recovery. Specifically, 2 × 5-minute CWI is superior to both contrasts baths and passive recovery in alleviating DOMS after exercise-induced muscle damage. Our recommendation for rugby union players aiming to attenuate the effects of DOMS postgames is to take 2 × 5-minute CWIs baths immediately after the game.

Evaluation of Hydrotherapy, Using Passive Tests and Power Tests, for Recovery Across a Cyclic Week of Competitive Rugby Union

In team sports, a cycle of training, competition, and recovery occurs weekly during the competitive season. In this research, we evaluated hydrotherapy for recovery from a simulated game of rugby union tracked over a week of training. Twenty-four experienced male rugby union players (mean ± SD age 19.46 ± 0.82 years, weight 82.38 ± 11.12 kg, height 178.54 ± 5.75 cm) were randomly divided into 3 groups: cold water immersion (n = 8), contrast bath therapy (n = 8), and a control group (n = 8). The 2 forms of hydrotherapy were administered immediately after a simulated rugby game. Testing was conducted 1 hour before the game and at 5 intervals postgame: 1, 48, 72, 96, and 144 hours. Dependent variables included countermovement jump, 10- and 40-m sprints, sessional rating of perceived exertion (RPE), flexibility, thigh circumference, and self-reported delayed onset muscle soreness (DOMS). Significant differences in DOMS were found between the cold water immersion and contrast bath groups at 48 hours post intervention (p = 0.02), and between the control and contrast bath groups at 72 (p = 0.03) and 96 (p = 0.04) hours post intervention. Cold water immersion and contrast bath groups reported significantly different RPE at 72 hours (p = ?) and 96 hours post (p = 0.05) intervention. Athletes' perceptions of muscle soreness and sessional RPE scores for training were greater in the contrast bath group (20%) after the simulated game and throughout the training week. Although results from passive and power tests were inconclusive in determining whether cold water immersion or passive recovery was more effective in attenuating fatigue, results indicated contrast baths had little benefit in enhancing recovery during a cyclic week of rugby union.

Evaluation of passive recovery, cold water immersion, and contrast baths for recovery, as measured by game performances markers, between two simulated games of rugby union.

ABSTRACT: In team sports, during the competitive season, peak performance in each game is of utmost importance to coaching staff and players. To enhance recovery from training and games a number of recovery modalities have been adopted across professional sporting teams. To date there is little evidence in the sport science literature identifying the benefit of modalities in promoting recovery between sporting competition games. This research evaluated hydrotherapy as a recovery strategy following a simulated game of rugby union and a week of recovery and training, with dependent variables between two simulated games of rugby union evaluated. Twenty-four male players were randomly divided into three groups: one group (n=8) received cold water immersion therapy (2 X 5min at 10oC, whilst one group (n=8) received contrast bath therapy (5 cycles of 10oC/38oC) and the control group (n=8) underwent passive recovery (15mins, thermo neutral environment). The two forms of hydrotherapy were administered following a simulated rugby union game (8 circuits x 11 stations) and after three training sessions. Dependent variables where generated from five physical stations replicating movement characteristics of rugby union and one skilled based station, as well as sessional RPE values between two simulated games of rugby union. No significant differences were identified between groups across simulated games, across dependent variables. Effect size analysis via Cohen's d and ηp2 did identify medium trends between groups. Overall trends indicated that both treatment groups had performance results in the second simulated game above those of the control group of between 2% and 6% across the physical work stations replicating movement characteristics of rugby union. In conclusion, trends in this study may indicate that ice baths and contrasts baths may be more advantageous to athlete's recovery from team sport than passive rest between successive games of rugby union We are pleased to resubmit our revised manuscript JSCR-08-1992 and have addressed the comments and suggestions raised by the reviewers. Please find below a list of changes or rebuttal against each point.

