Cryotherapy involves the surface application of low temperatures to enhance the healing of soft tissue injuries. Typical devices embody a remote source of chilled water that is pumped through a circulation bladder placed on the treatment site. In contrast, the present device uses thermoelectric refrigeration modules to bring the cooling source directly to the tissue to be treated, thereby achieving significant improvements in control of therapeutic temperature while having a reduced size and weight. A prototype system was applied to test an oscillating cooling and heating protocol for efficacy in regulating skin blood perfusion in the treatment area. Data on 12 human subjects indicate that thermoelectric coolers (TECs) delivered significant and sustainable changes in perfusion for both heating (increase by (±SE) 173.0 ± 66.0%, P < 0.005) and cooling (decrease by (±SE) 57.7 ± 4.2%, P < 0.0005), thus supporting the feasibility of a TEC-based device for cryotherapy with local temperature regulation.
Issue Section:
Technical Brief
Topics:
Biological tissues,
Blood,
Blood flow,
Cooling,
Skin,
Temperature,
Thermoelectric coolers,
Heating
References
1.
Barber
, F. A.
, 2000
, “A Comparison of Crushed Ice and Continuous Flow Cold Therapy
,” Am. J. Knee Surg.
, 13
(2
), pp. 97
–101
.2.
Warren
, T. A.
, 2004
, “Intra-Articular Knee Temperature Changes: Ice Versus Cryotherapy Device
,” Am. J. Sports Med.
, 32
(2
), pp. 441
–445
.3.
Airaksinen
, O. V.
, Kyrklund
, N.
, Latvala
, K.
, Kouri
, J. P.
, Grönblad
, M.
, and Kolari
, P.
, 2003
, “Efficacy of Cold Gel for Soft Tissue Injuries a Prospective Randomized Double-Blinded Trial
,” Am. J. Sports Med.
, 31
(5
), pp. 680
–684
.4.
Kanlayanaphotporn
, R.
, and Janwantanakul
, P.
, 2005
, “Comparison of Skin Surface Temperature During the Application of Various Cryotherapy Modalities
,” Arch. Phys. Med. Rehabil.
, 86
(7
), pp. 1411
–1415
.5.
Schaser
, K.-D.
, Disch
, A. C.
, Stover
, J. F.
, Lauffer
, A.
, Bail
, H. J.
, and Mittlmeier
, T.
, 2007
, “Prolonged Superficial Local Cryotherapy Attenuates Microcirculatory Impairment, Regional Inflammation, and Muscle Necrosis After Closed Soft Tissue Injury in Rats
,” Am. J. Sports Med.
, 35
(1
), pp. 93
–102
.6.
Abramson
, D. I.
, Chu
, L. W.
, Tuck
, S.
, Jr.
, Lee
, S. W.
, Richardson
, G.
, and Levin
, M.
, 1966
, “Effect of Tissue Temperatures and Blood Flow on Motor Nerve Conduction Velocity
,” JAMA, J. Am. Med. Assoc.
, 198
(10
), pp. 1082
–1088
.7.
Ashworth
, N. L.
, Marshall
, S. C.
, and Satkunam
, L. E.
, 1998
, “The Effect of Temperature on Nerve Conduction Parameters in Carpal Tunnel Syndrome
,” Muscle Nerve
, 21
(8
), pp. 1089
–1091
.8.
Hubbard
, T. J.
, and Denegar
, C. R.
, 2004
, “Does Cryotherapy Improve Outcomes With Soft Tissue Injury?
,” J. Athletic Train.
, 39
(3
), pp. 278
–279
.9.
Khoshnevis
, S.
, Nordhauser
, J. E.
, Craik
, N. K.
, and Diller
, K. R.
, 2014
, “Quantitative Evaluation of the Thermal Heterogeneity on the Surface of Cryotherapy Cooling Pads
,” ASME J. Biomech. Eng.
, 136
(7
), p. 074503
.10.
Khoshnevis
, S.
, Craik
, N. K.
, and Diller
, K. R.
, 2014
, “Cold-Induced Vasoconstriction May Persist Long After Cooling Ends: An Evaluation of Multiple Cryotherapy Units
,” Knee Surg. Sports Traumatol. Arthroscopy
(in press).11.
Khoshnevis
, S.
, Craik
, N.
, and Diller
, K.
