Turkiye Klinikleri Journal of Sports Sciences

.: ORIGINAL RESEARCH
The Effects of Local Hot and Cold Applications on Knee Joint Position Sense in Non-Elite Athletes: Experimental Study
Elit Olmayan Sporcularda Lokal Sıcak ve Soğuk Uygulamaların Diz Eklemi Pozisyon Duyusuna Etkisi: Deneysel Çalışma
Muhammet ÖZERa, Muammer ALTUNb, Haydar KAYNAKb, Nuri KARABULUTa, Devrim AKSEKİc
aDepartment of Physical Education and Sports Teaching, Uşak University Faculty of Sports Sciences, Uşak, Türkiye
bDepartment of Coaching Education, Manisa Celal Bayar University Faculty of Sports Sciences, Manisa, Türkiye
cDepartment of Orthopedics and Traumatology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
Turkiye Klinikleri J Sports Sci. 2022;14(2):135-41
doi: 10.5336/sportsci.2021-86526
Article Language: EN
Full Text
ABSTRACT
Objective: Many athletes who are slightly injured and have pain during the game return to play immediately after a short cold application. However, athletes who have recently recovered from injury and still have hot applications also enter the play in a controlled manner when necessary. This study aimed to explore the specific effects of hot and cold applications on active joint position sense (JPS). Material and Methods: Twenty-seven (14 males and 13 females) athletes without any injury or complaint related to the knee participated in this study. JPS measurements were repeated for both knees at target angles of 15°, 30°, 45°, and 60°, before and immediately after the hot application. One week later, the same tests were repeated with cold application. Local cooling and heating were applied for 15 min, by using gel-packs at 0°C and 44°C. Results: JPS was not affected by extremity dominance. The main effect of gender was significant only in 60°, and females made lower errors. Although no differences were observed before the hot and cold application, the absolute errors in all angles were higher for the cold than for the no-cold condition and lower for hot than the no-hot condition. Significant difference levels were at 15°, 30°, 45°, and 60° after the cold application, and at 45° and 60° after the hot application. Absolute errors increased as the target angle increased in all conditions. Conclusion: Results showed that hot application improves the proprioceptive quality of the knee joint in athletes, but cold application deteriorates.

Keywords: Joint position sense; hot application; cold application; knee proprioception
ÖZET
Amaç: Oyun sırasında hafif yaralanan ve ağrıları olan birçok sporcu kısa bir soğuk uygulamadan hemen sonra oyuna döner. Öte yandan sakatlığı yeni atlatan ve hâlen sıcak uygulamaları olan sporcular da gerektiğinde kontrollü bir şekilde oyuna dönerler. Bu çalışma, sıcak ve soğuk uygulamaların aktif eklem pozisyon hissi 'joint position sense (JPS)' üzerindeki spesifik etkilerini araştırmayı amaçladı. Gereç ve Yöntemler: Bu çalışmaya diz ile ilgili herhangi bir yaralanma veya şikâyeti olmayan 27 (14 erkek ve 13 kadın) sporcu katıldı. Sıcak uygulamadan önce ve hemen sonra 15°, 30°, 45° ve 60° hedef açılarında her iki diz için JPS ölçümleri tekrarlandı. Bir hafta sonra aynı testler soğuk uygulama ile tekrarlandı. 0°C ve 44°C'de jel paketleri kullanılarak 15 dk boyunca lokal soğutma ve ısıtma uygulandı. Bulgular: JPS ekstremite baskınlığından etkilenmedi. Cinsiyetin ana etkisi sadece 60°de anlamlıydı ve kadınlar daha az hata yaptı. Sıcak ve soğuk uygulama öncesinde herhangi bir farklılık görülmemesine rağmen tüm açılardaki mutlak hatalar, soğukta soğuk olmayan duruma göre daha yüksek, sıcak için ise sıcak olmayan duruma göre daha düşüktü. Soğuk uygulamadan sonra 15°, 30°, 45° ve 60°de, sıcak uygulamadan sonra 45° ve 60°de önemli fark seviyeleri olmuştur. Her koşulda hedef açısı arttıkça mutlak hatalar arttı. Sonuç: Sonuçlar, sporcularda sıcak uygulamanın diz ekleminin propriyoseptif kalitesini iyileştirdiğini ancak soğuk uygulamanın bozduğunu gösterdi.

