Article

# Whole-body cryostimulation increases parasympathetic outflow and decreases CORE body temperature

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## Abstract

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 3 minutes (approx. - 120oC). The cardiovascular and autonomic parameters were measured noninvasively with Task Force® Monitor. The changes in core body temperature were determined with the Vital Sense® telemetric measurement system. Results show that 3 minutes 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 hours after the exposure and were not harmful for examined subjects.

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... WBC activates physiological mechanisms which goal is to maintain a constant body core temperature. It might include rapid and short-term regulatory mechanisms predominantly focused upon cardiovascular and autonomic nervous system functions [16][17][18]. Peripheral blood vessels constriction might lead to a reduction in temperature of the cold-exposed skin area. In consequence, it might decrease the perfusion of the skin vascular bed reducing convective and conductive heat loss [19,20]. ...
... In summary, acute response on WBC session seems to involve modulation of HR and SV what impact on the subsequent physiological reactions [16][17][18]. ...
... Schaal et al. suggested that the sleep enhancing effects were related to an increase in post-exercise parasympathetic reactivation [24]. Moreover, reduction of daytime sleepiness in CFS in the current study could be related to a decrease in core temperature after the WBC session that occurs 50-60 min after exposure [18]. A relationship between the circadian rhythms of core temperature and sleep has been observed [25]. ...
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Background The aim of this study was to explore the tolerability and effect of static stretching (SS) and whole body cryotherapy (WBC) upon fatigue, daytime sleepiness, cognitive functioning and objective and subjective autonomic nervous system functioning in those with Chronic Fatigue Syndrome (CFS) compared to a control population. Methods Thirty-two CFS and eighteen healthy controls (HC) participated in 2 weeks of a SS + WBC programme. This programme was composed of five sessions per week, 10 sessions in total. Results A significant decrease in fatigue was noted in the CFS group in response to SS + WBC. Some domains of cognitive functioning (speed of processing visual information and set-shifting) also improved in response to SS + WBC in both CFS and HC groups. Our study has confirmed that WBC is well tolerated by those with CFS and leads to symptomatic improvements associated with changes in cardiovascular and autonomic function. Conclusions Given the preliminary data showing the beneficial effect of cryotherapy, its relative ease of application, good tolerability, and proven safety, therapy with cold exposure appears to be an approach worth attention. Further studies of cryotherapy as a potential treatment in CFS is important in the light of the lack of effective therapeutic options for these common and often disabling symptoms.
... WBC activates physiological mechanisms that maintain a constant core temperature. Acute exposure to ambient cryotherapeutic temperatures is an extremely stressful stimulant that induces rapid and short-term regulatory mechanisms predominantly associated with the cardiovascular and autonomic nervous systems [5]. In addition, WBC programs have been shown to improve immediate recall and orientation in older participants with mild cognitive impairment and reduce fatigue in multiple sclerosis (MS) patients [6,7]. ...
... In summary, WBC with a stretching program might improve autonomic nervous system function [5][6][7]20] A previous CFS study using a network analysis approach showed evidence of disturbance glucose metabolism and in homeostasis in the autonomic nervous and cardiovascular systems [32]. Thus, it seems that autonomic nervous system function, cognitive function and aortic stiffness could be related to fatigue in CFS. ...
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This study represents a comparison of the functional interrelation of fatigue and cognitive, cardiovascular and autonomic nervous systems in a group of Chronic Fatigue Syndrome (CFS) patients compared with those in healthy individuals at different stages of analysis: at baseline and after changes induced by whole-body cryotherapy (WBC) combined with a static-stretching (SS) program. The study included 32 patients (Fukuda criteria) and 18 healthy controls. Fatigue, cognitive, cardiovascular and autonomic function and arterial stiffness were measured before and after 10 sessions of WBC with SS. In the patients, a disturbance in homeostasis was observed. The network relationship based on differences before and after intervention showed comparatively higher stress and eccentricity in the CFS group: 50.9 ± 56.1 vs. 6.35 ± 8.72, p = 0.002, r = 0.28; and 4.8 ± 0.7 vs. 2.4 ± 1, p < 0.001, r = 0.46, respectively. Before and after intervention, in the CFS group increased fatigue was related to baroreceptor function, and baroreceptor function was in turn related to aortic stiffness, but no such relationships were observed in the control group. Differences in the network structure underlying the interrelation among the four measured criteria were observed in both groups, before the intervention and after ten sessions of whole cryotherapy with a static stretching exercise.
... Interestingly, the authors had set the question whether or not either WBC or CWI were capable of achieving the T sk (<13 • C) believed to be required for analgesic purposes (Bleakley and Hopkins, 2010), yet they concluded that this temperature was reached by neither of the two procedures . Zalewski et al. confirmed that the maximum drop in core temperature occurred 50-60 min post-WBC (Zalewski et al., 2014). ...
... This could be induced by enhanced oxygenation of the working muscles as well as by reduction of cardiovascular strain and increased work economy at submaximal intensities (Krüger et al., 2015). In addition to beneficial effects on inflammation and muscle damage, WBC induces peripheral vasoconstriction, which improves muscle oxygenation (Hornery et al., 2005), lowers submaximal heart rate and increases stroke volume (Zalewski et al., 2014), stimulates autonomic nervous parasympathetic activity and increases norepinephrine (Hausswirth et al., 2013). These effects favor post-exercise recovery and induce analgesia (Krüger et al., 2015). ...
Article
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Nowadays, whole-body cryotherapy is a medical physical treatment widely used in sports medicine. Recovery from injuries (e.g., trauma, overuse) and after-season recovery are the main purposes for application. However, the most recent studies confirmed the anti-inflammatory, anti-analgesic, and anti-oxidant effects of this therapy by highlighting the underlying physiological responses. In addition to its therapeutic effects, whole-body cryotherapy has been demonstrated to be a preventive strategy against the deleterious effects of exercise-induced inflammation and soreness. Novel findings have stressed the importance of fat mass on cooling effectiveness and of the starting fitness level on the final result. Exposure to the cryotherapy somehow mimics exercise, since it affects myokines expression in an exercise-like fashion, thus opening another possible window on the therapeutic strategies for metabolic diseases such as obesity and type 2 diabetes. From a biochemical point of view, whole-body cryotherapy not always induces appreciable modifications, but the final clinical output (in terms of pain, soreness, stress, and post-exercise recovery) is very often improved compared to either the starting condition or the untreated matched group. Also, the number and the frequency of sessions that should be applied in order to obtain the best therapeutic results have been deeply investigated in the last years. In this article, we reviewed the most recent literature, from 2010 until present, in order to give the most updated insight into this therapeutic strategy, whose rapidly increasing use is not always based on scientific assumptions and safety standards.