Effect of Time Ratio of Heat to Cold on Brachial Artery Blood Velocity During Contrast Baths

Contrast baths have been adopted widely in clinics. However, the time ratio of heat to cold modalities has not been well established. The purpose of this study was to explore the effect of time ratio on brachial artery mean blood velocity (aMBV) and determine the optimal duration in the second heating phase. This was a within-participant, repeated-measures, experimental study. Thirty-four young volunteers who were healthy were recruited. Each participant performed 2 kinds of contrast baths within 2 separate sessions. In the first trial with a fixed time ratio, participants immersed their left hands in a 40°C hot bath for 3 minutes and then in an 18°C cold bath for 1 minute. This procedure was repeated 3 times. In the second trial, after the initial 3-minute hot bath and 1-minute cold bath, a 10-minute 40°C hot bath immersion was adopted as the second cycle. A color Doppler ultrasound scanner was used to measure aMBV, which was used to calculate the percentage of change related to the baseline (aMBV%) and the fluctuation in the heating phases (ΔaMBV%). In the first trial, compared with the first heating phase, the ΔaMBV% was significantly lower by 57% and by 46% in the second and third heating phases, respectively. In the second trial, the ΔaMBV% beyond the 7th minute did not reach a significantly lower level. The results cannot be generalized to elderly individuals or patients with medical conditions. A longer duration in the second heating phase during contrast baths was required to produce a sufficient fluctuation in blood flow.

The Effect of Type-2-Diabetes-Related Vascular Endothelial Dysfunction on Skin Physiology and Activities of Daily Living

A common factor contributing to organ damage in type 2 diabetes mellitus (T2DM) is impaired tissue blood flow caused by damage to vascular endothelial cells (VECs). Damage can occur even before the clinical diagnosis of diabetes. It can be caused by both a high average blood glucose concentration and/or large daily spikes in blood glucose. While much of the present literature focuses on the damage to VECs and organs from these large glucose excursions, this review will focus on the consequence of this damage, that is, how endothelial cell damage in diabetes affects normal daily activities (e.g., exercise, reaction to typical stimuli) and various treatment modalities (e.g.. contrast baths and electrical stimulation therapy). It is important to understand the effects of VEC damage such as poor skin blood flow, compromised thermoregulation, and altered response to skin pressure in designing diabetes technologies as simple as heating pads and as complex as continuous glucose monitors. At the simplest level, people with diabetes have poor circulation to the skin and other organs. In the skin, even the blood flow response to locally applied pressure, such as during standing, is different than for people who do not have T2DM. Simple weight bearing on the foot can occlude the skin circulation. This makes the skin more susceptible to damage. In addition, endothelial damage has far-reaching effects on the whole body during normal activities of daily living, including an impaired response to local heat, such as hot packs and contrast baths, and higher body temperatures during whole body heating due to impaired blood flow and a reduced ability to sweat. Finally, because of multiple organ damage, people with T2DM have poor balance and gait and impaired exercise performance.

A Random Control Trial of Contrast Baths and Ice Baths for Recovery during Competition in U/20 Rugby Union

Players in team sports must recover in a relatively short period of time to perform at optimal levels. To enhance recovery, cryotherapy is widely used. To date, there are limited scientific data to support the use of cryotherapy for recovery. Players (n = 26) from a premier rugby club volunteered to participate in a random control trial (RCT) using contrast baths, ice baths, and no recovery. Statistical analysis, between group and within group, with repeated measures was conducted along with determination of effect sizes in 2 field tests. Pre and postfield tests including a 300-m test and a phosphate decrement test and subjective reports were conducted during the RCT. No significant difference was identified between base tests and retests in the phosphate decrement test or the 300-m tests. Effect size calculations identified a medium to large effect (d = 0.72) for 300-m tests for contrast baths against control. Trivial effects were identified for ice baths (d = 0.17) in the 300-m test against control. Effect size calculations in the phosphate decrement test showed a trivial effect (d = 0.18) contrast baths and a negative effect (d = -0.62) for ice baths. Treatment-treatment analysis identified a large effect for contrast baths (d = 0.99) in the phosphate decrement test and a medium effect for contrast baths (d = 0.53) in the 300-m test. Effect scores across contrast baths, ice baths, and passive recovery along with subjective reports indicate a trend toward contrast baths benefiting recovery in rugby. The continued use of 5-minute ice baths for recovery should be reconsidered based on this research because trends suggest a detrimental effect.

