Effects of Contrast Therapy Using Infrared and Cryotherapy as Compared with Contrast Bath Therapy on Blood Flow, Muscle Tone, and Pain Threshold in Young Healthy Adults

Effect of repeated hot and cold stimulation for the neck and shoulders on muscle fatigue recovery: a pilot study

Increased use of electronic devices such as smartphones has led to an increase in neck and shoulder stiffness to the forefront of the public people. It is said that prolonged posture with the head tilted forward causes excessive muscle activity in the head and neck region, resulting in muscle fatigue symptoms such as stiff shoulders. Various bathing methods have been proposed as a means of recovering from muscle stiffness, and in particular, contrast water therapy (CWT) is said to be highly effective in recovering from muscle fatigue. In the present study, we examined the effect of CWT with hot and cold stimulation of the neck and shoulders (CWTNS) on muscle fatigue recovery. As the result, in the CWTNS condition, the effects of vasodilation and vasoconstriction were observed, and muscle hardness was significantly lower than that in the Control condition in 20 subjects (2 males, 18 females). Stress hormones were also decreased during and after bathing compared to those before bathing. These results motivate further exploration of the possibility that the effects of CWTNS could be muscle-recovery without high stress load.

Mechanisms and Efficacy of Contrast Therapy for Musculoskeletal Painful Disease: A Scoping Review

Background: Contrast therapy (CT) is a non-pharmacological treatment that alternates between cryotherapy and thermotherapy. It helps reduce VAS pain, improve joint ROM, enhance function, alleviate muscle soreness, and manage swelling, while also improving blood circulation. This scoping review summarizes recent studies on its use for musculoskeletal injuries (e.g., exercise-induced muscle damage, ankle sprain), degenerative conditions (e.g., osteoarthritis), and painful disorders (e.g., complex regional pain syndrome), assessing its healing potential compared to other conservative therapies. Methods: PubMed, Scopus, and Cochrane Library were searched to identify relevant publications. Articles were selected using the following inclusion criteria: randomized controlled trials, written in English, published between 2004 and 2024, and addressing the use of CT in the management of musculoskeletal painful conditions. Results: Data from 7 articles and 303 patients with musculoskeletal painful conditions treated with CT were included. There was considerable heterogeneity in terms of treatment protocols, with significant differences in the application method, duration, sequence of individuals in each hot/cold cycle, total treatment time, and the pathologies studied. Nevertheless, all studies showed an improvement in the patients' initial clinical conditions. Conclusions: This review highlights the lack of guidelines for the clinical use of CT in musculoskeletal painful conditions. The heterogeneity of the studies reviewed (different clinical scores, follow-up periods, data, and samples) makes the results imprecise. In addition, the modest quality of the trials does not allow the authors to draw clear conclusions about the effectiveness of CT compared with other therapies.

Acute effects of cold, heat and contrast pressure therapy on forearm muscles regeneration in combat sports athletes: a randomized clinical trial