... Cold-induced vasodilation occurs, enabling a four-fold higher blood flow than normal resulting in the elimination of metabolic products. At distance from the cold stimulation, an increase in the parasympathetic cardiac control may also happen, as a compensatory mechanism downregulating the blood pressure (Louis et al., 2020;Zalewski et al., 2014), even during the night (Douzi et al., 2019). Changes in muscle, skin and core body temperature, with a maximum drop of core temperature after 50-60 min and the autonomic and thermal reactions to cryostimulation have been observed even up to 6 h after WBC exposure (Costello et al., 2012(Costello et al., , 2015Savic et al., 2013;Zalewski et al., 2014). ...
... At distance from the cold stimulation, an increase in the parasympathetic cardiac control may also happen, as a compensatory mechanism downregulating the blood pressure (Louis et al., 2020;Zalewski et al., 2014), even during the night (Douzi et al., 2019). Changes in muscle, skin and core body temperature, with a maximum drop of core temperature after 50-60 min and the autonomic and thermal reactions to cryostimulation have been observed even up to 6 h after WBC exposure (Costello et al., 2012(Costello et al., , 2015Savic et al., 2013;Zalewski et al., 2014). Such changes may result in lower fatigue sensation and mood improvement with possible positive impact on depression and sleep quality (Rymaszewska et al., 2008). ...
Article
Currently available treatments for the management of obesity struggle to provide clinically significant weight loss and reduction of the chronic low-grade inflammatory state in order to reduce obesity-related complications. This scoping review aims to provide an up-to-date picture of the therapeutic effects of Whole-Body Cryostimulation (WBC) in patients with obesity and evidence-based indications for its complementary use in the treatment of obesity. We searched the literature until the end of August 2021, retrieving 8 eligible studies out of 856, all evaluated for their methodological quality using the Downs and Black checklist. Overall, the limited data presented in this review article seem to support the efficacy of WBC as an adjuvant treatment in obesity. The cryogenic stimulus has important anti-inflammatory/antioxidant effects and its effectiveness is directly related to the individual percentage of fat mass and initial fitness capacity, mimicking an exercise-induced effect. Based on the limited results gathered, WBC emerges as a promising adjuvant therapy to reduce systemic inflammation, oxidative stress, abdominal obesity, and body mass. However, the data presented in this review article fail to reach definitive conclusions with regards to the efficacy of WBC in the treatment of obesity. Application of WBC protocols yields the potential to widen the therapeutic armor for the treatment of obesity and obesity-related disorders but larger, high-quality studies are still needed.
... Such reaction stimulates baroreceptors and leads to a diminution of the sympathetic nerve activity and an increase in vagal control of the myocardium (Zalewski et al. 2013). As such, it is well established that WBC is effective in increasing post-exercise and resting heart rate variability (HRV), an indicator of increased parasympathetic tone activation (Westerlund et al. 2006;Schaal et al. 2013;Hausswirth et al. 2013;Zalewski et al. 2014). ...
... These authors found a larger decrease in mean skin temperature after WBC and associated it with a stronger stimulation of the ANS, especially of the parasympathetic tone. Several studies also demonstrated that acute exposure to WBC at temperatures ranging from − 60 to − 120 °C significantly increased the parasympathetic activity (Westerlund et al. 2006;Zalewski et al. 2014;Douzi et al. 2018). In the present study, the effects of WBC on HRV indices of parasympathetic activity were similar after one and five exposures. ...
Article
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PurposeA predominance of parasympathetic drive is observed following cold exposure. Such modulation of the autonomic nervous system (ANS) is associated with faster post-exercise recovery. Within this context, whole-body cryotherapy (WBC) has been spreading in sport medicine, though the optimal temperature and frequency are unclear. The aim of this study was to examine the effects of different cryotherapy conditions on the sympathovagal balance.Methods Forty healthy males were randomly assigned into five different groups (− 110 °C, − 60 °C, − 10 °C, control temperature [≃ 24 °C]) and undertook 5 WBC sessions over 5 consecutive days. Cardiac autonomic activity was assessed through heart rate variability (HRV) using power density of high frequency (HF), root-mean square difference of successive R–R intervals (RMSSD) and sympathovagal balance (LF/HF). Systemic sympathetic activity was assessed via circulating blood catecholamines.ResultsMean weekly RMSSD (pre: 48 ± 22 ms, post: 68 ± 29 ms) and HF (pre: 607 ± 692 ms2, post: 1271 ± 1180 ms2) increased (p < 0.05) from pre to post WBC, only in the − 110 °C condition. A rise in plasma norepinephrine was found after the first − 110 °C WBC session only (pre: 173 ± 98, post: 352 ± 231 ng L−1, p < 0.01); whereas, it was not significant after the 5th session (pre: 161 ± 120, post: 293 ± 245 ng L−1, p = 0.15).Conclusion These results suggest that one − 110 °C WBC exposure is required to stimulate the ANS. After five daily exposures, a lower autonomic response was recorded compared to day one, therefore suggesting the development of physiological habituation to WBC.
... In this sense, our results showed greater parasympathetic and lower sympathetic activity during the SWS episode following cold exposure. It is known that cold exposure prompted parasympathetic activity reactivation after physical exercise by increasing central blood volume and blood pressure (Mourot et al., 2008), which stimulates arterial and cardiopulmonary baroreceptors (Zalewski et al., 2014) that reduce sympathetic nerve activity and increase parasympathetic activity (Zalewski et al., 2014). These results were consistent with previous studies investigating the effect of cold exposure on the autonomic nervous system (Haddad et al., 2012;Schaal et al., 2015). ...
