1. Cryotherapy Techniques Applied to Acute Ankle Sprains
Tyler Beauchamp

2. Definitions Cry/o/therapy – “cry” meaning cold ROM – range of motion
MMT – manual muscle testing
RTP – return to play
Edema – swelling
Inversion – foot rolls in
Eversion – foot rolls out
Dorsiflexion – toes to the nose
Plantarflexion – foot to the floor

3. Introduction
Cryotherapy is used for rehabilitation purposes to decrease swelling and increase ROM
Used to block nerve fibers from moving from the injured site to the thalamus
Used in the inflammatory response phase of the healing process
Cryotherapy includes any treatment that utilizes ice to facilitate healing. This is mostly used on acute injuries.
This keeps the brain from recognizing the injury, allowing for a decrease in pain. Once treatment is applied the patient receives a feeling of numbness that begins with a burning, achy sensation.
Cryotherapy can be applied in many different forms including ice packs, cold whirlpools, cryocuff and biocryo applications.

4. Nociceptor (in the skin)  2. Sensory Nerve  3
Nociceptor (in the skin)  2. Sensory Nerve  3. T-cell (transmits a signal to the thalamus)  4. Thalamus  5. Sensory Cortex (area of the brain that identifies the location of pain)
This process is important because it is the beginning of the inflammation process, if nerve fibers are slowed using cryotherapy the brain takes longer to sense that there is an injury.

6. Cryotherapy Methods

7. Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols
Ice pack (compression) vs intermittent
Purpose: to compare intermittent cryotherapy to a standard cryotherapy treatment
Participants: 89 subjects with mild or moderate ankle sprains within the past 48 hours (16+ years old)
Method: subjects randomly assigned into two groups; standard ice application or intermittent ice application
Results: no significant difference between the two groups for ankle function or swelling
Intermittent reduced the level of subjective pain during activity compared to the standard application

8. Comparison of Three Treatment Procedures for Minimizing Ankle Sprain Swelling
Purpose: to compare the effects of cold, heat, and contrast bath on swelling in subjects with acute ankle sprains
Participants: 30 students (18-22 years old) with an acute ankle sprain
Method: randomly assigned to one of three treatment groups; cold whirlpool, warm whirlpool, or contrast bath
Results: cold therapy showed a significant difference in reduction of swelling
Warm whirlpool and contrast bath showed no significant difference in reducing swelling

9. Problem
There is no declarative research that has provided information to determine which method is most effective
Each method of cryotherapy has been observed in research on its effectiveness but most have not been compared to another method
Studies using cryocuff or biocryo are scarce
Both applications utilize the same methods that both ice packs and cold whirlpools have

10. Purpose
To compare and determine the most effective method for increasing ROM and decreasing edema in male collegiate level basketball players during season
Cryocuff and biocryo applications will be compared in order to determine effectiveness
Effectiveness in decreasing edema and increasing ROM; which will decrease the amount of time the athlete spends on the sideline.
Acute ankle sprains are the most recurring injury in pro basketball players

11. Importance
It is important to reach a declarative conclusion and understand how each method works in a specific situation
Having evidence would help collegiate programs select the appropriate treatment method for an athlete to RTP quicker
Decreasing edema allows for further treatment and strengthening to take place
This is important because it allows us to develop the most appropriate application.
Cryotherapy allows for a decrease in pain which allows for strengthening and treatment to be done with the least amount of discomfort.

12. Procedures
30 male collegiate basketball players suffering from an acute ankle injury (18 – 24 years)
Subjects randomly divided into two different groups; cryocuff and biocryo treatment groups
Each participant will partake in therapeutic exercise to further strengthen the ankle
Those with +3 recurrent ankle sprains will be excluded
Pre-test / post-test method
Each participant will receive a full examination and history of the lower extremity prior to the study, including ROM measurements for all movements of the ankle and MMT (inversion and plantarflexion) of the ankle.
Each treatment group will receive inferential electrical stimulation with the treatment which is applied for 20 minutes, 3 times a week for 4 weeks. With at least 48 hours in between treatments.
Pre-test / post-test: ROM and MMT will be done before and after each treatment. Using a goniometer and therabands.

13. Goniometer
Theraband

14. Expected Results Hypotheses:
Application of the biocryo regimen will prove to be more beneficial in decreasing edema rather than the cryocuff treatment
Application of the biocryo regimen will prove to have more of a significant impact on increasing ROM rather than the cryocuff treatment
I expect these results because the biocryo regimen does not use a continuous compress like the cryocuff, it actually tries to push swelling out of the ankle in an effort to heal the injury.

15. References
Bleckley, C. M., McDonough, S. M., & MacAuley, D. (2006). Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. British Journal of Sports Medicine, 40(8), p Retrieved February 17, 2013, from the SPORTDiscus database.
Cote, D. J., Prentice, W. E., Hooker, D. N., & Shields, E. W. (1988). Comparison of Three Treatment Procedures for Minimizing Ankle Sprain Swelling. Journal of the American Physical Therapy Association,68, Retrieved March 3, 2013, from the PubMed database.
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