Anahtar Kelimeler: Eklem pozisyon duyusu; sıcak uygulama; soğuk uygulama; diz propriyosepsiyonu
REFERENCES:
  1. Bleakley CM, Costello JT, Glasgow PD. Should athletes return to sport after applying ice? A systematic review of the effect of local cooling on functional performance. Sports Med. 2012;42(1):69-87. [Crossref]  [PubMed] 
  2. Oliveira R, Ribeiro F, Oliveira J. Cryotherapy impairs knee joint position sense. Int J Sports Med. 2010;31(3):198-201. [Crossref]  [PubMed] 
  3. Lehmann JF, De Lateur BJ. Therapeutic heat. In: Lehmann JF, ed. Therapeutic Heat and Cold. 4th ed. Baltimore: Williams and Wilkins; 1990. p.417-562.
  4. Wenger CB, Hardy JD. Temperature regulation and exposure to heat and cold. In: Lehmann JF, ed. Therapeutic Heat and Cold. 4th ed. Baltimore: Williams and Wilkins; 1990. p.150-78.
  5. Mense S. Effects of temperature on the discharges of muscle spindles and tendon organs. Pflugers Arch. 1978;374(2):159-66. [Crossref]  [PubMed] 
  6. Troni W, Demattei M, Contegiacomo V. The effect of temperature on conduction velocity in human muscle fibers. J Electromyogr Kinesiol. 1991;1(4):281-7. [Crossref]  [PubMed] 
  7. Kramer JF. Effect of therapeutic ultrasound intensity on subcutaneous tissue temperature and ulnar nerve conduction velocity. Am J Phys Med. 1985;64(1):1-9. [PubMed] 
  8. Herrera E, Sandoval MC, Camargo DM, Salvini TF. Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion. Phys Ther. 2010;90(4):581-91. [Crossref]  [PubMed] 
  9. Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med. 2007; 41(6):365-9; discussion 369. [Crossref]  [PubMed]  [PMC] 
  10. Todnem K, Knudsen G, Riise T, Nyland H, Aarli JA. The non-linear relationship between nerve conduction velocity and skin temperature. J Neurol Neurosurg Psychiatry. 1989; 52(4):497-501. [Crossref]  [PubMed]  [PMC] 
  11. Uchio Y, Ochi M, Fujihara A, Adachi N, Iwasa J, Sakai Y. Cryotherapy influences joint laxity and position sense of the healthy knee joint. Arch Phys Med Rehabil. 2003;84(1):131-5. [Crossref]  [PubMed] 
  12. Kaynak H, Altun M, Özer M, Akseki D. Effect of hot and cold applications on elbow proprioception. Gazz Medica Ital Arch per le Sci Mediche. 2019;178(4):177-181. [Crossref] 
  13. Ozmun JC, Thieme HA, Ingersoll CD, Knight KL. Cooling does not affect knee proprioception. J Athl Train. 1996;31(1):8-11. [PubMed]  [PMC] 
  14. Dover G, Powers ME. Cryotherapy does not impair shoulder joint position sense. Arch Phys Med Rehabil. 2004;85(8):1241-6. [Crossref]  [PubMed] 
  15. Hopper D, Whittington D, Davies J. Does ice immersion influence ankle joint position sense? Physiother Res Int. 1997;2(4):223-36. Erratum in: Physiother Res Int 1998;3(1):iii. Chartier JD [corrected to Davies J]. [Crossref]  [PubMed] 
  16. Furmanek MP, Słomka KJ, Sobiesiak A, Rzepko M, Juras G. The effects of cryotherapy on knee joint position sense and force production sense in healthy individuals. J Hum Kinet. 2018;61:39-51. [Crossref]  [PubMed]  [PMC] 
  17. Altun M. Effects of local cold applications to leg muscles and knee joint on 30-m sprint performance. Gazz Medica Ital Arch per le Sci Mediche. 2017;176(4):154-61. [Crossref] 
  18. Altun M, Kaynak H, Unal M, Özer M, Akseki D. Effect of hot and cold applications on jump performance. Turkiye Klin J Sport Sci. 2014;6(1):14-23. [Link] 
  19. Wassinger CA, Myers JB, Gatti JM, Conley KM, Lephart SM. Proprioception and throwing accuracy in the dominant shoulder after cryotherapy. J Athl Train. 2007;42(1):84-9. [PubMed]  [PMC] 
  20. Costello JT, Donnelly AE. Cryotherapy and joint position sense in healthy participants: a systematic review. J Athl Train. 2010;45(3): 306-16. [Crossref]  [PubMed]  [PMC] 
