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[1] (Français) La glace traite-t-elle la douleur? Une étude sur l’efficacité clinique de la thérapie
analgésique par le froid.
Ernst E, Fialka V
J Pain Symptom Manage 1994 Jan ; 9(1) : 56-9
[2] (Français) L’approche du corps soignant vers le contrôle non-pharmacologique de la douleur
McCaffery M
Int J Murs Stud 1990; 27(1): 1-5
[3] (Français) Le soulagement de la douleur par des modalités cutanées, le positionnement et les
mouvements
McCaffery M, Wolff M
Hosp J 1992 ; 8(1-2): 121-53
[4] (Français) Contrôle de la douleur après une intervention chirurgicale : guide du patient, Agency for
Health Care Policy and Research
Decubitus 1992 Nov;5Ç6):50-2
[5] (Français) Les effets d’un froid extrême sur les nerfs sensoriels
Barnard D
Ann R Coll Surg Engl 1980 May;62(3):180-7
[6] (Français) L’effet analgésique des vibrations et du refroidissement sur la douleur, induit par une
stimulation électrique intra neurale
Bini G, Cruccu G, Hagbarth KE, Schady W, Torebjork E
Pain 1984 Mar; 18(3): 239-48
[7] (Français) Validation des interventions de stimulation cutanées pour gérer la douleur
Mobily PR, Herr KA, Nicholson AC
University of lowa, Collège of Nursing, lowa City 52242.
Int J Nurs Stud 1994 Dec; 31(6): 533-44
[8] Cold and cryotherapy. A review of the literature on general principles and practical applications
[Article in German]
Kerschan-Schindl K, Uher EM, Zauner-Dungl A, Fialka-Moser V
Universitätsklinik für Physikalische Medizin und Rehabilitation, Wien.
[email protected]
Acta Med Aus-triaca 1998; 25(3): 73-8
[9] Cryotherapy
Hocott JE
[1]
(Français) La glace traite-t-elle la douleur? Une étude sur l’efficacité clinique de la thérapie analgésique par le
froid.
Ernst E, Fialka V
J Pain Symptom Manage 1994 Jan ; 9(1) : 56-9
(Français) Parmi les traitements physiothérapeutiques pour réduire la douleur, la glace tient une place importante depuis
de nombreuses années. L’expérience nous montre que la glace a un puissant effet analgésique à court terme dans de
nombreuses situations douloureuses, en particulier lorsqu’il s’agit du système musculaire.
Les applications en série devraient donc être efficaces. L’évidence scientifique des tests cliniques est tout de même
fragmentaire. Elle s’applique à la fois à une analgésie aiguë et à une analgésie périodique provoquée par le froid.
Le mécanisme de cette cryothérapie devrait inclure à un seuil de tolérance élevé un effet antinoceptive sur le système de
contrôle, une diminution de la conduction nerveuse, une réduction des spasmes musculaires et une prévention des
oedèmes après lésion. ?
On en déduit que l’on peut utiliser la glace pour une variété de douleurs du système musculaire; encore faut il que
l’évidence de son efficacité soit établie avec plus de conviction.
Publication Types:
Review
Review, tutorial
PMID: 8169463, Ul: 94223144
[2]
(Français) L’approche du corps soignant vers le contrôle non-pharmacologique de la douleur
McCaffery M
Int J Murs Stud 1990; 27(1): 1-5
(Français)
Une combinaison des méthodes de contrôle pharmacologiques de la douleur avec des méthodes non-pharmacologiques
donne au patient la meilleure efficacité pour le soulagement de la douleur.
L’infirmière peut apporter une contribution significative au contrôle de la douleur en étant capable de proposer une
variété de méthodes non-pharmacologiques pour soulager la douleur que le patient pourra utiliser en les combinant avec
les méthodes plus traditionnelles d’analgésie ou d’anesthésie locale.
De récentes recherches soutiennent la sortie des plus vieilles méthodes du contrôle non-pharmacologique de la douleur,
comme une distraction, quelque chose de particulier, d’humoristique, une sorte de relaxation qui utilise la mémoire des
patients pour qu’ils se souviennent des moments paisibles, en utilisant la stimulation cutanée et particulièrement en
utilisant le froid.
La stimulation cutanée a même été utilisée efficacement dans d’autres domaines que la douleur. Des exemples
spécifiques de ces techniques sont présentés.
PMID: 2179151, Ul: 90186074
L’approche du corps soignant vers le contrôle non-pharmacologique de la douleur
[3]
(Français) Le soulagement de la douleur par des modalités cutanées, le positionnement et les mouvements
McCaffery M, Wolff M
Hosp J 1992 ; 8(1-2): 121-53
(Français) Le positionnement, le mouvement et certaines modalités cutanées sont facilement utilisés par toutes les
personnes qui donnent des soins y compris par la famille afin d’apporter un confort et un soulagement de la douleur pour
les patients en phase terminale de la maladie. Pour ces patients, l’utilisation de ces techniques est plus appropriées si
elles sont utilisées en plus des méthodes pharmacologiques de contrôle de la douleur. Les patients eux-même se
servent de modalités cutanées avec une assistance minimum des autres, ce qui favorise un sentiment d’indépendance.
Les autres techniques sont appliquées par la famille et les amis, ce qui leurs donne l’assurance d’être assistés par les
personnes qu’ils aiment. Les techniques présentées ici sont aisément utilisées à la maison ou lors d’un séjour à l’hôpital
et elles comportent relativement peu de risques, sont simples et peu coûteuses.
Cet article est un guide spécifique pour les patients et les soignants en relation avec l’utilisation de massages
superficiels , de chaud et froid superficiels, d’application de menthol sur la peau, de stimulation électrique transcutanée
du système nerveux (TENS), de la position et du mouvement. Grâce à leur simplicité et leur facilité d’utilisation, ces
techniques ont tendance à être oubliées. Pourtant, prendre le temps de présenter ces méthodes aux patients ainsi
qu’aux familles ont souvent pour résultat d’apporter une contribution significative au confort du patient qui est sur le point
de mourir.
PMID: 1286847, Ul: 93162587
[4]
(Français) Contrôle de la douleur après une intervention chirurgicale : guide du patient, Agency for Health Care
Policy and Research
Decubitus 1992 Nov;5Ç6):50-2
(Français) Qu’est-ce que la douleur ?
La douleur est une sensation inconfortable qui vous dit que quelque chose ne va pas dans votre corps. La douleur est le
chemin emprunté par votre corps pour alerter votre cerveau. Votre moelle épinière et vos nerfs fournissent un chemin
pour que les messages puissent voyager jusqu’à votre cerveau et à partir de votre cerveau jusqu’aux autres parties de
votre corps.
