The influence of Cryo-cOmpression (GameReady) therapy on joint position reproduction in the shouLDer (COLD)

“A randomised controlled trial to assess the effects of a cryotherapy (Gameready) intervention intervention for 30 minutes with and without compression on shoulder joint position sense (proprioception)”

GameReady® is an easy-to-use, fully adjustable system which provides intermittent compression with circumferential cold therapy. The system continuously circulates cold water from the GameReady unit’s reservoir, via a connected hose, through an inner chamber of the selected anatomical wrap, before returning to the reservoir. The cold water is refreshed through the ice before it returns into the anatomical wrap, thus delivering ‘continuous’ cold therapy. The unit simultaneously pumps air into the outer chamber of the anatomical wrap, intermittently inflating and deflating according to the pressure settings selected. Thus, providing greater surface contact and assisting in preventing/limiting swelling.

The effect of cryotherapy on proprioception, which is a component of the somatosensory system and plays a critical role in human movement, is not well understood (Costello & Donnelly, 2010). The term ‘proprioception’ developed as a result of Sherrington’s work in 1906 and has later been defined as the ability of an individual to sense joint position, movement and force to discriminate movements of the limbs, and is therefore reliant on neural input from mechanoreceptors located in the joint capsule, ligaments, muscles, tendons and skin (Gandevia, Refshauge, & Collins, 2002; Sherrington, 1906). Proprioception is an essential element of injury prevention and rehabilitation, that is too commonly ignored. Proprioceptive deficit is associated with increased likelihood of injury and as such the effects of cryotherapy on proprioception should be considered (Corrigan, Cashman, & Brady, 1992; Payne, Berg, & Latin, 1997; Riva, Bianchi, Rocca, & Mamo, 2016).

To the researchers knowledge, there have been no studies which have assessed the influence of cryotherapy (GameReady) treatment without compression on shoulder joint position sense, no studies which have used cryotherapy with compression on shoulder joint position sense, and none which have compared these modalities. This study hopes to bridge this literature gap and provide clinicians with the necessary information to make informed decisions about the application of cryotherapy. Therefore, the aims of this study are to establish whether, or not, GameReady (cryo-compression) has an influence on shoulder joint proprioception.