Due to the specific loads that occur in combat sports athletes' forearm muscles, we decided to compare the immediate effect of monotherapy with the use of compressive heat (HT), cold (CT), and alternating therapy (HCT) in terms of eliminating muscle tension, improving muscle elasticity and tissue perfusion and forearm muscle strength. This is a single-blind, randomized, experimental clinical trial. Group allocation was performed using simple 1:1 sequence randomization using the website randomizer.org. The study involved 40 40 combat sports athletes divided into four groups and four therapeutic sessions lasting 20 min. (1) Heat compression therapy session (HT, n = 10) (2) (CT, n = 10), (3) alternating (HCT, n = 10), and sham, control (ShT, n = 10). All participants had measurements of tissue perfusion (PU, [non-reference units]), muscle tension (T-[Hz]), elasticity (E-[arb- relative arbitrary unit]), and maximum isometric force (Fmax [kgf]) of the dominant hand at rest (Rest) after the muscle fatigue protocol (PostFat.5 min), after therapy (PostTh.5 min) and 24 h after therapy (PostTh.24 h). A two-way ANOVA with repeated measures: Group (ColdT, HeatT, ContrstT, ControlT) × Time (Rest, PostFat.5 min, PostTh.5 min, Post.24 h) was used to examine the changes in examined variables. Post-hoc tests with Bonferroni correction and ± 95% confidence intervals (CI) for absolute differences (△) were used to analyze the pairwise comparisons when a significant main effect or interaction was found. The ANOVA for PU, T, E, and Fmax revealed statistically significant interactions of Group by Time factors (p < 0.0001), as well as main effects for the Group factors (p < 0.0001; except for Fmax). In the PostTh.5 min. Period, significantly (p < 0.001) higher PU values were recorded in the HT (19.45 ± 0.91) and HCT (18.71 ± 0.67) groups compared to the ShT (9.79 ± 0.35) group (△ = 9.66 [8.75; 10.57 CI] > MDC(0.73), and △ = 8.92 [8.01; 9.83 CI] > MDC(0.73), respectively). Also, significantly (p < 0.001) lower values were recorded in the CT (3.69 ± 0.93) compared to the ShT (9.79 ± 0.35) group △ = 6.1 [5.19; 7.01 CI] > MDC(0.73). For muscle tone in the PostTh.5 m period significantly (p < 0.001) higher values were observed in the CT (20.08 ± 0.19 Hz) group compared to the HT (18.61 ± 0.21 Hz), HCT (18.95 ± 0.41 Hz) and ShT (19.28 ± 0.33 Hz) groups (respectively: △ = 1.47 [1.11; 1.83 CI] > MDC(0.845); △ = 1.13 [0.77; 1.49 CI] > MDC(0.845), and △ = 0.8 [0.44; 1.16 CI], < MDC(0.845)). The highest elasticity value in the PostTh.5 m period were observed in the CT (1.14 ± 0.07) group, and it was significantly higher than the values observed in the HT (0.97 ± 0.03, △ = 0.18 [0.11; 0.24 CI] > MDC(0.094), p < 0.001), HCT (0.90 ± 0.04, △ = 0.24 [0.17; 0.31 CI] > MDC(0.094), p < 0.001) and ShT (1.05 ± 0.07, △ = 0.094 [0.03; 0.16 CI] = MDC(0.094), p = 0.003) groups. For Fmax, there were no statistically significant differences between groups at any level of measurement. The results of the influence of the forearm of all three therapy forms on the muscles' biomechanical parameters confirmed their effectiveness. However, the effect size of alternating contrast therapy cannot be confirmed, especially in the PostTh24h period. Statistically significant changes were observed in favor of this therapy in PU and E measurements immediately after therapy (PostTh.5 min). Further research on contrast therapy is necessary.

Close relationships between neck and upper-back stiffness and transverse cervical artery flow velocity

PURPOSE

Neck and upper-back stiffness is encountered in daily life, with symptoms appearing as dullness or aches predominantly in the trapezius muscle (TM). Our previous study demonstrated that TM hardness as measured with a muscle hardness meter correlates well with transverse cervical artery (TCA) flow supplying the TM. Muscle hardness meters, however, cannot measure hardness in the TM alone. Meanwhile, recent advances in ultrasound elastography have enabled the evaluation of localized hardness in targeted tissues. The present study, therefore, aimed to clarify the relationship between TM hardness as measured by elastography and TCA hemodynamics as measured on Doppler sonography, with reference to daily symptoms of upper-back stiffness.

METHODS

The study population comprised 66 healthy young adults (32 males, 34 females; mean age, 21 ± 1 years). Relationships were evaluated between TM hardness as a negative correlate of strain ratio from elastography and TCA hemodynamics on Doppler sonography. Hemodynamics in the TCA were evaluated according to the frequency of neck and upper-back stiffness.