Le récepteur des cellules nerveuses dans et sous la peau sert à sentir la chaleur, le froid, la lumière, le toucher, la
pression et la douleur. Vous avez des milliers de récepteurs comme ceux-ci, la plus grande quantité fait sentir la douleur
et une plus petite quantité le froid.
Si votre corps a subi une lésion – dans ce cas, une opération chirurgicale – ces minuscules cellules envoient des
messages à travers les nerfs jusqu’à votre moelle épinière qui les transmettra plus haut jusqu’à votre cerveau.
Les médicaments anti-douleur bloquent ces messages ou bien réduit leurs effets sur le cerveau. Parfois, la douleur peut
être simplement gênante, comme un léger mal de tête. D’autres fois, comme à la suite d’une opération, la douleur qui ne
disparaît pas, même après avoir pris des médicaments anti-douleur peut être le signal indiquant un problème.
Après votre opération, les infirmières et les médecins vont vous poser des questions sur vos douleurs par soucis de
confort, mais aussi parce qu’ils veulent savoir si quelque chose ne va pas. Vous devez parler à vos médecins ainsi
qu’aux infirmières si vous avez des douleurs.
PMID: 1489516, Ul: 93143859
[5]
(Français) Les effets d’un froid extrême sur les nerfs sensoriels
Barnard D
Ann R Coll Surg Engl 1980 May;62(3):180-7
(Français) Les effets d’un froid extrême sur les nerfs sensoriels ont été discutés, et une application clinique de ces effets
est proposée.
Les changements structurels observés après la congélation des nerfs sensoriels chez le rat ont été décrits et mis en
corrélation avec les résultats obtenus chez les patients atteints de douleur faciale chronique traités par un blocage
cryogénique des nerfs périphériques.
Il est suggéré que cette technique offre des particularités qui n’ont pas été vues avec d’autres méthodes d’interruption
des conduits périphériques de la douleur et procure une alternative utile aux méthodes déjà existantes pour le traitement
des douleurs chroniques.
PMID: 7396346
[6]
(Français) L’effet analgésique des vibrations et du refroidissement sur la douleur, induit par une stimulation
électrique intra neurale
Bini G, Cruccu G, Hagbarth KE, Schady W, Torebjork E
Pain 1984 Mar; 18(3): 239-48
(Français) Des expériences psychophysiques ont été réalisées sur 16 patients afin de déterminer comment les faibles
stimulations cutanées mécaniques ou thermiques interfèrent avec la sensation de douleur. Une douleur modérée ou
intense était déclenchée par des stimulations électriques à basse fréquence ( 2 Hz ) à l’intérieur des fascicules cutanés
des nerfs médians au niveau du poignet et les vibrations, la pression, le chaud ou le froid étaient appliqués de courtes
périodes (généralement 20 à 60 secondes) à l’intérieur ou en dehors de la partie de la peau vers laquelle la douleur était
projetée.
Les vibrations appliquées à l’intérieur de cette partie douloureuse réduisaient la sensation de douleur plus efficacement
que lorsqu’elles étaient appliquées en dehors de cette zone. Une douleur modérée était parfois complètement supprimée
mais une douleur intense était seulement modérément réduite.
La pression et le froid produisaient un soulagement de la douleur alors que la chaleur (tiède) avait un effet ambigu. Le
point de départ de la sensation de douleur provient de la stimulation des fibres tronculaires et non des récepteurs
nociceptifs périphériques.
L’effet de suppression de la douleur par les vibrations et le froid ne sont pas explicables en terme d’une moindre
excitabilité des terminaisons nerveuses nociceptives de la peau. Toutefois, les résultats indiquent que les récepteurs
sensitifs mécaniques et thermiques (au froid) à des seuils d’activité bas suppriment la douleur au niveau central
(probablement de manière segmentaire).
PMID: 6203084
[7]
(Français) Validation des interventions de stimulation cutanées pour gérer la douleur
Mobily PR, Herr KA, Nicholson AC
University of lowa, Collège of Nursing, lowa City 52242.
Int J Nurs Stud 1994 Dec; 31(6): 533-44
(Français) The purpose of this study was to identify validate specific activities considered important in the implementation
of selected cutaneous stimulation pain management interventions including-heat and cold application, massage and
Transcutaneous Electrical Nerve Stimulation (TENS).
A two-round Delphi survey was completed by nurses selected for their expertise in pain management. Data were
analysed using a modification of Fehring’s diagnostic content validity method. Consistently high scores were obtained by
the raters for each intervention and activity, with most activities perceived as critical to the intervention.
From this process, a list of activities for each cutaneous stimulation intervention evolved that are applicable to educatiCn,
clinical practice and clinical nursing research.
PMID: 7896516, Ul: 95204124
[8]
Cold and cryotherapy. A review of the literature on general principles and practical applications
[Article in German]
Kerschan-Schindl K, Uher EM, Zauner-Dungl A, Fialka-Moser V
Universitätsklinik für Physikalische Medizin und Rehabilitation, Wien.
[email protected]
Acta Med Aus-triaca 1998; 25(3): 73-8
Cryotherapy increases the threshold of pain and induces physiological changes.
lt influences hemodynamics (reduction of skin- and muscle temperature through vasoconstriction), metabolism (reduction
of ischemia due to hypoxia), and neural control (reduction of nerve conduction velocity and muscle tone).
Cryotherapy is indicated mainly in locomotor system related pain. Such pain can be induced by degenerative changes,
postoperatively, and during mobilisation of contracted joints.
Cryotherapy may be used as short term therapy (less than 15 min) as well as long term therapy (more than 20 min).
For maximal efficacy the intensity of application as well as the application medium must be considered. Due to
biorhythm, cold application seems to be more effective in the afternoon.
Publication Types:
Review
Review, tutorial
PMID: 9816398, UI: 99033186
[9]
Cryotherapy
Hocott JE
Cryotherapy diminishes the inflammatory reaction to trauma and reduces edemahematoma formation and pain.
During the rehabilitation period, cold applicationnables the patient to develop strength and mobility in an injured area,
with minimal inflammation and discomfort.
Heat potentiates the body’s inflammatory reaction to trauma and results in increased discomfort.
Cryotherapy should be used initially and heat should be reserved for improving mobility and absorbing hematomas after
all inflammation has subsided.
PMID: 7468403
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[1] Whole-body cryotherapy in rehabilitation of patients with rheumatoid diseases-pilot study.
[Article in German]
Metzger D, Zwingmann C, Protz W, Jackel WH
Hochrhein-Institut für Rehabilitationsforschung, Department für Epidemiologie und Sozialmedizin, Bad
Sackingen.
