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Purpose: To assess the effect of whole-body cryotherapy (WBC) on postmatch recovery in basketball. Methods: Using a crossover design, 17 youth male players (age 16.2 [1.2] y, stature 190.5 [9.4] cm, body mass 79.2 [9.6] kg, experience 9.9 [3.9] y) completed 2 simulated matches, followed by WBC (4 min, −75 to − 85 °C) or a placebo intervention (CON). Countermovement-jump height, change-of-direction performance, 10- and 20-m sprint times, heart-rate variability (log-transformed squared root of the mean sum of the squared differences between R-R intervals [Ln-rMSSD]), muscle soreness, and perceived recovery (Perceived Recovery Status Scale [PRS]) were recorded at prematch, postmatch, postrecovery, and 24 hours postmatch. Additionally, Ln-rMSSD was recorded upon awakening on match day and the following morning. Results: Compared with CON, higher PRS values were reported in WBC at prematch and postrecovery (P ≤.026), while no significant between-interventions differences were found for any other measure (P >.05). Regarding the effect of time, our findings revealed that 20-m sprint times, Ln-rMSSD, and PRS deteriorated in both interventions from prematch to postmatch (ie, acute changes, P ≤.045), while muscle soreness worsened in WBC only (P ≤.003). Conversely, countermovement-jump height, change-of-direction, and 10-m sprint performance were unaffected by match play in the acute phase (P >.05), while none of the investigated measures showed impairments at 24 hours postmatch, compared with prematch (P >.05). Conclusions: Overall, these findings suggest that WBC was mostly ineffective for improving postexercise recovery in the investigated sample, with benefits observed for perceived recovery being potentially influenced by the participants' status at baseline (ie, higher prematch PRS scores in WBC compared with CON). [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of shorter, more frequent rest breaks with per-cooling as an alternative heat-acclimation session on physiological, perceptual, and self-paced maximal cycling performance, compared with continuous heat exposure. Methods: Thirteen participants completed 1 continuous and 3 intermittent-heat-exposure (IHE) maximal self-paced cycling protocols in a random order in heat (36 °C, 80% relative humidity): 1 × 60-minute exercise (CON), 3 × 20-minute exercise with 7.5-minute rest between sets (IHE-20), 4 × 15-minute exercise with 5-minute rest between sets (IHE-15), and 6 × 10-minute exercise with 3-minute rest between sets (IHE-10). Mixed-method per-cooling (crushed-ice ingestion and cooling vest) was applied during rest periods of all IHE protocols. Results: Total distance completed was greater in IHE-10, IHE-15, and IHE-20 than in CON (+11%, +9%, and +8%, respectively), with no difference observed between IHE protocols. Total time spent above 38.5 °C core temperature was longer in CON compared with IHE-15 and IHE-20 (+62% and +78%, respectively) but similar to IHE-10 (+5%). Furthermore, a longer time above 38.5 °C core temperature occurred in IHE-10 versus IHE-15 and IHE-20 (+54% and +69%, respectively). Sweat loss did not differ between conditions. Conclusion: IHE with per-cooling may be a viable alternative heat-acclimation protocol in situations where training quality takes precedence over thermal stimulus or when both factors hold equal priority. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate acute psychophysiological responses to repeated-sprint training in hypoxia (RSH) combined with whole-body cryotherapy (WBC). Method: Sixteen trained cyclists performed 3 sessions in randomized order: RSH, WBC-RSH (WBC pre-RSH), and RSH-WBC (WBC post-RSH). RSH consisted of 3 sets of 5 × 10-second sprints with 20-second recovery at a simulated altitude of 3000 m. Power output, muscle oxygenation (tissue saturation index), heart-rate variability, and recovery perception were analyzed. Sleep quality was assessed on the nights following test sessions and compared with a control night using nocturnal ActiGraphy and heart-rate variability. Results: Power output did not differ between the conditions (P =.27), while the decrease in tissue saturation index was reduced for WBC-RSH compared to RSH-WBC in the last set. In both conditions with WBC, the recovery perception was higher compared to RSH (WBC-RSH: +15.4%, and RSH-WBC: +21.9%, P <.05). The number of movements during the RSH-WBC night was significantly lower than for the control night (−18.7%, P <.01) and WBC-RSH (−14.9%, P <.05). RSH led to a higher root mean square of the successive differences of R-R intervals and high-frequency band during the first hour of sleep compared to the control night (P <.05) and RSH-WBC (P <.01). Conclusions: Inclusion of WBC in an RSH session did not modify the power output but could improve prolonged performance in hypoxia by maintaining muscle oxygenation. A single RSH session did not deteriorate sleep quality. WBC, particularly when performed after RSH, positively influenced recovery perception and sleep. [ABSTRACT FROM AUTHOR]

