Research for whole body Cryotherapy
Results show that 3min of WBC to causes significant changes in autonomic balance which are induced by peripheral and central blood volume changes. Cryostimulation also induced changes in core body temperature, with a maximum drop observed 50– 60 min after the stimulation. Autonomic and thermal reactions to cryostimulation were observed up to 6 h after treatment and were not harmful.
The cardiovascular, autonomic and thermal response to whole-body cryostimulation exposure are not completely known. Thus the aim of this study was to evaluate objectively and noninvasively autonomic and thermal reactions observed after short exposure to very low temperatures.
We examined 25 healthy men with mean age 30.1+-3.7 years and comparable anthropomorphical characteristic. Each subject was exposed to cryotherapeutic temperatures in a cryogenic chamber for 3min (approx. 120°C).
The cardiovascular and autonomic parameters were measured noninvasively with Task Forces Monitor. The changes in core body temperature were determined with the Vital Senses telemetric measurement system.
Results show that 3min to cryotherapeutic temperatures causes significant changes in autonomic balance which are induced by peripheral and central blood volume changes.
Cryostimulation also induced changes in core body temperature, maximum drop of core temperature was observed 50– 60 min after the stimulation. Autonomic and thermal reactions to cryostimulation were observed up to 6 h after the exposure and were not harmful for examined subjects.Publisher Website
Whole-body cryotherapy applied together with kinesitherapy was effective in reducing pressure pain in the ligaments (average 20%) and tension in significant pelvic muscles (average 30%). The cryotherapy and kinesitherapy combination applied to the treatment of spinal overload syndrome gives satisfactory clinical outcome.
In pain syndromes involving the lumbo-sacral region, the pelvis, and the lower extremities, the mobility of the hip joint is disrupted by structural and functional changes in tissues, which also cause irritation of the ligaments and muscles of the pelvis. Dislocation of the pelvis with incorrect alignment of the sacroiliac bone leads to an oblique load on the lumbar vertebrae and muscle tension.
In recent years whole-body cryotherapy has come to be more and more often applied in the comprehensive treatment of spinal overload syndrome, to reduce pain, relax skeletal muscles, and increase joint mobility. Material and method. The research was conducted in the SP ZOZ outpatient rehabilitation clinic in Zgorzelec, Poland, from December 2004 to March 2005.
The study group consisted of 20 persons, 13 women (65%) and 7 men (35%), ranging in age from 23 to 77 years (mean age 47). Each of the subjects received whole-body cryotherapy in a 20-day cycle, once a day for 3 minutes at a temperature of -130 degrees C. The length of the pelvic muscles implicated in overload syndrome, the pain pressure of the pelvic ligaments, the Pidelou test, and Patrick’s symptom were assessed before therapy was commenced and after its completion.
Immediately after each session the patients received kinesitherapy under supervision of a physiotherapist, Magine exercises, post-isometric relaxation using Mitchel’s method for the muscles and the intraspinal, lumbo-sacral and ilio-lumbar ligaments, active of the lumbar spine in the non-painful direction, and neuromobilization using Butler’s method. This was supplemented by exercises on the ergometer in horizontal position.
Whole-body cryotherapy applied together with kinesitherapy was effective in reducing pressure pain in the ligaments (average 20%) and tension in significant pelvic muscles (average 30%).
The cryotherapy and kinesitherapy combination applied to the treatment of spinal overload syndrome gives satisfactory clinical outcome.Publisher Website
It is concluded that cold chamber exposures have an analgesic effect in patients suffering from fibromyalgia and that in addition the thermal tolerance is increased
There are only a few studies looking at the analgesic effect of cold chamber exposures in patients suffering from fibromyalgia. However, in addition to the pain symptoms, patients with this syndrome also frequently suffer from an increased sensitivity to cold. Thus, the effect of cold chamber exposures (-67°C, 1-3 min) on the sensitivity to pain, thermal comfort and actual pain intensity was examined in 17 female patients with fibromyalgia (ACR criteria) and compared with a control group without applications.
The measured parameters were pressure, heat and cold pain thresholds (pressure algometry, Peltier thermode), thermal comfort (local thermal cutaneous stimulation applied by a Peltier thermode; systematically varied stimulation sequence) as well as the actual pain intensity and feeling of general well-being (visual analogue scales, VAS). The thermal pain thresholds were determined on the inner surface of the forearm, and the sensitivity to pressure pain at the styloideus radii. The thermal comfort measurements were carried out at the forehead. After cold chamber exposures, cold and pressure pain thresholds were significantly or very significantly increased while no shifts of the threshold were evidenced for heat pain. In the range of the applied thermode temperatures of 17.5 – 27.5 °C the subjective temperature sensation curve was significantly increased after cold chamber exposure as compared to initial values and control period.
The mean thermal tolerance range calculated from the intersection points of comfort curve and temperatures applied showed a statistically significant increase. Such an improvement of the thermal tolerance could not be evidenced for the control group. The mean values of the actual pain scores (VAS) were also significantly reduced after cold chamber exposures, and the overall-being improved. It is concluded that cold chamber exposures have an analgesic effect in patients suffering from fibromyalgia and that in addition the thermal tolerance is increased.
Now, further studies have to be carried out to determine if repeated cold chamber applications yield in stable adaptive improvements of pain sensitivity and thermal discomfort.PDF Article
For patients with rheumatoid arthritis, a significant reduction of DAS28 (Disease Activity Score) and VAS (visual analog scale) measures were seen after an average of 63 days with p<0.01. In ankylosing spondylitis patients, the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) was analysed and showed a significant reduction (p = 0.01). Significant pain relief also allowed more intensive physiotherapy.
As yet, whole-body cryotherapy is especially used for the therapy of chronic inflammatory arthritis. An analgetic effect has been described in several studies. However, only few data exist concerning the long-term effects of this therapy. PATIENTS AND METHODS: A total of 60 patients with rheumatoid arthritis (n = 48), and ankylosing spondylitis (n = 12) was analyzed. Patients underwent treatment with whole-body cryotherapy twice a day. The average age was 55.7 +/- 10.33. The study group consisted of 48 female and twelve male patients. The average number of therapeutic treatments with cryotherapy was 15.8 +/- 8.37, the average follow-up 63.4 +/- 63.48 days.
13 patients (21.7%) discontinued treatment because of adverse effects. For patients with rheumatoid arthritis, DAS28 (Disease Activity Score) and VAS (visual analog scale) were determined. A significant reduction of both parameters was found (DAS 3.9 +/- 1.22 vs. 3.4 +/- 1.08; p < 0.01; VAS 51.4 +/- 16.62 vs. 37.9 +/- 19.13; p < 0.01). BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) was analyzed for patients with ankylosing spondylitis, and also showed a significant reduction (4.4 +/- 1.91 vs. 3.1 +/- 1.34; p = 0.01).
Thus, whole-body cryotherapy is an effective option in the concept of treatment of inflammatory rheumatic diseases. The relief of pain allows an intensification of physiotherapy. A significant reduction of pain over a period of 2 months could be shown.Publisher Website
Cryotherapy reduces pain and swelling, results in skeletal muscle relaxation and has been shown to increase the range of motion in joint disorders. There are relatively few contra-indications, and treatments are short and convenient, and improve ability to do physical therapy. It provides a useful modality for rehabilitation and prevention of osteoporosis.
Cryotherapy is use of temperature lower than -100 degrees C onto body surface, for 2-3 minutes, in aim to cause physiological reactions for cold and to use such adapting reactions. Organism’s positive response to cryotherapy supports treatment of basic disease and facilitates kinesitherapy. Low temperature may be obtained by use of air flow cooled with liquid nitrogen; this could be applied either locally, over chosen part of the body, or generally, over the whole body, in cryosauna or in cryochamber.