... In this sense, our results showed greater parasympathetic and lower sympathetic activity during the SWS episode following cold exposure. It is known that cold exposure prompted parasympathetic activity reactivation after physical exercise by increasing central blood volume and blood pressure (Mourot et al., 2008), which stimulates arterial and cardiopulmonary baroreceptors (Zalewski et al., 2014) that reduce sympathetic nerve activity and increase parasympathetic activity (Zalewski et al., 2014). These results were consistent with previous studies investigating the effect of cold exposure on the autonomic nervous system (Haddad et al., 2012;Schaal et al., 2015). ...
Article
Exercise training during evening may disturb sleep patterns and hinder recovery process. The present study aimed to examine the effect of whole body cryotherapy (WBC) exposure after training in the evening on sleep quality and night heart rate variability (HRV). A total of 22 physically active men were randomized to undergo either WBC (3-min at −40°C, wind speed of 2.3 m s⁻¹) or passive recovery (control) following an evening training consisting of 25 min of continuous running at 65% of the maximal aerobic speed (MAS) followed by intermittent running at 85% of the MAS. Each night following the training, the number of movements and HRV during sleeping time were recorded. The next morning, subjective sleep quality and perceived pain were assessed using Spiegel questionnaire and a visual analogue scale, respectively. The number of movements during the night following WBC was significantly reduced (p < 0.05) compared with the control condition. Subjective sleep quality following WBC was significantly better than the control group (p < 0.05). During the estimated slow-wave sleep (SWS), the high frequency power (HF) was higher in the WBC group than the control group (p < 0.05), and the low frequency power (LF) and the LF/HF ratio were lower than the control group (p < 0.05). Pain was significantly reduced following WBC compared to the control (p < 0.01). In conclusion, the use of 3-min WBC after training in the evening improves subjective and objective sleep quality in physically active subjects, which may be due to greater pain relief and improved parasympathetic nervous activity during the SWS period.
... Some findings in the literature revealed slight discrepancies in the evolution of rectal temperature from pre to post-WBC session. Westerlund et al. [43] indicated that mean rectal temperature did not change during WBC, as confirmed by Zalewski et al. [44] who investigated core temperature (measured from swallowed capsules) and found that this parameter remained unchanged immediately after cryostimulation (p > 0.05) compared to baseline. Finally, Cuttel et al. [14] (see Fig. 1 p. 43) and Costello et al. [11] (see Fig. 4 p. 6) even found a slight increased trend for rectal temperature during similar cold air exposure at − 110 • C. It should be noted, however, that the latter authors observed a decrease in rectal temperature for immersion in 8 • C cold water. ...
Article
In order to determine the required duration of whole-body exposure to extreme cold (−110 °C) in males and females for achieving the same cold-induced response, a mathematical model of skin cooling kinetics was developed. This modeling is derived from the implementation of a new experimental cryotherapy protocol to obtain continuous skin temperature maps over time. Each 3-min whole-body cryostimulation session was divided into six incremental sessions of 30 s carried out over six consecutive days. Seventeen young, healthy subjects (8 males aged 22.6 +/-3.0 years and 9 females aged 23.7 +/-4.7 years) agreed to participate in this study. The smallest sex-related difference in temperature was found in the trunk area (2.93 °C after 3 min) while the greatest temperature drop was found in the lower limbs (5.92 °C after 3 min). The largest temperature variation was observed between the trunk and the lower limbs, and peaked at 2.67 °C in males and 6.99 °C in females. For both sexes, skin cooling kinetics showed a strong transient exponential type decrease followed by linear regression behavior. It appeared that for achieving the same cold-induced response, the required duration of cryostimulation is longer for males. For example, a trunk skin cooling of −12 °C could be achieved in 125s for females vs 170s for males (+36% longer); for the lower limbs, the same skin cooling magnitude could be reached after 87s for females vs 140s for males (+62% longer).
... Maksymalny spadek temperatury rdzenia obserwuje się 50-60 minut po zakończeniu kriostymulacji. Jednakże zauważalny spadek temperatury głębokiej ciała po zabiegu kriostymulacji ogólnoustrojowej nie jest czynnikiem zagrażającym funkcjonowaniu organizmu człowieka [74]. ...
... The physiological benefits of WBC in athletes have been attributed to cold-induced analgesia, reduction of muscle temperature, and suppression of inflammation-derived RONS and cytokines. Studies into the effects of a cold therapy on exercise performance and recovery have reported diverse outcomes ranging from beneficial [11][12][13] through negligible [14][15][16][17] to negative ones [18,19]. Roberts et al. [19] indicated that post-exercise cold water immersion could even attenuate acute anabolic signaling and long-term adaptation of muscular system to exercise. ...
Article
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The oxi-inflammatory response is part of the natural process mobilizing leukocytes and satellite cells that contribute to clearance and regeneration of damaged muscle tissue. In sports medicine, a number of post-injury recovery strategies, such as whole-body cryotherapy (WBC), are used to improve skeletal muscle regeneration often without scientific evidence of their benefits. The study was designed to assess the impact of WBC on circulating mediators of skeletal muscle regeneration. Twenty elite athletes were randomized to WBC group (3-min exposure to −120 °C, twice a day for 7 days) and control group. Blood samples were collected before the first WBC session and 1 day after the last cryotherapy exposure. WBC did not affect the indirect markers of muscle damage but significantly reduced the generation of reactive oxygen and nitrogen species (H2O2 and NO) as well as the concentrations of serum interleukin 1β (IL-1β) and C-reactive protein (CRP). The changes in circulating growth factors, hepatocyte growth factor (HGF), insulin-like growth factor (IGF-1), platelet-derived growth factor (PDGFBB), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF), were also reduced by WBC exposure. The study demonstrated that WBC attenuates the cascade of injury–repair–regeneration of skeletal muscles whereby it may delay skeletal muscle regeneration.
... The endothermic property acts in concert with the physical channels of heat transfer (heat absorption or loss), and as part of the homeothermic processes, to achieve homeostasis of Tb [1]. Both the endothermic and homeothermic functions are coordinated centrally through a Tc set-point by a "thermostat" mechanism in the hypothalamus, which is part of the limbic system in the brain [1,8,129,130] (Figure 1). The limbic system regulates emotions and motivation, which drives behavior to avoid pain and to seek reward. ...
