An exploration of stroke survivors' perspectives on cycling and the use of electric bikes.

Background: Contrast therapy is the alternation of thermotherapy and cryotherapy. Commonly used modalities of contrast therapy include contrast water therapy (CWT) and cold/hot packs. Despite a lack of research, it is widely used in clinical and sporting settings, particularly to aid recovery. Objectives:The scoping review aims to provide a comprehensive overview of research surrounding the use of contrast therapy for soft tissue injury management and recovery.Major Findings: Twenty-nine full text papers were included, following a search of the databases listed: PubMed, Cochrane, SPORTDiscus, EBSCO, CINHAL and MEDLINE (via OVID). The majority of research on contrast therapy focuses on recovery, using contrast water therapy. Despite a consensus for contrast therapy temperatures of 10-15°C (cold) and 38-40°C (hot), significant variation amongst recovery protocols still exists, with temperatures ranging from 8-15°C and 35.5-45°C and duration ranging from 6-31 minutes. Generally, beneficial effects are reported to subjective measures such as self-reported perception of recovery, fatigue and muscle soreness following contrast therapy. However, the evidence is less clear regarding the influence on physiological measures and performance. Conclusion:Contrast therapy appears to be most commonly used in the form of contrast water therapy for post-exercise recovery purposes. There remains a significant lack of research surrounding the efficacy of contrast therapy for soft tissue injury management and the use of alternative modalities.

Background/Aims For the management of sports injury, cryotherapy is commonly applied, yet modalities differ extensively in application including levels of compression. The aim of this study was to provide a comprehensive review of the current position in the literature on contemporary cryo-compression applications for musculoskeletal sports injury management. Methods A total of eight databases were searched: Sport Discus, Science Direct, CINHAL, Scopus, PubMed, Cochrane, ProQuest and MEDLINE. Publications were restricted to 30 years and had to be in the English language. Medical subject headings, free-text words, and limiting descriptors for concepts related to cryotherapy and compression for sports injury were applied. Inclusion criteria determined at least one modality of cryotherapy treatment applied simultaneous to compression or as a comparison, relevant to sports injury management. Modalities included cryo-compressive devices and gel/ice packs, in association with concomitant compression. Male, female, healthy and injured participants were included. Two reviewers independently selected eligible articles, resulting in 22 studies meeting the inclusion criteria following full-text appraisal. Results Inconsistent methodologies, low sample sizes and variability in outcome measures provided uncertainty over optimum protocols. A lack of previous understanding in the protocols in the available literature for isolated cryotherapy/compression applications prevents understanding of the therapeutic benefits of combined cryo-compression. No definitive agreement behind optimal cryo-compression applications were identified collectively from studies other than the consensus that compression aids the magnitude of cooling. Conclusions Although compression appears a useful adjunct to cooling modalities for the management of sports injury, no definitive agreement on optimum compression concurrent with cooling protocols were drawn from the studies. This was because of several methodological gaps in reporting throughout studies, highlighting a lack of studies that represent applications of compression and cryotherapy within a sporting context or applied nature within the available research.

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Clinical assessment and management of musculoskeletal conditions of different joints may be broken down into considerations of Pain, Alignment, Strength and Stability (PASS). In recent years these factors have allowed a systematic approach and has enabled the development in our understanding of clinical subgroups, which enable targeted or stratified care. This paper considers the use of the PASS concept to determine the most appropriate treatment and interventions, specifically when considering treatment of two common musculoskeletal conditions, patellofemoral pain and low back pain.