The most efficiently is applying cryotherapy twice a day, with at least 3 hours interval. Kinesitherapy is necessarily used after each cryotherapy session. Whole treatment takes 2 to 6 weeks, depending on patient’s needs. Cryotherapy reduces pain and swellings, causes skeletal muscles relaxation and increase of their force, also, motion range in treated joints increases.
Thus, cryotherapy seems to fulfill all necessary conditions for rehabilitation in osteoporosis. Cryotherapy represents numerous advantages: it takes short time for applying, being well tolerated by patient, also patient’s status improves quickly. In addition, contraindications against cryotherapy are rare. All this makes cryotherapy a method for a broad use in prophylactics and treatment of osteoporosis.
After three weeks of whole body cryotherapy, a decrease of at least 50% from the baseline of the Hamilton’s depression rating scale (17 scores) in 34.6% of the study group and 2.9% of the control group were found, a decrease of at least 50% from the baseline Hamilton’s anxiety rating scale score in 46.2% of the study group and in none of the control group were found.
Rheumatism has been treated using whole-body cryotherapy (WBCT) since the 1970s. The aim of this study was to assess the efficacy of WBCT as an experimental, adjunctive method of treating depressive and anxiety disorders. Materials and Methods: A control (n=34) and a study group (n=26), both consisting of outpatients 18–65 years old with depressive and anxiety disorders (ICD-10), received standard psychopharmacotherapy.
The study group was additionally treated with a series of 15 daily visits to a cryogenic chamber (2–3 min, from –160°C to –110°C). The Hamilton’s depression rating scale (HDRS) and Hamilton’s anxiety rating scale (HARS) were used as the outcome measures.
After three weeks, a decrease of at least 50% from the baseline HDRS-17 scores in 34.6% of the study group and 2.9% of the control group and a decrease of at least 50% from the baseline HARS score in 46.2% of the study group and in none of the control group were noted.
These findings, despite such limitations as a small sample size, suggest a possible role for WBCT as a short-term adjuvant treatment for mood and anxiety disorders.Publisher Website
An acute increase in the high frequency power (HFP) of RR-intervals induced by WBC indicated an increase in cardiac parasympathetic modulation, but after repeated WBC the increase was attenuated. The repeated WBC exposure-related increase in resting low frequency power (LFP) of RR-intervals resembles the response observed related to exercise training
The purpose of this study was to examine thermal (body temperature, thermal sensation and comfort ratings), circulatory (blood pressure, heart rate variability) and neuromuscular performance responses to whole-body cryotherapy (WBC, -110 °C).
Altogether 66 healthy subjects were exposed to WBC for two minutes. The acute and long- term changes were examined, when the subjects were exposed to WBC three times a week during three months. Skin temperatures decreased very rapidly during WBC, but remained such a high level that there was no risk for frostbites. The effects on rectal temperature were minimal. Repeated exposures to WBC were mostly well tolerated and comfortable and the subjects became habituated at an early stage of trials. WBC increased both systolic (24 mmHg) and diastolic (5 mmHg) blood pressures temporarily.
Adaptation of blood pressure was not found during three months. The acute cooling-related increase in high-frequency power of RR-intervals indicated an increase in cardiac parasympathetic modulation, but after repeated WBC the increase was attenuated. The repeated WBC exposure-related increase in resting low frequency power of RR-intervals resembles the response observed related to exercise training.
There are signs of neuromuscular adaptation, especially in dynamic performance. A single WBC decreased flight time in drop-jump exercise, but after repeated WBC these changes were almost vanished. This adaptation was confirmed by the change of the activity of the agonist muscle, which increased more and the change of the activity of antagonist muscle, which increased less/did not change after repeated WBC indicating reduced co-contraction and thus, neuromuscular adaptation.PDF Article
WBC stimulates the sympathetic nervous system via alpha-adrenergic receptors, causing peripheral vasoconstriction. This induces adaptive changes with effects of analgesia, reduction of inflammation, and increases in serum markers of tissue repair. The largest focuses of research are in sport’s recovery and performance, along with adjuvant treatment in multiple sclerosis, depression and cardiovascular health.
Whole Body Cryotherapy (WBC) is a hypothermic application designed to reduce musculoskeletal pain and inflammation. WBC stimulates the sympathetic nervous system via alpha-adrenergic receptors, causing dramatic peripheral vasoconstriction. This induces adaptive changes correlating with effects of analgesia, reduction of inflammation, and increases in serum markers of tissue repair.
Research conducted over the last two decades, primarily in Europe, has established therapeutic efficacy of WBC in a wide range of clinical areas. The largest focuses of research have been pain management and athletic performance. It has been shown to effectively reduce pain and swelling and improve physical performance.
Due to the numerous adaptive physiological responses, WBC has also been studied as an adjunct treatment for: atopic dermatitis, cardiovascular health, depression and Multiple Sclerosis.PDF Article
62 elderly women were exposed to WBC in combination with physiotherapy for 6 weeks and compared with a healthy women. Results showed a statistically significant changes in bone turnover markers: decreased serum osteocalcin and increased carboxyterminal cross-linked telopeptide of type I collagen (ICTP). Improvements in muscle function were attributed to physiotherapy.
To prevent the osteoporosis by applying physiotherapy is important for avoiding fractures. Cryotherapy is an established method of physiotherapy; and is usually followed by relaxing gymnastics. The aim of the study was to assess the possible influence of whole body cryotherapy followed by relaxing gymnastics on bone turnover and muscular function in elderly women. The study was carried out on 62 elderly women (mean age 69.2 ± 4.5 yr). None had a past history of osteoporotic fracture.
Osteoporosis was diagnosed in 14 of them, osteopenia in another 30, and normal BMD was shown in the remaining 18. The control group were 20 young healthy women. The subjects were exposed to whole body cryotherapy for 6 weeks, 5 times weekly (3 minutes session each time) in a cryochambre of a temperature between -110 and -150°C. Then, they performed relaxing gymnastics for 45 minutes. Serum osteocalcin (OC) and carboxyterminal cross-linked telopeptide of type I collagen (ICTP) were measured, and a functional assessment of back flexors and extensors by the isokinetic method was carried out at the beginning and at the end of the study.
We observed a statistically significant decrease of OC (p < 0.05) and an increase of ICTP (p < 0.05) in serum in the entire group of elderly women following the physiotherapy course. Bone turnover markers in the control group increased, but only statistically significant changes were in ICTP (p < 0.05). The functional muscle analysis revealed positive influence of physiotherapy for back flexors and extensors activity (p < 0.05).
In conclusion, cryotherapy followed by relaxing gymnastics influences the bone turnover in elderly women. On the other hand, this form of physiotherapy induced positive changes in muscle function, in terms of back flexors and extensors activity.Publisher Website
The results indicates complete elimination of tinnitus in 4 patients, decrease in their intensity in 47 patients, maintenance of the ailment on the same level in 13 people and slightly increase of tinnitus in 16 patients. After treatment decrease of average hearing loss and average hearing damage were observed. Treatment of tinnitus may be effective by using whole-body cryotherapy.
MATERIALS AND METHODS:
The research was carried out in 120 patients (aged 20-68) with tinnitus, divided into two groups: I–80 patients treated by cryotherapy and II–40 patients non treated. There were: 73 women and 47 men. Among patients of I group: 39 reported bilateral tinnitus, 20 reported right tinnitus, 15 reported left tinnitus and 6 reported tinnitus in head. Duration of the ailment took from 1 month to 23 years. The methods included: taking a history, otolaryngological physical examination, audiometry establishing level of tinnitus, medical consultation, X-ray examination of chest and cervical spine and CT of head. After examinations and additional consultations the patients were qualified for cryotherapy unless there were some contraindications. The patients underwent 10 procedures in two cycles with the weekend break. They were in cryochamber in temperature of -110˚C for 3 minutes. After cryotherapy they used kinesitherapy for 45 minutes. Intensity and troublesomeness of tinnitus was evaluated using self-assessment chart (point scale 0-100) and audiometry establishing level of tinnitus before and after treatment.