[2] Reduction of pain-related behaviours with either cold or heat treatment in an animal model of acute
arthritis
Sluka KA, Christy MR, Peterson WL, Rudd SL, Troy SM
Physical Therapy Graduate Program, College of Medicine, The University of lowa,
lowa City 52242-1008, USA.
Arch Phys Med Rehabil 1999 Ma r; 80(3): 313-7
[3] Physiotherapy methods of relieving pain
Moncur C, Shields MN
Baillieres Clin Rheumatol 1987 April 1 (1):183-93
[4] The influence of heat and cold on the pain threshold in rheumatoid arthritis
Cupkovic B, Vitulic V, Babic-Naglic D, DurrigT. T
Department of Rheumatology and Rehabilitation, University Hospital, Rebro,
Zagreb, Croatia.
Z Rheumatol 1993 Sep-Oct; 52(5): 289-91
[5] Treating arthritis with locally applied heat or cold
Oosterveld FG, Rasker JJ
Department of Rheumatology, Hospital Medisch Spectrum Twente, The Netherlands.
Semin Arthritis Rheum 1994 0ct;24(2):82-90
[6] New perspectives on osteoarthritis
Oddis CV
Division of Rheumatology and Clinical Immunology, Department of Medicine,
University of Pitbsburgh School of Medicine, Pennsylvania 15213, USA.
Am J Med 1996 Feb 26;100ÇZA):10S-15S
[7] Cryotherapy in osteoporosis
[Article in Polish]
Ksiezopolska-Pietrzak K
Pol Merkuriusz Lek 1998 Oct; 5(28): 222-4
[1]
Whole-body cryotherapy in rehabilitation of patients with rheumatoid diseases-pilot study.
[Article in German]
Metzger D, Zwingmann C, Protz W, Jackel WH
Hochrhein-Institut für Rehabilitationsforschung, Department für Epidemiologie und Sozialmedizin, Bad Sackingen.
Cryotherapy as a whole-body cold therapy (with cold air cooled by addition of nitrogen blown on the patients in an open
cabin) for treatment of inflammatory rheumatic diseases already started in Bad Sackingen in 1986.
In 1996, anew cold chamber (this time a closed chamber without any addition of nitrogen) based on compressor
technology was introduced. The aim of our study was to test whether significant pain relief could be achieved by means
of this cold therapy. Furthermore, we were interested in the practicability and acceptance of this new technique. Wellbeing during the treatment application and pain level were assessed using verbal and numerical rating scales.
The sample consisted of 120 consecutive patients (75% women, age: 30-67 yrs, M = 52.6 yrs). These patients were
suffering from primary fibromyalgia (40.7%), rheumatoid arthritis (17.3%), chronic low back pain (16.4%),
ankylosingspondylitis (10.9%),osteoarthritis (9.1%), secondary fibromyalgia (3.6%) and other autoimmune diseases (l
.8%) (mean duration of symptoms:
4 yrs).
The patients were treated 2.5 minutes on average in the main chamber (mean temperature: -105 degrees C).
The patients’ statements concerning their pain level were analysed by means of analyses of variance with repeated
measures and paired-sample t-tests. RESULTS: The pain level after application of the cold therapy decreases
significantly. The pain reduction last about 90 minutes. The initial pain level decreases during the whole time of
treatment, no significant improvement, though, can be shown from the middle let the end of the four-weeks treatment.
According to the results of our study, there is evidence that the whole-body cold therapy generates important short-term
effects and somewhat weaker effects over the treatment period as a whole. Short-term pain reduction facilitates
intensive application of physiotherapy and Occupation Therapy.
The treatment procedure is practicable and ail in ail well tolerated. From the patients’ point of view, whole-body cold
therapy is an essential part of the rehabilitation program.
PMID: 10832164, Ul: 20291627
[2]
Reduction of pain-related behaviours with either cold or heat treatment in an animal model of acute arthritis
Sluka KA, Christy MR, Peterson WL, Rudd SL, Troy SM
Physical Therapy Graduate Program, College of Medicine, The University of lowa,
lowa City 52242-1008, USA.
Arch Phys Med Rehabil 1999 Ma r; 80(3): 313-7
OBJECTIVE: To assess -the effects of heat and cold on quantifiable pain behaviours in an animal model of arthritis that
minimizes the motivational affective component of pain.
DESIGN: The effects of superficial heat (40 degrees C) and cold (4 degrees C) on pain behaviours in rats with knee joint
inflammation were tested before and after induction of inflammation and after treatment with heat or cold.
SUBJECTS: Joint inflammation was induced in male Sprague-Dawley rats by intra-articular injection of the knee joint
with 3% kaolin and 3% carrageenan.
MAIN OUTCOME MEASURES: Withdrawal latency to heat applied to the paw (PWL) assessed secondary hyperalgesia;
spontaneous pain behaviours assessed degree of weight bearing/ guarding; and joint circumference assessed joint
swelling.
RESULTS: Cold treatment of the inflamed knee joint significantly reversed the PWL immediately after treatment dp =
.003) without affecting spontaneous pain behaviours or joint circumference. In contrast, heat treatment produced a small
but significant decrease in spontaneous pain behaviours (p = .03) without affecting PWL or jint circumference.
CONCLUSION: Acute arthritic pain can be treated with either superficial heat for reducing guarding or with cold for
reducing pain or hyperalgesia outside the injury site.
PMID: 10084440, UI: 99181931
[3]
Physiotherapy methods of relieving pain
Moncur C, Shields MN
Baillieres Clin Rheumatol 1987 April 1 (1):183-93
Management of pain in the person with arthritis requires interdisciplinary team work with the patient being the final
manager. lt is important that any health care provider perceive the patient as a person who happens to have arthritis–not
as ‘an arthritic’. Defining a person by one’s disease process is dehumanising.
The patient has the same aspirations as anyone who is able-bodied–to be free from disease. While the patient may know
that a cure is not imminent, there is still the hope for one. Therefore, as the patient comes for physiotherapy, there may
be a hidden wish that the moist packs, TENS, or therapeutic pool will be curative.
lt is important that the patient understand that no equipment in the physiotherapy department has curative powers. This
will help avoid unnecessary dependency behaviours on the part of the patient. Careful instruction and supervision of the
patient by the physiotherapist, in concert with reinforcement from the physician, can prepare the patient to apply heat,
cold or a variety of treatments at home. Although the patient is given the responsibility for this part of his care, periodic
follow-up and reassessment should be completed to determine changes in his physiological, psychological, and
functional status.
Physiotherapists who have a clear understanding of the physical treatment of pain associated with the rheumatic
diseases can be a valuable asset to medical care.
Publication Types:
Review
Review, tutorial
PMID: 3334214, UI: 89249421
[4]
The influence of heat and cold on the pain threshold in rheumatoid arthritis
Cupkovic B, Vitulic V, Babic-Naglic D, DurrigT. T
Department of Rheumatology and Rehabilitation, University Hospital, Rebro,
Zagreb, Croatia.
