Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion

Phys Ther. 2010 Apr;90(4):581-91. doi: 10.2522/ptj.20090131. Epub 2010 Feb 25.


Background: It is well known that reducing tissue temperature changes sensory and motor nerve conduction. However, few studies have compared the effect of different cold modalities on nerve conduction parameters.

Objective: The purpose of this study was to compare the effects of ice pack, ice massage, and cold water immersion on the conduction parameters of the sural (sensorial) and tibial motor nerves.

Design: An experimental study was conducted in which the participants were randomly assigned to 1 of 3 intervention groups (n=12 per group). Independent variables were cold modality and pre- and post-cooling measurement time. Dependent variables were skin temperature and nerve conduction parameters.

Methods: Thirty-six people who were healthy, with a mean (SD) age of 20.5 (1.9) years, participated in the study. Each group received 1 of the 3 cold modalities, applied to the right calf region for 15 minutes. Skin temperature and nerve conduction parameters were measured before and immediately after cooling.

Results: All 3 modalities reduced skin temperature (mean=18.2 degrees C). There also was a reduction in amplitude and an increase in latency and duration of the compound action potential. Ice massage, ice pack, and cold water immersion reduced sensory nerve conduction velocity (NCV) by 20.4, 16.7, and 22.6 m/s and motor NCV by 2.5, 2.1, and 8.3 m/s, respectively. Cold water immersion was the most effective modality in changing nerve conduction parameters.

Limitations: The cooling area of the ice massage and ice pack was smaller than that of the cold water immersion. The examiner was not blinded to the treatment group. The population included only participants who were healthy and young.

Conclusions: All 3 modalities were effective in reducing skin temperature and changing sensory conduction at a physiological level that is sufficient to induce a hypoalgesic effect. The results suggest that cold water immersion, as applied in this study, is the most indicated modality for inducing therapeutic effects associated with the reduction of motor nerve conduction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Action Potentials / physiology
  • Adult
  • Cold Temperature*
  • Female
  • Humans
  • Ice
  • Immersion
  • Male
  • Massage
  • Motor Neurons / physiology*
  • Neural Conduction / physiology*
  • Sensory Receptor Cells / physiology*
  • Skin Temperature
  • Tibial Nerve / physiology


  • Ice