Search Results (7)

Background/Objectives: Knee osteoarthritis (KOA) is a degenerative joint disease typically managed with conservative treatments, such as anti-inflammatory medications and intra-articular hyaluronic acid injections; however, advanced cases may eventually require surgical intervention. Recently, cooled radiofrequency ablation (CRFA) has emerged as a novel treatment option for alleviating KOA-related pain by temporarily disabling pain-transmitting nerves. This study evaluated the short-term effects of CRFA on pain relief and walking ability in KOA patients, with a specific focus on functional improvements in walking capacity. Methods: This study included 58 patients (71 knees) with KOA who underwent CRFA after experiencing inadequate pain control with conservative treatments. The cohort consisted of 28 men and 30 women, with a mean age of 75.2 years (55–90). Under ultrasound guidance, CRFA was performed on the superior lateral geniculate nerve, superior medial geniculate nerve, and inferior medial geniculate nerve, with each targeted nerve ablated. Pre- and post-procedural evaluations (one month after CRFA) included assessments of visual analog scale (VAS) scores for pain at rest and during walking, range of motion (ROM), knee extensor strength, walking speed, and gait stability. Results: Significant improvements in the mean VAS (rest/walking) and mean walking speed (comfortable/maximum) were observed following CRFA. However, no significant changes were noted in ROM, knee extensor strength, or walking stability. Conclusions: These findings suggest that rehabilitation may be essential to further enhance walking stability. Overall, CRFA appears to be a promising short-term treatment option for reducing VAS pain scores and enhancing walking speed in patients with KOA. Full article

We compared the effect of bilateral knee joint cooling with or without a pre-cooling warm-up on sprint cycling performance to a non-cooling control condition. Seventeen healthy young males (25 ± 2 years, 174 ± 6 cm, 70 ± 9 kg) performed three conditions in a counterbalanced order (condition 1: warming + cooling + cycling; condition 2: cooling + cycling; condition 3: cycling). For warming, a single set of cycling intervals (a 10 s sprint with maximal effort followed by a 180 s active recovery; resistive load 4% and 1% body mass for sprint and recovery, respectively) was performed. For cycling, five sets of cycling intervals were performed. For cooling, 20 min of bilateral focal knee joint cooling was applied. Peak and average values of anaerobic capacity and wheel cadence during each set across conditions were statistically compared. There was no condition effect over set (condition × set) in anaerobic capacity (F_8,224 < 1.49, p > 0.16) and wheel cadence (F_8,224 < 1.48, p > 0.17). Regardless of set (condition effect: F_2,224 > 8.64, p < 0.0002), conditions 1 and 2 produced higher values of anaerobic capacity (p ≤ 0.05). Similarly (condition effect: F_2,224 > 4.62, p < 0.02), condition 1 showed higher wheel cadence (p < 0.02) than condition 3. A bilateral joint cooling for 20 min with or without pre-cooling warm-up may improve overall sprint cycling capacity during five sets of cycling intervals when compared to the non-cooling condition. Full article

We investigated the effect of ten-sessions (with or without receiving modalities) of training and 4-weeks of detraining in individuals with anterior knee pain (AKP). Thirty patients with AKP (19 males; 11 females; pain duration: 46 months) were randomly assigned to either a rehabilitation program (with or without pre-exercise modality). Quadriceps (strength, activation, power, and endurance) and self-reported functions (pain perception and functional outcomes) were recorded pre- and post-rehabilitation and detraining (4-weeks). The application of electro-cryotherapy did not produce a summative effect on quadriceps or self-reported functions (condition × time: F_2,56 < 2.27, p > 0.11 for all tests). Regardless of the modality application (time effect), quadriceps (strength: 12%, p = 0.06; power: 20%, p = 0.006; endurance: 13%, p = 0.0002) and self-reported (pain perception during daily activities: −70%, p < 0.0001; at least: −44%, p = 0.04; at worst: −43%, p < 0.0001; functional outcome scores: 13%, p = 0.0003) functions improved after ten sessions of rehabilitation. The improved values were maintained after 4-weeks of detraining, but functional outcome scores showed an 8% further increase (p = 0.02). Regardless of electro-cryotherapy application prior to voluntary exercises at each session, quadriceps and self-reported function improved after ten sessions of rehabilitation for AKP. Improved functioning lasted throughout a 4-week detraining period. Full article