Article
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The international community has recognized global warming as an impending catastrophe that poses significant threat to life on earth. In response, the signatories of the Paris Agreement (2015) have committed to limit the increase in global mean temperature to <1.5 °C from pre-industry period, which is defined as 1850–1890. Considering that the protection of human life is a central focus in the Paris Agreement, the naturally endowed properties of the human body to protect itself from environmental extremes should form the core of an integrated and multifaceted solution against global warming. Scholars believe that heat and thermoregulation played important roles in the evolution of life and continue to be a central mechanism that allows humans to explore, labor and live in extreme conditions. However, the international effort against global warming has focused primarily on protecting the environment and on the reduction of greenhouse gases by changing human behavior, industrial practices and government policies, with limited consideration given to the nature and design of the human thermoregulatory system. Global warming is projected to challenge the limits of human thermoregulation, which can be enhanced by complementing innate human thermo-plasticity with the appropriate behavioral changes and technological innovations. Therefore, the primary aim of this review is to discuss the fundamental concepts and physiology of human thermoregulation as the underlying bases for human adaptation to global warming. Potential strategies to extend human tolerance against environmental heat through behavioral adaptations and technological innovations will also be discussed. An important behavioral adaptation postulated by this review is that sleep/wake cycles would gravitate towards a sub-nocturnal pattern, especially for outdoor activities, to avoid the heat in the day. Technologically, the current concept of air conditioning the space in the room would likely steer towards the concept of targeted body surface cooling. The current review was conducted using materials that were derived from PubMed search engine and the personal library of the author. The PubMed search was conducted using combinations of keywords that are related to the theme and topics in the respective sections of the review. The final set of articles selected were considered “state of the art,” based on their contributions to the strength of scientific evidence and novelty in the domain knowledge on human thermoregulation and global warming.
... Other authors point to the method of 24 h HRV measurement as helpful in determining a possibility for OTS development, indicating a reduced flexibility of the heart rate adjustment in subjects with OTS or at risk of OTS development [35]. If the OTS syndrome is associated with a dysfunction of the autonomic nervous system in response to repeated physical exercise, it would be interesting to determine whether this fact influences the circadian rhythm and/or external parameters which, in authors opinion, significantly impact the functioning of the sympathetic and the parasympathetic systems [33,40]. Another interesting aspect is a correlation between OTS and the Chronic Fatigue Syndrome (CFS), as opinions on CFS aetiology have changed significantly. ...
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http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Abstract Each training that requires achieving a higher heart rate limit and/or increased concentration in time may cause fatigue, considered to be a natural defence mechanism of a body. In the case of excessive fatigue and insufficient time designated for rest and regeneration, an overtraining syndrome (OTS) may develop. The main symptom of overtraining is increased fatigue that fails to become reversed in normal conditions of regeneration. Although authors are familiar with the overtraining syndrome and associated symptoms, as of today no diagnostic tool has been developed that may form a basis for a final diagnosis, and the 204 diagnosis itself is frequently based on a subjective assessment of the athlete. Possible causes of the band overtraining syndrome are disorders of sodium, inflammatory processes resulting from physical activity and / or disorders of the autonomic nervous system.
... Whole-body cryostimulation has an immediate and lasting effect on ANS balance that may be observed via improved HRV [128,129]. For example, 3 min whole-body cryostimulation has increased HF, decreased LF, and decreased LF/HF ratios for upwards of 6 h post-cryotherapy [130][131][132]. Cryotherapy in the evening, after training or competition, has also shown positive effects on sleep quality [129,131,132], which subsequently would improve HRV considering the positive influence of quality sleep hygiene on HRV. ...
Article
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Human performance optimization of tactical personnel requires accurate, meticulous, and effective monitoring of biological adaptations and systemic recovery. Due to an increased understanding of its importance and the commercial availability of assessment tools, the use of heart rate variability (HRV) to address this need is becoming more common in the tactical community. Measuring HRV is a non-invasive, practical method for objectively assessing a performer’s readiness, workload, and recovery status; when combined with additional data sources and practitioner input, it provides an affordable and scalable solution for gaining actionable information to support the facilitation and maintenance of operational performance. This narrative review discusses the non-clinical use of HRV for assessing, monitoring, and interpreting autonomic nervous system resource availability, modulation, effectiveness, and efficiency in tactical populations. Broadly, HRV metrics represent a complex series of interactions resulting from internal and external stimuli; therefore, a general overview of HRV applications in tactical personnel is discussed, including the influence of occupational specific demands, interactions between cognitive and physical domains, and recommendations on implementing HRV for training and recovery insights into critical health and performance outcomes.
... Both forms of cryotherapies have more recently gained popularity as a means of promoting well-being and recovery for athletes [8] and are primarily employed to promote recovery after exercise-induced muscle damage [9]. WBC exposure after simulated trail running in athletes elicited reductions in perceived sensations of muscle pain and restored maximal muscle strength 1 h post-exposure better than 24 h of passive recovery [10]. ...
Article
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Whole- (WBC) and partial-body cryotherapy (PBC) are commonly used sports medicine modalities for the treatment of injury and exercise recovery. Physiological and perceptual effects have the potential to be utilised in a novel application that involves pre-exercise WBC and PBC exposure to improve physical performance. A systematic literature search of multiple databases was conducted in July 2021 to identify and evaluate the effects of pre-exercise exposure of WBC or PBC on physical performance measures, and any potential translational effects. The following inclusion criteria were applied: (1) use of WBC or PBC exposure pre-exercise, (2) use of WBC or PBC in healthy and/or athletic populations, (3) control group was used in the data collection, and (4) investigated physiological, psychosocial or direct physical performance impacts of pre-exercise cryotherapy exposure. A total of 759 titles were identified, with twelve relevant studies satisfying the inclusion criteria after full-text screening. The twelve studies were categorised into three key areas: performance testing (n = 6), oxidative stress response (n = 4) and lysosomal enzyme activity (n = 2). The potential for eliciting favourable physical and physiological responses from pre-exercise WBC or PBC is currently unclear with a paucity of good quality research available. Furthermore, a lack of standardisation of cryotherapy protocols is a current challenge.
