Einfluß von Eisbeutel, Kaltluft und N2-Kaltgas auf die gelenknahe elektrische Schmerzschwelle

Author(s): Mühlbauer, M.

Journal/Book: Physikalische Medizin Rehabilitationsmedizin Kurortmedizin. 1992; 2/1: 1-6.

Abstract: Objective: The treatment of musculosceletal pain is an important task of physical therapy, especially of cryotherapy. However, experimental models to quantify physiological effects in order to determine the optimal therapy are missing.Subjective: An experimental model to quantify electrical induced pain in joint tissue will be presented. The analgetic effects of three characteristic cryotherapeutical treatments (ice bag, cold air stream, cold N2-gas) will be demonstrated.Design: Monopolar EMG needles were inserted 0,5-1 cm deep into the humeroradial joint tissue an both sides. They delivered (every 30 s; 1/min at each side) an increasing electrical stimulus (0,5 ms rectangular impulses; 285 Hz) up to a maximum of 10 mA. As soon as a painful sensation arises, the stimulus was interrupted by the test person. The attained value in mA was registered and defined as the pain threshold. Depending an needle position and individual factors, it ranged between 2,5 and 4 mA.The study involved a test group of 10 healthy persons (6 females, 4 males), 20-15 years of age. In randomised sequence following treatments have been applicated (application time and -temperature in parenthesis) at the right humeroradial joint: a) ice bag (15 min/± 0 °C); b) cold air stream (10 min/- 11 °C; c) cold N2-gas (10 min/- 17 °C). The left side served as control. In addition, a series without any application has been performed.Results: After a 3-5 min delay, pain threshold increased to following maxima: cold air stream (10 min) + 4,02 mA ± 2,21 SD, p<0,001; ice bag (15 min) + 2,13 mA ± 177 SD, p = 0,004; cold N2-gas (16 min) + 1,4 mA ± 1,1 SD, p = 0,009. Within a few minutes, all values decreased to the same plateau of ca. + 0,8 mA above baseline, persisting until the end of Observation (40 min). On the contralateral (left) side the pain threshold increased up to a more or less persisting level of ca. + 0,5 mA.Conclusions: I) The demonstrated method is capable to quantify physicotherapeutical effects an pain threshold in joint tissue. 2) The analgetic effect of cold air stream is superior to ice bag and cold N2-gas for local cooling of joint tissue. 3) Soon after application, the elevated pain thresholds decrease again, presumably related to the local rewarming of the tissue. 4) Until the end of observation, pain thresholds remain on an elevated plateau above baseline an homolateral side as well as contralateral. Both maybe due to a longlasting central nervous component of cryotherapeutical analgetic effects.

Keyword(s): Kryotherapie

Zurück | Weiter