Engelhard Daniel, Hofer Pierre, Annaheim Simon
Orthopädie St. Gallen, St. Gallen, Switzerland.
Empa, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland.
BMJ Open Sport Exerc Med. 2019 Jun 14;5(1):e000527. doi: 10.1136/bmjsem-2019-000527. eCollection 2019.
Different cooling strategies exist for emergency treatments immediately after sports trauma or after surgery. The aim of this study was to investigate the effects of three cooling regimen during the immediate postoperative phase as well as in the rehabilitation phase.
36 patients undergoing anterior cruciate ligament reconstruction received either no cooling (control-group, Con, N=12), were cooled with a menthol-containing cooling bandage (Mtl, N=12) or cooled with an ice containing cold pack (CP, N=12). During a 12-week physiotherapy treatment the cross section of the vastus medialis muscle was examined (day-1; 30; 60; 90) and painkiller consumption was documented.
A significant reduction in the cross section area 30 days after surgery was observed in CP and Con (Mtl: -3.2±1.7%, p=0.14, CP: -8.8±4.3%, p<0.01, Con: -7.2±8.1%, p<0.05). After 90 days of therapy, a significant increase in muscle cross section area was observed in Mtl (Mtl: 4.6%±6.1%, p<0.05, CP: 1.9%± 8.1%, p=0.29, Con: 3.3%±9.4%, p=0.31). The absolute painkiller consumption was lower for Mtl (25.5±3.7 tablets) than for CP (39.5±6.9 tablets) or Con (34.8±4.2 tablets).
We observed a beneficial effect of cooling by a menthol-containing bandage during the rehabilitation phase. Reduction of muscle cross section within 30 days after surgery was prevented which highly contributed to rehabilitation success after 90 days of therapy. Painkiller consumption was reduced with Mtl.
对于运动创伤后或手术后的紧急治疗，存在不同的冷却策略。本研究的目的是调查三种冷却方案在术后即刻阶段以及康复阶段的效果。
36例行前交叉韧带重建术的患者，一组不进行冷却（对照组，Con，N = 12），一组使用含薄荷醇的冷却绷带进行冷却（Mtl，N = 12），另一组使用含冰的冷敷袋进行冷却（CP，N = 12）。在为期12周的物理治疗期间，检查股内侧肌的横截面积（第1天、30天、60天、90天）并记录止痛药的消耗量。
术后30天，CP组和Con组的横截面积显著减小（Mtl组：-3.2±1.7%，p = 0.14；CP组：-8.8±4.3%，p<0.01；Con组：-7.2±8.1%，p<0.05）。治疗90天后，Mtl组的肌肉横截面积显著增加（Mtl组：4.6%±6.1%，p<0.05；CP组：1.9%±8.1%，p = 0.29；Con组：3.3%±9.4%，p = 0.31）。Mtl组的止痛药绝对消耗量低于CP组（39.5±6.9片）和Con组（34.8±4.2片）（25.5±3.7片）。
我们观察到含薄荷醇绷带冷却在康复阶段具有有益效果。术后30天内肌肉横截面积的减小得到预防，这对90天治疗后的康复成功有很大贡献。Mtl组的止痛药消耗量减少。