... Homeothermic mechanisms cause intrinsic regulation of heat gain (metabolic production) and loss (sweat and evaporation) to maintain core body temperature set point (Gisolfi and Mora, 2016;Madden and Morrison, 2019;Zalewski et al., 2014). Fluctuation from set point of body temperature stimulates hypothalamus to restore core temperature through changes in behaviors and physiological responses induced by the ANS (Morrison and Blessing, 2011). ...
Article
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Thermoregulation is a homeostatic mechanism that is disrupted in some neurological diseases. Patients with multiple sclerosis (MS) are susceptible to increases in body temperature, especially with more severe neurological signs. This condition can become intolerable when these patients suffer febrile infections such as coronavirus disease-2019 (COVID-19). We review the mechanisms of hyperthermia in patients with MS, and they may encounter when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Finally, the thermoregulatory role and relevant adaptation to regular physical exercise are summarized.
... The sequence of the events is the following: at the beginning of the cold exposure, the acute cold-induced changes concern peripheral vasoconstriction which induces an increase in central blood volume and in blood pressure [38]. This series of events stimulate arterial and cardiopulmonary baroreceptors, reducing thereby sympathetic nerve activity and increasing parasympathetic activity which leads to a decrease in heart rate [39]. Such feature can also happen at distance from the cold exposure. ...
Article
The sleep apnea syndrome (SAS) is a sleep related-breathing disorder with several features such a systemic inflammation, oxidative stress, a cognitive impairment and a poor sleep quality. Patients with SAS present an increased incidence of cardiovascular diseases. There is no real effective treatment that prevents and treats all of these illness symptoms. Cooling therapies are often used in sport medicine and in athletes after training and competitions to reduce inflammation, oxidative stress and to enhance sleep quality. In this short article, we hypothesize that the use of cooling therapies (whole body cryotherapy, cold-water immersion...) could be an efficient strategy to facilitate the treatment of SAS’ patients by reducing the level of systemic inflammation and oxidative stress and enhancing sleep quality.
... Skin temperature differed significantly between different durations, except between 150 and 180-s, while there was no significant difference in heart rate and blood pressure. In contrast, Zalewski et al. (2014) evaluated 25 healthy men with a mean age of 30.1 ± 3.7 years. Each subject was exposed to cryotherapeutic temperatures in a cryogenic chamber for 3 min (approximately -120 °C). ...
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Background: Cryotherapy brings benefits for muscle recovery and reduction of lactate thresholds in fighters; however, the effect of cryotherapy on the autonomous cardiac recovery (ACR) of wrestlers is not yet defined in the scientific literature. Objective: To analyze the effect of cryotherapy on ACR after simulated combat exercise in mixed martial arts (MMA) fighters. Methods: Crossover randomized clinical trial with a sample of 17 MMA fighters (male, age >18 years). There was simulated combat of three rounds of MMA; each round lasted 5-min, there were the 60s between rounds. ACR was assessed by resting heart rate (RHR), which was monitored by a portable Polar-FT1® device. We measured RHR in the interval between the rounds at the 30s and 60s of rest in the conditions: without cryotherapy (Control), application of an ice pack in the thoracic region (TC); Immersion of feet in ice water (FC). Results: At 30-s of RHR, the control condition was better than FC to reduce RHR in rounds 1 and 2 (p<0.05; η2p:0.28). At the 60s of RHR, the control condition was better than FC and TC (p<0.05; η2p:0.32). The control condition had a better RHR recovery rate than the FC condition after rounds one (η2p: 0.23), two (η2p: 0.46), and three (η2p: 0.27) (p<0.05). The TC condition did not show differences concerning the control and FC conditions. Conclusion: Cryotherapy applications in the thoracic region and by complete immersion of the feet did not generate significant effects on the ACR of MMA fighters.
... Many studies have evaluated the changes in skin temperature following WBC and PBC and focused on the extent to which cryostimulation lowered the temperature (Costello et al., 2012;Fond et al., 2014;Selfe et al., 2014;Hausswirth et al., 2013). However, there is a scarcity of research on the body's thermal responses for several hours after cryostimulation (Zalewski et al., 2014). Therefore, the duration of the effects of a cryostimulation session is still unclear. ...
Article
Cryostimulation is widely used to treat inflammation, rheumatism, acute soft tissue injuries, and neurodegeneration. It helps prevent injury and promotes recovery. This study aimed to examine the duration of the effects of evening partial body cryostimulation (PBC) on core and skin temperatures. Seven male athletes participated in this study. On the day of PBC, at 18:00, each athlete was exposed to PBC (approx. −180 °C) in a specially designed cabin for 3 min. On the control day, at 18:00, the participants sat still on a sofa for 10 min. On both days, bedtime was at around 23:00. Wrist and abdominal skin temperatures, except during PBC, were recorded with Thermochron thermistors after 17:30. Core temperatures were monitored with an ingestible and telemetric core body temperature sensor and a data recorder. The circadian rhythm of the core temperature was observed on both days. The core temperature at 22:30 was found to be lower on the PBC day. Wrist and abdominal skin temperatures recovered after PBC; however, the residual effects on both were different. The abdominal skin temperature at 22:30 was lower on the PBC day. Subjective sleep quality and next morning sleepiness did not differ between the conditions. These results suggested that the effects of a 3-min evening PBC session on the core and skin temperatures lasted for several hours. However, these differences did not affect the subjective sleep quality.