The results indicates complete elimination of tinnitus in 4 patients, decrease in their intensity in 47 patients, maintenance of the ailment on the same level in 13 people and slightly increase of tinnitus in 16 patients. In audiometry we could observe in I group changes in frequency of tinnitus in 138 ears and changes in intensity of tinnitus in 91 ears. After treatment decrease of average hearing loss and average hearing damage were observed.
Treatment of tinnitus may be effective by using whole-body cryotherapy.Publisher Website
Three brief exposures to WBC separated by 1 week are not sufficient to induce physiological changes in IL-6 or core temperature. There are however significant changes in tissue oxyhaemoglobin, deoxyhaemoglobin, tissue oxygenation index, skin temperature and thermal sensation. We conclude that a 2 minute WBC exposure was the optimum exposure length at temperatures of -135˚C and could be applied as the basis for future studies.
Whole body cryotherapy (WBC) is the therapeutic application of extreme cold air for a short duration. Minimal evidence is available for determining optimal exposure time.
To explore whether the length of WBC exposure induces differential changes in inflammatory markers, tissue oxygenation, skin and core temperature, thermal sensation and comfort.
This study was a randomised cross over design with participants acting as their own control. Fourteen male professional first team super league rugby players were exposed to 1, 2, and 3 minutes of WBC at -135˚C.
Testing took place the day after a competitive league fixture, each exposure separated by seven days.
No significant changes were found in the inflammatory cytokine interleukin six. Significant reductions (p,0.05) in deoxyhaemoglobin for gastrocnemius and vastus lateralis were found. In vastus lateralis significant reductions (p,0.05) in oxyhaemoglobin and tissue oxygenation index (p,0.05) were demonstrated.
Significant reductions (p,0.05) in skin temperature were recorded. No significant changes were recorded in core temperature. Significant reductions (p,0.05) in thermal sensation and comfort were recorded.
Three brief exposures to WBC separated by 1 week are not sufficient to induce physiological changes in IL-6 or core temperature. There are however significant changes in tissue oxyhaemoglobin, deoxyhaemoglobin, tissue oxygenation index, skin temperature and thermal sensation.
We conclude that a 2 minute WBC exposure was the optimum exposure length at temperatures of -135˚C and could be applied as the basis for future studies.Publisher Website
The obtained results may suggest that cryotherapy prior to exercise may have some antioxidant and anti-inflammatory properties. The relations between the level of studied oxidative stress and inflammatory markers may testify to the contribution of reactive oxygen species in cytokines release into the blood system in response to exercise and WBC.
The aim of the study was to determine the effect of single whole-body cryotherapy (WBC) session applied prior to submaximal exercise on the activity of antioxidant enzymes, the concentration of lipid peroxidation products, total oxidative status, and the level of cytokines in blood of volleyball players. The study group consisted of 18 male professional volleyball players, who were subjected to extremely cold air (−130˚C) prior to exercise performed on cycloergometer.
Blood samples were taken five times: before WBC, after WBC procedure, after exercise preceded by cryotherapy (WBC exercise), and before and after exercise without WBC (control exercise). The activity of catalase statistically significantly increased after control exercise. Moreover, the activity of catalase and superoxide dismutase was lower after WBC exercise than after control exercise (? < 0.001). After WBC exercise, the level of IL- 6 and IL-1? was also lower (? < 0.001) than after control exercise. The obtained results may suggest that cryotherapy prior to exercise may have some antioxidant and anti-inflammatory properties.
The relations between the level of studied oxidative stress and inflammatory markers may testify to the contribution of reactive oxygen species in cytokines release into the blood system in response to exercise and WBC.Publisher Website
A study in 30 healthy subjects showed that immediately post- WBC there was decreased heart rate and cardiac output, and increased stroke volume, total peripheral resistance and baroreceptor reflex sensitivity. At 3 h and 6 h after WBC there was a significant drop in baroreceptor reflex sensitivity due to increased thermogenesis. There were no significant increases in BP.
Whole-body cryotherapy (WBC) is an increasing applied cryotherapeutic method, that involves application of a cryotherapeutic factor to stimulate the body by the means of intense hypothermia of virtually the body’s entire area. This method is still not well recognized in Western Europe. However in recent years it is becoming increasingly popular in sports medicine and also in clinical application.
Cryotherapeutic agents used in WBC are considered to be a strong stress stimulus which is associated with a variety of changes in functional parameters, particularly of the cardiovascular and autonomic nervous systems. However, such strong influence upon the entire body could be associated with the risk of unexpected reactions which might be dangerous for homeostasis. The present study evaluated the complex hemodynamic physiological reactions in response to WBC exposure in healthy subjects. Thirty healthy male volunteers participated.
Each subject was exposed to WBC (-120°C) for 3-min. None of the participants had been exposed to such conditions previously. The research was conducted with modern and reliable measurements techniques, which assessed complex hemodynamic reactions and skin temperature changes non-invasively. All measurements were performed four times (before WBC, after WBC, WBC + 3 h and WBC + 6 h) with a Task Force Monitor (TFM – CNSystems, Medizintechnik, Gratz, Austria). Body superficial temperature was measured by infrared thermographic techniques – infrared camera Flir P640 (Flir Systems Inc., Sweden).
Our results show a significant decrease in heart rate, cardiac output, and increase in stroke volume, total peripheral resistance and baroreceptors reflex sensitivity. These changes were observed just after WBC exposure. At stages WBC + 3 h and WBC + 6 h there was observed a significant drop in baroreceptors reflex sensitivity due to increased thermogenesis. In conclusion, the present findings suggest that WBC strongly stimulates the baroreceptor cardiac reflex in response to body fluid changes which sequentially modulate HR and BP control in supine and resting healthy subjects.
The study was performed on randomized and homogenic group of young healthy subjects. Our findings are important for WBC safety determination in research and clinical studies.Publisher Website
Significant improvements were seen in both groups in terms of range of movement, and on patients scores for overall improvement (using VAS). A statistically significant difference in all outcomes was seen in the groups who combined WBC with physiotherapy: clinically measured ROMS, pain and function: clinically measured ROM., pain and function. VAS and ASES scores were also significantly improved (p<0.01)
To compare 2 different treatment approaches, physical therapy modalities, and joint mobilization versus whole-body cryotherapy (WBC) combined with physical therapy modalities and joint mobilization, for symptoms of adhesive capsulitis (AC) of the shoulder. Design: A randomized trial. Setting: Hospital.
Patients with AC of the shoulder (NZ30). Intervention: Patients were randomly assigned to 2 groups. The WBC group received physical therapy modalities, passive joint mobilization of the shoulder, and WBC, whereas the non-WBC group received only physical therapy modalities and passive joint mobilization of the shoulder. Main Outcome Measures: Visual analog scale (VAS), active range of motion (ROM) of flexion, abduction, internal and external rotation of the shoulder, and the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) were measured before and after the intervention.
A statistically significant difference between groups was found for the VAS, active ROM of flexion, abduction, internal rotation, and external rotation, and the ASES with greater improvements in the WBC group (Ps<.01). Overall, both groups showed a significant improvement in all outcome measures and ROM measures from pre to post at a level of P<.01.
There is significant improvement with the addition of WBC to treatment interventions in this sample of patients. Archives of Physical Medicine and Rehabilitation 2013;94:9-16Publisher Website
We observed in the athletes increase of haptoglobin and an increase of MSCV after the treatment period. Conclusions. WBC reduces sports haemolysis, as judged from MSCV and haptoglobin data, supported from other haematological values, as well as the absence of mean corpuscolar volume and reticulocytes increase. The treatment is useful to prevent the physiological impairments derived from sport haemolysis.
Sport’s anemia is a common risk for athletes. The principal source of an accelerated turnover of the erythrocytes in sportsmen is the intravascular hemolysis. This phenomenon is induced by mechanical breakage for impact of feet and muscular contractions, but also by osmotic changes causing membrane fragility, typically evident after exercise, when free radicals are increased.
