In hydrotherapy, baths are one of the ways to apply water to the human body for therapeutic purposes. Baths can be a full or partial immersion of the body in the water of different temperatures. Since ancient times, thermoneutral, warm and hot temperatures (33.5°C - 41°C) have been widely used for foot baths.

In hydrotherapy, ice is a therapeutic agent used in medicine as an integral part of injury treatment and rehabilitation. The application of ice has been shown to produce physiological changes. Ice massage is performed by means of a rubber bag filled with ice or ice water to the head and spine for durations of 15 to 20 minutes. It is a simple and inexpensive procedure, and a study comparing three types of cold simulations (ice application to hands, forehead, and face) and their effects on cardiovascular adaptations (E.g., application of ice to sites other than the hands, including the forehead and face), Blood Pressure (BP) and Heart Rate (HR),(16) were reduced, with a significant improvement in Heart Rate Variability (HRV) toward vagal dominance. The ice pack or intense, prolonged cold applications to the back have a sedative effect on the spinal cord and also on the vasomotor sympathetic nerve centers.

There are few studies on ice massage to the head and spine alone on blood pressure and HRV on warm foot bath as a single treatment in different groups, but no studies on the combination of both treatments.

Because individual treatments have their own benefits, they usually result in greater effects when combined. The present study aimed to investigate the effect of warm foot bath with ice massage to the head and spine on autonomic variables in healthy individuals.

Grouping:

Subjects will be divided into three groups by computer generated randomization:

·       Group 1: Warm foot bath with ice massage to head and spine for 20 minutes (n ≥ 30).

·       Group 2: Warm foot bath for 20 minutes (n ≥30).

·       Group 3: Ice massage to head and spine for 20 minutes (n ≥ 30)

 Method:

·       Institutional ethical clearance will be obtained prior to the conduct of the study.

·       Informed consent will be obtained from the individuals by explaining the study objectives, methods, intervention and will be obtained from every participant after an appraisal about the study protocol.

·       All the rights of the individual pertaining to the study in their own language.

·       After selecting the eligible subjects.

·       Allotment will be done by using a Computer-generated random number.

·       Group 1: Warm foot bath with ice massage to head and spine for 20 minutes (n  30).

·       Group 2: Warm foot bath for 20 minutes (n ≥ 30).

·       Group 3: Ice massage to head and spine for 20 minutes (n ≥ 30).

·       Assessments will be done before and after the intervention (Fig. 1).

·  Data collected will be tabulated and analyzed using appropriate statistical methods.