A Randomized Controlled Study of Contrast Baths on Patients with Carpal Tunnel Syndrome

Study Design Randomized clinical trial. Introduction: Contrast baths are a treatment modality commonly used in hand clinics. Yet the benefits of contrast baths have been poorly substantiated. Contrast baths have been suggested for the purposes of reducing hand volume, alleviating pain, and decreasing stiffness in affected extremities. Purpose of the Study To determine the effects of specific contrast bath protocols on hand volume in patients diagnosed with Carpal Tunnel Syndrome. Methods Study participants were randomly assigned to one of three treatment group protocols—contrast baths with exercise, contrast baths without exercise, and an exercise-only control treatment group. Study participants were evaluated with hand volumetry, before and after treatment at two different data collection periods—pre- and postoperatively. Results Data were gathered on 58 participants before Carpal Tunnel Release surgery and on 56 participants after Carpal Tunnel Release surgery, for a total of 114 treatments. The changes in hand volume (the after treatment volume minus the before treatment volume) were analyzed using one-way and multi-way analysis of variance (ANOVA). Although all three treatments resulted in a slight increase in hand volume both pre- and postsurgery, the increase was not clinically significant with regard to hand volumes. Also no significant differences were noted among the three treatments. Specifically, the ANOVA for presurgery differences among treatments had F = 0.155 (2 and 55 df), p = 0.857. The ANOVA for postsurgery difference among treatments had F = 0.544 (2 and 53 df), p = 0.584. Conclusions The use of contrast bath treatment has no significant effect on increase or decrease of hand volume in Carpal Tunnel Syndrome patients, pre- and/or postoperatively. Level of evidence 1B.

Evaluation of contrast baths and ice baths for recovery in U/20 rugby union

Introduction: Players in team sports must recover from competition and training in a relatively short period of time in order to perform at optimal levels in either training or games. To enhance recovery Cryotherapy is widely used. To date there is limited scientific data to support the use of Cryotherapy for recovery. Methods: Players (n = 25) from a U/20 competition volunteered to participate in a random control trial using contrast baths, ice baths and no recovery. Between group and with-in group analysis with repeated measures were used to identify significant differences in three field tests. Multistage shuttle test, 300 m test and a phosphate decrement test were performed several times across four weeks during training. Results: Repeated measures analysis identified a significant difference between base tests, retests and last tests multistage shuttle test (p < 0.001) and the phosphate decrement test (p < 0.05). However no treatment interaction was identified. No significant difference was identified in 300 m test and retests; a lack of data was available from retests. Discussion: Results from this study may indicate that during pre-season training, the physical work undertaken may be more important than the recovery protocol for improvements in fitness parameters tested in this study. However, consideration should take into account the number of days between sessions. With no games at this stage of the season, participants had up to 4 days off, allowing for ample recovery. The relative small sample size in groups and level of missing data is another factor impacting on results. Future research should be directed towards larger sample sizes and during periods of cyclic activity which include games and training to evaluate benefits of cryotherapy in recovery from team sport.

A Systematic Review of the Effectiveness of Contrast Baths

Study Design Systematic review. Introduction Contrast baths are used as an intervention in hand therapy, yet it is unclear which patients, if any, benefit from this intervention. Purpose of the Study To examine the nature and quality of the evidence regarding the use of contrast baths using a systematic review process. Methods Of a total of 28 clinical research articles on contrast baths, from 1938 forward, ten met the inclusion criteria set by the authors. Results These studies addressed the physiological changes of hot and cold on blood flow, intramuscular temperature, subcutaneous temperature, and the influence of room temperature and age. The subjects included normal/healthy volunteers and patients with a diagnosis of rheumatoid arthritis, diabetes, or foot/ankle injuries. The diversity of conditions, protocols, and outcomes limited the ability to make definitive conclusions on efficacy. Conclusions The contrast bath procedure may increase superficial blood flow and skin temperature, though the evidence on the impact on edema is conflicting. No relationship between physiologic effects and functional outcomes has been established. Level of Evidence: 2A