Whole- body cryotherapy (WBC) covers a wide range of therapeutic applications and consists of briefly exposing the body to extremely cold air. In sports medicine, WBC is used to improve recovery from muscle injury; however, empirical studies on its application to this area are lacking. Design and Methods. We recruited ten rugby players of the Italian National Team.
In these athletes we measured hematological parameters, before including mean sphered cell volume (MSCV) by means of Coulter LH750, besides of haptoglobin, and after WBC. The subjects underwent five sessions on alternate days once daily for one week. During the study period, the training workload was the same as that of the previous weeks.
We observed in the athletes increase of haptoglobin and an increase of MSCV after the treatment period.
WBC reduces sports haemolysis, as judged from MSCV and haptoglobin data, supported from other haematological values, as well as the absence of mean corpuscolar volume and reticulocytes increase.
The treatment is useful to prevent the physiological impairments derived from sport haemolysis.Publisher Website
Professional tennis players experienced an intensified inflammatory response after the completed tournament season, which may lead to overreaching. Applying whole- body cryostimulation in conjunction with moderate-intensity training was more effective for the recovery process than the training itself. The 5-day exposure to cryostimulation twice a day ameliorated the cytokine profile, resulting in a decrease in pro-inflammatory cytokine TNF-a, and an increase in anti-inflammatory cytokine interleukin 6.
Tournament season can provoke overreaching syndrome in professional tennis players, which may lead to deteriorated performance. Thus, appropriate recovery methods are crucial for athletes in order to sustain high-level performance and avoid injuries. We hypothesized that whole-body cryostimulation could be applied to support the recovery process. Objective: To assess the effects of 5 days of whole-body cryostimulation combined with moderate-intensity training on immunologic, hormonal, and hematologic responses; resting metabolic rate; and tennis performance in a posttournament season. Design: Controlled laboratory study.
National Olympic Sport Centre. Patients or Other Participants: Twelve high-ranking professional tennis players. Intervention(s): Participants followed a moderate-intensity training program. A subgroup was treated with the 5-day whole- body cryostimulation (-120˚C) applied twice a day. The control subgroup participated in the training only. Main Outcome Measure(s): Pretreatment and posttreatment blood samples were collected and analyzed for tumor necrosis.
Cryostimulation is a general term used to describe localized cold therapy, water immersion, and ice- pack therapy as well as whole-body cryostimulation.1,2 It is a popular rehabilitation method because it limits secondary tissue damage and functions as a support for training programs. Whole-body cryostimulation relies on the exposure of a whole organism to an extremely low temperature (below -100˚C) in a special chamber for 2 to 3 minutes. This form of cryostimulation was first introduced and modeled for therapeutic purposes in the 1970s by Yamauchi et al.3 Due to its limited availability, whole-body cryostimulation is used rarely.4,5 However, it may accelerate the factor a, interleukin 6, testosterone, cortisol, and creatine kinase. Resting metabolic rate and performance of a tennis drill were also assessed.
Proinflammatory cytokine (tumor necrosis factor a) decreased and pleiotropic cytokine (interleukin 6) and cortisol increased in the group exposed to cryostimulation. In the same group, greater stroke effectiveness during the tennis drill and faster recovery were observed. Neither the training program nor cryostimulation affected resting metabolic rate.
Professional tennis players experienced an intensified inflammatory response after the completed tourna- ment season, which may lead to overreaching. Applying whole- body cryostimulation in conjunction with moderate-intensity training was more effective for the recovery process than the training itself. The 5-day exposure to cryostimulation twice a day ameliorated the cytokine profile, resulting in a decrease in tumor necrosis factor a and an increase in interleukin 6.PDF Article
There are a number of theories as to why WBC could have be preventative of Alzheimer’s. Most important concepts: reactive oxygen species as a consequence of inflammation can lead to disruption of the blood brain barrier, neuronal loss and cognitive decline. Oxidative stress can lead to deposition of amyloid-ß plaques. In addition, hypothermia has been shown to be neuroprotective.
Alzheimer’s disease (AD), which is the most common form of dementia, constitutes one of the leading causes of disability and mortality in aging societies. Currently recommended medications used in treating AD include cholinesterase inhibitors and the NMDA antagonist – memantine, but poorly counteract pro- gression of the disease.
According to current knowledge, the neuropathological process underlying the etiology of AD begins many years, if not decades, before the development of overt symptoms of dementia. Mild cognitive impairment (MCI) is regarded as the first detectable manifestation of cognitive decline. Nowadays, there is a general consensus that vascular alterations, oxidative stress and inflammatory response contribute to the development of AD.
Following these mechanisms and tracing the anti-inflam- matory and anti-oxidative effects of cryostimulation, we postulate that whole-body cryotherapy (WBCT) might be utilized as a means of preventing AD.
WBCT is a relatively safe and cost-effective procedure, which is widely applied in various medical specialties. Thus, there is an urgent necessity to evaluate the long-term effectiveness of WBCT in the prevention of AD in patients with MCI and healthy individuals.Publisher Website
Bone biomarkers (OPG, RANK, RANKL) as indicators of bone turnover rate were measured in 10 elite rugby players after a week of WBC treatments. OPG was statistically significantly increased, as was the OPG/RANKL ration, indicating new bone formation and an osteogenic effect.
Whole body cryotherapy (WBC) consists of a brief exposure to extreme cold air (-110 ˚C) in a controlled chamber and it is applied in sports medicine to improve recovery from musculoskeletal trauma. The aim of this study is to better define the beneficial effect of WCB on the musculoskeletal system of athletes, in particular on bone remodelling.
Remodelling osteoimmunological biomarkers OPG, RANKL and RANK were measured after WBC treatment in 10 male rugby players randomly selected from the Italian National team.
OPG levels were increased significantly, supporting the view that WBC induces an osteogenic effect. Further studies evaluating the effect of WBC on bone metabolism are desirable.Publisher Website
The common marker of muscle damage like creatine kinase remains unchanged and the stress hormone—cortisol shows only a decreasing tendency after the WBC. Nevertheless, we found significant changes in activity of lysosomal enzymes and activity of protease inhibitor, which are also accredited parameters of post-exercise changes in organism. Thus we propose that those proteins may be novel indicators of the effects of application of whole-body cryostimulation in sport recovery.
In this study higher activity of certain lysosomal enzymes with concomitant lower a1-antitryspin activity was revealed in serum of kayaker women after intense exercise without any external stimuli as compared with the exercise preceded by extreme cold application. Whole-body cryostimulation may have hormetic, beneficial impact on reduction of muscle damage.
In studied group of kayaker women the common marker of muscle damage like creatine kinase remains unchanged and the stress hormone—cortisol shows only a decreasing tendency after the WBC. Nevertheless, we found significant changes in activity of lysosomal enzymes and activity of protease inhibitor, which are also accredited parameters of post-exercise changes in organism.
Thus we propose that those proteins may be novel indicators of the effects of application of whole-body cryostimulation in sportsmen.PDF Article
The effects of WBC in MS patients with depression (n=12) and those without depressive symptoms (n=10) were compared. At baseline, TAS was significantly lower in those with, rather than those without depressive symptoms. After a course of WBC, TAS was raised more in depressive than in non-depressive MS patients (p<0.002) with no significant effects on SOD and CAT in erythrocytes.
Oxidative stress (OS) plays an important role in the pathogenesis of multiple sclerosis (MS). In MS patients depression is often observed. Cryotherapy might have an effect on OS. The aim of this study was to compare the effects of whole body cryotherapy (WBCT) on changes in total antioxidative status (TAS) of plasma and activities of antioxidative enzymes in erythrocytes from depressive and non depressive MS patients. Methods. Twenty-two MS patients with secondary progressive disease course (12 depressive and 10 non depressive) were treated with 10 exposures in a cryochamber. Before and after WBCT the plasma TAS and the activities of superoxide dismutase (SOD) and catalase (CAT) in the erythrocytes were measured.