Z Rheumatol 1993 Sep-Oct; 52(5): 289-91
Superficial heat and cold are commonly used therapeutic methods in patients with rheumatoid arthritis. Both procedures
have analgesic effect. In r0 inpatients with rheumatoid arthritis the pain threshold was measured before and after warm
bath and ice massage. Rheumatoid patients had significantly lower pain threshold compared to the healthy subjects in
normal circumstances.
Heat and cold remarkably raise the pain threshold right after the application. The pain threshold is also raised 10 and 30
min after cryotherapy, but not after the warm bath. Between investigated groups there were no statistically significant
differences in the pain threshold values in any observed time.
We consider that both methods have a reasonable place in the therapy of rheumatoid arthritis.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 8259720, UI: 94082526
[5]
Treating arthritis with locally applied heat or cold
Oosterveld FG, Rasker JJ
Department of Rheumatology, Hospital Medisch Spectrum Twente, The Netherlands.
Semin Arthritis Rheum 1994 0ct;24(2):82-90
The scientific for the treatment of arthritis with locally applied heat or cold is reviewed. Experimental studies in vitro, in
animals, in healthy subjects, and in patients are considered.
Results of investigations of the effects of locally applied heat or cold on the deeper tissues of joints and on joint
temperature in patients are not consistent. In general, locally applied heat increases and locally applied cold decreases
the temperature of the skin, superficial and deeper tissues, and joint cavity. Most studies’ dealing with the effects of heat
and cold on pain, joint stiffness, grip strength, and joint function in inflamed joints report beneficial effects. In vitro studies
show that higher temperatures increase the breakdown of articular cartilage and tissues that contain collagen.
Therefore, one goal of physical therapy should be to decrease intra-articular temperature in actively inflamed arthritic
joints.
Publication Types:
Review
Review, tutorial
PMID: 7839157, UI: 95141086
[6]
New perspectives on osteoarthritis
Oddis CV
Division of Rheumatology and Clinical Immunology, Department of Medicine,
University of Pitbsburgh School of Medicine, Pennsylvania 15213, USA.
Am J Med 1996 Feb 26;100ÇZA):10S-15S
Osteoarthritis (OA) is the most common rheumatologic disease, afflicting tens of millions of U.S. citizens. lt is not an
inevitable consequence of aging; rather, it is a degene ative process acquired because of metabolic, mechanical,
genetic, and other influences.
lt is characterized by progressive loss of cartilage and bony overgrowth. Because cartilage is not innervated, the pain of
OA arises from secondary effects, such as joint capsule distension, stretching of periosteal nerve endings, and, possibly,
synovial inflammation.
Psychologic factors, including stress and depression, may influence the perception of pain by OA patients. The risk of
OA apparently is not increased by normal joint use, but persons who participate in competitive sports or who play with
abnormal or injured joints are at increased risk. Obesity increases OA risk, and weight loss has been found to decrease
it. Some forms of premature OA appear to be inherited. The objective diagnosis of OA is mode on the basis of
radiography.
However, many individuals with radiographic evidence of OA are asymptomatic in the affected joint. It is essential to
ensure that pain in the affected joint, is attributable to OA and not another cause. The management of OA should include
physical medicine measures such as heat or cold therapy and often neglected environmental measures, such as
reducing chair height and using shoe orthotics.
Therapeutic exercise is beneficial for many patients and includes an initial warm-up with range of motion, muscle
strengthening, and aerobic activity (such as swimming). A major question in the pharmacologic management of OA is
whether nonsteroidal anti-inflammatory drugs (NSAIDs) are superior to analgesics in terms of symptomatic relief; studios
indicate that they are not. The question is relevant because of the adverse effects of NSAID use, particularly in the
elderly population.
Publication Types:
Review
Review, tutorial
PMID: 8604721, UI: 96199291
[7]
Cryotherapy in osteoporosis
[Article in Polish]
Ksiezopolska-Pietrzak K
Pol Merkuriusz Lek 1998 Oct; 5(28): 222-4
Cryotherapy is use of temperature lower than -100 degrees C onto body surface, for 2-3 minutes, in aim to cause
physiological reactions for cold and to use such adapting reactions. Organism’s positive response to cryotherapy
supports treatment of basic disease and facilitates kinesitherapy. Low temperature may be obtained by use of air flow
cooled with liquid nitrogen; this could be applied either locally, over chosen part of the body, or generally, over the whole
body, in cryosauna or in cryochamber.
The most efficiently is applying cryotherapy twice a day, with at least 3 hours interval. Kinesitherapy is necessarily used
after each cryotherapy session. Whole treatment takes 2 to6 weeks, depending on patient’s needs.
Cryotherapy reduces pain and swellings, causes skeletal muscles relaxation and increase of their force, also, motion
range in treated joints increases. Thus, cryotherapy seems to fulfil ail necessary conditions for rehabilitation in
osteoporosis. Cryotherapy represents numerous advantages: it takes short time for applying, being well tolerated by
patient, also patient’s status improves quickly. In addition, contraindications against cryotherapy are rare.
All this makes cryotherapy a method for a broad use in prophylactics and treatment of osteoporosis.
Publication Types:
Review
Review, tutorial
PMID: 10101448. UI: 99201664
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[1] Combination of cold and compression after knee surgery. A prospective randomised study.
Schröder D, Passier HH
Sportklinik, Stuttgart, Germany.
Knee Surg Sports Traumatol Arthrose 1994; 2(3): 158-65
[2] The role of cold compression dressings in the postoperative treatment of total knee arthroplasty.
Levy AS, Marmar E
Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia,
Pennsylvania 19141.
Clin Orthop 1993 Dec; (297): 174-8
[3] The effects of cold -therapy in the postoperative management of pain in patients undergoing anterior
cruciate ligament reconstruction.
Cohn BT, Draeger RI, Jackson DW
Southern California Center for Sports Medicine, Long Beach 90806.
Am J Sports Med 1989 May-Jun; 17(3): 344-9
[4] The effect of postoperative cold therapy in join-t surgery using a new cooling device
[Article in German]
Munst P, Bonnaire F, Kuner EH
Unfallchirurgische Abteilung, Chirurgischen Universitätsklinik Freiburg i. Br.
Unfallchirurgie 1988 Aug;14Ç4):2Z4-30
[5] Effects of thermal therapy on rehabilitation after total knee arthroplasty. A prospective randomised
study
Hecht PJ, Bachmann S, Booth RE Jr, Rothman RH
Clin Orthop 1983 Sep ; (178): 198-201
[6] Effects of continuous cryotherapy on the surgically traumatized musculoskeletal System.