Article
BACKGROUND: Whole-body cryotherapy (WBC) is used as a conditioning method for athletes. However, the scientific evidence for its effects is still insufficient. OBJECTIVE: To elucidate the effects of transient WBC on the expression of heat shock protein (HSP) 70 and the secretion of related hormones in humans. MATERIALS AND METHODS: The participants in this study were six healthy adult men. WBC was performed for 3 min in a booth at a temperature in the range of -150 to -120°C, and measurements were taken immediately before (Pre), immediately after (Post), and 60 min after WBC (Post60). For measurement of core body temperature (gastrointestinal temperature), participants ingested a capsule-type wireless temperature sensor. The body surface temperature was measured using a noncontact thermometer, and measurements were taken at four sites on the body surface (chest, abdomen, front of the thigh, and front of the lower thigh). Leukocyte count, lactate dehydrogenase, creatine kinase, hemoglobin, hematocrit, adrenaline, noradrenaline, cortisol, adrenocorticotropic hormone (ACTH), erythropoietin, and HSP70 in the collected blood were measured. RESULTS: The results showed a decrease in body surface temperature and an increase in noradrenaline and ACTH immediately after WBC. In addition, the core body temperature decreased 60 min after WBC, accompanied by an increase in HSP70 expression. CONCLUSION: WBC may increase HSP70 expression via noradrenaline and ACTH. The results of this study suggest the usefulness of WBC in triggering protein synthesis and the maintenance of immune function after training.
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PURPOSE The purpose of this study was to provide a scientific basis for physiological recovery of cooling tubing intervention during simulated match in elite male wrestlers. METHODS Fourteen national wrestler were divided Cooling Tubing Group (CTG, n=7) and Non Cooling Group (NCG, n=7). The simulated match was conducted at 3 minutes 1 round, 1 minute rest, 3 minutes 2 rounds, and was performed according to each weight class. At the end of the match, CTG cooled the face, chest, elbow, and thigh by cooling mask, vest, and tubing, and then took a rest. NCG took a rest without any special treatment. To compare and analyze the changes of the two groups, measured the variables at rest, immediately after the simulation, 10 minutes, and 30 minutes. RESULTS There was no interaction effect between CTG and NCG intervention. However, the skin temperature (p
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Background: Fetal tachycardia can occur with maternal fever (hyperthermia); therefore, a low maternal temperature (hypothermia) might produce fetal bradycardia. Cases: Five cases of fetal bradycardia are presented in gestations complicated by maternal hypothermia. The fetal heart rate (FHR) tracings demonstrated stable baselines of 88-96 beats per minute with moderate variability and accelerations. All baselines returned to normal after maternal warming measures. Conclusion: A possible cause for fetal bradycardia with a stable baseline and moderate variability is maternal hypothermia, a pattern not indicative of fetal hypoxia. Delivery is not indicated, and maternal warming results in FHR baseline normalization.
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Introduction: This study aimed to explore the relationship between elite rugby union match and post-match sleep architecture and to investigate the effects of a high-heat capacity mattress (MAT) and a whole-body cryotherapy session (WBC) on post-match sleep architecture. Methods: Nineteen elite male U23 rugby union players performed in three official matches, followed by three experimental conditions, in a randomized order: MAT, WBC, and no intervention (CONT). Match load was evaluated using global positioning system (GPS) trackers and video analyses. Sleep architecture was assessed by polysomnography (PSG). Core body temperature (CBT) and mattress surface temperature were monitored during sleep. Linear mixed-effects models were conducted to assess the effects of each experimental condition on sleep, with match load variables as covariates. Results: A lower wake after sleep onset (β = -10.5 min, p < 0.01) and higher rapid-eye-movement sleep proportion (β = +2.8%, p < 0.05) were reported for MAT compared with CONT. Moreover, a lower mean CBT (β = -0.135°C, p < 0.001) and mean mattress surface temperature (β = -2.736°C, p < 0.001) during sleep were observed for MAT compared CONT. Whole-body cryotherapy did not affect nocturnal CBT nor interfere with sleep architecture. For every 100-m increase in high-speed running distance, a higher slow-wave sleep (SWS; β = +1.1%, p = 0.05) and lower light sleep proportion (β = -1.2%, p < 0.05) proportion were observed. Conversely, for every 10 supplementary collisions, a lower SWS (β = -1.9, p = 0.09) and higher light sleep (β = +2.9%, p < 0.001) proportion were observed. Conclusion: MAT use had a positive effect on sleep architecture after an elite rugby union match, potentially through a more efficient nocturnal heat transfer.
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We assessed the effects of a 3-min partial-body cryostimulation (PBC) exposure-where the whole body is exposed to extreme cold, except the head-on cognitive inhibition performance and the possible implications of parasympathetic cardiac control and cerebral oxygenation. In a randomized controlled counterbalanced cross-over design, eighteen healthy young adults (nine males and nine females) completed a cognitive Stroop task before and after one single session of PBC (3-min exposure at − 150 °C cold air) and a control condition (3 min at room temperature, 20 °C). During the cognitive task, heart rate variability (HRV) and cerebral oxygenation of the prefrontal cortex were measured using heart rate monitoring and near-infrared spectroscopy methods. We also recorded the cerebral oxygenation during the PBC session. Stroop performance after PBC exposure was enhanced (562.0 ± 40.2 ms) compared to pre-PBC (602.0 ± 56.4 ms; P < 0.042) in males only, accompanied by an increase (P < 0.05) in HRV indices of parasympathetic tone, in greater proportion in males compared to females. During PBC, cerebral oxygenation decreased in a similar proportion in males and females but the cerebral extraction (deoxyhemoglobin: ΔHHb) remained higher after exposure in males, only. These data demonstrate that a single PBC session enhances the cognitive inhibition performance on a Stroop task in males, partly mediated by a greater parasympathetic cardiac control and greater cerebral oxygenation. The effects of PBC on cognitive function seem different in females, possibly explained by a different sensitivity to cold stimulation.
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This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects (benefits and harms) of whole-body cryotherapy (cold air exposure) for preventing and treating muscle soreness after exercise in adults.
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The time course of physiological and psychological markers during cold acclimation (CA) was explored. The experiment included 17 controlled (i.e., until the rectal temperature reached 35.5°C or 170 min had elapsed; for the CA-17 session, the subjects (n = 14) were immersed in water for the same amount of time as that used in the CA-1 session) head-out water immersions at a temperature of 14°C over 20 days. The data obtained in this study suggest that the subjects exhibited a thermoregulatory shift from peripheral-to-central to solely central input thermoregulation, as well as from shivering to non-shivering thermogenesis throughout the CA. In the first six CA sessions, a hypothermic type of acclimation was found; further CA (CA-7 to CA-16) led to a transitional shift to a hypothermic-insulative type of acclimation. Interestingly, when the subjects were immersed in water for the same time as that used in the CA-1 session (CA-17), the CA led to a hypothermic type of acclimation. The presence of a metabolic type of thermogenesis was evident only under thermoneutral conditions. Cold-water immersion decreased the concentration of cold-stress markers, reduced the activity of the innate immune system, suppressed specific immunity to a lesser degree and yielded less discomfort and cold sensation. We found a negative correlation between body mass index and Δ metabolic heat production before and after CA.