Although local cryotherapy (LC) is performed with various cooling agents (C_Ag) such as ice, water, and gasses, in clinical practice, it is mostly performed with cooling gasses. Presently, LC with cooling gasses is very popular but the inference about the thermal (stimulus) effect on the tissues is mainly based on research carried out using ice packs. The proposed objective of the study was to evaluate the dynamics of temperature changes in the knee joint area in response to a 3-min exposure to liquid nitrogen vapors (LNVs), cold air (CA) and ice bag (IB). The study group included 23 healthy volunteers with an average age of 26.67 ± 4.56. The exposed (ROI_E) and contralateral (ROI_NE) areas of the knee joint after exposure to C_Ag were observed. Immediately after 3 min of LC, the ROI_E temperature dropped by 10.11 ± 0.91 °C after LNV, 7.59 ± 0.14 °C after IB and 6.76 ± 1.3 °C after CA. Significant tissue cooling was maintained up to 15 min after LNV (p < 0.01), 10 min after IB (p < 0.05) and 5 min after CA (p < 0.05). LC causes significant temperature changes both in ROI_E and ROI_NE. The greatest cooling potential was demonstrated for LNV and the lowest for CA. Full article

Recent evidence suggests an innovative approach to muscle conditioning: focal knee joint cooling (FKJC) appears to improve quadriceps function, including static (isometric) strength. However, there is limited evidence on the effects of FKJC on dynamic (concentric and eccentric) strength. Thus, the purpose of the study was to examine dynamic quadriceps strength following FKJC as well as static strength. Twenty-one college-aged participants volunteered. They randomly underwent 20 min of FKJC and control condition at least 72 h apart. FKJC involves two ice bags, placed on the anterior and posterior surfaces of the knee, whereas the control condition received a plastic ice bag filled with candy corn. We assessed isometric and isokinetic (concentric and eccentric) quadriceps strength at two different velocities (60°/s and 180°/s). Participants performed three maximal voluntary contractions for each mode of muscle contraction, before and after each treatment (immediately, 20, and 40 min after). The outcome variable was maximum knee extension peak torque. FKJC did not change peak torque during any mode of muscle contraction (p > 0.05). The current findings suggest that 20 min of FKJC does not change static (isometric) or dynamic (isokinetic) strength of the quadriceps. FKJC was neither beneficial nor harmful to static or dynamic muscular strength. Full article

A 41-year-old active (exercising >600 min per week) male without a surgical history complained of nine years of intermittent bilateral anterior knee pain after physical activity. He was diagnosed with bilateral chondromalacia (grade IV chondrosis) with plica syndrome, for which he underwent bilateral patella cartilage debridement with medial plica excision (additional removal of lateral retinaculum in the right knee). The patient then performed 12 weeks of an aggressive postoperative rehabilitation program. Each rehabilitation session consisted of disinhibitory modalities (sensory level of transcutaneous electrical stimulation and cryotherapy: focal knee joint cooling and cold-water immersion) and voluntary exercises (aerobic, resistance, and flexibility). During rehabilitation, pain perception, knee joint skin temperature and circumference, and functional outcome measures (Kujala anterior knee pain scale, International Knee Documentation Committee Score, and lower-extremity functional scale) were also recorded. While the patient’s pathology and surgical intervention were not extreme, progressions in the rehabilitation components and functional outcome measures in this clinical case could be used as a future reference for postoperative interventions. Additionally, surgery-induced inflammation seemed to last for four weeks. Full article

Rehabilitation using cryotherapy has widely been used in inflammatory diseases to relieve pain and decrease the disease activity. The aim of this study was to explore the metabolite changes in inflammatory knee-joint synovial fluids following local cryotherapy treatment (ice or cold CO₂). We used proton nuclear magnetic resonance (¹H NMR) spectroscopy to assess the metabolite patterns in synovial fluid (SF) in patients with knee arthritis (n = 46) before (D0) and after (D1, 24 h later) two applications of local cryotherapy. Spectra from aqueous samples and organic extracts were obtained with an 11.75 Tesla spectrometer. The metabolite concentrations within the SF were compared between D1 and D0 using multiple comparisons with the application of a false discovery rate (FDR) adjusted at 10% for each metabolite. A total of 32 metabolites/chemical structures were identified including amino acids, organic acids, fatty acids or sugars. Pyruvate, alanine, citrate, threonine was significantly higher at D1 vs D0 (p < 0.05). Tyrosine concentration significantly decreases after cryotherapy application (p < 0.001). We did not observe any effect of gender and cooling technique on metabolite concentrations between D0 and D1 (p > 0.05). The present study provides new insight into a short-term effect of cold stimulus in synovial fluid from patients with knee arthritis. Our observations suggest that the increased level of metabolites involved in energy metabolism may explain the underlying molecular pathways that mediate the antioxidant and anti-inflammatory capacities of cryotherapy. Full article