cryotherapy의 효과검증(review 논문)

급성기 통증, 부종제거에 놀라운 효과를 보이는 ice pack조차도 검증이 이렇게 어려운가 보다. acupuncture의 치료효과 검증은 어떻겠는가?   내가 보는 대부분의 환자는 나의 등살에 운동을 하지 않고서는 견디기 힘들다. 그러다 보니 운동을 하다가 많은 환자들이 sports injury를 유발하면서 다시 통증을 호소하기도 했다.   두가지 해결책이 나왔는데, 한가지는 "운동의 방법론개선"이었다. 이동국, 박지성선수의 재활방법론을 공부한 박남옥 물리치료사 선생님 덕분에 알게 되었다. Skill은 복잡하고 어렵고, 이론은 아주 simple하다. 척추와 관절의 안정성을 확보하면서 반복적인 근력운동, balance training을 하는 것이다.   또 한가지는 "ice pack의 적절한 사용"이었다. 논문에 근거하여 급성기 통증에 얼음찜질을 skin쪽은 30분, 관절안쪽은 1시간 이상, 허리디스크처럼 더 깊은 곳은 1시간 30분 이상을 적용하였다. 그랬더니 muscle energy technique, pnf, joint mobilozation만큼 효과적으로 급성통증을 제어할 수 있었다.   논문으로 정리해본다.   panic bird........   The use of ice in the treatment of acute soft-tissue injury. 2004년 Ireland.   - cryotherapy는 조직온도를 낮추어 통증, 대사, muscle spasm을 감소시키고, 염증과정을 줄여서 soft-tissue회복을 돕는 역할 - 조직온도의 변화는 ice pack의 초기온도, 시간(duration), 빈도수(frequency), subcutaneous fat의 분포에 따라 다름   냉찜질의 변수 1) cryothepy mode(형태와 온도) - 얼음을 깨서 사용 - cryocuff or colf compressive devices - commercial ice machines - commercial/gel ice packs - ice submergence(얼음물에 담그기)   - temperature of cooling device and the subject's tissue temperature reduction은 드물게 보고됨   2) duration 3) frequency - 22개의 논문중 13개의 논문이 조직손상후 지속적으로 cryotherpay 적용 - 7개는 intermittent - 5개는 확인 안됨 - range from 10~20min 하루 2-4회에서 continous   4) 적응증(조직 손상후 즉시 또는 rehabilitive 시기)  - 조직손상후 즉시 적용하는 아이스팩의 목표는 염증대사를 줄여 secondary hypoxic injury를 줄이고, 조직손상을 줄이고자. - 재활운동기에 적용하는 아이스팩의 목표는 통증을 줄여 강도높은 운동을 촉진하기 위해   - 두개의 논문에서 재활목적으로 운동과 냉치료를 병행     <img src="https://t1.daumcdn.net/cfile/cafe/132D030D4988FEBCA3" border="0" hspace="1" vspace="1" class="tx-daum-image" style="CLEAR: none; FLOAT: none" actualwidth="833" width="833" />     치료 효과 1. Ice 와 Heat - thermotherapy보다 cryotherapy가 효과적(ankle sprian) - 한개의 논문에서 운동과 동시에 ice submersion할 경우 heat보다 훨씬 더 효과적   2. Ice 와 Ice and Electrical stimulation - 치료효과 차이 없음   3. Ice 와 no Ice - Ice 적용이 훨씬 효과적임 - minor arthroscopic knee surgery후에 운동만 시킨 그룹과 아이스팩을 같이 한 그룹의비교에서 ice 적용이 훨씬 효과적   4. Ice continuous와 ice intermittent - 수근관증후군 수술후에 Ice continuous와 ice intermittent를 비교하였더니 연속으로 ice를 적용한 그룹에서 통증완화에 훨씬 더 효과적   5.  Ice compression와 no ice -  Ice compression이 효과적   6.  Ice compression와 ice -  Ice compression이 효과적   7.  Ice compression와 compression - 대개 no significant different - 또는 ice compression이 약간 효과적   8. ice compression + placebo injection과 ice compression + injection과 placebo injection - ice compression + placebo injection이 placebo injection보다 효과적 - ice compression + injection이 더 효과적     <img src="https://t1.daumcdn.net/cfile/cafe/1537D60F4988FF4ABE" border="0" hspace="1" vspace="1" class="tx-daum-image" style="CLEAR: none; FLOAT: none" actualwidth="806" width="806" />       The use of ice in the treatment of acute soft-tissue injury. 2004년 Ireland.   BACKGROUND: There are wide variations in the clinical use of cryotherapy, and guidelines continue to be made on an empirical basis.   STUDY DESIGN: Systematic review assessing the evidence base for cryotherapy in the treatment of acute soft-tissue injuries.   METHODS: A computerized literature search, citation tracking, and hand searching were carried out up to April 2002. Eligible studies were randomized-controlled trials describing human subjects recovering from acute soft-tissue injuries and employing a cryotherapy treatment in isolation or in combination with other therapies. Two reviewers independently assessed the validity of included trials using the Physiotherapy Evidence Database (PEDro) scale.   RESULTS: Twenty-two trials met the inclusion criteria. There was a mean PEDro score of 3.4 out of of 10. There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients. Few studies assessed the effectiveness of ice on closed soft-tissue injury, and there was no evidence of an optimal mode or duration of treatment.   CONCLUSION: Many more high-quality trials are needed to provide evidence-based guidelines in the treatment of acute soft-tissue injuries.       1: <A href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'Arthritis%20Rheum.');">Arthritis Rheum.</A> 2008 Dec 30;61(1):78-83. [Epub ahead of print] <DD class=abstract> <DIV class=lib_icon></DIV> <H2>Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling.</H2></DD> <DD class=abstract>1: <A href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'Emerg%20Med%20J.');">Emerg Med J.</A> 2008 Feb;25(2):65-8.