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Autonomic Responses to Cold Pain: Effect of Type, Duration, and Habituation in Cryotherapy.
Medicine & Science in Sports & Exercise ( IF 4.1 ) Pub Date : 2024-11-29 , DOI: 10.1249/mss.0000000000003620
Jasmine M McDowell,Gretchen Addington,Kristen Metzler-Wilson,Thad E Wilson
Medicine & Science in Sports & Exercise ( IF 4.1 ) Pub Date : 2024-11-29 , DOI: 10.1249/mss.0000000000003620
Jasmine M McDowell,Gretchen Addington,Kristen Metzler-Wilson,Thad E Wilson
PURPOSE
Cold limb immersion, a form of cryotherapy, can cause cardiovascular changes due to cold-pain induced autonomic reflexes. This cryotherapy treatment side effect has received less attention but could have direct implications for physical rehabilitation of individuals with cardiovascular comorbidities.
METHODS
To test hypotheses related to the pressor effects of varied limb sites and surface areas of cryotherapy, two common lower limb injury sites (ankle and knee) were immersed into cold water (15 min, 1-3 °C) and then referenced to a standard cold pressor test (CPT). Beat-by-beat arterial blood pressure (finger photoplethysmography), heart rate (ECG), systemic vascular conductance (SVC; Modelflow), and calf vascular conductance (VC; venous occlusion plethysmography) were measured in 14 healthy participants.
RESULTS
At 2 min, CPT increased mean arterial pressure (MAP; 21 ± 4 mmHg) more than either ankle or leg immersion (15 ± 4 and 15 ± 5 mmHg, respectively; P = 0.015). SVC and calf VC decreased but were not different across treatments (P = 0.417 and P = 0.086). MAP and SVC were not different from 2 min to 15 min of immersion (P = 0.164 and P = 0.522), but calf VC decreased further by the end of immersion (3.1 ± 0.5 to 2.8 ± 0.4 and 2.7 ± 3 to 1.7 ± 0.2 units; P = 0.028). MAP increases with CPT were similar with solely CPT and when CPT followed ankle or leg immersion (27 ± 5 and 23 ± 4 mmHg, respectively; P = 0.199).
CONCLUSIONS
These data indicate robust pressor responses without autonomic reflex habituation and that cryotherapy immersion location but not surface area appears to mediate cardiovascular responses. This cryotherapy side effect may be an important consideration for patients with cardiovascular-related comorbidities.
中文翻译:
对冷痛的自主神经反应:冷冻疗法中类型、持续时间和习惯化的影响。
目的 冷肢浸是冷冻疗法的一种形式,由于冷痛引起的自主神经反射,会导致心血管变化。这种冷冻疗法治疗的副作用受到的关注较少,但可能对患有心血管合并症的个体的身体康复产生直接影响。方法 为了检验与冷冻疗法不同肢体部位和表面积的加压作用相关的假设,将两个常见的下肢损伤部位(踝关节和膝关节)浸入冷水中(15 分钟,1-3 °C),然后参考标准冷加压试验 (CPT)。逐次动脉血压(手指光电容积脉搏波描记法)、心率 (ECG)、体循环血管电导率 (SVC;Modelflow) 和 14 名健康参与者的小腿血管电导 (VC;静脉闭塞体积描记法)。结果 2 分钟时,CPT 平均动脉压 (MAP;21 ± 4 mmHg) 的增加程度高于踝关节或腿部浸泡 (15 ± 4 和 15 ± 5 mmHg;P = 0.015)。SVC 和小牛 VC 降低,但不同处理之间没有差异 (P = 0.417 和 P = 0.086)。浸泡 2 min 至 15 min 时 MAP 和 SVC 无差异 (P = 0.164 和 P = 0.522),但浸泡结束时犊牛 VC 进一步下降 (3.1 ± 0.5 至 2.8 ± 0.4 和 2.7 ± 3 至 1.7 ± 0.2 单位;P = 0.028)。CPT 的 MAP 增加与单独使用 CPT 和踝关节或腿部浸泡后 CPT 相似 (分别为 27 ± 5 和 23 ± 4 mmHg;P = 0.199)。结论 这些数据表明没有自主神经反射习惯化的强劲升压反应,并且冷冻疗法浸没位置而不是表面积似乎介导了心血管反应。这种冷冻疗法的副作用可能是心血管相关合并症患者的一个重要考虑因素。
更新日期:2024-11-29
中文翻译:
![](https://scdn.x-mol.com/jcss/images/paperTranslation.png)
对冷痛的自主神经反应:冷冻疗法中类型、持续时间和习惯化的影响。
目的 冷肢浸是冷冻疗法的一种形式,由于冷痛引起的自主神经反射,会导致心血管变化。这种冷冻疗法治疗的副作用受到的关注较少,但可能对患有心血管合并症的个体的身体康复产生直接影响。方法 为了检验与冷冻疗法不同肢体部位和表面积的加压作用相关的假设,将两个常见的下肢损伤部位(踝关节和膝关节)浸入冷水中(15 分钟,1-3 °C),然后参考标准冷加压试验 (CPT)。逐次动脉血压(手指光电容积脉搏波描记法)、心率 (ECG)、体循环血管电导率 (SVC;Modelflow) 和 14 名健康参与者的小腿血管电导 (VC;静脉闭塞体积描记法)。结果 2 分钟时,CPT 平均动脉压 (MAP;21 ± 4 mmHg) 的增加程度高于踝关节或腿部浸泡 (15 ± 4 和 15 ± 5 mmHg;P = 0.015)。SVC 和小牛 VC 降低,但不同处理之间没有差异 (P = 0.417 和 P = 0.086)。浸泡 2 min 至 15 min 时 MAP 和 SVC 无差异 (P = 0.164 和 P = 0.522),但浸泡结束时犊牛 VC 进一步下降 (3.1 ± 0.5 至 2.8 ± 0.4 和 2.7 ± 3 至 1.7 ± 0.2 单位;P = 0.028)。CPT 的 MAP 增加与单独使用 CPT 和踝关节或腿部浸泡后 CPT 相似 (分别为 27 ± 5 和 23 ± 4 mmHg;P = 0.199)。结论 这些数据表明没有自主神经反射习惯化的强劲升压反应,并且冷冻疗法浸没位置而不是表面积似乎介导了心血管反应。这种冷冻疗法的副作用可能是心血管相关合并症患者的一个重要考虑因素。