Context: The medial collateral ligament is the most commonly injured ligament in the knee. The high-speed pivoting and agility movements that are common in the sport of American Football put participants at an increased risk for a valgus force stress from contact or noncontact injuries. Positional release therapy (PRT) also considered strain/counterstrain focuses on releasing the tension in a tissue through unloading the involved body part. Case Presentation: Two male student-athletes participating in football with a mean age of 20.5 years were diagnosed by a physician with medial collateral ligament grade 2 sprain. Both patients sustained their injuries in a regular season game with a contact valgus force from an opposing player. Management and Outcomes: After the initial 72 hours of compression, elevation, and cryotherapy, the patients were both treated with PRT followed by progressive loading exercises. Following 4 treatment sessions of PRT over the next 6 days, the patients started with quadriceps engagement exercises, single-leg squats to 60° knee flexion, side steps, triceps dips, slow controlled lunges, and toe walk. The patients progressed to full body weight squats, single-leg landing, step-up tri-extension, and sidekicks with a leg on table. Then, the patients completed function movements and sports-specific exercises. Conclusions: In this case series, 2 patients competing in intercollege American Football were treated with PRT and progressive loading exercises to facilitate return to unrestricted activities and improve outcome measures. Commonly, a grade 2 medial collateral ligament sprain is conservatively treated with return to sport taking 20 days on average. In this type 2 case series, the clinician found success utilizing PRT early in the recovery process, which in these 2 cases lead to restoration of function, outcome measure improvement, and an expedited return to sport. The expedited return to sport occurred at an average of 18 days for these patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effect of cold application on amiodarone‐related vein phlebitis. A quasi‐experimental design was used. The study sample consisted of 79 patients who received an amiodarone infusion. The control group of the study consisted of patients receiving amiodarone treatment, while the intervention group consisted of patients receiving cold application during the amiodarone infusion. In the intervention group, after the start of amiodarone treatment, cold gel packs were applied a total of 12 times for 15 min at 2‐h intervals. The rate of phlebitis development was 59% in the intervention group and 95% in the control group (p <.001). It was found that 52.2% of the patients in the intervention group had first grade phlebitis and 84.4% of the patients in the control group who developed phlebitis had second grade phlebitis (p <.001). The 15‐min cold application was found to be effective in terms of the rate of phlebitis development, phlebitis grade and time of phlebitis development. (ClinicalTrials.gov NCT05058053). [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of contrast heat and cold pressure therapy (CHCP) on muscle tone, elasticity, stiffness, perfusion unit, and muscle fatigue indices after plyometric training consisting of five sets of jumping on a 50-cm high box until exhaustion. A prospective, randomized, controlled single-blind study design was used. Twenty professional MMA fighters were included in the study. The experimental group (n = 10) was subjected to the CHCP protocol (eGR), while the control group (cGR) (n = 10) was subjected to sham therapy. Both protocols consisted of three CHCP sessions performed immediately after plyometric exercise, 24 and 48 h afterwards. Measurements were taken at the following time points: 1) at rest; 2) 1 min post-exercise; 3) 1 min post-CHCP therapy; 4) 24 h post-CHCP therapy; 5) 48 h post-CHCP therapy. The results of the eGR compared to the cGR showed significantly higher perfusion at time point 5 (p < 0.001), higher muscle tone at time points 1, and 3-5 (p < 0.001 for all), higher stiffness at time points 1, 3-5 (p < 0.001 for all) and a higher pain threshold at time points 1 and 5 (p < 0.001 for all). This study suggests a positive effect of CHCP therapy on muscle biomechanics, the pain threshold, and tissue perfusion, which may contribute to increasing the effectiveness of post-exercise muscle recovery in MMA athletes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the safety and efficacy of selective intraarterial hypothermia combined with mechanical thrombectomy in the treatment of acute cerebral infarction based on microcatheter technology. Methods: A total of 142 patients with anterior circulation large vessel occlusion were randomly assigned to the hypothermic treatment group (test group) and the conventional treatment group (control group). National Institutes of Health Stroke Scale (NIHSS) scores, postoperative infarct volume, the 90-day good prognosis rate (modified Rankin Scale (mRS) score =2 points), and the mortality rate of the two groups were compared and analyzed. Blood specimens were collected from patients before and after treatment. Serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-6 (IL-6), IL-10, and RNA-binding motif protein 3 (RBM3) were measured. Results: The 7-day postoperative cerebral infarct volume [(63.7 ± 22.1) ml vs. (88.5 ± 20.8) ml] and NIHSS scores at postoperative Days 1, 7, and 14 [(6.8 ± 3.8) points vs. (8.2 ± 3.5) points; (2.6 ± 1.6) points vs. (4.0 ± 1.8) points; (2.0 ± 1.2) points vs. (3.5 ± 2.1) points] in the test group were significantly lower than those in the control group. The good prognosis rate at 90 days postoperatively (54.9 vs. 35.2%, P = 0.018) was significantly higher in the test group than in the control group. The 90-day mortality rate was not statistically significant (7.0 vs. 8.5%, P=0.754). Immediately after surgery and 1 day after surgery, SOD, IL-10, and RBM3 levels in the test group were relatively higher than those in the control group, and the differences were statistically significant. Immediately after surgery and 1 day after surgery, MDA and IL-6 levels in the test group were relatively reduced compared with those in the control group, and the differences were statistically significant (P < 0.05). In the test group, RBM3 was positively correlated with SOD and IL-10. Conclusion: Mechanical thrombectomy combined with intraarterial cold saline perfusion is a safe and effectivemeasure for the treatment of acute cerebral infarction. Postoperative NIHSS scores and infarct volumes were significantly improved with this strategy compared with simple mechanical thrombectomy, and the 90-day good prognosis rate was improved. The mechanism by which this treatment exerts its cerebral protective effect may be by inhibiting the transformation of the ischaemic penumbra of the infarct core area, scavenging some oxygen free radicals, reducing inflammatory injury to cells after acute infarction and ischaemia-reperfusion, and promoting RBM3 production in cells. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion Despite being well‐studied and widely utilized, the efficacy of cryotherapy after total knee arthroplasty (TKA) in enhancing early rehabilitation lacks consensus. The aim of this systematic review and meta‐analysis was to investigate (1) whether cryotherapy is able to promote the rehabilitation of patients undergoing TKA and (2) whether continuous cold flow device has superior results than cold pack in cryotherapy.A comprehensive trial searching was performed in the PubMed, Embase, Cochrane Library, and Google Scholar electronic databases in May, 2024. Randomized controlled trials (RCTs) comparing cryotherapy with no cryotherapy or comparing continuous cold flow device with cold pack after TKA were included. The primary outcome was visual analogue scale (VAS) of pain, and secondary outcomes included opioid consumption, blood loss (hemoglobin decrease and drainage), range of motion (ROM), swelling, length of stay (LOS), and adverse event.A total of 31 RCTs were included in this meta‐analysis with 18 trials comparing cryotherapy with no cryotherapy and 13 trials comparing continuous cold flow device with cold pack. Pooled results showed cryotherapy group had significantly lower VAS scores than no cryotherapy group on postoperative day (POD) 1 (MD, −0.59 [95% CI, −1.14 to −0.04]; p = 0.04), POD 2 (MD, −0.84 [95% CI, −1.65 to −0.03]; p = 0.04), and POD 3 (MD, −0.86 [95% CI, −1.65 to −0.07]; p = 0.03). Cryotherapy group also showed reduced opioid consumption, reduced hemoglobin loss, decreased drainage, and improved ROM after TKA. Continuous cold flow device group had comparable VAS, opioid consumption, blood loss, ROM, knee swelling, and LOS with cold pack group.Cryotherapy can effectively alleviate postoperative pain, reduce blood loss, improve ROM, and thus promote the postoperative rehabilitation for TKA patients, but the continuous cold flow device did not show better efficacy than cold packs. These findings support the routine use of cryotherapy for the rapid rehabilitation of TKA patients, and the traditional cold pack is still recommended. [ABSTRACT FROM AUTHOR]

The information contained in this article is suitable for clinicians practicing in the United States desiring a general overview of the assessment and management of spinal cord injury (SCI), focusing on initial care, assessment, acute management, complications, prognostication, and future research directions. SCI presents significant challenges, affecting patients physically, emotionally, and financially, with variable recovery outcomes ranging from full functionality to lifelong dependence on caregivers. Initial care aims to minimize secondary injury through thorough neurological evaluations and imaging studies to assess the severity of the injury. Acute management prioritizes stabilizing respiratory and cardiovascular functions and maintaining proper spinal cord perfusion. Patients with unstable or progressive neurological decline benefit from timely surgical intervention to optimize neurological recovery. Subacute management focuses on addressing common complications affecting the respiratory, gastrointestinal, and genitourinary systems, emphasizing a holistic, multidisciplinary approach. Prognostication is currently based on neurological assessments and imaging findings, but emerging biomarkers offer the potential to refine outcome predictions further. Additionally, novel therapeutic interventions, such as hypothermia therapy and neuroprotective medications are being explored to mitigate secondary damage and enhance recovery. This paper serves as a high-yield refresher for clinicians for the assessment and management of acute spinal cord injury during index admission. [ABSTRACT FROM AUTHOR]

Introduction: Thermal atrial fibrillation (AF) ablation exerts an additive treatment effect on the cardiac autonomic nervous system (CANS). This effect is mainly reported during ablation of the right superior pulmonary vein (RSPV), modulating the right anterior ganglionated plexus (RAGP), which contains parasympathetic innervation to the sinoatrial node in the epicardial fat pad between RSPV and superior vena cava (SVC). However, a variable response to neuromodulation after ablation is observed, with little to no effect in some patients. Our objective was to assess clinical and anatomic predictors of thermal ablation‐induced CANS changes, as assessed via variations in heart rate (HR) postablation. Methods: Consecutive paroxysmal AF patients undergoing first‐time PV isolation by the cryoballoon (CB) or radiofrequency balloon (RFB) within a 12‐month time frame and with preprocedural cardiac computed tomography (CT), were evaluated. Preablation and 24‐h postablation electrocardiograms in sinus rhythm were collected and analyzed to assess HR. Anatomic evaluation by CT included the measurement of the shortest distance between the SVC and RSPV ostium (RSPV‐SVC distance). Results: A total of 97 patients (CB, n = 50 vs. RFB, n = 47) were included, with similar baseline characteristics between both groups. A significant HR increase postablation (ΔHR ≥ 15 bpm) occurred in a total of 37 patients (38.1%), without difference in number of patients between both thermal ablation technologies (CB, 19 [51%]), RFB, 18 [49%]). Independent predictors for increased HR were RSPV‐SVC distance (odds ratio [OR]: 0.49, CI: 0.34–0.71, p value <.001), and age (OR: 0.94, CI: 0.89–0.98, p value =.003). Conclusions: Thermal balloon‐based PV isolation influences the CANS through its effect on the RAGP, especially in younger patients and patients with shorter RSPV‐SVC distance. [ABSTRACT FROM AUTHOR]

Arterial puncture is a painful procedure performed to assess patients’ respiratory status. Pain is a stressful situation for unconscious patients as they cannot communicate their feeling verbally. To control patients’ pain and prevent the adverse effects of painkillers, nonpharmacological pain management strategies have been solicited. The aim of this study is to investigate the effect of cryoanalgesia on unconscious patients’ pain during arterial puncture. We adopted a quasi-experimental one-group research design. A sample of 86 unconscious patients in a surgical intensive care unit were recruited in this study. The intervention was applying an ice pack over the puncture site for 5 minutes before the arterial puncture procedure. Pain was assessed for 2 times; before and after application of cryoanalgesia. A statistically significant difference in participants’ pain scores between pre-tests and post-tests was noted. For the intubated ventilated participants, the mean pain score before and after applying cryoanalgesia was 5.26 versus 4.00 (P ≤ .05). For the non-intubated or intubated non-ventilated participants, the mean pain score was 6.66 versus 4.63 (P ≤ .05). Cryoanalgesia is a feasible and effective method incorporate during arterial puncture along with standard procedure elements to achieve maximum pain reduction for unconscious patients during arterial punctures. [ABSTRACT FROM AUTHOR]

