COMPARISON OF CRYOTHERAPY MODALITY APPLICATION OVER THE ANTERIOR THIGH ACROSS RUGBY UNION POSITIONS; A CROSSOVER RANDOMIZED CONTROLLED TRIAL.

Abstract

Background: In deliberation of the diverse physical traits of rugby union and the known interference adipose tissue has on the ability to cool deeper tissues, evidence is required to understand the effect of cryotherapy modalities to provide optimum outcomes post-injury. Purpose: To investigate differences in the cooling ability of three different cryotherapy modalities in a rugby union population in an attempt to describe optimum cooling protocols for the anterior thigh. Study Design: Within-subjects randomized control crossover. Methods: Twenty-one healthy male rugby union players took part. Skin surface temperature measured via thermal imaging camera (ThermoVision A40M, Flir Systems, Danderyd, Sweden) alongside Thermal Comfort and Sensation questionnaires following interventions of either Wetted Ice (WI), Crushed Ice (CI) applied in a polythene bag secured by plastic wrap, or CryoCuff® (CC), applied for 20-minutes over the anterior thigh. Participants were grouped by their typical playing position for the sport of rugby union; i.e. forwards and backs. Results: Significant differences (p=<0.05) in Tsk for all modalities compared to baselineand comparing post Tsk between CI and CC (p=0.01) and WI to CC (p=0.01) were displayed. Significantly greater reductions in Tsk noted immediately-post in the ‘forwards’ group (p=≤0.05) compared to the ‘backs’ group for, all modalities (p=≤0.05). Thermal Comfort and Sensation scores demonstrated significant changes baseline compared to post for all modalities (p=<0.05). No significant differences were found when comparing between modalities for Thermal Comfort (p=0.755) or Sensation (p=0.225) for whole group or between positional groups. Conclusions: Physiological responses to cooling differed across modalities with WI producing the greatest decrease in Tsk. Significant variability in Tsk was also displayed between positional factions. Results uphold the importance of the individualization of local cooling protocols when considering physical traits and characteristics within a rugby union population. Findings provide further understanding of the physiological responses to cooling through Tsk quantification in specific populations, helping to guide sports medicine practitioners on optimal cooling application development in sport. Level of Evidence: Level 2b.