, “Experimental Characterization of the Domains of Coupling and Uncoupling Between Surface Temperature and Skin Blood Flow
,” Int. J. Transp. Phenom.,
13
(4), pp. 277
–301
.12.
Anson
, J. A.
, McCormick
, J.
, and Zambramski
, J. M.
, 1992
, “Oxygen Dissociation Characteristics of Hemoglobin and Blood Substitute in Relation to Temperature
,” BNI Q.
, 8
, pp. 35
–42
.13.
Waugh
, R.
, and Evans
, E. A.
, 1979
, “Thermoelasticity of Red Blood Cell Membrane
,” Biophys. J.
, 26
(1
), pp. 115
–131
.14.
Large
, A.
, and Heinbecker
, P.
, 1944
, “Nerve Degeneration Following Prolonged Cooling of an Extremity
,” Ann. Surg.
, 120
(5
), pp. 742
–749
.15.
Kennett
, R. P.
, and Gilliatt
, R. W.
, 1991
, “Nerve Conduction Studies in Experimental Non-Freezing Cold Injury: II. Generalized Nerve Cooling by Limb Immersion
,” Muscle Nerve
, 14
(10
), pp. 960
–967
.16.
Francis
, T. J.
, and Golden
, F. S.
, 1985
, “Non-Freezing Cold Injury: The Pathogenesis
,” J. R. Nav. Med. Serv.
, 71
(1
), pp. 3
–8
.17.
Jia
, J.
, and Pollock
, M.
, 1997
, “The Pathogenesis of Non-Freezing Cold Nerve Injury. Observations in the Rat
,” Brain J. Neurol.
, 120
(Pt. 4
), pp. 631
–646
.18.
Thomas
, J. R.
, and Oakley
, E. H. N.
, 2002
, “Nonfreezing Cold Injury
,” Medical Aspects of Harsh Environments
(The Textbooks of Military Medicine
, Vol. 1), United States Department of Defense, Washington, DC, pp. 467
–490
.19.
Johnson
, J. M.
, and Kellogg
, D. L.
, 2010
, “Local Thermal Control of the Human Cutaneous Circulation
,” J. Appl. Physiol.
, 109
(4
), pp. 1229
–1238
.20.
Music
, M.
, Finderle
, Z.
, and Cankar
, K.
, 2011
, “Cold Perception and Cutaneous Microvascular Response to Local Cooling at Different Cooling Temperatures
,” Microvasc. Res.
, 81
(3
), pp. 319
–324
.21.
Goldsmid
, H. J.
, 2009
, Introduction to Thermoelectricity
, Springer
, New York.22.
Putra
, N.
, Ardiyansyah, Sukyono
, W.
, Johansen
, D.
, and Iskandar
, F. N.
, 2010
, “The Characterization of a Cascade Thermoelectric Cooler in a Cryosurgery Device
,” Cryogenics
, 50
(11–12
), pp. 759
–764
.23.
Rothman
, S. M.
, Smyth
, M. D.
, Yang
, X.-F.
, and Peterson
, G. P.
, 2005
, “Focal Cooling for Epilepsy: An Alternative Therapy That Might Actually Work
,” Epilepsy Behav.
, 7
(2
), pp. 214
–221
.24.
Henriques
, F. C.
, and Moritz
, A. R.
, 1947
, “Studies of Thermal Injury
,” Am. J. Pathol.
, 23
(4
), pp. 530
–549
.25.
Diller
, K. R.
, 2006
, “Stress Protein Expression Kinetics
,” Annu. Rev. Biomed. Eng.
, 8
(1
), pp. 403
–424
.26.
Moor Instruments
, 2013
, “MoorVMS-LDF Specifications
,” Moor Instruments, Devon, UK, accessed Apr. 09, 2013, http://gb.moor.co.uk/product/moorvms-ldf-laser-doppler-monitor/1/o/14/specifications27.
Fleiss
, J. L.
, 1999
, Design and Analysis of Clinical Experiments
, Wiley-Interscience
, New York
.28.
Khoshnevis
, S.
, Craik
, N. K.
, Brothers
, R. M.
, and Diller
, K. R.
, “Cryotherapy-Induced Persistent Vasoconstriction After Cutaneous Cooling: Hysteresis Between Skin Temperature and Blood Perfusion
,” Eur. J. Appl. Physiol.
(in press).Copyright © 2015 by ASME
You do not currently have access to this content.