Perioperative Cryotherapy Study Group
[Article in German]
Albrecht S, Le Blond R, Cordis R, Kleihues H, Gill C
Abteilungen für Orthopädie sowie Physiotherapie und Physikalische Therapie des
Evangelischen Waldkrankenhauses Spandau.
Unfallchirurgie 1996 Aug;22(4):168-75
[7] The use of cold compression dressings after total knee replacement: a randomised controlled trial
Webb JM, Williams D, Ivory JP, Day S, Williarnson DM
Nuffield Orthopaedic Centre, Oxford, United Kingdom.
Orthopaedics 1998 Jan; 21(1): 59-61
[8] Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction
Barber FA, McGuire DA, Click S
Piano Orthopaedic and Sports Medicine Center, Texas 75093, USA.
Arthroscopy 1998 Mar;14(2):130-5
[9] Postoperative lumbar microdiscectomy pain. Minimalization by irrigation and cooling
Fountas KN, Kapsalaki EZ, Johns-ton KW, Smisson HF 3rd, Vogel RL, Robinson JS Jr
Department of Neurological Surgery, Medical Center of Central Georgia, Macon,
USA.
Spine 1999 Sep 15;24Ç18):1958-60
[10] Use of cryotherapy for orthopaedic patients
McDowell JH, McFarland EG, Nalli BJ
Orthop Murs 1994 Sep-Oct; 13(5): 21-30
[1]
Combination of cold and compression after knee surgery. A prospective randomised study.
Schröder D, Passier HH
Sportklinik, Stuttgart, Germany.
Knee Surg Sports Traumatol Arthrose 1994; 2(3): 158-65
The objective of this study was to investigate the effect of continuous long-term application of a combined cooling and
compression system (Cryo/Cuff, Aircast Inc., Summit, New Jersey, USA) on postoperative swelling, range of motion
ÇROM), pain, consumption of analgesics, and return of function after anterior cruciate ligament (ACL) reconstruction.
We compared the cold-compression system with traditional ice therapy. There were 44 patients in the series (aged 15-40
years) who were randomly assigned to a control group (ICE) or a study group (CC). The ICE group consisted of 23
patients (aged 24.2 +/- 4.5 years); the CC group consisted of 21 patients (aged 24.8 +/- 5.6 years).
The ICE group received ice bags postoperatively; the CC group was provided with the Cryo/Cuff during the 14-day
hospital stay. Girth, ROM, pain score (visual analog scale, and consumption of analgesics were determined on
postoperative days 1 2, 3, 6, 14, and 28.
Twelve weeks after surgery, isokinetic testing was performed, and the functional knee score was determined. In the CC
group, significantly less. swelling was observed (ft 0.035). These patients also reported less pain and had a significantly
reduced consumption of analgesics (P < 0.04). On ail examination days, ROM in the CC group was up to 17 degrees
greater than in the ICE group (P< 0.02). The functional knee score was significantly increased in the CC group (P =
0.025).
The results from our study document the advantages of continuous cold-compression therapy over cold alone following
ACL reconstruction.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 7584198, UI: 96052600
[2]
The role of cold compression dressings in the postoperative treatment of total knee arthroplasty.
Levy AS, Marmar E
Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia,
Pennsylvania 19141.
Clin Orthop 1993 Dec; (297): 174-8
A prospective randomised study was performed to evaluate the role of cold compressive dressings in the postoperative
treatment of total knee arthroplasty (TKA). Eighty consecutive unilateral and ton bilateral primary total knee replacements
were evaluated in terms of blood loss, pain relief, and range of motion.
Patients in the cold compression group demonstrated an average of 548 ml in suction drainage, whereas those in the
control group averaged 807 ml. This resulted in an average 3.1 mg haemoglobin drop in the cold compression group and
4.7 mg in the control group. When body habitus and weight were taken into account in the cold compression group, an
average total blood loss of 1298 cc was calculated, with 744 ml arising from soft tissue extravasation.
The corresponding total blood loss calculated average was 1908 ml in the control group, with 1101 ml attributed to soft
tissue extravasation. Total injectable morphine per kilogram per initial 48 hours averaged 0.53 mg in the cold
compression patients and 0.69 mg in the control patients. In the cold compression knees, range of motion averaged 86
degrees before operation, 53 degrees on postoperative day CPOD) 7, and 77 degrees on POD 14. In the control knees,
range of motion averaged 88 degrees before operation, 44 degrees on POD 7, and 65 degrees on POD 14.
The use of cold compression in the postoperative, period of TKA results in a dramatic decrease in blood loss. In addition,
mild improvements are seen in early return of motion and injectable narcotic pain needs in the postoperative period.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 7902225, UI: 94062196
[3]
The effects of cold -therapy in the postoperative management of pain in patients undergoing anterior cruciate
ligament reconstruction.
Cohn BT, Draeger RI, Jackson DW
Southern California Center for Sports Medicine, Long Beach 90806.
Am J Sports Med 1989 May-Jun; 17(3): 344-9
This prospective study assessed 54 consecutive arthroscopically assisted ACL reconstructions for the amount of
postoperative pain relief provided by cold therapy, using the Hot/Ice Thermal Blanket. Twenty-six randomly selected
patients undergoing this procedure were compared to a control group consisting of 28 patients having the identical
procedure in which the Hot / Ice unit was not used postoperatively.
The initial ACL injury in both groups was sports related with the exception of three patients whose injury occurred while
on the job. The Hot/Ice Thermal Blanket consists of two rubber pads (blankets) connected by a hose to the main cooling
unit. The pads were applied to either side of the operated knee in the operative suite. The pads received fluid which was
circulated from the main unit. The temperature of the fluid was set at 50 degrees in the recovery room and the unit was
run continuously until the time of discharge, which was approximately 4 days.
Hot / Ice patients required 53% less injectable Demerol and 67% less oral Vistaril than patients in the control group.
Hot/ice patients had made the conversion from injectable to oral pain medication an average of 1.2 days sooner than did
their non-Hot / Ice counterparts. There was no appreciable difference in length of hospital stay.
Physical therapy and nursing records documented a greater percentage of compliant patients in the Hot/Ice group.
According to these records the Hot/Ice patients were more helpful in self-assistance, were out of bed and ambulating in
the halls more quickly, and did their range of motion exercises with greater ease.
(ABSTRACT TRUNCATED AT 250 WORDS)
Publication Types:
Clinical trial
Controlled clinical trial
PMID: 2729484, UI: 89270831
[4]
The effect of postoperative cold therapy in join-t surgery using a new cooling device
[Article in German]
Munst P, Bonnaire F, Kuner EH
Unfallchirurgische Abteilung, Chirurgischen Universitätsklinik Freiburg i. Br.
