The Effect of Brief Skin Cooling on Isometric Muscle Strength

The Effect of Brief Skin Cooling on Isometric Muscle Strength and the Neuronal Mechanism Underlying This Effect

There is sympathetic innervation of the muscular spindle. The application of cold to the skin provides an increase in sympathetic activity. In rehabilitation practice, short-term local cold is applied to the skin to provide motor facilitation. The aim of this study was to examine whether short-term local cold application provides an increase in isometric contractile strength and, if so, whether this effect is related to muscle spindle activity.

Study Overview

• Status: Completed
• Conditions: Cryotherapy Effect
• Intervention / Treatment: Procedure: Cheer; Procedure: The cold pressure test

Detailed Description

Cold application is frequently used in sports medicine and rehabilitation due to its beneficial effects on the neuromuscular system. Its main beneficial effects are facilitating muscle contraction (motor facilitation), increasing isometric muscle force formation and reducing spasticity. The motor effects of cold application may vary depending on the application time, cooling agent (ice, ice water, cooling spray, etc.) and subcutaneous fatty tissue thickness. Short-term cold application can increase contraction force through motor facilitation. As the duration of cold application increases, the effects of cold that inhibit motor functions, such as gamma motor neuron inhibition, muscle spindle inhibition, and muscle conduction block, come to the fore. With this effect, it is used in the treatment of spasticity.

Neurophysiological studies to explain the motor effects of cold application have generally focused on the monosynaptic muscle spindle-based reflex. The monosynaptic muscle spindle-based reflex activates muscle spindles and stimulates alpha motor neurons via Group Ia afferent nerves. This effect is also known as the servo-motor (servo-assistance) effect of the muscle spindle. The increase in the sensitivity of the muscle spindle can provide motor facilitation by strengthening the servo-assistance effect.

It has been shown that the muscle spindle has sympathetic innervation. It has been shown that the cold stress test can be an alternative to the classical autonomic nerve test and can be used to test sympathetic system activation. Additionally, studies have shown that cold stress test, mental arithmetic, isometric contraction and muscle ischemia cause an increase in muscle spindle sensitivity through increased sympathetic activity.

A literature review has shown that there is no study examining the mechanism underlying the effect of local cold application on motor facilitation. Demonstrating the effect of local cold application on increasing maximum contraction force through muscle spindle sensitivity is also important for clinical applications to be more effective and efficient. The aim of this study was to examine whether short-term local cold application increases isometric contraction force and, if there is an increase, whether this effect is related to muscle spindle activity.

• Study Type: Interventional
• Enrollment (Actual): 15
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34173
    • Istanbul Physical Medicine Rehabilitation Training & Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being healthy
• Being a young adult (20-45 years old)
• Volunteer

Exclusion Criteria:

• Scar, dermatitis, etc. in the skin tissue where the surface electromyography electrode will be placed
• Upper extremity bone and joint disease, history of neuromuscular disease
• Heart disease, Hypertension
• Cold intolerance

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: experimental group; Heart rate, maximum isometric muscle strength, Soleus H-reflex, M-wave, and V-wave measurements were taken in three consecutive periods. First-period maximal isometric contraction; second-period maximal isometric contraction + cold pressure test; third-period maximal isometric contraction + Cheering	Procedure: Cheer; Maximum isometric contraction was performed with cheering.; Procedure: The cold pressure test; Maximum isometric contraction was performed with the cold pressure test.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Heart rate	Heart rate was monitored with DII derivation electrocardiographic recording. Heart rate was reported as beats per minute.	during procedure
Soleus H-reflex amplitude	By stimulating the tibial nerve with an electrical current, the Soleus H-reflex was obtained. Its peak to peak amplitude will be measured in microvolts.	during procedure
Soleus V-wave amplitude	Soleus V-wave was obtained by applying an electrical current to the tibial nerve during maximum voluntary contraction (MCV). Peak-to-peak amplitude was measured in microvolts.	during procedure
Maximum isometric muscle strength	Maximum isometric muscle strength of ankle plantar flexors was measured using a force sensor	during procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Skin temperature	The skin temperature of the back of the hand exposed to the cold application was measured with an infrared thermometer and the results were reported in degrees Celsius.	during procedure

Collaborators and Investigators

• Sponsor: Istanbul Physical Medicine Rehabilitation Training and Research Hospital
• Investigators: Principal Investigator: Mert Cetin, MD, İstanbul Physical Therapy Rehabilitation Training & Research Hosptial

Study record dates

Study Major Dates

• Study Start (Actual): April 10, 2023
• Primary Completion (Actual): April 20, 2023
• Study Completion (Actual): April 22, 2023

Study Registration Dates

• First Submitted: September 29, 2023
• First Submitted That Met QC Criteria: October 5, 2023
• First Posted (Actual): October 12, 2023

Study Record Updates

• Last Update Posted (Actual): October 12, 2023
• Last Update Submitted That Met QC Criteria: October 5, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Keywords: muscle spindle; sympathetic system; sympathetic outflow; motor facilitation; soleus v-wave; cold stress test; contractile force
• Other Study ID Numbers: CISVWSA

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No