Original article
Changes in Lower-Leg Blood Flow During Warm-, Cold-, and Contrast-Water Therapy

https://doi.org/10.1016/j.apmr.2004.11.046Get rights and content

Abstract

Fiscus KA, Kaminski TW, Powers ME. Changes in lower-leg blood flow during warm-, cold-, and contrast-water therapy.

Objective

To examine arterial blood flow in the lower leg during warm-, cold-, and contrast-water therapy.

Design

A crossover trial with repeated measurements on the dependent variable.

Setting

Hydrotherapy area of a climate-controlled sports medicine clinic.

Participants

A volunteer sample of 24 healthy men.

Intervention

Four randomly assigned treatments were performed on each subject on consecutive days.

Main Outcome Measure

Arterial blood flow (mL per 100mL/min) from baseline measurements were recorded in a 3-minute to 1-minute on-off ratio for 20 minutes by using strain gauge plethysmography.

Results

Contrast therapy produced fluctuations in blood flow throughout the 20-minute treatment. Warm-water therapy (40°C) resulted in significant (P<.001) changes in blood flow compared with the control and contrast conditions. Cold-water therapy (13°C) did not produce significantly decreased blood flow as compared with the control condition.

Conclusions

We suggest that further studies involving contrast therapy to the lower leg in injured populations be carried out to determine whether our initial findings are clinically relevant.

Section snippets

Design

We used a repeated-measures crossover trial design for this investigation. The independent variables included 4 levels of treatment (20-min control; 20-min warm [40°C] water therapy; 20-min cold [13°C] water therapy; 20-min contrast-water therapy) and time interval (65 recorded intervals). The order of treatment was randomly assigned by using a counterbalanced scheme.

Participants

Twenty-four men (age, 23.0±2.5y; height, 177.1±6.1cm; mass, 77.2±3.4kg) who were free from injury, circulatory problems, cold

Results

The ANOVA revealed a significant treatment main effect (F3,30=38.8, P<.001) with change in blood flow differences greater than .66mL per 100mL/min considered noteworthy, as determined by the Tukey post hoc analysis (fig 3). Specifically, a significant increase in blood flow was observed during the warm-water immersion (4.35±0.45mL per 100mL/min) and contrast (2.99±1.66mL per 100mL/min) conditions as compared with the cold-water immersion (1.41±0.40mL per 100mL/min) and control (1.43±0.06mL per

Discussion

The results of this study suggest that contrast therapy produced fluctuations in blood flow throughout the 20-minute treatment. Several studies9, 10, 11, 12, 13 have been conducted measuring blood flow during hot and cold whirlpool therapy, whereas none have been performed measuring blood flow during contrast therapy. Furthermore, several other studies2, 3, 14, 15, 16 have been conducted examining the effects of other cold therapies on localized blood flow. These studies examined blood flow

Conclusions

This study has revealed that contrast-water therapy produces significant fluctuations in blood flow during a 20-minute treatment. This is valuable information because it was commonly thought that physiologic changes from warm- and cold-water therapy were not excessive enough to produce these peripheral fluctuations. We suggest that further studies involving contrast therapy to the lower leg in injured populations be carried out to determine whether our initial findings are clinically relevant.

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