  21. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;(198):43-9. [Crossref]  [PubMed] 
  22. Jerosch J, Prymka M. Knee joint proprioception in normal volunteers and patients with anterior cruciate ligament tears, taking special account of the effect of a knee bandage. Arch Orthop Trauma Surg. 1996;115(3-4):162-6. [Crossref]  [PubMed] 
  23. Jerosch J, Prymka M. Knee joint proprioception in patients with posttraumatic recurrent patella dislocation. Knee Surg Sports Traumatol Arthrosc. 1996;4(1):14-8. [Crossref]  [PubMed] 
  24. Akseki D, Akkaya G, Erduran M, Pinar H. Patellofemoral ağri sendromunda diz ekleminin propriyosepsiyonu [Proprioception of the knee joint in patellofemoral pain syndrome]. Acta Orthop Traumatol Turc. 2008;42(5):316-21. Turkish. [Crossref]  [PubMed] 
  25. Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg Br. 1991;73(1):53-6. [Crossref]  [PubMed] 
  26. Marks R. Repeatability of position sense measurements in persons with osteoarthritis of the knee: a pilot study. Clin Rehabil. 1995; 9(4):314-9. [Crossref] 
  27. Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: A critical review of methods. J Sport Health Sci. 2016;5(1):80-90. [Crossref]  [PubMed]  [PMC] 
  28. Olsson L, Lund H, Henriksen M, Rogind H, Bliddal H, Danneskiold-Samsøe B. Test-retest reliability of a knee joint position sense measurement method in sitting and prone position. Adv Physiother. 2004;6(1):37-47. [Crossref] 
  29. Serinken MA, Gençoğlu C, Kayatekin BM. The effect of eccentric exercise-induced delayed-onset muscle soreness on positioning sense and shooting percentage in wheelchair basketball players. Balkan Med J. 2013;30(4): 382-6. [Crossref]  [PubMed]  [PMC] 
  30. Kaynak H, Altun M, Özer M, Akseki D. Sporda propriosepsiyon ve sıcak-soğuk uygulamalarla ilişkisi [Proprioception in Sport and Its Relations with Hot and Cold Applications]. CBÜ Beden Eğitimi ve Spor Bilim Derg. 2015;10(1):10-35. [Link] 
  31. Barrack RL, Skinner HB, Brunet ME, Cook SD. Joint kinesthesia in the highly trained knee. J Sports Med Phys Fitness. 1984;24(1):18-20. [PubMed] 
  32. Surenkok O, Aytar A, Tüzün EH, Akman MN. Cryotherapy impairs knee joint position sense and balance. Isokinet Exerc Sci. 2008; 16(1):69-73. [Crossref] 
  33. Yanagisawa O, Homma T, Okuwaki T, Shimao D, Takahashi H. Effects of cooling on human skin and skeletal muscle. Eur J Appl Physiol. 2007;100(6):737-45. [Crossref]  [PubMed] 
  34. Hardaker N, Moss AD, Richards J, Jarvis S, McEwan I, Selfe J. Relationship between intramuscular temperature and skin surface temperature as measured by thermal imaging camera. Thermol Int. 2007;17(1):45-50. [Link] 
  35. Alexander J, Selfe J, Oliver B, Mee D, Carter A, Scott M, et al. An exploratory study into the effects of a 20 minute crushed ice application on knee joint position sense during a small knee bend. Phys Ther Sport. 2016;18:21-6. [Crossref]  [PubMed] 
  36. Ribeiro F, Moreira S, Neto J, Oliveira J. Is the deleterious effect of cryotherapy on proprioception mitigated by exercise? Int J Sports Med. 2013;34(5):444-8. [Crossref]  [PubMed] 
  37. Magalhães T, Ribeiro F, Pinheiro A, Oliveira J. Warming-up before sporting activity improves knee position sense. Phys Ther Sport. 2010; 11(3):86-90. [Crossref]  [PubMed] 
  38. Herrington L. Knee-Joint position sense: the relationship between open and closed kinetic chain tests. J Sport Rehabil. 2005;14(4):356-62. [Crossref] 
  39. Kaynak H, Altun M, Tok S. Effect of force sense to active joint position sense and relationships between active joint position sense, force sense, jumping and muscle strength. J Mot Behav. 2020;52(3):342-51. [Crossref]  [PubMed] 

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