The effect of cryotherapy on postural stabilization assessed by standardized horizontal perturbations of a movable platform.

Background: Cryotherapy is a frequently used therapy in the acute treatment of sports injuries, although it has possible negative effects on dynamic postural stabilization.

Research Question: What is the effect of cryotherapy on the postural stabilization assessed by imposed platform perturbations?

Methods: Twenty-four healthy participants (15 male, 9 female) performed 2 test sessions (before and after cryotherapy) consisting of 4 trials each. Each trial included 30 s single leg stance (SLS) on both legs and 4 testing blocks (2 for each leg) of 30 s for the dynamic testing. A single testing block comprised 4 perturbations. After the first session, cryotherapy was applied to the right leg by placing it in ice water at a temperature between 10 °C and 12 ° for 20 min.

Outcome Measures: We assessed the Center of Pressure speed (CoPs) and the mean force variation for both static and dynamic tests. Additionally, the Time To Stability (TTS) was calculated for the perturbations.

Results: In the static trials there was an interaction between leg and session present for the mean force variation (p = 0.01) with a large η of 0.24, which shows higher variation of vertical force after application of the cryotherapy on the right leg. During the dynamic trials we found an interaction between leg and session for the TTS suggesting increase of the TTS due to the cryotherapy (p = 0.04), with a large η of 0.17. No interaction effect was present for the CoPs in the mediolateral and anteroposterior direction (p = 0.62 and p = 0.12, respectively).

Significance: Cryotherapy applied to the lower extremity results in a worse postural stabilization when assessed by platform perturbations. This might be the result of an altered balance strategy, due to impaired proprioception from the affected body part. More research is needed to examine the duration of this effect.

Level Of Evidence: Level 3, associative study.