Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT06079437 |
Other study ID # |
CISVWSA |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
April 10, 2023 |
Est. completion date |
April 22, 2023 |
Study information
Verified date |
October 2023 |
Source |
Istanbul Physical Medicine Rehabilitation Training and Research Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
There is sympathetic innervation of the muscular spindle. The application of cold to the skin
provides an increase in sympathetic activity. In rehabilitation practice, short-term local
cold is applied to the skin to provide motor facilitation. The aim of this study was to
examine whether short-term local cold application provides an increase in isometric
contractile strength and, if so, whether this effect is related to muscle spindle activity.
Description:
Cold application is frequently used in sports medicine and rehabilitation due to its
beneficial effects on the neuromuscular system. Its main beneficial effects are facilitating
muscle contraction (motor facilitation), increasing isometric muscle force formation and
reducing spasticity. The motor effects of cold application may vary depending on the
application time, cooling agent (ice, ice water, cooling spray, etc.) and subcutaneous fatty
tissue thickness. Short-term cold application can increase contraction force through motor
facilitation. As the duration of cold application increases, the effects of cold that inhibit
motor functions, such as gamma motor neuron inhibition, muscle spindle inhibition, and muscle
conduction block, come to the fore. With this effect, it is used in the treatment of
spasticity.
Neurophysiological studies to explain the motor effects of cold application have generally
focused on the monosynaptic muscle spindle-based reflex. The monosynaptic muscle
spindle-based reflex activates muscle spindles and stimulates alpha motor neurons via Group
Ia afferent nerves. This effect is also known as the servo-motor (servo-assistance) effect of
the muscle spindle. The increase in the sensitivity of the muscle spindle can provide motor
facilitation by strengthening the servo-assistance effect.
It has been shown that the muscle spindle has sympathetic innervation. It has been shown that
the cold stress test can be an alternative to the classical autonomic nerve test and can be
used to test sympathetic system activation. Additionally, studies have shown that cold stress
test, mental arithmetic, isometric contraction and muscle ischemia cause an increase in
muscle spindle sensitivity through increased sympathetic activity.
A literature review has shown that there is no study examining the mechanism underlying the
effect of local cold application on motor facilitation. Demonstrating the effect of local
cold application on increasing maximum contraction force through muscle spindle sensitivity
is also important for clinical applications to be more effective and efficient. The aim of
this study was to examine whether short-term local cold application increases isometric
contraction force and, if there is an increase, whether this effect is related to muscle
spindle activity.