RESULTS

TM strain ratio correlated with peak systolic velocity (PSV) in the TCA (r = 0.273, p = 0.036), particularly in symptomatic subjects (r = 0.417, p = 0.022). PSV in the TCA decreased with increasing frequency of daily symptoms (p = 0.045).

CONCLUSION

TCA hemodynamics correlated with muscle hardness when evaluating localized TM hardness. This relationship and low PSV in the TCA were evident in symptomatic subjects. These results suggest that PSV in the TCA is associated with neck and upper-back stiffness.

Optimal Duration of Cold and Heat Compression for Forearm Muscle Biomechanics in Mixed Martial Arts Athletes: A Comparative Study

BACKGROUND Cold and heat therapies for recovery in sports are commonly used, including in the mixed martial arts (MMA). The Game Ready (GR) device can be used for local monotherapy with either heat or cold and for contrast therapy. This study aimed to compare the effects of duration of cold and heat compression on biomechanical changes in the forearm muscles of 20 healthy mixed martial arts athletes. MATERIAL AND METHODS Twenty MMA volunteers (26.5±4.5 years old) underwent 3 different phases of the GR: (1) stimulation time 10 min (eGR-10, GR experimental group), (2) 10 min (cGR-10, sham control group) and (3) 20 min (eGR-20, GR experimental group). The following outcomes were assessed: muscle tone (T), stiffness (S), flexibility (E), pressure pain threshold (PPT), microvascular response (PU), and maximum isometric strength (Fmax). All measurements were performed before GR (rest) and after GR stimulation (post). RESULTS Both eGR-10 and eGR-20 significantly improved outcomes T (p<0.001), S (p<0.001), E (p=0.001, and p<0.001, respectively), PPT (p<0.001), PU (p<0.001), and Fmax (p<0.001). Notably, eGR-20 exhibited superior improvements in PU, Fmax, and PPT, with larger effect sizes (p<0.001). While eGR-10 demonstrated more pronounced reductions in T and S (p<0.001), these results underscore the potential for tailored GR therapy durations to optimize specific recovery goals for MMA athletes. CONCLUSIONS GR stimulation affects muscle biomechanical changes, pain threshold, muscle strength, and tissue perfusion. The study results suggest that 10 min of GR stimulation is sufficient to achieve changes that can be used to optimize recovery for MMA athletes.

The Effect of Contrast Bath Therapy and Knee Pad Device on Pain, Range of Motion, and Functional Disability in Patients With Osteoarthritis Knee: A Randomized Control Trial

Background and objective A degenerative joint condition mostly affecting the weight-bearing joints is osteoarthritis (OA). The majority of the time, it involves the knee joint. Pain and stiffness are common in grade 1 and 2 OA. And that's the main reason people ask for help. Physiotherapy treatment can be helpful for symptomatic management of early OA. Along with exercises, contrast bath therapy (CBT) is a therapeutic alternative to medication to alleviate pain and stiffness in OA. Many studies have been done using the traditional water immersion CBT. However, there is a paucity of studies on contrast therapy given using a device. This study intends to find the effect of a knee pad device (KPD) on pain, range of motion, and functional disability in knee OA patients when compared with CBT. Methods About 60 patients having unilateral knee OA were selected and randomly divided into two groups: group A received CBT for 20 minutes, and group B was treated with a KPD for 20 minutes and the Otago exercise program was given in both groups for 30 minutes. Both groups received treatment for three sessions per week for two weeks. Outcome measures used for assessment at baseline and post-treatment were visual analog scale (VAS), knee range of motion, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale, and distance covered in a two-minute walk test. Results Both the groups showed significant improvement post-treatment (p < 0.05). Group B showed more significant improvement when compared with group A. The enhancement in VAS (2.39, p < 0.020), range of motion (2.11, p < 0.039), WOMAC (2.09, p < 0.04), and two-minute walk test (2.03, p < 0.046) showed improvement in functional ability. Conclusion The findings of this study showed that both groups showed improvement following treatment, but that the use of a KPD in combination with strengthening and balance retraining is more efficient in reducing pain and enhancing quality of life in patients with grade 1 or 2 knee OA than conventional CBT.

