The use of thermal imaging in assessing skin temperature following cryotherapy: a review

doi:10.1016/j.jtherbio.2011.11.008

Journal of Thermal Biology

Volume 37, Issue 2, February 2012, Pages 103-110

https://doi.org/10.1016/j.jtherbio.2011.11.008 Get rights and content

Abstract

Background

Cryotherapy is used in various clinical and sporting settings to reduce odema, decrease nerve conduction velocity, decrease tissue metabolism and to facilitate recovery after exercise induced muscle damage. The basic premise of cryotherapy is to cool tissue temperature and various modalities of cryotherapy such as whole body cryotherapy, cold spray, cryotherapy cuffs, frozen peas, cold water immersion, ice, and cold packs are currently being used to achieve this. However, despite its widespread use, little is known regarding the effectiveness of different cryotherapy modalities to reduce skin temperature.

Objectives

To provide a synopsis of the use of thermal imaging as a method of assessing skin temperature following cryotherapy and to report the magnitude of skin temperature reductions associated with various modalities of cooling.

Design

Structured narrative review.

Methods

Three electronic databases were searched using keywords and MESH headings related to the use of thermal imaging in the assessment of skin temperature following cryotherapy. A hand-search of reference lists and relevant journals and text books complemented the electronic search.

Summary

Nineteen studies met the inclusion criteria. A skin temperature reduction of 5–15 °C, in accordance with the recent PRICE (Protection, Rest, Ice, Compression and Elevation) guidelines, were achieved using cold air, ice massage, crushed ice, cryotherapy cuffs, ice pack, and cold water immersion. There is evidence supporting the use and effectiveness of thermal imaging in order to access skin temperature following the application of cryotherapy.

Conclusions

Thermal imaging is a safe and non-invasive method of collecting skin temperature. Although further research is required, in terms of structuring specific guidelines and protocols, thermal imaging appears to be an accurate and reliable method of collecting skin temperature data following cryotherapy. Currently there is ambiguity regarding the optimal skin temperature reductions in a medical or sporting setting. However, this review highlights the ability of several different modalities of cryotherapy to reduce skin temperature.

Highlights

► Ambiguity exists regarding optimal skin temperature reductions after cryotherapy. ► This article reviews the use of thermal imaging to access skin temperature. ► Several techniques are available to assess skin temperature. ► Thermal imaging is a safe and non-invasive method of collecting skin temperature. ► Information is provided regarding a number of cooling modalities.

Section snippets

Overview

Cryotherapy, the therapeutic use of cold, is applied in various clinical, rehabilitative and sporting settings to reduce odema, decrease tissue metabolism and provide analgesia (Knight, 1995). The basic premise of cryotherapy is to cool tissue temperature (Bleakley and Hopkins, 2010); various modalities such as whole body cryotherapy, cold water immersion, ice, and cold packs are currently used to achieve this. Each of these cooling modalities has a different thermal property and therefore a

Research methods

We searched Medline, Pubmed, and Science Direct search engines to identify studies that assessed skin temperature following a cryotherapy application using infrared thermal imaging. Keywords used included “thermal imaging and cryotherapy”, “thermal imaging and cooling”, “thermology and cryotherapy”, “skin temperature and cryotherapy”, “skin temperature and cooling”, and “thermology and cooling”. No restrictions were made on study design or comparison group. Due to the advent of digital

Magnitude and duration of skin tissue cooling

Physiotherapists, coaches, athletic trainers, and clinicians administer cryotherapy for numerous reasons, including the reduction of pain and swelling, to relieve muscle spasm, and to facilitate movement (Costello and Donnelly, 2011, Costello et al., In press). It has previously been suggested that cold application may relieve pain by numerous mechanisms including altered nerve conduction velocity (NCV), inhibition of nociceptors, a reduction in muscle spasm and/or a reduction in metabolic

Technical issues with the methodology of thermal imaging following cryotherapy

Hardware and analysis software produced by Flir Systems (Danderyd, Sweden) was the most commonly used in this review. In terms of the area thermographed the knee (Selfe et al., 2010, Selfe et al., 2009, Selfe et al., 2007, Kim et al., 2002, Karki et al., 2004) was the most common with five studies focusing on that joint. Other studies focused the ankle (Kennet et al., 2007), chest (Cholewka et al., in press), thigh (Hardaker et al., 2007), and back (Cholewka et al., in press, Cholewka et al.,

Advantages and limitations of infrared imaging following cryotherapy

A number of methods and devices of recoding skin temperature following the application of cryotherapy have been reported in the literature including thermocouples (Merrick et al., 2003), thermistors (Gregson et al., 2011), and other wireless sensors such as an iButton (Lichtenbelt et al., 2006). The greatest advantage of TI over these other methods of assessing skin temperature is the fact this it is non-invasive and portable. TI does not have to be in contact with the skin, an obvious

Conclusion

Thermal imaging is a safe and non-invasive method of collecting skin temperature. Although further research is required, in terms of structuring specific guidelines and protocols, thermal imaging appears to be an accurate and reliable method of collecting skin temperature data following cryotherapy. Despite the ambiguity regarding optimal skin temperature reductions in a clinician or sporting setting, this review highlights the ability of several different modalities of cryotherapy, including

Conflict of interest statement

The authors declare they have no conflict of interest on the content of this paper.

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ReviewThe use of thermal imaging in assessing skin temperature following cryotherapy: a review

Abstract

Background

Objectives

Design

Methods

Summary

Conclusions

Highlights

Section snippets

Overview

Research methods

Magnitude and duration of skin tissue cooling

Technical issues with the methodology of thermal imaging following cryotherapy

Advantages and limitations of infrared imaging following cryotherapy

Conclusion

Conflict of interest statement

Int. J. Heat Mass Trans.

Phys. Med.

Diabetes Res. Clin. Pract.

Arch. Phys. Med. Rehabilitat.

Phys. Ther. Sport

The Knee

Efficacy of cold gel for soft tissue injuries

Am. J. Sports Med.

The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance

British J.Sports Med.

The Glamorgan Protocol for recording and evaluation of thermal images of the human body

Thermol. Int.

Guidelines for the management of acute soft tissue injury using Protection, Rest, Ice, Compression and Elevation

Is it possible to achieve optimal levels of tissue cooling in cryotherapy?

Phys. Ther. Rev.

Temperature effects of whole body cryotherapy determined by termography

Thermol. Int.

Thermovision diagnostics in chosen spine diseases treated by whole body cryotherapy

J. Therm. Anal. Calorim.

Effects of cold water immersion on knee joint position sense in healthy volunteers

J. Sports Sci.

Cold urticaria following an ice application: a case study

Clin. J. Sports Med.

Effect of whole body cryotherapy with spinal decompression on cervical disc herniation by digital infrared thermal imaging

J. Phys. Ther. Sci.

Influence of cold water immersion on limb and cutaneous blood flow at rest

Am. J. Sports Med.

Relationship between intramuscular temperature and skin surface temperature as measured by thermal imaging camera

Thermol. Int.

Breast thermography

Cancer

Review
The use of thermal imaging in assessing skin temperature following cryotherapy: a review