Effect of Topical Cooling with Ice and Cold Spray on Knee Joint Position Sense of Athletes with Patellofemoral Pain Syndrome

Abstract

Background: Patellofemoral pain syndrome (PFPS) is one of the most common knee injuries in athletes and non-athletes. Due to the pain and muscle inhibition, it is possible that the disorder has negative effects on joint position sense. Cryotherapy is one of the most common methods applied in sports injuries. Objectives: The aim of this study was to evaluate the effect of topical cooling with ice and cold spray on knee joint position sense of athletes with PFPS. Methods: In this quasi-experimental study, 30 athletes with PFSP were divided into two groups of cold spray and crushed ice application. The effect of cooling on joint position sense was measured by the target reconstruction method (30° of knee flexion) while standing. In order to analyze the data, SPSS 23 and statistical tests of Shapiro-Wilk, paired t-test, and independent t-tests were used. The absolute error of 30° knee flexion angle reconstruction immediately after cryotherapy was significantly higher than before it in various cooling methods. Nevertheless, crushed ice application had a greater impact on the accuracy of joint position sense than spraying. Results: The results of this study indicate the negative effects of cryotherapy on the accuracy of the knee joint position sense (P < 0.05). However, cryotherapy with crushed ice application has a greater effect on reducing the accuracy of joint position sense (P < 0.001) than cold spray (P < 0.001). Conclusions: Decreased accuracy of position sense is likely to cause mechanical instability and increase the rate of injury. Therefore, it is recommended to use crushed ice application rather than topical cooling to reduce the knee joint position sense.