Mac Auley D C
Institute of Postgraduate Medicine and Health Science University of Ulster, Northern Ireland.
Int J Sports Med. 2001 Jul;22(5):379-84. doi: 10.1055/s-2001-15656.
Ice, compression and elevation are the basic principles of acute soft tissue injury. Few clinicians, however, can give specific evidence based guidance on the appropriate duration of each individual treatment session, the frequency of application, or the length of the treatment program. The purpose of this systematic review is to identify the original literature on cryotherapy in acute soft tissue injury and produce evidence based guidance on treatment. A systematic literature search was performed using Medline, Embase, SportDiscus and the database of the National Sports Medicine Institute (UK) using the key words ice, injury, sport, exercise. Temperature change within the muscle depends on the method of application, duration of application, initial temperature, and depth of subcutaneous fat. The evidence from this systematic review suggests that melting iced water applied through a wet towel for repeated periods of 10 minutes is most effective. The target temperature is reduction of 10-15 degrees C. Using repeated, rather than continuous, ice applications helps sustain reduced muscle temperature without compromising the skin and allows the superficial skin temperature to return to normal while deeper muscle temperature remains low. Reflex activity and motor function are impaired following ice treatment so patients may be more susceptible to injury for up to 30 minutes following treatment. It is concluded that ice is effective, but should be applied in repeated application of 10 minutes to be most effective, avoid side effects, and prevent possible further injury.
冰敷、加压和抬高是急性软组织损伤的基本原则。然而，很少有临床医生能够针对每次治疗的合适时长、应用频率或整个治疗疗程的时长给出具体的循证指导。本系统评价的目的是识别关于急性软组织损伤冷冻疗法的原始文献，并给出基于证据的治疗指导。使用关键词“冰敷”“损伤”“运动”“锻炼”，通过Medline、Embase、SportDiscus以及英国国家运动医学研究所的数据库进行了系统的文献检索。肌肉内的温度变化取决于应用方法、应用时长、初始温度以及皮下脂肪的深度。该系统评价的证据表明，通过湿毛巾反复应用10分钟的融化冰水最为有效。目标温度是降低10 - 15摄氏度。采用反复而非持续的冰敷有助于在不损害皮肤的情况下维持肌肉温度降低，并使浅表皮肤温度恢复正常，而深层肌肉温度仍保持较低。冰敷治疗后反射活动和运动功能会受损，因此患者在治疗后长达30分钟内可能更容易受伤。结论是冰敷是有效的，但应以每次10分钟的反复应用方式进行，以达到最有效、避免副作用并防止可能的进一步损伤的效果。