The level of TAS in depressive MS group was significantly lower than in non depressive MS (P < 0.0003). WBCT increased the level of TAS in depressive (P < 0.002) more than in non depressive MS patients (P < 0.01). WBCT treatment of MS patients resulted in the significant increase of TAS level in plasma but had no effects on activities of SOD and CAT.
Our results indicate that WBCT suppresses OS in MS patients, especially in depressive patients.Publisher Website
The analysis of results showed that in response to 20 sessions of whole body cryostimulation, the level of anti-inflammatory cytokines IL-6 and IL-10 increased while pro-inflammatory cytokine IL1-α level decreased. Maximum effect was achieved after the series of 20 sessions.
Cryotherapy is used in the early treatment of acute injuries (sprains, strains, fractures) yet only a few papers discuss the possible influence of whole-body cryostimulation on inflammation mechanisms or immunology.
It is postulated that cold exposure can have an immunostimulating effect related to enhanced noradrenaline response and can be connected with paracrine effects. The aim of this study was to examine the effect of different sequences of whole-body cryostimulations on the level of pro- and anti-inflammatory cytokines in healthy individuals.
The research involved 45 healthy men divided into three groups.The groups were subjected to 5, 10 or 20, 3-minute long whole-body cryostimulations each day at -130°C. Blood was collected for analysis before the stimulations, after completion of the whole series, and 2 weeks after completion of the series, for the examination of any long-term effect.The analysis of results showed that in response to cryostimulation, the level of ani-inflammatory cytokines IL-6 and IL-10 increased while Il-1α cytokine level decreased.
It seems that the most advantageous sequence was the series of 20 cryostimulations due to the longest lasting effects of stimulation after the completion of the whole series of treatments.Publisher Website
This randomised crossover design study compared passive recovery with WBCT for 96h post-exercise. Pro-inflammatory cytokines IL-1 and CRP were decreased, and anti-inflammatory cytokines (IL-1ra) increased when compared to PAS. TNF-a, IL-10 and IL-6 remain unchanged.
The objectives of the present investigation was to analyze the effect of two different recovery modalities on classical markers of exercise-induced muscle damage (EIMD) and inflammation obtained after a simulated trail running race.
Endurance trained males (n=11) completed two experimental trials separated by 1 month in a randomized crossover design; one trial involved passive recovery (PAS), the other a specific whole body cryotherapy (WBC) for 96 h post-exercise (repeated each day).
For each trial, subjects performed a 48 min running treadmill exercise followed by PAS or WBC. The Interleukin (IL) -1 (IL-1), IL-6, IL-10, tumor necrosis factor alpha (TNF-a), protein C-reactive (CRP) and white blood cells count were measured at rest, immediately post-exercise, and at 24, 48, 72, 96 h in post-exercise recovery. A significant time effect was observed to characterize an inflammatory state (Pre vs. Post) following the exercise bout in all conditions (p,0.05).
Indeed, IL-1b (Post 1 h) and CRP (Post 24 h) levels decreased and IL-1ra (Post 1 h) increased following WBC when compared to PAS. In WBC condition (p,0.05), TNF-a, IL-10 and IL-6 remain unchanged compared to PAS condition.
Overall, the results indicated that the WBC was effective in reducing the inflammatory process.
These results may be explained by vasoconstriction at muscular level, and both the decrease in cytokines activity pro-inflammatory, and increase in cytokines anti-inflammatory.Publisher Website
Maximal muscle strength and perceived sensations were recovered after the first WBC session (post 1 h), while recovery took 24 h with FIR, and was not attained through the PAS recovery modality. No differences in plasma CK activity were recorded between conditions. Three WBC sessions performed within the 48 hours after a damaging running exercise accelerate recovery from EIMD to a greater extent than FIR or PAS modalities.
Enhanced recovery following physical activity and exercise-induced muscle damage (EIMD) has become a priority for athletes. Consequently, a number of post-exercise recovery strategies are used, often without scientific evidence of their benefits. Within this framework, the purpose of this study was to test the efficacy of whole body cryotherapy (WBC), far infrared (FIR) or passive (PAS) modalities in hastening muscular recovery within the 48 hours after a simulated trail running race.
In 3 non-adjoining weeks, 9 well-trained runners performed 3 repetitions of a simulated trail run on a motorized treadmill, designed to induce muscle damage. Immediately (post), post 24 h, and post 48 h after exercise, all participants tested three different recovery modalities (WBC, FIR, PAS) in a random order over the three separate weeks. Markers of muscle damage (maximal isometric muscle strength, plasma creatine kinase [CK] activity and perceived sensations [i.e. pain, tiredness, well-being]) were recorded before, immediately after (post), post 1 h, post 24 h, and post 48 h after exercise. In all testing sessions, the simulated 48 min trail run induced a similar, significant amount of muscle damage.
Maximal muscle strength and perceived sensations were recovered after the first WBC session (post 1 h), while recovery took 24 h with FIR, and was not attained through the PAS recovery modality. No differences in plasma CK activity were recorded between conditions.
Three WBC sessions performed within the 48 hours after a damaging running exercise accelerate recovery from EIMD to a greater extent than FIR or PAS modalities.Publisher Website
Participation in the whole body cryostimulation caused an increase in maximal anaerobic power in males (from 11.1 to 11.9 W×kg–1; P < 0.05), but not in females. It can be concluded that whole body cryostimulation can be beneficial, at least in males, for increasing anaerobic capacity in sport disciplines involving speed and strength.
The aim of this study was to determine the influence of whole body cryostimulation on aerobic and anaerobic capacities. Materials and Methods: To test the hypothesis that whole body cryostimulation improves physical capacity, thirty subjects (fifteen males and fifteen females) undertook two ergocycle trials before and after the ten sessions of cryogenic chamber treatment. To assess baseline aerobic capacity, the progressive cycle ergometer test was applied. This allowed determination of maximal oxygen uptake and ventilatory thresholds. Twenty-second Wingate test was performed to assess baseline levels of anaerobic power. After finishing the treatments in the cryogenic chamber, the exercise protocol was repeated. Before the first, and after the last whole body cryostimulation, venous blood samples were drawn to determine basic blood values, including levels of erythrocytes, leukocytes and thrombocytes, hemoglobin concentration, and hematocrit.
There were no changes in aerobic capacity, in both females and males, after ten sessions of 3-minute-long exposures to cryogenic temperature (–130°C). Participation in the whole body cryostimulation caused an increase in maximal anaerobic power in males (from 11.1 to 11.9 W×kg–1; P < 0.05), but not in females.
It can be concluded that whole body cryostimulation can be beneficial, at least in males, for increasing anaerobic capacity in sport disciplines involving speed and strength.Publisher Website
WBC has been shown to reduce sport-related haemolysis and reduce recovery time. There is no enhancement of bone marrow production and therefore no risk of breaking anti-doping rules. Inflammation is reduced, indicated by increased anti-inflammatory IL-10 and decreases in pro-inflammatory IL-2 and IL-8 as well as decrease in intercellular adhesion molecule-1 supported the anti-inflammatory response. Increases in noradrenaline relate to the body’s adaptation to stress.
Cold therapy is commonly used as a procedure to relieve pain symptoms, particularly in inflammatory diseases, injuries and overuse symptoms. A peculiar form of cold therapy (or stimulation) was proposed 30 years ago for the treatment of rheumatic diseases.
The therapy, called whole-body cryotherapy (WBC), consists of exposure to very cold air that is maintained at -110°C to -140°C in special temperature-controlled cryochambers, generally for 2 minutes. WBC is used to relieve pain and inflammatory symptoms caused by numerous disorders, particularly those associated with rheumatic condi- tions, and is recommended for the treatment of arthritis, fibromyalgia and ankylosing spondylitis. In sports medicine, WBC has gained wider acceptance as a method to improve recovery from muscle injury.