Focal therapy, a minimally invasive strategy for localized prostate cancer, has been widely employed in the targeted treatment of localized prostate cancer in recent years. We analyzed 1312 relevant papers from the last decade using Web of Science Core Collection data. Our analysis covered countries, institutions, journals, authors, keywords, and references to offer a multifaceted perspective on the development of this field. The U.S. led in publications, contributing over half of the top 10 institutions. Emberton, M from University College London was the most published and cited author. "EUROPEAN UROLOGY" was the top journal by impact factor in 2022. Analysis of references and keywords suggests the prevalence of brachytherapy-related research, while high-intensity focused ultrasound (HIFU), cryotherapy, and irreversible electroporation (IRE) are emerging as new research focuses. Consequently, more high-quality evidence is necessary to evaluate the long-term effectiveness and safety of these novel therapeutic methods. [ABSTRACT FROM AUTHOR]

Background: This systematic review and network meta-analysis assessed via direct and indirect comparisons the recovery effects of hydrotherapy and cold therapy at different temperatures on exercise induced muscle damage. Methods: Five databases were searched in English and Chinese. The included studies included exercise interventions such as resistance training, high-intensity interval training, and ball games, which the authors were able to define as activities that induce the appearance of EIMD. The included RCTs were analyzed using the Cochrane Risk of Bias tool. Eligible studies were included and and two independent review authors extracted data. Frequentist network meta-analytical approaches were calculated based on standardized mean difference (SMD) using random effects models. The effectiveness of each intervention was ranked and the optimal intervention was determined using the surface under the cumulative ranking curve (SUCRA) indicator. Results: 57 studies with 1220 healthy participants were included, and four interventions were examined: Cold Water Immersion (CWI), Contrast Water Therapy (CWT), Thermoneutral or Hot Water Immersion (TWI/HWI), and Cryotherapy(CRYO). According to network meta-analysis, Contrast Water Immersion (SUCRA: 79.9%)is most effective in recovering the biochemical marker Creatine Kinase. Cryotherapy (SUCRA: 88.3%) works best to relieve Delayed Onset Muscle Soreness. In the recovery of Jump Ability, cryotherapy (SUCRA: 83.7%) still ranks the highest. Conclusion: We found that CWT was the best for recovering biochemical markers CK, and CRYO was best for muscle soreness and neuromuscular recovery. In clinical practice, we recommend the use of CWI and CRYO for reducing EIMD. Systematic Review Registration: [PROSPERO], identifier [CRD42023396067]. [ABSTRACT FROM AUTHOR]

Simple Summary: The majority of newly diagnosed prostate cancer patients are eligible for active surveillance, and those at moderate to high risk frequently receive definitive treatments such as radiotherapy or radical prostatectomy. A considerable proportion of patients will experience biochemical recurrence, as well as localized and distant metastatic recurrence following definitive treatment. Salvage cryotherapy has emerged as a safe and effective alternative for treating localized recurrence. This review examines the oncologic and functional outcomes of whole-gland and focal salvage cryotherapy, as well as the crucial role of multiparametric prostate MRI and PSMA-targeted PET imaging. The outcomes of cryotherapy compared to those of other salvage ablation techniques like high-intensity focused ultrasound (HIFU) are also explored. Prostate cancer is the most common non-cutaneous malignancy in men, with the majority of newly diagnosed patients eligible for active surveillance. Despite definitive treatment, a considerable percentage of men will experience biochemical recurrence and even regional and distant metastatic recurrence after radiation therapy or radical prostatectomy. Salvage prostatectomy, while oncologically effective, poses significant morbidity with poor functional outcomes. Salvage cryotherapy has emerged as a promising alternative for localized recurrence, demonstrating safety and efficacy. This review examines the oncologic and functional outcomes of whole-gland and focal salvage cryotherapy, including disease-free survival, cancer-specific survival, and overall survival. The crucial role of multiparametric prostate MRI and evolving role of next-generation PSMA-targeted PET imaging are also examined. The comparison of outcomes of cryotherapy to other salvage ablation modalities, such as high-intensity focused ultrasound (HIFU), is also explored. [ABSTRACT FROM AUTHOR]

Background: Post-cardiac arrest syndrome (PCAS) presents a multifaceted challenge in clinical practice, characterized by severe neurological injury and high mortality rates despite advancements in management strategies. One of the important critical aspects of PCAS is post-arrest lung injury (PALI), which significantly contributes to poor outcomes. PALI arises from a complex interplay of pathophysiological mechanisms, including trauma from chest compressions, pulmonary ischemia–reperfusion (IR) injury, aspiration, and systemic inflammation. Despite its clinical significance, the pathophysiology of PALI remains incompletely understood, necessitating further investigation to optimize therapeutic approaches. Methods: This review comprehensively examines the existing literature to elucidate the epidemiology, pathophysiology, and therapeutic strategies for PALI. A comprehensive literature search was conducted to identify preclinical and clinical studies investigating PALI. Data from these studies were synthesized to provide a comprehensive overview of PALI and its management. Results: Epidemiological studies have highlighted the substantial prevalence of PALI in post-cardiac arrest patients, with up to 50% of survivors experiencing acute lung injury. Diagnostic imaging modalities, including chest X-rays, computed tomography, and lung ultrasound, play a crucial role in identifying PALI and assessing its severity. Pathophysiologically, PALI encompasses a spectrum of factors, including chest compression-related trauma, pulmonary IR injury, aspiration, and systemic inflammation, which collectively contribute to lung dysfunction and poor outcomes. Therapeutically, lung-protective ventilation strategies, such as low tidal volume ventilation and optimization of positive end-expiratory pressure, have emerged as cornerstone approaches in the management of PALI. Additionally, therapeutic hypothermia and emerging therapies targeting mitochondrial dysfunction hold promise in mitigating PALI-related morbidity and mortality. Conclusion: PALI represents a significant clinical challenge in post-cardiac arrest care, necessitating prompt diagnosis and targeted interventions to improve outcomes. Mitochondrial-related therapies are among the novel therapeutic strategies for PALI. Further clinical research is warranted to optimize PALI management and enhance post-cardiac arrest care paradigms. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal pain is a non-negligible multifaceted condition affecting more than 30% of the global population. Superficial heat therapy (HT), through increasing tissue temperatures, plays a role in increasing local metabolism and function and relieving pain. Knee (KP) and sports pain represent two relevant fields of superficial HT application. Methods: In the present paper, a panel of experts performed a narrative review of the literature regarding the role of superficial HT in the management of knee and sports activity-related pain. Results: According to the reviewed literature, HT represents a therapeutic option in the management of musculoskeletal pain due to three main effects: pain relief, promotion of healing, and return to normal function and activity. Moreover, HT plays a role in sport activities both before and after exercise. Before performing sports, HT helps in preparing muscles for performance. After performing sports, it is capable to promote recovery and healing pathways. Combining and sequencing superficial heat and cold therapy represent an interesting topic of study. Overall, the application of heat wraps for superficial HT can be considered safe. Conclusions: HT has been shown to be a potentially beneficial and safe option in the management of several conditions including KP and sports. The key in the application of superficial HT is a multimodal and multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: The management of pain after shoulder surgery typically includes the use of cryotherapy and the prescription of opioid analgesics. Much focus has been placed lately on the opioid epidemic, which in part is fueled by excessive prescription of opioid medication. Previous studies have found a combination of cryotherapy and compression effective at reducing analgesic consumption and increasing recovery in patients undergoing knee and spine surgery; however, efficacy in patients undergoing shoulder surgery has not been evaluated. Purpose: To evaluate the effectiveness of a cryo–pneumatic compression device on postoperative shoulder pain, narcotic use, and quality of life when compared with standard care cryotherapy. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In total, 200 patients older than 18 years scheduled for unilateral shoulder surgery were enrolled. Patients were randomized to receive either postoperative cryo–pneumatic compression or standard care. The intervention group received a cryo–pneumatic device, while the standard care group received the treating surgeon's preferred method of postoperative care, including standard cryotherapy. Narcotic use was evaluated by the number of oral morphine milligram equivalents consumed during the postoperative period, as well as the time to cessation of narcotic use. Patient-reported outcome measures consisted of a numeric rating scale pain score, 36-item Short Form Survey, patient experience assessed using the net promoter score, and adverse events. Outcomes were evaluated at 2, 6, and 12 weeks postoperatively. Results: Patients receiving cryo–pneumatic compression reported a significant decrease in opioid consumption when compared with standard care (oral morphine milligram equivalents median, 56.1 vs 112; P =.02468). A significant increase in self-reported function was seen in the cryo–pneumatic compression group at 2 weeks when compared with standard care (mean, 61.2 vs 54.2; P =.0412). Conclusion: In patients undergoing unilateral shoulder surgery, the use of cryotherapy with pneumatic compression, when compared with standard care, resulted in significantly decreased opioid consumption as well as increased function at 2 weeks. Registration: NCT04185064 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Background: Acne vulgaris poses a significant dermatological challenge, necessitating alternative treatments due to limitations and side effects associated with current therapies. This pilot clinical trial investigated the feasibility and efficacy of precision cryotherapy for acne vulgaris. Methods: A total of 20 volunteers underwent targeted precision cryotherapy using a carbon dioxide‐based device. Treatment outcomes were assessed using various parameters, including Investigator Global Assessment (IGA) score, acne lesion count, erythema index (EI), global evaluation score, and participant satisfaction. Safety monitoring included adverse event reporting and physical examination. Results: Precision cryotherapy demonstrated a significant reduction (90.25%) in the acne lesion count by week 4, with clinical improvement indicated by IGA score reduction (p < 0.001). The EI showed notable improvements at weeks 1, 2, and 4. The global evaluation score demonstrated a 75%–100% clinical improvement at Visit 4. Participants reported high satisfaction (6.75 ± 0.79) with the procedure. No adverse event or discomfort was reported. Conclusion: Precision cryotherapy effectively improved acne lesions, which was safe and satisfactory for participants. These findings suggest its potential as an alternative therapeutic modality, especially for populations with limited treatment options. Further research is needed to validate the results and explore underlying mechanisms. [ABSTRACT FROM AUTHOR]

