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Cryotherapy for acute ankle sprains: a randomised controlled study of two
different icing protocols
C. M. Bleakley, S. M. McDonough and D. C. MacAuley
British Journal of Sports Medicine 2006;40:700-705
ABSTRACT
Background: The use of cryotherapy in the management of acute soft tissue injury
is largely based on anecdotal evidence. Preliminary evidence suggests that
intermittent cryotherapy applications are most effective at reducing tissue
temperature to optimal therapeutic levels. However, its efficacy in treating
injured human subjects is not yet known.
Objective: To compare the efficacy of an intermittent cryotherapy treatment
protocol with a standard cryotherapy treatment protocol in the management of
acute ankle sprains.
Subjects: Sportsmen (n = 44) and members of the general public (n = 45) with
mild/moderate acute ankle sprains.
Methods: Subjects were randomly allocated, under strictly controlled double
blind conditions, to one of two treatment groups: standard ice application (n =
46) or intermittent ice application (n = 43). The mode of cryotherapy was
standardised across groups and consisted of melting iced water (0°C) in a
standardised pack. Function, pain, and swelling were recorded at baseline and
one, two, three, four, and six weeks after injury.
Results: Subjects treated with the intermittent protocol had significantly
(p<0.05) less ankle pain on activity than those using a standard 20 minute
protocol; however, one week after ankle injury, there were no significant
differences between groups in terms of function, swelling, or pain at rest.

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