Unfortunately, there are few papers concerning the application of the treatment on athletes. The study of possible enhancement of recovery from injuries and possible modification of physiological parameters, taking into consideration the limits imposed by antidoping rules, is crucial for athletes and sports physicians for judging the real benefits and/or limits of WBC. According to the available literature, WBC is not harmful or detrimental in healthy subjects. The treatment does not enhance bone marrow production and could reduce the sport-induced haemolysis. WBC induces oxidative stress, but at a low level. Repeated treatments are apparently not able to induce cumulative effects; on the contrary, adaptive changes on antioxidant status are elicited – the adaptation is evident where WBC precedes or accompanies intense training.
WBC is not characterized by modifications of immunological markers and leukocytes, and it seems to not be harmful to the immunological system. The WBC effect is probably linked to the modifications of immunological molecules having paracrine effects, and not to systemic immunological functions. In fact, there is an increase in anti- inflammatory cytokine interleukin (IL)-10, and a decrease in proinflammatory cytokine IL-2 and chemokine IL-8. Moreover, the decrease in intercellular adhesion molecule-1 supported the anti-inflammatory response.
Lysosomal membranes are stabilized by WBC, reducing potential negative effects on proteins of lysosomal enzymes. The cold stimulation shows positive effects on the muscular enzymes creatine kinase and lactate dehydrogenase, and it should be considered a procedure that facilitates athletes’ recovery. Cardiac markers troponin I and high-sensitivity C-reactive protein, parameters linked to damage and necrosis of cardiac muscular tissue, but also to tissue repair, were unchanged, demonstrating that there was no damage, even minimal, in the heart during the treatment. N-Terminal pro B-type natriuretic peptide (NT-proBNP), a parameter linked to heart failure and ventricular power decrease, showed an increase, due to cold stress.
However, the NT-proBNP concentrations observed after WBC were lower than those measured after a heavy training session, suggesting that the treatment limits the increase of the parameter that is typical of physical exercise. WBC did not stimulate the pituitary-adrenal cortex axis: the hormonal modifications are linked mainly to the body’s adaptation to the stress, shown by an increase of noradrenaline (norepinephrine).
We conclude that WBC is not harmful and does not induce general or specific negative effects in athletes. The treatment does not induce mod- ifications of biochemical and haematological parameters, which could be suspected in athletes who may be cheating. The published data are generally not controversial, but further studies are necessary to confirm the present observations.Publisher Website
MS patients treated with WBC for 3 cycles had increases in TAS compared with healthy controls. MS patients treated with WBC in conjunction with an anti-oxidant in the form of 14 days of melatonin, also had significant increases in the activity of SOD and CAT measured in the erythrocytes.
There is strong evidence that multiple sclerosis (MS) is characterized not only by immune mediated inflammatory reactions but also by neurodegenerative processes. Accumulated data indicate that oxidative stress (OS) plays a major role in this process. Generated in excess, reactive oxygen species (ROS) lead to oxidative stress and are involved in demyelination and axonal damage in MS.
ROS generation may be inhibited partly by hypothermia, which is known as a potent putative neuroprotectant and may inhibit generating free radicals and oxidative stress. Whole-body cryotherapy (WBCT) treatment may improve both survival and neurological outcome in MS patients. The aim of the study was to determine the effects of WBCT on oxidative stress by the level of total antioxidative status (TAS) in plasma and the activity of antioxidative enzymes: superoxide dismutase (SOD) and catalase (CAT) in the erythrocytes from MS patients. Moreover, we measured the combined effects of WBCT and melatonin on TAS and activity of antioxidative enzymes in MS patients. Sixteen MS patients were treated with 3 cycles of 10 exposures in a cryogenic chamber.
The last cycle was accompanied by a 14-day-long supplementation of melatonin (10 mg daily). Healthy subjects as a control group had 1 cycle of WBCT. Our preliminary results for the first time showed that WBCT treatment of MS patients resulted in the increase of TAS but had no effects on activity of antioxidative enzymes: SOD and CAT.
Supplementation of melatonin and the treatment along with WBCT significantly increased the activity of SOD and CAT in erythrocytes of MS patients.PDF Article
Cold-induced thermoregulation is associated with an increase in lipid metabolism. Adipose tissues are activated during exposure to cold to generate heat. In a group of 69 healthy volunteers, increases in HDL, and decreases in total cholesterol, LDL and TG were seen only in the group exposed to more than 10 sessions of cryotherapy.
Systemic cryostimulation is useful treatment, both in sport and medicine, during which human body is exposed to very low, cryogenic temperature (below -100 °C). Although there exists some evidence of its beneficial effect in biological regeneration, so far it has not been unequivocally determined if the positive effect of repeated stimulations depends on their number in a series. The aim of this research was to estimate the influence of 5, 10 and 20 sessions of 3 min-long exposures to cryogenic temperature (-130 °C) on the lipid profile in physically active men.
Sixty-nine healthy volunteers participated in the study. The blood samples were taken in the morning, after overnight fasting, before the first cryostimulation session, and the following morning after the last one (5th,10th, 20th). In serum specimens the concentration of total cholesterol (TCh), HDL cholesterol and triglicerydes were determined using enzymatic methods.
LDL cholesterol level was calculated using Friedewald formula. The changes in lipid profile (LDL decrease with simultaneously HDL increase) occurred after at least 10 sessions of cryostimulation.Publisher Website
Muscle enzymes, creatine kinase (CK) and lactate dehydrogenase (LAD) levels significantly decreased after treatment. No alterations in immunological function were observed but there is a decrease in pro- inflammatory cytokine/chemokine and an increase in anti-inflammatory cytokine. As measured by changes in serum CK and LAD concentrations, and cytokines pathway, short-term cold air exposure was found to improve recovery from exercise-induced muscle injury and/or damage associated with intense physical training.
Whole-body cryotherapy (WBC) covers a wide range of therapeutic applications and consists of briefly exposing the body to extremely cold air. In sports medicine, WBC is used to improve recovery from muscle injury; however, empirical studies on its application to this area are lacking.
To fill this gap, we compared changes in immunological parameters (C3, IgA, IgM, IgG, C-reactive protein, PGE2), cytokines (IL-2, IL-8, IL-10), adhesion molecules (sICAM-1), and muscle enzymes (creatine kinase [CK], lactate dehydrogenase [LAD]) before and after WBC in 10 top-level Italian National team rugby players. The subjects underwent five sessions on alternate days once daily for 1 week.
During the study period, the training workload was the same as that of the previous weeks. Compared to baseline values, immunological parameters remained unchanged, while CK and LAD levels significantly decreased after treatment.
No alterations in immunological function were observed but there is a decrease in pro- inflammatory cytokine/chemokine and an increase in anti-inflammatory cytokine.
As measured by changes in serum CK and LAD concentrations, and cytokines pathway, short-term cold air exposure was found to improve recovery from exercise-induced muscle injury and/or damage associated with intense physical training.Publisher Website
RA patients treated with WBC when compared with those treated with physiotherapy were shown to have reduced levels of histamine (which remained lower for 3 months after treatments were discontinued). Markers of neutrophil activation and cartilage metabolism were also decreased but not with statistical significance.
Conventional physiotherapy (electrotherapy, magnetic fields), kinesitherapy, and whole-body cryotherapy (plus kinesitherapy) are used to relieve pain and inflammation or to improve function in rheumatic diseases. The aim of this study was to investigate the effects of different physiotherapies and cryotherapy on biochemical blood parameters of patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Materials and methods: Twenty patients with RA and 17 patients with OA received whole-body cryotherapy at -140 to -160°C for 2 to 3 min, once daily for 4 weeks.
