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.

References

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/specifications
27.
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).
You do not currently have access to this content.