Evaluation of upper extremity rehabilitation in hemiplegic patients with and without complex regional pain syndrome type 1

We investigated the effects of the complex regional pain syndrome (CRPS) type 1 on upper extremity rehabilitation in hemiplegic patients. Eighty patients were enrolled and were randomly assigned to either study (40 hemiplegic patients with CRPS) or control (40 hemiplegic patients without CRPS) groups. All patients participated in a hemiplegia rehabilitation program consisting of neurodevelopmental techniques, stretching and strengthening exercises, and conventional methods. Additionally, participants in the study group received analgesic and calcitonin therapy, elevation, range of movement therapy for the affected joints, and contrast baths. Clinical findings were assessed before and after rehabilitation using the upper-limb function (ULF), hand movements (HM), and advanced hand activities (AHA) subscales of the Motor Assessment Scale (MAS) and the Ashworth scale for upper extremities. A statistically significant difference in MAS ULF was apparent at admission and upon discharge in both groups. In the control group, a significant difference was found between MAS HM and MAS AHA on admission and at discharge, no difference was found in the study group for these parameters. No difference was found for either group with regard to the Ashworth scale. No between-group differences were found regarding MAS ULF, MAS HM, and MAS AHA at admission and at discharge. Our data showed no influence of CRPS on MAS ULF, MAS HM, and MAS AHA and the Ashworth scale for upper extremities.

The Effects of Aging on the Skin Blood Response to Warm, Cold, and Contrast Warm and Cold Baths

Objectives: To examine the effects of aging on the ability of contrast baths to increase the circulation in the skin of the foot compared with immersion in a continuous warm water bath of the same temperature as the warm component of the contrast bath.Methods: A laser Doppler flow meter was used to assess skin blood flow on the dorsal and plantar aspects of the foot during immersion in a warm bath (100°F (37.8°C)) compared with contrast baths with a ratio of 3 minutes of warm (100°F (37.8°C)) and 1 minute of cold (60°F (15.6°C)); the cycle was repeated for 16 minutes. Fourteen participants whose average age was 55.1 ± 9.1 years were examined and compared with 12 younger participants whose average age was 23.9 ± 5.8 years.Results: For both groups of participants, the use of alternating hot and cold bath temperatures elicited an increase in skin blood flow above that which was found with warm water immersion alone. The greatest response was in the younger participants. For the older participants, skin blood...

Effects of contrast baths on skin blood flow on the dorsal and plantar foot in people with type 2 diabetes and age-matched controls

Contrast baths have been used for therapy for over 2,000 years. The basic concept is to alternate warm and cool water baths during a treatment session. It is believed that this will increase circulation better than just placing the limb in a warm water bath. However, there is little supportive evidence for this assertion. Further, for subjects with diabetes, with underlying impairments in their circulation, this may not work at all. Fourteen people with type 2 diabetes were compared to 14 age-matched controls. Skin blood flow of the foot (BF) was measured during 16 minutes of contrast baths at two different intervals: 3 minutes warm and 1 minute cold and 6 minutes warm and 2 minutes cold. In control subjects, warm and cold contrast baths with the ratio 3 minutes warm to 1 minute cold elicited significantly (p < 0.01) greater BF than placing the limb continuously in warm water or using a 6:2 ratio of warm to cold bath time. In control subjects, there was also a greater plantar than dorsal BF. For subjects with diabetes, there was no statistical difference between BF with contrast baths versus warm whirlpool; but in both cases BF was significantly less than that seen in control subjects under similar circumstances. There was also very little difference between BF on the plantar and dorsal aspects of the foot in the subjects with diabetes. Patients with diabetes do not show a vascular response to contrast bath therapy. The BF response to contrast temperatures may be a good diagnostic test for diabetic vascular impairment.