Acute Effects of Cold Therapy on Knee Skin Surface Temperature: Gel Pack Versus Ice Bag

Background: To our knowledge there has been no research that has compared the effectiveness of two popular cold therapy modalities applied to healthy human knees, with a surgical dressing, over a 4 h period.

Hypothesis: To determine whether gel packs are more effective than ice bags at reducing skin surface temperature in humans.

Study Design: This was a randomised, repeated measures crossover study, which included nine healthy participants.

Level Of Evidence: Level 2.

Methods: Two cold therapy modalities-a gel pack (DonJoy-Orthopaedic Pty Ltd, Normanhurst, New South Wales, Australia) and an ice bag (ICE'N'EASY, Bokarina, Queensland, Australia)-were applied on top of a surgical dressing, covering the knee. Each participant randomly received two cold therapy treatments, in separate sessions, at least 4 days apart. Each session utilised the time protocol of 20 min application on the hour, for 4 h. Skin surface temperature was recorded throughout the session at 1 min intervals.

Results: In the first application, the ice bag (5°C±1.7°C) was more effective at reducing skin surface temperature (p<0.04) from baseline than the gel pack (4°C±0.9°C), and had a significantly greater cooling rate (p<0.02). On the subsequent three applications, both modalities were just as effective at reducing skin surface from baseline, and had similar cooling rates.

Conclusions: An ice bag initially was more effective than the gel pack at reducing skin surface temperature of healthy knees, with a surgical dressing. Over a 4 h period both gel packs and ice bags were just as effective at reducing skin surface temperature and at maintaining these lower temperatures.