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February 4, 2021 — Ultrasound in Medicine and Biology


The aim of this randomized controlled laboratory study was to evaluate the role of standardized protection, rest, ice (cryotherapy), compression and elevation (PRICE) therapy on microvascular blood flow in human skeletal muscle. Quantifiable contrast-enhanced ultrasound was used to analyze intramuscular tissue perfusion (ITP) of the rectus femoris (RF) and vastus intermedius (VI) muscles in 20 healthy athletes who were randomly assigned to PRICE or control groups. Baseline perfusion measurements (resting conditions, T0) were compared with cycling exercise (T1), intervention (PRICE or control, T2) and follow-up at 60 min post-intervention (T3). The 20 min PRICE intervention included rest, cryotherapy (3°C), compression (35 mm Hg) and elevation. After intervention, PRICE demonstrated a decrease of ITP in VI (–47%, p = 0.01) and RF (–50%, p = 0.037) muscles. At T3, an ongoing decreased ITP for the RF (p = 0.003) and no significant changes for the VI were observed. In contrast, the control group showed an increased ITP at T2 and no significant differences at T3. PRICE applied after exercise led to a down-regulation of ITP, and the termination of PRICE does not appear to be associated with a reactive hyperemia for at least 60 min after treatment.

Authors: Thilo Hotfiel 1; Matthias Wilhelm Hoppe 2; Rafael Heiss 3; Christoph Lutter 4; Thomas Tischer 4; Raimund Forst 1; Christian Manfred Hammer 1; Jürgen Freiwald 5; Martin Engelhardt 6; Casper Grim 6

1 Friedrich-Alexander-University Erlangen-Nuremberg; 2 University of Leipzig; 3 University Hospital Erlangen; 4 University Medical Center Rostock; 5 University of Wuppertal; 6 University of Osnabruck

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