Effect of Cryotherapy on Proprioception and Throwing Accuracy In the Dominant Shoulder among Female Recreational Players

Published by Oriental Scientific Publishing Company © 2018 This is an Open Access article licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/ ), which permits unrestricted Non Commercial use, distribution and reproduction in any medium, provided the original work is properly cited. Effect of Cryotherapy on Proprioception and Throwing Accuracy In the Dominant Shoulder among Female Recreational Players

The shoulder has the greatest mobility functions as compared to any other joint in the body, and it compromises its stability to serve mobility function 1 . Because of the greater mobility function, there is a need for muscular coordination to maintain joint stability 2 . Proprioceptive input is from the peripheral mechanoreceptors to the central nervous system 3,4 .
When the deformation or a simply stretch in the muscle, skin or any other joint tissue activates the Mechanoreceptors and the impulse transmitted from the mechanoreceptors to the afferent neural impulses to the central nervous system, and are used for proper joint stability and function 5 .
Athletic event results in injury, however the athletes have left shorter time span to return to their routine activity and there is a increasing need for the treatment modality that relieves pain and resolves the injury immediately 6,7 Cryotherapy serves the purpose of relieving the pain and helps the athletes to return back to the event immediately. The mechanism by which the cryotherapy relieves pain faster as compared to other therapeutic modality is by decreasing the tissue temperature have been shown to decrease nerve conduction velocity, muscle force production , and muscular power 8,9 . Researchers have highlighted the effects of taping and other foaming bandages in the management of pain around the shoulder joint, but none of the researcher have highlighted the need for returning to athletic performance in the shorter span. Cryotherapy is left without much attention among the researchers, but there are innumerous effects of this cryotherapy modality in targeting the functional performance is left out without much research. Hence the study has been done to emphasize the effects of cryotherapy on throwing accuracy of dominant shoulder among female recreational players

Sample Design
Convenient sampling method was employed and informed consent was obtained from each subjects and this study has been approved by the ethical committee and Institutional review board of Ramakrishna  10 Female players will be selected as per the inclusion and exclusion criteria. The procedures were explained and an informed consent statement was obtained from them.

Training protocol: Cryotherapy application
Crushed ice immersed in terry towels was employed as the cryotherapy modality in this study. This particular application is used frequently and is the most functional type of cryotherapy for shoulder 20 . Treatment duration was 15 minutes. Immersion method of cryotherapy application is used by crushing 2000 mL ice into the ice water and terry towels were immersed by making the crushed ice clinging on the towel. The middle of the towel was centered over the acromion. The subjects were tested with their Cloths off to allow maximum skin/towel interface. The subject was instructed to relax during the cryotherapy application to limit muscle activity and minimize any change in tissue temperature. Immediately after the cryotherpy, the posttest assessment was performed.

Functional throwing performance index
Functional ability of the shoulder joint was assessed using the functional throwing performance index 19 . The subject stood 4.57m from the target, a 30.48 x 30.48 cm square on the wall at the height of 1.22m from the floor. The object of the test was to throw a rubber playground ball into the target as many times as possible over 30 seconds for pretest and for posttest the subject will be made to throw at the target for one minute and will be repeated rest time of one minute will be given between each trial . The FTPI was calculated as the number of throws within the target divided by the total number of balls thrown.

Data analysis
The collected data were tabulated and analyzed used inferential statistics. Mean and Standard Deviation were used to assess all the parameters. Paired t-test was adopted to find the Long term effect of cryotherapy on throwing accuracy of dominant shoulder among male cricketers. A paired t-test was used to compare in mean values of pre-test and post-test.
The statistical value shows the mean, standard, deviation t -test and p -value of effect of cryotherapy in throwing accuracy between per test and post test. In this table, p-value is less than 0.05 which is highly significant and indicates the increase in the throwing accuracy in the last minute compared to first minute

RESULTS
There was a significant change in the throwing accuracy after 10 minutes of cryotherapy application.

DISCUSSION
The effect of crushed ice application on throwing efficiency were investigated .crushed ice application for ten minutes was determined to Functional Throwing Performance Index . In this study the immediate effects of crushed ice application was examined. The statistical result shows there is a significant change after cryotherapy initially and gradually increases by the 10 mintes of treatment and showing the statistical p value <0.05.
As females show poor performance in motor activity when compared to males in athletic activity were employed in this study. The tissue temperature was well efficient with crushed ice than ice cubes ,hence it was employed in the study. As recreational players are more prone to injuries they must know the importance of cryotherapy and its relation to throwing.

CONCLUSION
There is a gradual increase in the throwing accuracy and the significant change is found in the tenth minute after application. Further research is needed to rule out the long term effects of cryotherapy.