<A href="http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3051&itool=AbstractPlus-def&uid=18212134&db=pubmed&url=http://emj.bmj.com/cgi/pmidlookup?view=long&pmid=18212134" target=_blank> <IMG id=linkout-icon-def-emermed_full alt="Click here to read" src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fcorehtml%2Fquery%2Fegifs%2Fhttp%3A--highwire.stanford.edu-icons-externalservices-pubmed-standard-emermed_full.gif" border=0></A> <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu18212134);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>Is ice right? Does cryotherapy improve outcome for acute soft tissue injury?</H2></DD> <DD class=abstract>1: <A href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'Am%20J%20Sports%20Med.');">Am J Sports Med.</A> 2004 Jan-Feb;32(1):251-61.<A href="http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3051&itool=AbstractPlus-def&uid=14754753&db=pubmed&url=http://ajs.sagepub.com/cgi/pmidlookup?view=long&pmid=14754753" target=_blank> <IMG id=linkout-icon-def-sagepub_full alt="Click here to read" src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fcorehtml%2Fquery%2Fegifs%2Fhttp%3A--highwire.stanford.edu-icons-externalservices-pubmed-custom-sagepub_full.gif" border=0></A> <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu14754753);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.</H2></DD> <DD class=abstract> <H2>1: <A href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'J%20Athl%20Train.');">J Athl Train.</A> 2004 Sep;39(3):278-279.<A href="http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3494&itool=AbstractPlus-nondef&uid=15496998&db=pubmed&url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15496998" target=_blank> <IMG id=linkout-icon-pmc-pmc alt="Click here to read" src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fcorehtml%2Fquery%2Fegifs%2Fhttp%3A--www.pubmedcentral.nih.gov-corehtml-pmc-pmcgifs-pubmed-pmc.gif" border=0></A> <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu15496998);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>Does Cryotherapy Improve Outcomes With Soft Tissue Injury?</H2></DD> <DD class=abstract>1: <A href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'J%20Athl%20Train.');">J Athl Train.</A> 2006 Apr-Jun;41(2):177-84.<A href="http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3494&itool=AbstractPlus-nondef&uid=16791303&db=pubmed&url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16791303" target=_blank> <IMG id=linkout-icon-pmc-pmc alt="Click here to read" src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fcorehtml%2Fquery%2Fegifs%2Fhttp%3A--www.pubmedcentral.nih.gov-corehtml-pmc-pmcgifs-pubmed-pmc.gif" border=0></A> <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu16791303);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>Knee joint effusion and cryotherapy alter lower chain kinetics and muscle activity.</H2></DD> <DD class=abstract></H2> 1: <A href="xxxxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'Sports%20Med.');">Sports Med.</A> 1990 Mar;9(3):173-91. <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu2180031);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>A rational management of tennis elbow.</H2></DD> <DD class=abstract> <H2>1: <A href="xxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'J%20Athl%20Train.');">J Athl Train.</A> 2004 Mar;39(1):88-94.<A href="http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3494&itool=AbstractPlus-nondef&uid=15085216&db=pubmed&url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15085216" target=_blank> <IMG id=linkout-icon-pmc-pmc alt="Click here to read" src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fcorehtml%2Fquery%2Fegifs%2Fhttp%3A--www.pubmedcentral.nih.gov-corehtml-pmc-pmcgifs-pubmed-pmc.gif" border=0></A> <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu15085216);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>Does Cryotherapy Hasten Return to Participation? A Systematic Review.</H2> <DIV class=authors><A href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Hubbard%20TJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Hubbard TJ</A>, <A href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Aronson%20SL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Aronson SL</A>, <A href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Denegar%20CR%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Denegar CR</A>.</DIV></DD> <DD class=abstract>1: <A href="xxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'Cochrane%20Database%20Syst%20Rev.');">Cochrane Database Syst Rev.</A> 2002;(1):CD003528.