A Review on Osteoarthritis Knee Management via Contrast Bath Therapy and Physical Therapy

One of the body's main weight-bearing joints is the knee joint. For this reason, osteoarthritis typically involves it. Osteoarthritis of the knee joint is the condition in which sub-chondral sclerosis of bone occurs, narrowing of joint space is present, and osteophyte formation is seen at the edges of the bone; because of this, there is pain, reduced knee range of motion, and this leads to functional activity limitations. This prevalence is increasing because of a reduced active lifestyle; this is becoming usual in younger populations. Non-pharmacological management of this condition using contrast bath therapy given by different methods like using hot and cold water, towel compression, and smart knee pad device, causes alternate vasodilatation and vasoconstriction helps to reduce pain symptoms. Physical therapy exercises like stretching, strengthening hip and knee muscles, and balance training showed beneficial effects on a range of motion and activities. Articles using keywords were searched on Google Scholar and PubMed, 70 articles were seen of which eight were reviewed that meet the inclusion criteria. Contrast therapy helps to remove metabolic waste by improving blood flow thus reducing pain. Strengthening the hip and knee muscles helps to stabilize the knee joint, and balance exercises help to improve proprioception. From this review, it is concluded that contrast bath therapy is effective in reducing pain when given with different methods of application as compared to individual hot or cold treatment, and given with the help of a device will be more effective than the traditional method. Along with this strengthening of the knee and hip musculature, stretching and balance exercise helps to improve range and functional activity. Exercise and electrotherapy aid in symptom relief and slow the progression rate of this condition.

Effects of alternating heat and cold stimulation using a wearable thermo-device on subjective and objective shoulder stiffness

BACKGROUND

Technological innovations have allowed the use of miniature apparatus that can easily control and program heat and cold stimulations using Peltier elements. The wearable thermo-device has a potential to be applied to conventional contrast bath therapy. This study aimed to examine the effects of alternating heat and cold stimulation (HC) using a wearable thermo-device on subjective and objective improvement of shoulder stiffness.

METHODS

Twenty healthy young male individuals (20.3 ± 0.6 years) participated in this study. The interventions were randomly conducted under four conditions, including HC, heat stimulation, cold stimulation, and no stimulation on their bilateral trapezius muscle, after a 30-min typing task. Each intervention was administered at least 1 week apart. The analyzed limb was the dominant arm. Muscle hardness was assessed using a portable muscle hardness meter, as well as the skin temperature over the stimulated area. After each condition, the participants were asked for feedback regarding subjective improvement in refreshed feelings, muscle stiffness, and muscle fatigue using an 11-point numerical rating scale.

RESULTS

With regard to muscle hardness, only the HC condition significantly decreased from 1.43 N to 1.37 N (d = 0.44, p < 0.05). Additionally, reduced muscle hardness in HC condition was associated with the degree of skin cooling during the intervention (cold max: r = 0.634, p < 0.01; cold change: r = -0.548, p < 0.05). Subjective improvement in refreshed feelings, muscle stiffness, and muscle fatigue was determined in the HC and heat stimulation conditions compared with the no stimulation condition (p < 0.01 and p < 0.05, respectively). Moreover, the HC condition showed significantly greater improvements in muscle stiffness and fatigue compared to the cold stimulation condition (p < 0.05).

CONCLUSIONS

The current study demonstrated that HC promoted not only better subjective symptoms, such as muscle stiffness and fatigue, but also lesser muscle hardness. Furthermore, an association was observed between the degree of skin temperature cooling and reduced muscle hardness during HC. Further investigations on the ratio and intensity of cooling should be conducted in the future to establish the optimal HC protocol for muscle stiffness or fatigue.

TRIAL REGISTRATION

UMIN000040620 . Registered 1 June 2020.