Different Rate And Magnitude Of Cooling During Ice Bag Treatment With And Without Damp Towel Wrap
Integra
Introduction
Despite the widespread use of an ice bag, there is no universally accepted clinical protocol for the application of an ice
bag (1). Regarding the use of barrier, several previous studies use a barrier, such as a towel, to wrap an ice bag before
applying to the body part (2) while other studies directly applied an ice bag to the body part (3). The aim of this study
was to compare skin surface temperature during the 20-minute application of ice bag with and without damp towel
wrap. The results would provide clinicians with evidence-based guidance on the appropriate protocol for cryotherapy
application regarding the use of barrier.
Methods
Thirty females participated in the study. A modality was applied to the right thigh. Three modalities used were an ice
bag, an ice bag with damp towel wrap and a bag containing room-temperature water (control). Skin surface temperature
underneath the modalities was monitored every minute for 20 minutes. A 2-way analysis of variance for repeated
measures was employed to determine the effects of modality type, application time and their interaction on skin surface
temperature.
Results
During 20-minute application, an (unwrapped) ice bag applied directly to the skin led to greater skin surface
temperature reduction than that of a ice bag with damp towel wrap and control (p<0.05). Cooling time to the lowest skin
surface temperature during the application of an unwrapped ice bag was shorter than that of a wrapped ice bag (p<0.05).
No subjects reported any adverse reactions following the experimental sessions.
Conclusion
The direct application of an ice bag over the skin appears to be a more effective mean of tissue cooling compared to the
application of an ice bag with damp towel wrap because of its greater extent of tissue temperature reduction and cooling
rate. A cooler cryotherapy technique may yield greater physiological and biological effects of tissue temperature
reduction such as decrease in edema, pain, muscle spasm and inflammation. A rapid cooling rate of cryotherapy
technique may be advantageous, particularly when treating acute musculoskeletal injuries, because the extent of
secondary injury would be minimised by the rapid decrease in cellular metabolism (4). Therefore, when using
cryotherapy, clinicians should consider using the direct application of an ice bag rather than the application of an ice
bag with damp towel wrap on the injured body part in order to maximise therapeutic effects of cryotherapy.
References
[1]. MacAuley D (2001). Clin J Sport Me, 11, 67-72.
[2]. Chesterton LS. et al. (2002). Arch Phy Med Rehabil, 83, 543-549.
[3]. Otte JW. et al. (2002). Arch Phy Med Rehabil, 83, 1501-1505.
[4]. Merrick MA. et al. (2003). J Athl Train, 38, 28-33.
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