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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.
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The aim of this article was to review current evidence about cryotherapy in inflammatory rheumatic diseases (therapeutic and biological effects). For therapeutic effects, we performed a systematic review (PubMed, EMBASE, Cochrane Library, LILACS databases, unpublished data) and selected studies including non-operated and non-infected arthritic patients treated with local cryotherapy or whole-body cryotherapy. By pooling 6 studies including 257 rheumatoid arthritis (RA) patients, we showed a significant decrease in pain visual analogic scale (mm) and 28-joint disease activity score after chronic cryotherapy in RA patients. For molecular pathways, local cryotherapy induces an intrajoint temperature decrease, which might downregulate several mediators involved in joint inflammation and destruction (cytokines, cartilage-degrading enzymes, proangiogenic factors), but studies in RA are rare. Cryotherapy should be included in RA therapeutic strategies as an adjunct therapy, with potential corticosteroid and nonsteroidal anti-inflammatory drug dose-sparing effects. However, techniques and protocols should be more precisely defined in randomized controlled trials with stronger methodology.
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The aim of this study was to compare the effects of a single whole-body cryostimulation (WBC) and a partial-body cryostimulation (PBC) (i.e., not exposing the head to cold) on indices of parasympathetic activity and blood catecholamines. Two groups of 15 participants were assigned either to a 3-min WBC or PBC session, while 10 participants constituted a control group (CON) not receiving any cryostimulation. Changes in thermal, physiological and subjective variables were recorded before and during the 20-min after each cryostimulation. According to a qualitative statistical analysis, an almost certain decrease in skin temperature was reported for all body regions immediately after the WBC (mean decrease±90% CL, -13.7±0.7°C) and PBC (-8.3±0.3°C), which persisted up to 20-min after the session. The tympanic temperature almost certainly decreased only after the WBC session (-0.32±0.04°C). Systolic and diastolic blood pressures were very likely increased after the WBC session, whereas these changes were trivial in the other groups. In addition, heart rate almost certainly decreased after PBC (-10.9%) and WBC (-15.2%) sessions, in a likely greater proportion for WBC compared to PBC. Resting vagal-related heart rate variability indices (the root-mean square difference of successive normal R-R intervals, RMSSD, and high frequency band, HF) were very likely increased after PBC (RMSSD: +54.4%, HF: +138%) and WBC (RMSSD: +85.2%, HF: +632%) sessions without any marked difference between groups. Plasma norepinephrine concentrations were likely to very likely increased after PBC (+57.4%) and WBC (+76.2%), respectively. Finally, cold and comfort sensations were almost certainly altered after WBC and PBC, sensation of discomfort being likely more pronounced after WBC than PBC. Both acute cryostimulation techniques effectively stimulated the autonomic nervous system (ANS), with a predominance of parasympathetic tone activation. The results of this study also suggest that a whole-body cold exposure induced a larger stimulation of the ANS compared to partial-body cold exposure.
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This study sought to a) compare and contrast the effect of 2 commonly used cryotherapy treatments, 4 min of − 110 °C whole body cryotherapy and 8 °C cold water immersion, on knee skin temperature and b) establish whether either protocol was capable of achieving a skin temperature ( < 13 °C) believed to be required for analgesic purposes. After ethics committee approval and written informed consent was obtained, 10 healthy males (26.5 ± 4.9 yr, 183.5 ± 6.0 cm, 90.7 ± 19.9 kg, 26.8 ± 5.0 kg/m 2 , 23.0 ± 9.3 % body fat; mean ± SD) participated in this randomised controlled crossover study. Skin temperature around the patellar region was assessed in both knees via non-contact, infrared thermal imaging and recorded pre-, immediately post-treatment and every 10 min thereafter for 60 min. Compared to baseline, average, minimum and maximum skin temperatures were signifi cantly reduced (p < 0.001) immediately post-treatment and at 10, 20, 30, 40, 50 and 60 min after both cooling modalities. Average and minimum skin temperatures were lower (p < 0.05) immediately after whole body cryotherapy (19.0 ± 0.9 ° C) compared to cold water immersion (20.5 ± 0.6 ° C). However, from 10 to 60 min post, the average, minimum and maximum skin temperatures were lower (p < 0.05) following the cold water treatment. Finally, neither protocol achieved a skin temperature believed to be required to elicit an analgesic effect.
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The blood pressure responses to an acute and long-term (three months) whole-body cryotherapy (WBC) were measured in men and women. Acute cold exposure (−10°C, −60°C, −110°C) increased both systolic and diastolic blood pressures temporarily. Neither significant gender differences nor adaptation in blood pressures were found during WBC. The variation of individual responses to the acute and long-term WBC was wide.
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The aim of this investigation was to elucidate the reductions in muscle, skin and core temperature following exposure to -110°C whole body cryotherapy (WBC), and compare these to 8°C cold water immersion (CWI). Twenty active male subjects were randomly assigned to a 4-min exposure of WBC or CWI. A minimum of 7 days later subjects were exposed to the other treatment. Muscle temperature in the right vastus lateralis (n = 10); thigh skin (average, maximum and minimum) and rectal temperature (n = 10) were recorded before and 60 min after treatment. The greatest reduction (P<0.05) in muscle (mean ± SD; 1 cm: WBC, 1.6±1.2°C; CWI, 2.0±1.0°C; 2 cm: WBC, 1.2±0.7°C; CWI, 1.7±0.9°C; 3 cm: WBC, 1.6±0.6°C; CWI, 1.7±0.5°C) and rectal temperature (WBC, 0.3±0.2°C; CWI, 0.4±0.2°C) were observed 60 min after treatment. The largest reductions in average (WBC, 12.1±1.0°C; CWI, 8.4±0.7°C), minimum (WBC, 13.2±1.4°C; CWI, 8.7±0.7°C) and maximum (WBC, 8.8±2.0°C; CWI, 7.2±1.9°C) skin temperature occurred immediately after both CWI and WBC (P<0.05). Skin temperature was significantly lower (P<0.05) immediately after WBC compared to CWI. The present study demonstrates that a single WBC exposure decreases muscle and core temperature to a similar level of those experienced after CWI. Although both treatments significantly reduced skin temperature, WBC elicited a greater decrease compared to CWI. These data may provide information to clinicians and researchers attempting to optimise WBC and CWI protocols in a clinical or sporting setting.