Introduction: Hamstring strain injuries (HSI) are one of the most common injuries for soccer players and there is a need for new clinical-based studies on the rehabilitation of these injuries. Objective: This study aimed to create a consensus on physiotherapy and rehabilitation approaches used in HSI by physiotherapists with super league experience in Turkey. Methods: Twenty-six male physiotherapists (duration of experience in professional life, on athlete health, and in the super league: 12.84 ± 6.04 years, 12.19 ± 5.96 years, 8.71 ± 5.31 years, respectively) from different institutions participated in the study. The research was carried out in three rounds using the Delphi method. Results: Data collected using LimeSurvey and Google Forms were analyzed using the Microsoft Excel and SPSS 22 software. The response rates over the three rounds were 100%, 96%, and 96%, respectively. The 10 main items that were agreed upon in Round 1 were divided into 93 sub-items. Their numbers in the second and third Rounds were 60 and 53, respectively. At the end of Round 3, the highest consensus was on eccentric exercise, dynamic stretching, interval running, and movement-enhancing field training. All sub-items at this round were classified as SUPER (S: Soft tissue restoration techniques; U: Using supportive approaches; P: Physical fitness exercises; E: Electro-hydro-thermal methods; and R: Return to sport activities). Conclusion: SUPER rehabilitation provides a new conceptual framework in terms of approaches used by clinicians in rehabilitation for athletes with HSI. Recognizing the lack of evidence for the various approaches involved, clinicians can modify their practice and researchers can explore whether these approaches are scientifically correct. [ABSTRACT FROM AUTHOR]

Introduction: Subglottic stenosis, manifested by granulation tissue hyperplasia, is challenging and requires multiple repeated treatments and stent maintenance at times. Corticosteroids prevent severe subglottic stenosis development owing to their antifibrotic and anti-inflammatory properties. Submucosal injection of glucocorticoids, a useful adjuvant therapeutic method, improves the mean interval between endoscopic procedures and reduces airway restenosis risks. Case Presentation: We report a rare case of a man with complex subglottic stenosis who underwent balloon dilatation combined with cryotherapy, stent placement, and adjuvant submucosal triamcinolone injection. The drug was injected efficiently and safely into the submucosal layer under percutaneous ultrasound guidance, and subglottic stenosis was well-controlled at a low cost. Conclusion: POCUS-guided medication injections may be a useful adjuvant medical therapy for subglottic stenosis. [ABSTRACT FROM AUTHOR]

Despite optimal cognitive function being essential for performance, there is a lack of research on the effectiveness of combined cooling interventions on team sport athlete's cognitive function when exercising in the heat. In a randomised, crossover design, 12 unacclimatised men (age: 22.3 ± 3.0 years, body mass: 73.4 ± 5.1 kg, height: 181.0 ± 5.3 cm and V˙O2 $\dot{\mathrm{V}}{\mathrm{O}}_{2}$ max: 51.2 ± 9.5 mL/kg/min) participated in a control (CON) and combined cooling trial (ice slurry and ice collar; COOL). A battery of cognitive tests were completed prior to, during (at half‐time) and following a 90‐min intermittent running protocol in the heat (33°C, 50% relative humidity (RH)). Perceptual and physiological measures were taken throughout the protocol. In CON, response times were quicker on the Stroop task complex level (p = 0.002) and the visual search test complex level at full‐time (p = 0.014) compared to COOL. During COOL, response times were quicker at half‐time on the Stroop task complex level (p = 0.024) compared to CON. Lower rectal temperatures were seen during COOL (CON: 37.44 ± 0.65°C and COOL: 37.28 ± 0.68°C) as well as lower skin, neck and forehead temperatures (main effect of trial, all p < 0.05). Lower ratings of thermal sensation and perceived exertion and enhanced thermal comfort were recorded during COOL (main effect of trial, all p < 0.05). Whilst minimal differences in cognitive function were found when using the combined cooling intervention, the findings highlight a practical and effective strategy to improving many physiological and perceptual responses to intermittent exercise in the heat. Highlights: Many studies have investigated the use of a combined cooling strategy on endurance exercise in the heat and found positive benefits on physiological, perceptual and cognitive responses to the intervention; however, there is a lack of research on intermittent exercise.The combined cooling intervention, consisting of an ice slurry and ice collar, was successful at lowering rectal, neck, forehead and skin temperatures as well as perceptual ratings of thermal sensation, comfort and perceived exertion.However, the combined cooling strategy did not elicit any consistent findings regarding cognitive function. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cryotherapy is widely utilized for therapeutic purposes, yet its specific effects on knee joint proprioception and quadriceps muscle performance in healthy individuals remain unclear. This study addresses this gap by examining the impact of a 20-minute cryotherapy session on knee joint proprioception and related muscle parameters in a cohort of healthy college students. OBJECTIVES: To investigate the effects of cryotherapy on knee joint proprioception and quadriceps muscle peak moment, work and power in healthy college male and female students. METHODS: Thirty-two healthy students, aged 19–23, underwent a 20-minute cryotherapy session using Cryogel packs applied to the anterior thigh and knee. An isokinetic dynamometer measured knee joint proprioception and quadriceps muscle parameters before, immediately after, 10-min, and 20-min post-cryotherapy. RESULTS: Proprioception values did not significantly differ between genders or post-tests (p > 0.05). However, the female group exhibited significantly lower moment, power, and work values compared to males (p < 0.05). No significant differences were observed within or between post-tests in moment, power, and work for both genders (p > 0.05). CONCLUSIONS: A 20-minute cryotherapy application demonstrated no adverse effects on knee joint proprioception or quadriceps muscle metrics in healthy college students, supporting the safety of cryotherapy in this context. [ABSTRACT FROM AUTHOR]

Thie present article addresses calculation of thermophysical processes in a thermoelectric device for local hypothermia of the knee joint. The calculation model consists of solutions for three problems: determination of the temperature field of the cross section of the knee joint undergoing cooling, assessment of the parameters of the thermoelectric modules included in the device, and identification of the characteristics of the system removing heat from the hot junctions of the thermoelements included in the thermal modules. [ABSTRACT FROM AUTHOR]