Unfallchirurgie 1988 Aug;14Ç4):2Z4-30
The effect of continuous cold therapy with a new cooling device in post-operative treatment after knee surgery has been
proved.
Ten patients with different operations of the knee joint participated in this study. Eight out of ten patients reported no or
poor pain, whereas in the control group especially after arthrotomy considerable or violent pain was reported.
After arthroscopic operations we found more an decrease of swelling and effusion, after arthrotomy more pain reduction.
The subjective feeling of ail patients was very good and they were generally very receptive to it.
PMID: 3176193, UI: 89020505
[5]
Effects of thermal therapy on rehabilitation after total knee arthroplasty. A prospective randomised study
Hecht PJ, Bachmann S, Booth RE Jr, Rothman RH
Clin Orthop 1983 Sep ; (178): 198-201
The role of local heat or cold therapy used in conjunction with exercise in the rehabilitation of total knee arthroplasty
patients was investigated.
Thirty-six osteoarthritic patients were analysed. Parameters evaluated were range of motion, swelling about the knee,
and pain. Ail patients received the total condylar knee prosthesis and began range of motion rehabilitation fourteen days
after operation.
Results showed that temperature alteration does not augment passive range of motion after total knee arthroplasty.
lt was also shown that cold application decreases swelling as compared with heat. Additionally, the application of cold
partially alleviates the discomfort of the rehabilitation process in certain patients.
Publication Types:
Clinical trial
Randomised controlled trial
[6]
Effects of continuous cryotherapy on the surgically traumatized musculoskeletal System. Perioperative
Cryotherapy Study Group
[Article in German]
Albrecht S, Le Blond R, Cordis R, Kleihues H, Gill C
Abteilungen für Orthopädie sowie Physiotherapie und Physikalische Therapie des
Evangelischen Waldkrankenhauses Spandau.
Unfallchirurgie 1996 Aug;22(4):168-75
The in-vivo effectiveness of continuous cold pressure therapy was evaluated in 24 patients following elective knee or hip
replacement surgery.
A cooling of the skin surface down to 8 degrees C resulted in a reduction of the epifascial tissue temperature to 22
degrees C. A significant reduction of subfascial pressure in combination with decreased protein leakage via redovac
output were notable.
Observing a constant decreased pH-level increased oxygen saturation and reduced drop of base excess were
interpreted as signs of reduced enzyme-linked metabolism activity. Clinically these findings were found in correlation to a
50% decrease of postoperative analgetic demands as well as a 20% increased range of motion level.
PMID: 8975448, UI: 96419900
[7]
The use of cold compression dressings after total knee replacement: a randomised controlled trial
Webb JM, Williams D, Ivory JP, Day S, Williarnson DM
Nuffield Orthopaedic Centre, Oxford, United Kingdom.
Orthopaedics 1998 Jan; 21(1): 59-61
This prospective, controlled study compared cold compressive dressings with wool and crepe in the postoperative
management of patients undergoing, total knee replacement (TKR).
Forty TKR patients were assessed for blood loss, pain, swelling, and range of motion. Patients in the cold compression
group had less blood loss through suction drainage (982 mL versus 768 mL).
A higher proportion of patients in the treatment group did not require blood transfusion postoperatively. Mean opiate
requirements were lower in the cold compression group (0.57 versus 0.71 mg/kg/48 hours).
The cold compression device appeared to reduce blood loss and pain following TKR.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 9474633, UI: 98134974
[8]
Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction
Barber FA, McGuire DA, Click S
Piano Orthopaedic and Sports Medicine Center, Texas 75093, USA.
Arthroscopy 1998 Mar;14(2):130-5
This prospective, randomised study evaluated continuous-flow cold therapy for postoperative pain in outpatient
arthroscopic anterior cruciate ligament (ACL) reconstructions.
In group 1, cold therapy was constant for 3 days then as needed in days 4 through 7. Group 2 had no cold therapy.
Evaluations and diaries were kept at l, 2, and 8 hours after surgery, and then daily. Pain was assessed using the VAS
and Likert scales. There were 51 cold and 49 non cold patients included.
Continuous passive movement (CPM) use averaged 54 hours for cold and 41 hours for non cold groups ÇP=.003).
Prone hangs were done for 192 minutes in the cold group and 151 minutes in the non cold group. Motion at l week
averaged 5/88 for the cold group and 5/79 the non cold group. The non cold group average visual analog scale (VAS)
pain and Likert pain scores were always greater than the cold group. The non cold group average Vicodin use (Knoll, Mt.
Olive, NJ) was always greater than the cold group use (P=.001).
Continuous-flow cold therapy lowered VAS and Likert scores, reduced Vicodin use, increased prone hangs, CPM, and
knee flexion. Continuous-flow cold therapy is safe and effective for outpatient ACL reconstruction reducing pain
medication requirements.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 9531122, UI: 98189607
[9]
Postoperative lumbar microdiscectomy pain. Minimalization by irrigation and cooling
Fountas KN, Kapsalaki EZ, Johns-ton KW, Smisson HF 3rd, Vogel RL, Robinson JS Jr
Department of Neurological Surgery, Medical Center of Central Georgia, Macon,
USA.
Spine 1999 Sep 15;24Ç18):1958-60
Study design :
Seventy patients undergoing de novo lumbar microdiscectomy were prospectively randomised into a control group and a
group in which cold intraoperative wound irrigation along with postoperative wound cooling was used.
Postoperative analgesia requirements and length of hospital stay were analysed and correlated.
Objectives :
To evaluate the role of intraoperative cold irrigation and postsurgical cooling in minimizing postoperative lumbar
discectomy pain.
Summary of background data :
Regulated hypothermia has been used frequently in pain reduction; however, the efficacy of such a strategy in lumbar
disc procedures has not been established.
Methods :
Seventy patients (43 men and 27 women), operated on the first time for lumbar disk herniation were prospectively
randomised into two groups. A standard microdiscectomy was performed on ail patients. In cohort A the wound site was
irrigated-with a cold (18 C) 5% bacitracin solution for .5 minutes. Additionally, a cooling micro temperature pump was
placed on the wound site for 24 hours after surgery.
The patients in the control group (cohort B) were treated in a standard fashion without additional hypothermic therapy. All
patients received postoperative analgesia ‘through a self-administered morphine pump. The amount of postoperative
analgesia received was calculated in morphine equivalents per kilogram. The length of hospital stay was also noted.
Results :
The total amount of pain medication was significantly smaller in cohort A than in the control group (cohort B). For the
statistical analysis of the results, covariate analyses for both the length of hospital stay and the morphine dose were
used, demonstrating a statistically significant difference with P= 0.0001. No postoperative wound infection was noted in
either group.
