Comparison of blood flow in the ankle of uninjured subjects during therapeutic applications of heat, cold, and exercise

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Abstract
Cryokinetics (alternating cold and exercise) is replacing heat modalities as the preferred therapy for rehabilitation of traumatic musculoskeletal injuries in athletes. Strain gauge plethysmography was used to measure blood flow to the ankle of 12 uninjured male subjects. A repeated measures design was used with each subject being tested under 6 experimental conditions: heat packs, cold packs, control, heat-exercise, cold-exercise and control-exercise. Exercise consisted of five min bouts (3.5 mph) interspersed with heat, cold or control throughout a 45 min period. Non-exercise, heat and cold were administered for 25 min each, followed by 20 min without treatment. Instantaneous blood flow was measured regularly during non-exercise periods and estimated during exercise, total flow was computed by integrating over the 45 min treatment-post treatment period. Total flow (ml flow/100 ml tissues per min) was greater (P < 0.0002) during cold-exercise than during heat treatments. There was neither cold-induced vasodilatation during, nor a reflex vasodilatation following, the 25 min cold application. During cryokinetics, exercise causes the increased blood flow and cold applications allows active motion in a painful joint.

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