Cryotherapy in interventional bronchoscopy is a new treatment modality which has recently been made available for the pediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this work was to elaborate on the application progress of cryotherapy in pediatric pulmonary diseases and also to assess indications, success rates, and complications of airway cryotherapy in children. In summary, cryotherapy via flexible bronchoscopy is a safe and feasible method. The application scope in pediatrics is similar to that in adults, and it is mainly used in airway obstructive diseases. However, it is primarily caused by benign conditions, and the interventional treatment mainly seeks to provide long-lasting symptomatic alleviation. Thus, prevention, treatment, and prognosis of long-term complications are issues that should be carefully considered in pediatric applications. [ABSTRACT FROM AUTHOR]

Applying cold to a bone injury can aid healing, though its mechanisms are complex. This study investigates how cold therapy impacts bone repair to optimize healing. Cold was applied to a rodent bone model, with the physiological responses analyzed. Vasoconstriction was mediated by an increase in the transient receptor protein channels (TRPs), transient receptor potential ankyrin 1 (TRPA1; p = 0.012), and transient receptor potential melastatin 8 (TRPM8; p < 0.001), within cortical defects, enhancing the sensory response and blood flow regulation. Cold exposure also elevated hypoxia (p < 0.01) and vascular endothelial growth factor expression (VEGF; p < 0.001), promoting angiogenesis, vital for bone regeneration. The increased expression of osteogenic proteins peroxisome proliferator-activated receptor gamma coactivator (PGC-1α; p = 0.039) and RNA-binding motif protein 3 (RBM3; p < 0.008) suggests that the reparative processes have been stimulated. Enhanced osteoblast differentiation and the presence of alkaline phosphatase (ALP) at day 5 (three-fold, p = 0.021) and 10 (two-fold, p < 0.001) were observed, along with increased osteocalcin (OCN) at day 10 (two-fold, p = 0.019), indicating the presence of mature osteoblasts capable of mineralization. These findings highlight cold therapy's multifaceted effects on bone repair, offering insights for therapeutic strategies. [ABSTRACT FROM AUTHOR]

Context: Exertional heat stroke (EHS) is the most deadly form the exertional heat illness with a higher incidence among active duty US military members than in the general population. Current guidelines on EHS recovery timelines and return to duty vary among the military branches. In some cases, individuals experience prolonged heat and exercise intolerance with repeat exertional heat illness events, which can complicate the recovery process. Management and rehabilitation of such individuals is unclear. Case Presentation: This manuscript addresses the case and management of a US Air Force Special Warfare trainee who experienced 2 episodes of EHS, despite early recognition, gold standard treatment, and undergoing 4 weeks of a stepwise recovery after an initial EHS. Management and Outcomes: After the second episode, a 3-step process was utilized, consisting of a prolonged and personalized recovery period, heat tolerance testing using Israeli Defense Force advanced modeling, and stepwise reacclimatization. This process allowed the trainee to successfully recover from repeat EHS and return to duty, and set a framework for future repeat EHS treatment guidelines. Conclusions: In individuals with repeat EHS, a prolonged recovery period followed by heat tolerance testing can be used to demonstrate appropriate thermotolerance and safely clear an individual to begin stepwise reacclimatization. Overall, patient care and military readiness may be improved by unified Department of Defense guidelines for return to duty after EHS. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Cold water immersion methods are not standardized in terms of operational indicators such as immersion temperature, duration and depth, leading to controversy over the efficacy of recovery from exercise fatigue in skeletal muscle. In this article, we analyze the effects of cold water immersion on muscle injury, muscle soreness and muscle strength recovery under different factors, in order to find the best immersion implementation plan, and thus provide evidence for the recovery of muscle fatigue. METHODS: A search of CNKI, WanFang Data, Web of Science, and PubMed databases was conducted for relevant literature published from January 1, 2000 to August 15, 2023. A total of 4 759 articles were initially retrieved, with 4 735 articles excluded through screening and 24 articles finally included. The Physical Therapy Evidence Database Scale was used to assess the methodological quality of the included literature, and Stata-MP 16 software was used to perform effect size combinations, subgroup analyses, Meta-regression, sensitivity tests, and publication bias analyses. RESULTS: (1) The article included a total of 24 randomized controlled trial studies, including 617 subjects, with overall high legal quality. (2) Meta-analysis showed that cold water immersion can significantly reduce creatine kinase blood value [standardized mean difference (SMD)=-0.17, 95% confidence interval (CI): -0.29 to -0.05, P < 0.01], alleviate muscle pain (SMD=-0.60, 95% CI: -0.81 to -0.38, P < 0.01), and promote maximum muscle strength recovery (SMD=0.17, 95% CI: 0.05 to 0.30, P < 0.01). (3) Subgroup analysis showed that: The immersing regimen with water temperature > 14 °C (SMD=-0.48, 95% CI: -0.76 to -0.20, P < 0.01) and duration of 12-14 minutes (SMD=-0.38, 95% CI: -0.61 to -0.15, P < 0.01) had the best effect in reducing creatine kinase blood values, and had a more significant intervention effect on endurance exercise (SMD=-0.45, 95% CI: -0.71 to -0.20, P < 0.01), while the immersion regimen with water temperature < 10 °C (SMD=-0.61, 95% CI: -0.79 to -0.43, P < 0.01), duration < 12 minutes (SMD=-0.76, 95% CI: -0.98 to -0.53, P < 0.01), and immersion depth above the iliac spine (SMD=-0.74, 95% CI: -0.97 to -0.52, P < 0.01) had the best effect on relieving muscle soreness, and had a more significant analgesic effect after endurance exercise (SMD=-0.42, 95% CI: -0.61 to -0.22, P < 0.01). (4) Meta regression showed that immersion water temperature, immersion duration, and exercise type were important regulatory factors affecting the effect size of creatine kinase; immersing water temperature and immersing depth were important regulatory factors affecting the effect size of visual analogue scale score, while exercise type was an important regulatory factor affecting the maximum isometric muscle strength effect size. CONCLUSION: (1) Evidence of extremely low to moderate strength suggests that cold water immersion can effectively reduce muscle damage, alleviate muscle soreness, and promote muscle strength recovery. (2) In terms of reducing muscle injury, immersion water temperature, immersion duration, and exercise type are significant regulatory factors that affect the efficacy of immersing. Among them, immersion water temperature > 14 °C and duration of 12-14 minutes are the best solutions to reduce muscle injury after exercise, and the immersing effect is better for endurance exercise. (3) In terms of reducing muscle soreness, immersion water temperature and immersion depth are important regulatory factors that affect the intervention effect. Among them, immersion water temperature < 10 °C, duration < 12 minutes, and immersing depth above the iliac spine are the best solutions to reduce muscle soreness, and have a better analgesic effect after endurance exercise. (4) In terms of promoting muscle strength recovery, exercise type is a key regulatory factor that affects the maximum isometric muscle strength effect. [ABSTRACT FROM AUTHOR]

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Objective: In the present systematic review, it was aimed to review the studies systematically that researched the effect of local cold application after total knee arthroplasty.Methods: The open-access full-text articles published between 2002-2023 in Turkish and English languages with prospective, randomized controlled experimental and semi-experimental control group design that researched the effects of local cold application on the operation site after total knee arthroplasty were examined to carry out a systematic review. The advanced screening method was applied using Turkish and English equivalents of the keywords ‘‘total knee arthroplasty and cold application’’, ‘‘total knee arthroplasty and cold therapy’’, ‘‘total knee arthroplasty and cold compress therapy’’, ‘‘the effect of cold therapy in total knee arthroplasty’’ separately and together in the Pubmed, Google Scholar, ScienceDirect, Cochrane, Turkish Medline, Scopus and Cinahl databases. Totally 2,233 articles were reached. 7 studies which met the sample criteria were included in the systematic review. Results: In the sample groups of the studies included in the systematic review, it was determined that cold application significantly reduced pain and swelling (P

This randomized clinical trial aims to evaluate cryotherapy as a therapeutic option for pain prevention after endodontic treatment with and without foraminal enlargement, in patients with asymptomatic apical periodontitis.120 teeth of patients with preoperative Visual Analogue Scale score indicating zero were treated. Specimens were randomly allocated into 4 groups: Control, Cryotherapy (ICT), Foraminal Enlargement (FE), and Cryotherapy and Foraminal Enlargement (ICT + FE). Working length was determined with an Electronic Apex Locator (EAL). Cryotherapy groups passed through a final irrigation protocol using 20 ml (2.5 ℃) of cold saline solution delivered at working length for 5 min. In FE groups a #40 K-file was used up to the 0.0 mark on the EAL display. Obturation was performed and postoperative pain was checked at 6, 12, 24, 48, and 72 h and 7 days after endodontic treatment.All experimental groups showed an increase in the level of postoperative pain, which started to decrease after 12 h. Foraminal enlargement caused a statistically significant increase in postoperativepain compared to ICT and control groups within the first 6 h (p < 0.05). Cryotherapy did not influence postoperative pain, regardless of whether or not foraminal enlargement was performed. [ABSTRACT FROM AUTHOR]

