A systematic review of the effectiveness of contrast baths.

STUDY DESIGN Systematic review. INTRODUCTION Contrast baths are used as an intervention in hand therapy, yet it is unclear which patients, if any, benefit from this intervention. PURPOSE OF THE STUDY To examine the nature and quality of the evidence regarding the use of contrast baths using a systematic review process. METHODS Of a total of 28 clinical research articles on contrast baths, from 1938 forward, ten met the inclusion criteria set by the authors. RESULTS These studies addressed the physiological changes of hot and cold on blood flow, intramuscular temperature, subcutaneous temperature, and the influence of room temperature and age. The subjects included normal/healthy volunteers and patients with a diagnosis of rheumatoid arthritis, diabetes, or foot/ankle injuries. The diversity of conditions, protocols, and outcomes limited the ability to make definitive conclusions on efficacy. CONCLUSIONS The contrast bath procedure may increase superficial blood flow and skin temperature, though the evidence on the impact on edema is conflicting. No relationship between physiologic effects and functional outcomes has been established. LEVEL OF EVIDENCE 2A.