<A href="http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3058&itool=AbstractPlus-def&uid=11869672&db=pubmed&url=http://dx.doi.org/10.1002/14651858.CD003528" target=_blank> <IMG id=linkout-icon-def-wiley_interscience_150x34 alt="Click here to read" src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fcorehtml%2Fquery%2Fegifs%2Fhttp%3A--www3.interscience.wiley.com-aboutus-images-wiley_interscience_150x34.gif" border=0></A> <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu11869672);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <DL class=commcorr> <DT>Update in: <DD><A href="http://www.ncbi.nlm.nih.gov/pubmed/12519601?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Cochrane Database Syst Rev. 2002;(4):CD003528. </A></DD></DL> <H2>Deep transverse friction massage for treating tendinitis</H2> <H2><a href='javascript:fileFilterViewer("http://cfile261.uf.daum.net/attach/134B990F496AE00109DA1F", "/cfile261/13/4B990F496AE00109DA1F", "Does Cryotherapy Hasten Return to Participation A Systemati.pdf", "grpid%3Dz4ZG%26fldid%3DHCsV%26dataid%3D184%26fileid%3D1%26regdt%3D20090102092155&url=http%3A%2F%2Fcfile261.uf.daum.net%2Fattach%2F134B990F496AE00109DA1F")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_pdf_s.gif" border="0" alt="첨부파일" class="vam"/> Does Cryotherapy Hasten Return to Participation A Systemati.pdf</a></H2> <H2> </H2> <H2><a href='javascript:fileFilterViewer("http://cfile282.uf.daum.net/attach/154B960F496AE006096DA3", "/cfile282/15/4B960F496AE006096DA3", "Does Cryotherapy Improve Outcomes With Soft Tissue Injury.pdf", "grpid%3Dz4ZG%26fldid%3DHCsV%26dataid%3D184%26fileid%3D2%26regdt%3D20090102092155&url=http%3A%2F%2Fcfile282.uf.daum.net%2Fattach%2F154B960F496AE006096DA3")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_pdf_s.gif" border="0" alt="첨부파일" class="vam"/> Does Cryotherapy Improve Outcomes With Soft Tissue Injury.pdf</a></H2> <H2> </H2> <H2><a href='javascript:fileFilterViewer("http://cfile274.uf.daum.net/attach/113C1D0F496AE00B0A3663", "/cfile274/11/3C1D0F496AE00B0A3663", "Effects of cryotherapy on arthrogenic muscle inhibition usi.pdf", "grpid%3Dz4ZG%26fldid%3DHCsV%26dataid%3D184%26fileid%3D3%26regdt%3D20090102092155&url=http%3A%2F%2Fcfile274.uf.daum.net%2Fattach%2F113C1D0F496AE00B0A3663")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_pdf_s.gif" border="0" alt="첨부파일" class="vam"/> Effects of cryotherapy on arthrogenic muscle inhibition usi.pdf</a></H2> <H2> </H2> <H2><a href='javascript:fileFilterViewer("http://cfile273.uf.daum.net/attach/144BAA0F496AE00E09F100", "/cfile273/14/4BAA0F496AE00E09F100", "Knee joint effusion and cryotherapy alter lower chain kinet.pdf", "grpid%3Dz4ZG%26fldid%3DHCsV%26dataid%3D184%26fileid%3D4%26regdt%3D20090102092155&url=http%3A%2F%2Fcfile273.uf.daum.net%2Fattach%2F144BAA0F496AE00E09F100")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_pdf_s.gif" border="0" alt="첨부파일" class="vam"/> Knee joint effusion and cryotherapy alter lower chain kinet.pdf</a></H2> <H2> </H2> <H2><a href='javascript:fileFilterViewer("http://cfile292.uf.daum.net/attach/124BA90F496AE01109531E", "/cfile292/12/4BA90F496AE01109531E", "The use of ice in the treatment of acute soft-tissue injury.pdf", "grpid%3Dz4ZG%26fldid%3DHCsV%26dataid%3D184%26fileid%3D5%26regdt%3D20090102092155&url=http%3A%2F%2Fcfile292.uf.daum.net%2Fattach%2F124BA90F496AE01109531E")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_pdf_s.gif" border="0" alt="첨부파일" class="vam"/> The use of ice in the treatment of acute soft-tissue injury.pdf</a></H2> <H2>.</H2></DD> <DD class=abstract>1: <A href="xxxxxxxxxxxxxxxxxxxxjavascript:AL_get(this,%20'jour',%20'Orthop%20Nurs.');">Orthop Nurs.</A> 1994 Sep-Oct;13(5):21-30. <XSCRIPT language=xxxxxxxxxxxxxxxxxxxxJavaScript1.2></XSCRIPT><A class=dblinks href="xxxxxxxxxxxxxxxxxxxxjavascript:PopUpMenu2_Set(Menu7854825);" target=_self [안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xx[안내]태그제한으로등록되지않습니다-xxonmouseout="PopUpMenu2_Hide();">Links</A></DD> <DD class=abstract> <DIV class=lib_icon></DIV> <H2>Use of cryotherapy for orthopaedic patients.</H2> <DIV class=authors><A href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22McDowell%20JH%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">McDowell JH</A>, <A href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22McFarland%20EG%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">McFarland EG</A>, <A href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Nalli%20BJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Nalli BJ</A>.</DIV></DD> <DD class=abstract></H2> </DD>