Background: Hypothermia is a relatively common complication in patients receiving continuous renal replacement therapy (CRRT). However, few studies have reported the factors associated with hypothermia. Methods: A retrospective cohort study was performed in five intensive care units (ICUs) to evaluate the incidence of hypothermia and the predictive factors for developing hypothermia during CRRT, with hypothermia defined as a time-weighted average temperature <36 °C. Results: From January 2020 to December 2021, 300 patients were enrolled. Hypothermia developed in 23.7% of them within the first 24 hours after CRRT initiation. Compared to non-hypothermic patients, hypothermic patients were older and had lower body weight, more frequent acidemia, and higher ICU and 30-day mortality rates. In the multivariate analysis, age >70 years (odds ratio [OR], 2.59; 95% CI, 1.38–4.98; P=0.004), higher positive fluid balance on the day before CRRT (OR, 1.11; 95% CI, 1.02–1.22; P=0.02), and CRRT dose (OR, 1.003; 95% CI, 1.00–1.01; P=0.04) were significantly associated with hypothermia. Conversely, a higher body weight was independently associated with mitigated risk of hypothermia (OR, 0.89; 95% CI, 0.81–0.97; P=0.01). Moreover, a higher coefficient of variance of temperature was associated with greater ICU mortality (OR, 1.41; 95% CI, 1.13–1.78; P=0.003). Conclusions: Hypothermia during CRRT is a relatively common occurrence, and factors associated with hypothermia onset in the first 24 hours include older age, lower body weight, higher positive fluid balance on the day before CRRT, and higher CRRT dose. Greater temperature variability was associated with increased ICU mortality. [ABSTRACT FROM AUTHOR]

This review examined the effect of acute heat mitigation strategies on physiological strain and exercise performance in females exercising in the heat. Three databases were searched for original research with an acute heat mitigation (intervention) and control strategy in active females and reporting core temperature, heart rate and/or aerobic exercise performance/capacity with ≥ 24°C wet bulb globe temperature. Hedges' g effect sizes were calculated to evaluate outcomes. Thirteen studies (n = 118) were included. Most studies that applied an acute heat mitigation strategy to females did not reduce thermal (9/10) or cardiovascular (6/6) strain or improve exercise performance/capacity (8/10). The most effective strategies for attenuating thermal strain were pre-cooling with ice-slurry (effect size = −2.2 [95% CI, −3.2, −1.1]) and ice-vests (−1.9 [−2.7, −1.1]), and pre- and per-cooling with an ice-vest (−1.8 [−2.9, −0.7]). Only pre-cooling with an ice-vest improved running performance (−1.8 [−2.9, −0.7]; ~0.43 min) whilst sodium hyperhydration improved cycling capacity at 70% V O2peak (0.8 [0.0, 1.6]; ~20.1 min). There is currently limited research on acute heat mitigation strategies in females, so the evidence for the efficacy is scarce. Some studies show beneficial effects with ice-slurry, ice-vests and sodium hyperhydration, which can guide future research to support female exercise performance in the heat. [ABSTRACT FROM AUTHOR]

Objective: Cervical ectropion occurs due to the eversion of the endocervix that exposes glandular cells to the vaginal milieu. The aim of the present study was to evaluate and compare the clinical efficacy of effervescent vaginal tablets of tranexamic acid and cryotherapy in women with symptomatic cervical ectopy. Methods: The current randomized clinical trial was conducted on 92 samples of women with cervical erosive ectropion from March 20, 2022 to August 27, 2022. Participants were divided into two groups; the intervention group (n = 46) was treated with a 400 mg effervescent vaginal tablet of tranexamic acid and the control group (n = 46) underwent cryotherapy. All the patients were requested to visit weekly in the first month and then monthly for the next 3 months, and the outcomes encompass improvement of symptoms (leukorrhea, dyspareunia, pelvic pain, post‐coital bleeding, and suprapubic pain) and cervical erosive ectropion view were monitored based on repeated examinations. Results: In this study, no statistically significant difference was observed in cure rate of symptoms between study groups (P value > 0.05). Women in both the tranexamic acid and cryotherapy groups reported significant improvements in dyspareunia (34 [75%] vs 31 [67%]), pelvic pain (34 [75%] vs 34 [74%]), post‐coital bleeding (37 [81%] vs 31 [67%]), leukorrhea (36 [78%] vs 36 [78%]), suprapubic pain (32 [71%] vs 33 [73%]) disappearance of cervical ectropion tranexamic acid (40 [86%], vs 39 [84%]). Conclusion: Our findings highlighted the equal effect of tranexamic acid and cryotherapy for treating cervical ectropion. Due to the ease of use, availability, and fewer side effects of tranexamic acid, it can be a suitable alternative to cryotherapy. Trial Registration: IRCT20220115053719N1. The name of the registry: Iranian Registry of Clinical Trials. URL of registration: https://en.irct.ir/trial/61483. Synopsis: Tranexamic acid and cryotherapy are effective in cervical ectropion treatment. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) in children under 15 years often results in airway compression, with bronchus intermedius (BI) being the most common site. Endoscopic enucleations can be used to remove lymph nodes and establish an airway in severe cases. Both rigid and flexible bronchoscopy are suitable, with alligator forceps being preferred for its ability to extract tissue. Recent studies have also explored cryoprobe enucleation. Case Presentation: An HIV-positive boy with persistent symptoms after 9 months of TB treatment was diagnosed based on his mother's and sister's Xpert MTB/RIF positive status. He was started on 4-drug TB treatment, but the child remained clinically symptomatic with abnormal chest X-ray and unconfirmed TB. Bronchoscopy was performed, revealing complete obstruction of BI due to caseating granulomas causing collapse of the right middle and lower lobes. Cryotherapy was used to recanalize the airway, and follow-up bronchoscopy confirmed patent BI. Conclusion: While cryotherapy was effective in the restoration of airway patency in this case, there is a lack of knowledge about its use in children. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the use of complementary and alternative treatment methods in burn wounds among patients who visited the emergency department with burn complaints. Material-Method: This descriptive, cross-sectional study was conducted with 100 patients who applied to the emergency department of a training and research hospital with burn complaints. Data were collected using three questionnaires: one on the patients' socio-demographic information, another on the characteristics of the burns, and a third that assessed knowledge and use of complementary treatment methods for burns. Results: It was determined that 32% of the participants were burned due to scalding, with most cases involving 1st and 2nd-degree burns. The participants reported that they were aware of traditional burn treatment methods, including washing with cold water (43.9%), using St. John's wort oil (17%), and applying yogurt (14.6%). The most commonly used methods in burn treatment were cold water (90.8%) and St. John's wort oil (5.7%). Conclusion: It was determined that while participants were aware of various complementary and alternative treatment methods for burn injuries, they did not frequently use these methods. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rotator cuff tendonitis (RCT) is one of the most common shoulder pathologies. It causes pain, limits shoulder joint movements, and impairs function. Despite various treatment methods, there are currently no specific guidelines regarding the most effective intervention for RCT. To the best of our knowledge, no studies have compared the effects of Kinesio taping (KT) and cold therapy (CT) on individuals with RCT. To this end, this study aimed to investigate and compare the short-term effects of KT and CT on pain relief and upper extremity functionality in individuals with RCT. Materials and Methods: One hundred and fourteen individuals were assessed for eligibility. Fifty-two individuals with RCT who met the inclusion criteria and agreed to participate were randomly allocated into either the KT or the CT group. A standardized home exercise program was given to all the participants. Their pain intensity, upper extremity function, shoulder range of motion (ROM), and grip strength were evaluated initially and after the three days of KT or CT applications. Results: All the assessment values significantly improved in the KT group. In the CT group, only the pain scores (except for the numerical rating scale (NRS) pain score during activity) were significantly improved in the CT group at the end of the third day of application compared to the initial values (p < 0.05). For all the measurement outcomes, the effects of time × group interactions were statistically significant (p < 0.05) in favor of the KT group, except for the resting pain (p = 0.688). Conclusions: The findings suggest that KT and CT could be used as adjunctive modalities to exercise for resting and night pain relief in patients with RCT. KT also had positive effects on the activity pain, function, ROM, and grip strength. The use of KT along with an exercise program could be a more effective therapeutic choice than the use of CT for improving night pain, activity pain, and upper extremity function during the short-term rehabilitation of RCT patients. [ABSTRACT FROM AUTHOR]