Conclusions :
Intraoperative and postoperative wound site cooling is a safe, inexpensive, and efficient therapeutic method. lt reduces
the patients’ postoperative pain, promotes earlier ambulation and decreases the length of hospital stay.
Publication Types: Clinical trial
Randomised controlled trial
PMID: 10515023, UI: 99444612
[ 10 ]
Use of cryotherapy for orthopaedic patients
McDowell JH, McFarland EG, Nalli BJ
Orthop Murs 1994 Sep-Oct; 13(5): 21-30
Effective pain management and prevention of oedema are goals for orthopaedic patients after injury and after surgery.
Cryotherapy is the use of cold to decrease swelling and pain when tissue is damaged secondary to trauma or surgery.
Although cryotherapy has been used for years by some practitioners to achieve these goals, it is gaining wider
acceptance in sports medicine for acute and postoperative care. Newer techniques of application have broadened its use
for postoperative care.
This article reviews the physiology of cold, basic principles of cryotherapy, various techniques of cold application, nursing
assessment and care, and patient teaching for a patient with cryotherapy.
PMID: 7854825, UI: 95158059
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[1] Combination of cold and compression after knee surgery. A prospective randomised study.
Schröder D, Passier HH
Sportklinik, Stuttgart, Germany.
Knee Surg Sports Traumatol Arthrose 1994; 2(3): 158-65
[2] The role of cold compression dressings in the postoperative treatment of total knee arthroplasty.
Levy AS, Marmar E
Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia,
Pennsylvania 19141.
Clin Orthop 1993 Dec; (297): 174-8
[3] The effects of cold -therapy in the postoperative management of pain in patients undergoing anterior
cruciate ligament reconstruction.
Cohn BT, Draeger RI, Jackson DW
Southern California Center for Sports Medicine, Long Beach 90806.
Am J Sports Med 1989 May-Jun; 17(3): 344-9
[4] The effect of postoperative cold therapy in join-t surgery using a new cooling device
[Article in German]
Munst P, Bonnaire F, Kuner EH
Unfallchirurgische Abteilung, Chirurgischen Universitätsklinik Freiburg i. Br.
Unfallchirurgie 1988 Aug;14Ç4):2Z4-30
[5] Effects of thermal therapy on rehabilitation after total knee arthroplasty. A prospective randomised
study
Hecht PJ, Bachmann S, Booth RE Jr, Rothman RH
Clin Orthop 1983 Sep ; (178): 198-201
[6] Effects of continuous cryotherapy on the surgically traumatized musculoskeletal System.
Perioperative Cryotherapy Study Group
[Article in German]
Albrecht S, Le Blond R, Cordis R, Kleihues H, Gill C
Abteilungen für Orthopädie sowie Physiotherapie und Physikalische Therapie des
Evangelischen Waldkrankenhauses Spandau.
Unfallchirurgie 1996 Aug;22(4):168-75
[7] The use of cold compression dressings after total knee replacement: a randomised controlled trial
Webb JM, Williams D, Ivory JP, Day S, Williarnson DM
Nuffield Orthopaedic Centre, Oxford, United Kingdom.
Orthopaedics 1998 Jan; 21(1): 59-61
[8] Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction
Barber FA, McGuire DA, Click S
Piano Orthopaedic and Sports Medicine Center, Texas 75093, USA.
Arthroscopy 1998 Mar;14(2):130-5
[9] Postoperative lumbar microdiscectomy pain. Minimalization by irrigation and cooling
Fountas KN, Kapsalaki EZ, Johns-ton KW, Smisson HF 3rd, Vogel RL, Robinson JS Jr
Department of Neurological Surgery, Medical Center of Central Georgia, Macon,
USA.
Spine 1999 Sep 15;24Ç18):1958-60
[10] Use of cryotherapy for orthopaedic patients
McDowell JH, McFarland EG, Nalli BJ
Orthop Murs 1994 Sep-Oct; 13(5): 21-30
[1]
Combination of cold and compression after knee surgery. A prospective randomised study.
Schröder D, Passier HH
Sportklinik, Stuttgart, Germany.
Knee Surg Sports Traumatol Arthrose 1994; 2(3): 158-65
The objective of this study was to investigate the effect of continuous long-term application of a combined cooling and
compression system (Cryo/Cuff, Aircast Inc., Summit, New Jersey, USA) on postoperative swelling, range of motion
ÇROM), pain, consumption of analgesics, and return of function after anterior cruciate ligament (ACL) reconstruction.
We compared the cold-compression system with traditional ice therapy. There were 44 patients in the series (aged 15-40
years) who were randomly assigned to a control group (ICE) or a study group (CC). The ICE group consisted of 23
patients (aged 24.2 +/- 4.5 years); the CC group consisted of 21 patients (aged 24.8 +/- 5.6 years).
The ICE group received ice bags postoperatively; the CC group was provided with the Cryo/Cuff during the 14-day
hospital stay. Girth, ROM, pain score (visual analog scale, and consumption of analgesics were determined on
postoperative days 1 2, 3, 6, 14, and 28.
Twelve weeks after surgery, isokinetic testing was performed, and the functional knee score was determined. In the CC
group, significantly less. swelling was observed (ft 0.035). These patients also reported less pain and had a significantly
reduced consumption of analgesics (P < 0.04). On ail examination days, ROM in the CC group was up to 17 degrees
greater than in the ICE group (P< 0.02). The functional knee score was significantly increased in the CC group (P =
0.025).
The results from our study document the advantages of continuous cold-compression therapy over cold alone following
ACL reconstruction.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 7584198, UI: 96052600
[2]
The role of cold compression dressings in the postoperative treatment of total knee arthroplasty.
Levy AS, Marmar E
Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia,
Pennsylvania 19141.
Clin Orthop 1993 Dec; (297): 174-8
A prospective randomised study was performed to evaluate the role of cold compressive dressings in the postoperative
treatment of total knee arthroplasty (TKA). Eighty consecutive unilateral and ton bilateral primary total knee replacements
were evaluated in terms of blood loss, pain relief, and range of motion.
Patients in the cold compression group demonstrated an average of 548 ml in suction drainage, whereas those in the
control group averaged 807 ml. This resulted in an average 3.1 mg haemoglobin drop in the cold compression group and
4.7 mg in the control group. When body habitus and weight were taken into account in the cold compression group, an
average total blood loss of 1298 cc was calculated, with 744 ml arising from soft tissue extravasation.
The corresponding total blood loss calculated average was 1908 ml in the control group, with 1101 ml attributed to soft
tissue extravasation. Total injectable morphine per kilogram per initial 48 hours averaged 0.53 mg in the cold
compression patients and 0.69 mg in the control patients. In the cold compression knees, range of motion averaged 86
degrees before operation, 53 degrees on postoperative day CPOD) 7, and 77 degrees on POD 14. In the control knees,
range of motion averaged 88 degrees before operation, 44 degrees on POD 7, and 65 degrees on POD 14.
