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Completed

NCT Number: NCT06079437

The Effect of Brief Skin Cooling on Isometric Muscle Strength

There is sympathetic innervation of the muscular spindle. The application of cold to the skin provides an increase in sympathetic activity. In rehabilitation practice, short-term local cold is applied to the skin to provide motor facilitation. The aim of this study was to examine whether short-term local cold application provides an increase in isometric contractile strength and, if so, whether this effect is related to muscle spindle activity.

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Key information

Conditions

Age range

20 year–45 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Istanbul Physical Medicine Rehabilitation Training & Research Hospital

Istanbul, 34173, Turkey (Türkiye)

About this study

Cold application is frequently used in sports medicine and rehabilitation due to its beneficial effects on the neuromuscular system. Its main beneficial effects are facilitating muscle contraction (motor facilitation), increasing isometric muscle force formation and reducing spasticity. The motor effects of cold application may vary depending on the application time, cooling agent (ice, ice water, cooling spray, etc.) and subcutaneous fatty tissue thickness. Short-term cold application can increase contraction force through motor facilitation. As the duration of cold application increases, the effects of cold that inhibit motor functions, such as gamma motor neuron inhibition, muscle spindle inhibition, and muscle conduction block, come to the fore. With this effect, it is used in the treatment of spasticity.

Neurophysiological studies to explain the motor effects of cold application have generally focused on the monosynaptic muscle spindle-based reflex. The monosynaptic muscle spindle-based reflex activates muscle spindles and stimulates alpha motor neurons via Group Ia afferent nerves. This effect is also known as the servo-motor (servo-assistance) effect of the muscle spindle. The increase in the sensitivity of the muscle spindle can provide motor facilitation by strengthening the servo-assistance effect.

It has been shown that the muscle spindle has sympathetic innervation. It has been shown that the cold stress test can be an alternative to the classical autonomic nerve test and can be used to test sympathetic system activation. Additionally, studies have shown that cold stress test, mental arithmetic, isometric contraction and muscle ischemia cause an increase in muscle spindle sensitivity through increased sympathetic activity.

A literature review has shown that there is no study examining the mechanism underlying the effect of local cold application on motor facilitation. Demonstrating the effect of local cold application on increasing maximum contraction force through muscle spindle sensitivity is also important for clinical applications to be more effective and efficient. The aim of this study was to examine whether short-term local cold application increases isometric contraction force and, if there is an increase, whether this effect is related to muscle spindle activity.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Being healthy
  • Being a young adult (20-45 years old)
  • Volunteer

Exclusion criteria

  • Scar, dermatitis, etc. in the skin tissue where the surface electromyography electrode will be placed
  • Upper extremity bone and joint disease, history of neuromuscular disease
  • Heart disease, Hypertension
  • Cold intolerance

Treatment and study plan

Cheer

Procedure

Maximum isometric contraction was performed with cheering.

The cold pressure test

Procedure

Maximum isometric contraction was performed with the cold pressure test.

Primary outcomes

  1. Heart rate

    Time frame: during procedure

    Heart rate was monitored with DII derivation electrocardiographic recording. Heart rate was reported as beats per minute.

  2. Soleus H-reflex amplitude

    Time frame: during procedure

    By stimulating the tibial nerve with an electrical current, the Soleus H-reflex was obtained. Its peak to peak amplitude will be measured in microvolts.

  3. Soleus V-wave amplitude

    Time frame: during procedure

    Soleus V-wave was obtained by applying an electrical current to the tibial nerve during maximum voluntary contraction (MCV). Peak-to-peak amplitude was measured in microvolts.

  4. Maximum isometric muscle strength

    Time frame: during procedure

    Maximum isometric muscle strength of ankle plantar flexors was measured using a force sensor

Secondary outcomes

  1. Skin temperature

    Time frame: during procedure

    The skin temperature of the back of the hand exposed to the cold application was measured with an infrared thermometer and the results were reported in degrees Celsius.

Sponsors and collaborators

Lead sponsor

Istanbul Physical Medicine Rehabilitation Training and Research Hospital

Other Gov

Registry information

Official study title

The Effect of Brief Skin Cooling on Isometric Muscle Strength and the Neuronal Mechanism Underlying This Effect

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Oct 12, 2023
Registry last updated
Oct 12, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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