Cryoablation is a well-established medical procedure for surgically treating atrial fibrillation. Cryothermal catheter therapy induces cellular necrosis by freezing the insides of pulmonary veins, with the goal of disrupting abnormal electrical heart signals. Nevertheless, tissue damage induced by cold temperatures may also lead to other complications after cardiac surgery. In this sense, the simulation of catheter ablation can provide safer environments for training and the performance of cryotherapy interventions. Therefore, in this paper, we propose a novel approach to help better understand how temperature rates can affect this procedure by using computer tools to develop a simulation framework to predict lesion size and determine optimal temperature conditions for reducing the risk of major complications. The results showed that a temperature profile of around −40 °C caused less penetration, reduced necrotic damage, and smaller lesion size in the tissue. Instead, cryotherapy close to −60 °C achieved a greater depth of temperature flow inside the tissue and a larger cross-section area of the lesion. With further development and validation, the framework could represent a cost-effective strategy for providing personalized modeling, better planning of cryocatheter-based treatment, and preventing surgical complications. [ABSTRACT FROM AUTHOR]

Even when pain control is implemented, calves may experience pain for days after hot-iron disbudding. Whether calves seek pain relief post-disbudding offers a novel approach to assessing pain in these animals. By employing an approach-aversion paradigm, we explored the ability of cold therapy to provide immediate pain relief in disbudded calves. Calves were habituated to the manual placement of a cool or ambient pack on their forehead for a short duration simultaneous to milk reward consumption, prior to disbudding. Calves were then disbudded under local anaesthesia (procaine) and analgesia (meloxicam), and responses to the packs were observed over subsequent days. Individual calves were consistently exposed to either cool or ambient packs in different halves of a two-sided experimental pen, allowing for the testing of approach-aversion and conditioned place preference. We found calves approached milk rewards quicker and maintained contact for longer when receiving cold therapy compared to the ambient control. However, calves did not display any conditioned preference for the pen where they received the cool pack. These results add to the growing evidence of lasting pain following disbudding procedures and suggests that cold therapy provides some form of pain relief post-disbudding. Future studies should seek other ways to use cold therapy post-disbudding to reduce aversiveness and human involvement. [ABSTRACT FROM AUTHOR]

Introduction: Chronic low back pain (CLBP) is the leading cause of years lived with disability worldwide. Transcutaneous electrotherapies have been widely used to treat CLBP but, with the partial exception of transcutaneous electrical nerve stimulation (TENS), their effect on pain, disability, quality-of-life, and psychosocial outcomes have not been systematically reviewed. The purpose of this systematic review and meta-analysis was to clarify the overall effect of transcutaneous electrotherapies on patient-reported outcome measures (PROMs) in CLBP patients. Methods: Four databases and two study registries were searched for studies that utilized transcutaneous electrotherapies as a primary intervention for CLBP, compared against active or passive controls. Two reviewers independently extracted study data and assessed risk of bias. Studies were grouped by intervention vs. comparison, and by time of follow-up. Meta-analyses were conducted where appropriate. Results: A total of 89 full-text were assessed for eligibility; 14 studies were included, with 6 in the meta-analyses (all TENS or mixed TENS). Pain: meta-analyses revealed no significant difference for TENS vs. active control, TENS vs. passive control, or mixed TENS vs. active control at post-intervention, nor for mixed TENS vs. active control at 1-month post-intervention. Interferential current (IFC) was more effective than active control (2 studies), while electromyostimulation (EMS) was generally superior to passive, but not active, controls (6 studies). Disability: Meta-analyses revealed no significant difference for TENS vs. active control at post-intervention, mixed TENS vs. active control at post-intervention, or mixed TENS vs. active control at 1-month post-intervention. IFC was more effective than active control (2 studies), while the EMS results were mixed (6 studies). We were unable to perform metaanalyses for quality-of-life or psychosocial outcomes. Conclusion: There is moderate evidence that TENS is similar to all controls for improving pain and disability. There is limited evidence that IFC is superior to active controls for improving pain and disability. There is limited evidence that EMS is superior to passive but not active controls for improving pain, and similar to all controls for improving disability. [ABSTRACT FROM AUTHOR]

The use of whole-body cryotherapy (WBC) for musculoskeletal ailments is growing. WBC, involving brief exposure to extremely low temperatures, is increasingly used for its analgesic, anti-inflammatory, and antioxidant effects. The paper examines the physiological impacts of WBC on cardiovascular, musculoskeletal, hematologic, hormonal, and metabolic systems. Specific orthopaedic applications discussed include its role in the management of fractures, osteoarthritis, osteonecrosis of the femoral head, osteomyelitis, adhesive capsulitis, tendinopathies, rheumatic pathologies, chronic pain syndromes, and fibromyalgia. The study also highlights the benefits and drawbacks of WBC, including its potential to improve athletic performance, recovery, mood, and well-being, while noting risks like frostbite and impaired muscle strength. Clinical evidence from various studies is evaluated, revealing a spectrum of outcomes. For instance, WBC shows promise in enhancing bone health in athletes and providing relief in osteoarthritis and fibromyalgia patients. However, evidence for its efficacy in conditions like chronic pain syndromes and osteomyelitis is less robust. The paper underscores the need for further research to establish standardised protocols and understand long-term effects. While WBC offers significant benefits in orthopaedics, understanding its limitations and potential risks is crucial for its safe and effective clinical application. [ABSTRACT FROM AUTHOR]

Introduction: In hemodialysis patients, pain associated with needle insertion into an arteriovenous fistula is a physical and psychological problem. The aim of this study was to assess the effectiveness of pre‐puncture application of an ice pack, EMLA cream, or lidocaine spray to reduce pain associated with access puncture. Methods: This was a multicenter study done in nine hemodialysis centers in Iraq. The study utilized a randomized, parallel‐group design, in which patients being dialyzed using an arteriovenous access were allocated into one of four groups. Access puncture was preceded by nothing (control group), by use of ice pack cooling at the puncture site, by application of EMLA cream, or by application of lidocaine spray. Pain after access puncture was assessed during a single treatment for each patient. Pain was quantified using a Visual Analogue Scale. Findings: A total of 1548 patients agreed to participate, and 1041 patients were included in the data analysis. Use of an ice pack, EMLA cream, or lidocaine spray each was associated with a lower pain score on access puncture compared with no pretreatment. The mean Visual Analogue Scores in the four groups were: 69.7 ± 15.7 in the controls, 39.8 ± 13.2 in the ice pack group, 45 ± 18.4 in the EMLA group, and 52.9 ± 15.2 in lidocaine group. Ranking of the pain severity scores suggested that ice pack use was associated with the least pain, followed by use of EMLA cream and use of lidocaine spray (severity score ranking, from lowest to highest, being 1.62, 2.18, and 2.63, respectively). Discussion: Application of an ice pack prior to vascular access puncture is a fast and inexpensive technique to limit pain associated with this procedure. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cryotherapy is an affordable and popular treatment of soft tissue injuries, which can reduce inflammation and pain. Studies have specifically addressed young adults and athletes, and these findings have been extended to older adults in clinical practice. Aging is associated with changes in the skin, including collagen degradation, decreased fat layer thickness, and reduced blood flow, which can alter the skin response to stress. Because of age-related changes, there are concerns about the direct use of ice on the skin of older individuals. Skin injuries were also observed after cryotherapy. This study aimed to assess the most effective and safe cryotherapy for superficial skin cooling among older women. Methods: Eighteen older women were enrolled in this blinded, randomized, crossover, clinical trial. The mean values (SD) of their age, height, and weight were 70.0 years (6.0), 156.0 cm (9.1), and 72.8 kg (19.5), respectively. The participants underwent cryotherapy using bagged ice, bagged ice plus a wet towel, or gel pack for 20 minutes. The surface temperature of the skin was measured at the end ofa 20-minute cryotherapy session using an infrared thermometer. Repeated-measures analysis of variance was conducted to analyze the effect of cryotherapy modalities and time, as well as the interaction between these 2 factors. The secondary outcome wasthe presence ofcryotherapy-induced lesions. Results and Discussion: Cryotherapy modalities had significant effects on superficial skin temperature (P = .001). Time points after application also had an effect (P< .001) and no interaction was observed between cryotherapy modalities and time points (P = .051). Bonferroni post hoc evaluation showed that bagged ice (P = .008) and gel (P = .007) were more effective in decreasing the superficial skin temperature than bagged ice plus wet towel. No difference was observed between bagged ice and gel (P = .32). Three of the 18 patients experienced adverse effects with the gel pack. Conclusion: This study of older women found that ice and gel cooled the skin more effectively than ice wrapped in towels. However, the gel pack had some adverse effects. Therefore, bagged ice is recommended for cryotherapy in older women. [ABSTRACT FROM AUTHOR]