The use of cold compression in the postoperative, period of TKA results in a dramatic decrease in blood loss. In addition,
mild improvements are seen in early return of motion and injectable narcotic pain needs in the postoperative period.
Publication Types:
Clinical trial
Randomised controlled trial
PMID: 7902225, UI: 94062196
[3]
The effects of cold -therapy in the postoperative management of pain in patients undergoing anterior cruciate
ligament reconstruction.
Cohn BT, Draeger RI, Jackson DW
Southern California Center for Sports Medicine, Long Beach 90806.
Am J Sports Med 1989 May-Jun; 17(3): 344-9
This prospective study assessed 54 consecutive arthroscopically assisted ACL reconstructions for the amount of
postoperative pain relief provided by cold therapy, using the Hot/Ice Thermal Blanket. Twenty-six randomly selected
patients undergoing this procedure were compared to a control group consisting of 28 patients having the identical
procedure in which the Hot / Ice unit was not used postoperatively.
The initial ACL injury in both groups was sports related with the exception of three patients whose injury occurred while
on the job. The Hot/Ice Thermal Blanket consists of two rubber pads (blankets) connected by a hose to the main cooling
unit. The pads were applied to either side of the operated knee in the operative suite. The pads received fluid which was
circulated from the main unit. The temperature of the fluid was set at 50 degrees in the recovery room and the unit was
run continuously until the time of discharge, which was approximately 4 days.
Hot / Ice patients required 53% less injectable Demerol and 67% less oral Vistaril than patients in the control group.
Hot/ice patients had made the conversion from injectable to oral pain medication an average of 1.2 days sooner than did
their non-Hot / Ice counterparts. There was no appreciable difference in length of hospital stay.
Physical therapy and nursing records documented a greater percentage of compliant patients in the Hot/Ice group.
According to these records the Hot/Ice patients were more helpful in self-assistance, were out of bed and ambulating in
the halls more quickly, and did their range of motion exercises with greater ease.
(ABSTRACT TRUNCATED AT 250 WORDS)
Publication Types:
Clinical trial
Controlled clinical trial
PMID: 2729484, UI: 89270831
[4]
The effect of postoperative cold therapy in join-t surgery using a new cooling device
[Article in German]
Munst P, Bonnaire F, Kuner EH
Unfallchirurgische Abteilung, Chirurgischen Universitätsklinik Freiburg i. Br.
Unfallchirurgie 1988 Aug;14Ç4):2Z4-30
The effect of continuous cold therapy with a new cooling device in post-operative treatment after knee surgery has been
proved.
Ten patients with different operations of the knee joint participated in this study. Eight out of ten patients reported no or
poor pain, whereas in the control group especially after arthrotomy considerable or violent pain was reported.
After arthroscopic operations we found more an decrease of swelling and effusion, after arthrotomy more pain reduction.
The subjective feeling of ail patients was very good and they were generally very receptive to it.
PMID: 3176193, UI: 89020505


[1] Postepisiotomy pain : warm versus cold sitz, bath.
LaFoy J, Geden EA
Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri.
J Obstet Gynecol Neonatal Murs 1989 Sep-Oct; 18(5): 399-403
[2] A comparison of cold and warm sitz baths for relief of postpartum perineal pain
Ramier D, Roberts J
J Obstet Gynecol Neonatal Murs 1986 Nov-Dec; 15(6): 471-4
[1]
Postepisiotomy pain : warm versus cold sitz, bath.
LaFoy J, Geden EA
Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri.
J Obstet Gynecol Neonatal Murs 1989 Sep-Oct; 18(5): 399-403
A repeated measure experimental design (N = .20) was used to assess the effectiveness of a warm versus cold sitz bath
in relieving postepisiotomy pain.
Sensation, distress, oedema, and haematoma ratings were obtained pre- and pos-treatments. Both therapies were found
comparable, with the exception that the cold bath was significantly more effective in reducing oedema.
Recommendations for further clinical research are presented. The recommendation for practice is that patients be
offered a choice of therapies.
Comment in: J Obstet Gynecol Neonatal Nurs 1990 Jan-Feb; 19(1): 13
PMID: 2795277, Ul: 90011438
[2]
A comparison of cold and warm sitz baths for relief of postpartum perineal pain
Ramier D, Roberts J
J Obstet Gynecol Neonatal Murs 1986 Nov-Dec; 15(6): 471-4
The effect of cold sitz baths for relieving perineal pain in the postpartum period after an episiotomy was evaluated.
Forty patients took both cold and warm sitz baths with random assignment of the initial bath. Patients rated the degree of
perineal pain before and after each sitz bath and at half-hour and one-hour intervals after each bath. A pain scale using
0-5, 0 representing no pain and 5 representing extreme pain, was used.
Analysis of pain scale scores using a two-way analysis of variance with replications showed that cold sitz baths were
significantly more effective in relieving perineal pain. The greatest amount of pain relief was experienced immediately
after the cold sitz baths.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 3641900, UI: 87085879

[1] Increased comfort and decreased inflammation of the eye by cooling after cataract surgery.
Fujishima H, Yagi Y, Toda l, Shimazaki J, Tsubota K
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Am J Ophthalmol 1995 Mar; 119(3): 301-6
[1]
Increased comfort and decreased inflammation of the eye by cooling after cataract surgery
Fujishima H, Yagi Y, Toda l, Shimazaki J, Tsubota K
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Am J Ophthalmol 1995 Mar; 119(3): 301-6
Purpose :
Cooling can reduce clinical symptoms and pain caused by traumatic swelling or fracture of extremities. We obtained
subjective and objective measures of the effects of cooling of the eyes after cataract surgery.
Methods :
Twenty patients with bilateral cataracts were enrolled in this study. For each patient, an ice-cold eye mask was applied
over gauze to one operated-on eye for two hours after the operation and was not applied after operation on the other
eye. After each operation, the patient rated comfort on a five-point scale.
The severity of inflammation associated with each procedure was evaluated by using an infrared radiation thermometer
to determine the central corneal temperature and a laser flare-cell meter to determine the cell and flare count, at intervals
up to 28 days after surgery.
Results :
Cooling, applied after the first operation in ton patients and after the second operation in ten patients, statistically
significantly increased the patients’ comfort level and was associated with a significant decrease in central corneal
temperature on days 0, l, and 3; in cell counts on days l, 3, 7, and 14; and in flare counts on days l, 14, and 28.
Conclusions :
Cooling increased the comfort level and reduced inflammation after
cataract surgery, with no adverse effects.
PMID: 7872390, UI: 95177238