Abstract
Objectives
To examine the effect of thermal agents on the range of movement (ROM) and mechanical
properties in soft tissue and to discuss their clinical relevance.
Data Sources
Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, and
EMBASE) were searched from their earliest available record up to May 2011 using Medical
Subjects Headings and key words. We also undertook related articles searches and read
reference lists of all incoming articles.
Study Selection
Studies involving human participants describing the effects of thermal interventions
on ROM and/or mechanical properties in soft tissue. Two reviewers independently screened
studies against eligibility criteria.
Data Extraction
Data were extracted independently by 2 review authors using a customized form. Methodologic
quality was also assessed by 2 authors independently, using the Cochrane risk of bias
tool.
Data Synthesis
Thirty-six studies, comprising a total of 1301 healthy participants, satisfied the
inclusion criteria. There was a high risk of bias across all studies. Meta-analyses
were not undertaken because of clinical heterogeneity; however, effect sizes were
calculated. There were conflicting data on the effect of cold on joint ROM, accessory
joint movement, and passive stiffness. There was limited evidence to determine whether
acute cold applications enhance the effects of stretching, and further evidence is
required. There was evidence that heat increases ROM, and a combination of heat and
stretching is more effective than stretching alone.
Conclusions
Heat is an effective adjunct to developmental and therapeutic stretching techniques
and should be the treatment of choice for enhancing ROM in a clinical or sporting
setting. The effects of heat or ice on other important mechanical properties (eg,
passive stiffness) remain equivocal and should be the focus of future study.
Keywords
List of abbreviations:
CI (confidence interval), CWI (cold water immersion), MD (mean difference), ROM (range of movement), US (ultrasound)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 09, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