The sec- ond group of patients (24 with RA and 28 with OA) received conventional physiotherapy for 4 weeks. We measured the parameters of neutrophil activation (respiratory burst, calprotectin) and markers of cartilage metabolism [N-acetyl- beta-D-hexosaminidase (NAHase), ectonucleotide pyro- phosphohydrolase (NTPPHase)] twice: before and 3 months after cryotherapy or physiotherapy.
We showed, for the first time, that cryotherapy significantly reduced (P \ 0.001) histamine levels in the blood of patients with RA. The effect was long-lasting (for at least 3 months). The levels of blood histamine in patients with OA were not changed significantly. Cryo- therapy also downregulated the respiratory burst of PMNs and NAHase activity and upregulated calprotectin levels and the activity of NTPPHase. However, these changes were not statistically significant. In contrast, there were no significant changes in histamine levels or the other biochemical parameters measured in groups of patients treated only with physiotherapy and kinesitherapy.
It may be concluded that the beneficial clinical effects of cryotherapy in RA patients are in part due to the action on the production, release, or degradation of histamine.Publisher Website
After 10 whole body cryotherapy sessions a significant increase in WBC count, especially lymphocytes and monocytes was noted. There was an increase in level of IL6 after first and the last cryostimulation the most pronounced after tenth session. It was concluded that repeated expositions to extremely low temperatures use in cryostimulation have mobilization effect on immunological system.
The influence of extremely low temperatures on the human body and physiological reactions are not fully recognized. It has been postulated that cryostimulation could modify immunological reactions, leukocytes mobilization and levels of cytokines.
The aim of this research was to estimate the influence of a ten sessions 3-min-long exposures to cryogenic temperature (-130 degrees C) on the white blood cell (WBC) count, level of IL6 and the total oxidative and antioxidative status in 15 young, clinically healthy men. Blood samples were obtained in the morning before cryostimulation, again 30 min after treatment and the next day in the morning, both during the first and tenth session.
The WBC count, level of IL6 and total lipid peroxides as the total oxidative status and the total antioxidative status (TAS), were measured. After completing a total of ten whole-body therapy sessions a significant increase in WBC count, especially lymphocytes and monocytes was noted.
There was an increase in level of IL6 after first and the last cryostimulation the most pronounced after tenth session. On the contrary the TAS level decreased significant after the treatment. It was concluded that repeated expositions to extremely low temperatures use in cryostimulation have mobilization effect on immunological system.Publisher Website
Localised hyperbaric CO2 cryotherapy was used on 51 hospitalised patients with acute (n=23) or chronic (n=28) pain. 41 had musculoskeletal and 10 neuropathic pain. Significant pain reduction was seen in both acute (p < 0.001) and chronic (p < 0.001) groups. Pain relief in neuropathic pain was noted, but with too few patients to claim significant efficacy.
To evaluate the analgesic effects of hyperbaric CO2 cryotherapy in elderly inpatients. Methods: An open-label prospective study was conducted in two geriatrics departments in patients with a broad range of pain characteristics.
Each patient underwent a physical evaluation followed by hyperbaric CO2 cryotherapy sessions, whose spacing and number were at the discretion of the physiotherapist. Patients completed a 100-mm visual analog scale for pain severity before and after the sessions.
We included 51 patients, who were treated between May 2 and June 30, 2005. Mean age was 83.7 years, and the female-to-male ratio was 4/1.The patients had acute or chronic pain whose origin was usually musculoskeletal (80.3%) or neurological (18.6%).
Pain scores decreased significantly after four sessions, from 52mm to 13mm (P<0.001) in patients with acute pain and from 45mm to 13mm (P < 0.001) in those with chronic pain.
Hyperbaric CO2 cryotherapy is an innovative tool that should be incorporated within the non-pharmacological armamentarium for achieving pain relief in older patients.Publisher Website
Statistically significant improvements in symptoms of anxiety and depression were seen in patients after a course of 15 daily WBC treatments when compared with a control group taking medication alone. The Hamilton’s depression and Hamilton’s anxiety rating scales were used as the outcome measures, with all items other than gastrointestinal and genitourinary symptoms showing significant improvement.
The whole body cryotherapy (WBCT) is becoming a more popular adjuvant method in rehabilitation and renewal. The objective was to evaluate influence of WBCT on depressive and anxiety symptoms. Materials and methods. The study group (n=26) was treated using a series of 15 daily visits to a cryo- genic chamber (-110° to 160°C) which lasted 2-3 minutes each.
A control (n=34) group was similar to the study group as concerning diagnoses (anxiety and depressive disorders), age and gender. Both groups received standard out-patient psychopharmacotherapy.
The Hamilton Depression Rating Scale and Hamil- ton Anxiety Rating Scale were used to evaluate the severity of symptoms before and after WBCT (3 weeks observation). The self-rating life satisfaction scale was used as well. Two efficacy measures were established: a significantly greater reduction of the scales’ scores and mean scores lower at the endpoint in the study group in comparison to the control group.
Both efficacy criteria were fulfilled for the depression scale in 12 of the 16 HDRS items except gastrointestinal and genitourinary symptoms, hypochondria, body mass and criticism. Concerning the HARS scale, in 11 of 14 anxiety items (except gastrointestinal and genitourinary symptoms and behav- ior) the mean reduction was significantly bigger and the mean final status was better in the experimental group in comparison to the control one.
As for the life satisfaction scale, efficacy was shown in 6 of the11 items: physical and mental health, everyday activity, vocational activity, hobbies and general life satisfac- tion – in the experimental group.
These findings suggest a possible role for WBCT as a short-term adjuvant therapy for depressive and anxious patients.PDF Article
The level of stress expressed by total oxidative status in plasma, resulting from exposure to extremely low temperatures, was statistically significantly lowered 30min after leaving the cryochamber than prior to the exposure. The next day, the TOS level still remained lower than the initial values. The TAS level decreased after leaving the cryochamber and remained elevated the following day.
We have examined the prooxidative–antioxidative reaction to extremely low temperatures (-130 ˚C) during a one-time cryostimulation in 15 young, clinically healthy individuals. The total lipid peroxides as the total oxidative status (TOS) and the total antioxidative status (TAS) were measured in blood plasma collected in the morning of the day of cryostimulation, 30 min after the cryostimulation, and on the following morning.
The level of stress expressed by total oxidative status in plasma, resulting from exposure to extremely low temperatures, was statistically significantly lowered 30min after leaving the cryochamber than prior to the exposure.
The next day, the TOS level still remained lower than the initial values. The TAS level decreased after leaving the cryochamber and remained elevated the following day.Publisher Website
WBC during 2 bouts of high-intensity exercise leads to improved performance (tlim) in thermoneutral conditions by increasing oxygenation to the working muscles, reduced cardiovascular strain (↓HR, ↓Oxygen consumption, ↓RPE) and increased work economy at submaximal intensities.
To examine the effects of a whole-body cryotherapy protocol (3 min at -110°C) on acute recovery and key variables of endurance performance during high-intensity intermittent exercise in a thermoneutral environment.
Eleven endurance athletes were tested twice in a randomized crossover design. 5 x 5 min of high-intensity running (HIR) were followed by one hour of passive rest at ~22°C, that either included 3 min of whole-body exposure to -110°C (WBC) or a placebo intervention of 3 min walking (PBO).
A ramp test protocol was performed before HIR (R1) and after the one hour recovery period (R2). Time to exhaustion (tlim) was measured along with alterations in oxygen content of the m. vastus lateralis (TSI), oxygen consumption (VO2), capillary blood lactate (Lac), heart rate (HR) and rating of perceived exertion (RPE) during submaximal and maximal running.
The difference in tlim between R1 and R2 was lower in the WBC condition compared to PBO (p < 0.05; effect size d = 1.13). During R2 TSI was higher in WBC during submaximal and maximal running (p < 0.01; d = 0.68 – 1.01). In addition VO2, HR and RPE were lower at submaximal level of R2 following WBC compared to PBO condition (p = 0.04 – <0.01; d = 0.23-0.83).