Topical ice has been shown to reduce pain scores and opioid use in adults with midline abdominal incisions. This study was designed to evaluate the efficacy of a cold therapy system in children following laparoscopic appendectomy. Patients 7 years and older who underwent laparoscopic appendectomy at our institution from December 2021–September 2022 were eligible. Patients were randomized to standard pain therapy (control) or standard plus cold therapy (treatment) utilizing a modified ice machine system with cool abdominal pad postoperatively. Pain scores on the first 3 postoperative days (PODs), postoperative narcotic consumption, and patient satisfaction were analyzed. Fifty-eight patients were randomized, 29 to each group. Average survey response rate was 74% in control and 89% in treatment patients. There was no significant difference in median pain scores or narcotic use between groups. Cold therapy contributed to subjective pain improvement in 71%, 74%, and 50% of respondents on PODs 1, 2, and 3 respectively. A majority of patients reported cold therapy to be a helpful adjunct in pain control after appendectomy, though it did not reduce postoperative pain scores or narcotic use in our cohort - likely due to this population's naturally expedient recovery and low baseline narcotic requirement. Randomized Controlled Trial. Level I. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is an underaddressed and distressing common side effect of cancer treatment. Effective management of CIPN merits a comprehensive team approach. Nurse navigators are in a unique position to provide education and support to people with CIPN and to advocate for treatment options. Objectives: To report on our experience in development and patient feedback of a CIPN clinical pathway with embedded patient education. We also report on the role of the nurse navigator in developing and implementing this project. Methods: We reviewed patient-reported outcome data to identify the incidence of CIPN in our gynecologic oncology patient population and developed a clinical pathway for management of CIPN. We also developed CIPN patient education materials and developed a process to deliver them to patients. We surveyed patients about their experience with CIPN and their satisfaction with their CIPN-related education. Results: Ten patients completed the satisfaction survey on CIPN education. Eight of 10 patients (80%) answered "Agree" or "Strongly agree" that the education was given in a timely manner. Eight of 10 patients (80%) answered that the education was easy to understand. Conclusion: Earlier identification of symptoms and awareness of resources, such as utilization of the CIPN pathway, can provide relief for people with CIPN and can minimize the effects of CIPN, leading to improved quality of life. The nurse navigator is uniquely positioned to impact the patient experience of CIPN. Next steps include evaluation of provider use of the pathway and continued tracking of patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Transplantation surgery becomes more widespread with time worldwide; organ transplantation increases the risk of developing malignancies. This phenomenon is primarily due to immunosuppressive treatment which is one of the mainstay approaches to prevent transplant rejection. It is aimed to describe clinical signs and symptoms of histologically proven ocular surface squamous neoplasia (OSSN) in renal transplant patients. Three patients, who previously underwent renal transplant surgery, diagnosed with OSSN are presented. The histopathological examination results were conclusive for squamous cell neoplasia in all cases. No recurrence in any patients was observed after total surgical excision, cryotherapy, and reconstruction with amniotic membrane. Solid organ transplant patients undergo intense immunosuppressive treatment to prevent transplant rejection. That immunosuppressive treatment increases the risk of developing secondary malignancies including OSSN. It is important to inform all transplant patients about these risks. Even though OSSN is known to be a relatively benign acting tumor that rarely metastasizes to distant organs, the clinical course might change if it develops in an immunocompromised patient. For this reason, these patients should be monitored for any formation of a mass on the ocular surface. Surgical management through complete excision can result in the complete resolution of a tumor. [ABSTRACT FROM AUTHOR]

Cryotherapy is widely used in health contexts, including first aid, treating acute musculoskeletal injuries and women undergoing chemotherapy. Studies have shown that frozen gloves can help reduce nail toxicity for women undergoing chemotherapy. Nail toxicity is a common issue among people undergoing chemotherapy, causing disfigurement and pain. Although cooling gloves have been shown to reduce nail toxicity, the range of temperatures used remains unclear, often resulting in discomfort. In this innovative study, we used a quasi-experimental, two group pretest-posttest design to evaluate the effectiveness of Chemo-Cooling Gloves developed by the researchers to help prevent nail toxicity. We assessed satisfaction with the gloves among 27 Thai women undergoing chemotherapy who were purposively recruited according to the inclusion criteria from a chemotherapy center of a university-affiliated hospital in a southern region of Thailand. Participants underwent a regimen of cyclophosphamide in combination with doxorubicin and 5-flu- orouracil every 21 days for six cycles. Each participant served as their own control, wearing the cooling glove on the one hand randomly selected, while the other hand remained unprotected and acted as the control. Data were collected using a demographic questionnaire, the Common Terminology Criteria for Adverse Events version 3.0, and the Chemo-Cooling Gloves Satisfaction Questionnaire. Data analysis utilized descriptive statistics and Cochran's Q test. The results revealed that nail toxicity was significantly lower in the protected hand than in the control hand during cycles 2 to 3 and 2 to 4, but no significant difference between the two hands during cycles 2 to 5 and 2 to 6. Overall satisfaction with the Chemo-Cooling Gloves was at the highest level. The use of frozen gloves aligns with evidence-based practice, as supported by our study. Nurses need to be trained in the proper use and application of the gloves and educate patients on the benefits and correct usage to maximize comfort and efficacy. By incorporating the Chemo-Cooling Gloves into routine practice, nurses can help improve patient adherence to chemotherapy regimens and potentially enhance treatment outcomes. [ABSTRACT FROM AUTHOR]

Facial nerve palsy is most commonly idiopathic, but it can also result from infections, inflammatory and cerebrovascular disorders, tumors, and trauma. We report the case of a 68-year-old patient who developed iatrogenic facial nerve palsy subsequent to dermatological cryosurgery on the right cheek. Remarkably, a full recovery occurred within 8 weeks. Drawing upon the promising outcome of this case and the existing literature on neuropathies linked with cold application in sports injuries, we propose neurapraxia as the probable pathomechanism underlying cryotherapy-induced nerve damage. [ABSTRACT FROM AUTHOR]

BACKGROUND: Spasticity is a common symptom of multiple sclerosis (MS), affecting 80% of patients. Many studies have aimed to detect methods to reduce spasticity under these conditions and found that spasticity can be efficiently reduced using cryotherapy. OBJECTIVE: To examine the impact of cryotherapy on spasticity among patients with MS. METHODS: Thirty-two participants were randomized into two groups. The study group was given airflow cryotherapy and a selected physical therapy program, whereas the control group was only given a selected physical therapy program. The treatment was administered three times each week for a total of twelve consecutive sessions. The outcome measures were the modified Ashworth scale and the H/M ratio. RESULTS: The study group showed significant decrease in calf muscle spasticity, indicated by a reduction in spasticity grade (p = 0.001) and a decrease in the H/M ratio of 33.81% (p = 0.001). The control group also showed significant reduction in calf muscle spasticity, as indicated by a reduction in spasticity grade (p = 0.001) and a reduction in the H/M ratio of 19.58% (p = 0.001). There was a significant decrease in the spasticity grade and H/M ratio of the study group posttreatment compared with those of the control group (p = 0.02 and p = 0.001). CONCLUSION: The combined effect of cryotherapy and a selected physical therapy program are more effective in controlling the spasticity of calf muscles in patients with MS than a selected physical therapy program alone. [ABSTRACT FROM AUTHOR]