WBC improves acute recovery during high-intensity intermittent exercise in thermoneutral conditions. The improvements might be induced by enhanced oxygenation of the working muscles as well as a reduction in cardiovascular strain and increased work economy at submaximal intensities.Publisher Website
WBCT leads to generation of reactive oxygen species (ROS) and oxidative stress. Superoxide dismutas (SOD) was lower after the 6th day of WBCT, while glutathione peroxidase (Gpx) was lower after Day 10. A lower activity of the antioxidant enzymes along with decreased lipid peroxidation products after training with WBCT, may indicate decreased ROS. Oxidative stress triggers adaptations that protected kayakers against pro-oxidant-antioxidant balance during training.
The effect of whole-body cryostimulation prior to kayak training on the prooxidant-antioxidant balance was evaluated and compared to the effect of a single cry- ostimulation treatment in untrained men. The kayakers underwent a ten-day training cycle with pre-training daily whole-body cryostimulation for three min (temperature: –120 to –140°C) and training without cryostimulation as a control. Blood samples were obtained before and after the sixth and the tenth day of training and from the untrained men before and 20 min after cryostimulation.
In untrained men cryostimulation induced an increase in the activity of superoxide dismutase (SOD) by 36% (P < 0.001) and glutathione peroxidase (GPx) by 68% (P < 0.01) in the erythrocytes and an increase in the conjugated dienes (CD) in plasma by 36% (P < 0.05) and in the erythrocytes by 71% (P < 0.001).
In the kayakers comparing both types of training after the sixth day, the level of CD in plasma was 46 (P < 0.001) and 40% (P < 0.01) lower in erythrocytes, and the concentration of thiobarbituric acid-reactive substances in plasma was 24% (P < 0.05) lower with pre-training cry- ostimulation. After the sixth day of training with cryostimulation, SOD activity was also 47% (P < 0.001) lower, while GPx activity after the tenth day was reduced by more than 50% (P < 0.01) as compared to control training.
Whole-body cryostimulation per se stimulates the generation of reactive oxygen species. Yet, the oxidative stress induced by kayak training was reduced by prior exposure to extremely low temperatures.Publisher Website
The authors propose the hypothesis that extreme cold exposure activates the sympathetic nervous system with release of ß-endorphins and noradrenaline in the blood and brain. Cold receptors in the skin would also send overwhelming electrical impulses to the brain, which could result in an anti-depressive effect. Sufficiently powered studies would be needed to prove the hypothesis.
Depression is a debilitating mood disorder that is among the top causes of disability worldwide. It can be characterized by a set of somatic, emotional, and behavioral symptoms, one of which is a high risk of suicide. This work presents a hypothesis that depression may be caused by the convergence of two factors:
- (A) A lifestyle that lacks certain physiological stressors that have been experienced by primates through millions of years of evolution, such as brief changes in body temperature (e.g. cold swim), and this lack of ‘‘thermal exercise’’ may cause inadequate functioning of the brain.
- (B) Genetic makeup that predisposes an individual to be affected by the above condition more seriously than other people. To test the hypothesis, an approach to treating depression is proposed that consists of adapted cold showers (20 °C, 2–3 min, preceded by a 5-min gradual adaptation to make the procedure less shocking) performed once or twice daily. The proposed duration of treatment is several weeks to several months.
The following evidence appears to support the hypothesis: Exposure to cold is known to activate the sympathetic nervous system and increase the blood level of beta-endorphin and noradrenaline and to increase synaptic release of noradrenaline in the brain as well. Additionally, due to the high density of cold receptors in the skin, a cold shower is expected to send an overwhelming amount of electrical impulses from peripheral nerve endings to the brain, which could result in an anti-depressive effect. Practical testing by a statistically insignificant number of people, who did not have sufficient symptoms to be diagnosed with depression, showed that the cold hydrotherapy can relieve depressive symptoms rather effectively.
The therapy was also found to have a significant analgesic effect and it does not appear to have noticeable side effects or cause dependence. In conclusion, wider and more rigorous studies would be needed to test the validity of the hypothesis.Publisher Website
Heart rate variability is used as an indirect indicator of autonomic nervous system activity. This study demonstrates that acute increases in parasympathetic tone in response to WBCT is an adaptation of the autonomic nervous system, and mimics the response induced by physical exercise. In the same way, the WBCT-related acute responses are less prominent after 3 months of training.
Heart rate monitoring was used to measure heart rate variability (HRV) at thermoneutral conditions (Ta 24 ˚C) in healthy women resting in supine position before and after acute and after repeated (3 times a week during a 3-month period) whole-body cryotherapies (WBC), at -110 °C.
The observed acute cooling-related increase in high frequency power (HFP) of RR-intervals indicates an increase in cardiac parasympathetic modulation. After 3 months of repeated WBC the increase in parasympathetic tone was attenuated, which may be interpreted as an adaptation of autonomic function.
The repeated WBC exposures-related increase in resting low frequency power (LFP) of RR-intervals during the 3 months resembles the response observed related to exercise training.Publisher Website
Patients with ankylosing spondylitis exposed to WBC in conjunction with physiotherapy had greater improvements in spinal mobility, particularly in the lumbar and thoracic areas than those who had physiotherapy alone.
The aim of our study was to assess the impact of whole-body cryotherapy with subsequent kinesitherapy on spinal mobility parameters in patients with ankylosing spondylitis. Material and methods. We enrolled 32 men with ankylosing spondylitis in a clinical trial. The subjects were randomly divided into 2 groups consisting of 16 persons, with no significant differences in age, duration, or stage of disease, treated with a cycle of 10 whole-body cryotherapy procedures with subsequent kinesitherapy or kinesitherapy alone, respectively. Routine spinal mobility parameters were determined for all patients before and after the end of the therapeutic cycle.
Significant improvement of spinal mobility was observed in both groups of patients, but in patients exposed to whole-body cryotherapy with subsequent kinesitherapy the percentage changes in the values of particular parameters were more distinct as compared to patients in whom kinesitherapy alone was used, mainly in respect to lumbar and thoracic spinal mobility.
The use of whole-body cryotherapy as a component of comprehensive therapy in patients with ankylosing spondylitis produces significant improvements in spinal mobility parameters as compared to patients in whom kinesitherapy alone is used.Publisher Website
Almost for each individual Hamilton’s Depression Rating Scale items, the overall score for all patients together was significantly lower after WBCT. The HDRS sum-score for each patient after WBCT was lower than that of the baseline and reached statistical significance in a paired samples t-test. Every patient was therefore considerably improved after WBCT.
Cryotherapy has a long tradition in somatic medicine. Yet we know very little about its impact on psyche and mood disturbances in particular. Therefore there is a real need for scientific investigations into this problem.
The study reported here was an initial approach to whole-body cryotherapy (WBCT) as a potential treatment modality for depression and was expected to provide rough data helping to design a future project with extended methodology, larger sample groups and longer follow-up. Methods: 23 Patients aged 37–70 years gave informed consent to participate in the study. Ten WBCT procedures (160s, -150 deg˚C) were applied within 2 weeks. Participants were recruited from depressed day hospital patients. Antidepressive medication was not ceased. Symptoms were rated at the beginning and end of this intervention using the 21-item Hamilton Depression Rating Scale (HDRS). Changes in scores were analyzed in the group of patients for every item separately as well as for the sum of all items for each patient.
Almost for each individual HDRS item, the overall score for all patients together was significantly lower after WBCT. This means that all symptoms, except for day–night mood fluctuations, were presumably positively influenced by cryotherapy. The HDRS sum-score for each patient after WBCT was lower than that of the baseline and reached statistical significance in a paired samples t-test. Every patient was therefore considerably relieved after WBCT.
It appears that WBCT helps in alleviating depression symptoms. Should this be confirmed in the extended study we are currently implementing, WBCT may become an auxiliary treatment in depression.PDF Article