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In Poland and all over the world, whole-body cryostimulation is becoming more and more popular in the treatment of different diseases and in sport. However, changes that occur in the human body subjected to cryogenic temperatures are still not completely understood. Therefore, the aim of this study was to evaluate changes in blood circulation and aerobic capacity induced by repeated exposure to whole-body cryostimulation of young and clinically healthy male subjects. The study included 25 young men, aged 21 ± 0.9 years, average body weight 74.65 ± 6.98 kg and height 179.5 ± 5.12 cm. The participants were exposed to extremely low temperatures in a cryogenic chamber once a day for 15 days. Each session lasted 3 min at -130°C and was preceded by 30-second, adaptation in a vestibule at -60°C. Blood pressure and heart rate were measured before entering the chamber, immediately after exiting and 10 min later. We also calculated pulse pressure and the mean arterial blood pressure. Before and after the treatment the maximal oxygen uptake was measured. Our results showed a significant increase in systolic blood pressure after each cryostimulation (by an average of 19 mmHg) and an increase in diastolic blood pressure only after the first cryostimulation (by 6 mm Hg). The increase in systolic blood pressure was accompanied by a significant decrease in heart rate (by about 7 bpm). No adaptation changes were observed after 15 treatments. There were no changes in aerobic capacity after 15 sessions of WBC, however we observed a significant decrease in RBC and hemoglobin concentration. Due to the increase in systolic blood pressure after WBC, this kind of physiotherapy treatment is not recommended for people with advanced or not pharmacologically controlled hypertension.
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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 conditions, 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 antiinflammatory 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 modifications 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.
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Cold habituation could affect sympatho-vagal balance, which modulates cold stress responses. The study examined cardiovascular autonomic function at the sinus node level during controlled breathing and while undertaking isometric exercise during whole-body cold exposure before and after cold acclimation. There were 10 male subjects who were exposed to control (25 degrees C) and cold (10 degrees C) environments for 2 h on 10 successive days in a laboratory. Time and frequency domain heart rate variability (HRV) in terms of root mean square of successive differences in RR intervals, total, high, and low frequency power were determined from controlled breathing at the beginning and end of cold acclimation. Heart rate and blood pressure during an isometric handgrip test (30% MVC for 3 min) were recorded at the beginning and end of cold acclimation. Catecholamines (NE and E), mean skin (Tsk), and rectal temperatures (Trect) were measured. Acute cold exposure increased total (36%), low (16%), and high frequency power (25%) and RMSSD (34%). Cold acclimation resulted in higher Tsk (0.6 degrees C) and lower NE (24%) response in cold. The cold-induced elevation in high frequency power became significant after cold acclimation, while other HRV parameters remained unchanged. A smaller increase in heart rate and blood pressure occurred at 10 degrees C during the handgrip test after cold acclimation. Cold exposure increased sympathetic activity, which was blunted after cold acclimation. Parasympathetic activity showed a minor increase in cold, which was enhanced after cold acclimation. In conclusion, cold habituation lowers sympathetic activation and causes a shift toward increased parasympathetic activity.
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Thermoregulatory accidents rank as the sixth leading cause of death among older adults. Therefore, there is an urgency to clarify the influence of age on thermoregulation. This investigation sought to evaluate the influence of age on the thermal, metabolic, and perceptual responses of healthy, physically active, old (OLD) and young (YNG) men during exposure to 12, 18, and 27 degrees C for 120 min. There were four old (67.7 +/- 4.6 yr) and four young (26.7 +/- 3.4 yr) adult men who participated. Following a baseline period (30 min), the subjects, wearing only cotton shorts, were moved into an environmental chamber where they remained seated for 120 min or until rectal temperature (Tre) was < or = 35 degrees C. Data were collected for Tre, mean skin temperature (Tsk), oxygen consumption (Vo2), tissue insulation (I), thermal sensation (TS), and heat production (HP). Analysis of variance demonstrated a significant (p < 0.05) time x group interaction for Tre, HP, and I, whereby Tre, HP and I were higher in the YNG vs. OLD. Also, Tsk differed between YNG and OLD with the OLD exhibiting a higher Tsk. TS did not differ, although subjects reported feeling colder with each trial. These data suggest that there may be a differential thermoregulatory response between OLD and YNG individuals. The higher Tsk in the OLD suggests a deficit in the peripheral response leading to an increased heat loss over a protracted period of time. This heat loss may contribute to the reduction in core temperature and to the development of hypothermia in the older adult.
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Thermal energy is transferred within and between bodies via several avenues, but for most unprotected human cold exposures, particularly during immersion, convective heat loss dominates. Lower tissue temperatures stimulate thermoreceptors, and the resultant afferent flow elicits autonomic homoeostatic responses (thermogenesis and vasoconstriction) that regulate body temperature within a narrow range. The most powerful effector responses occur when both superficial and deep thermoreceptors are cooled simultaneously, but thermoeffector activation can also occur as a result of peripheral cooling alone. The responses to cold, and the hazards associated with cold exposure, are moderated by factors which influence heat production and heat loss, including the severity and duration of cold stimuli, accompanying exercise, the magnitude of the metabolic response, and individual characteristics such as body composition, age, and gender. Cold stress can quickly overwhelm human thermoregulation with consequences ranging from impaired performance to death. This review provides a comprehensive overview of the human physiological responses to acute cold exposure.
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The aim of this study was to ascertain whether repeated local cooling induces the same or different adaptational responses as repeated whole body cooling. Repeated cooling of the legs (immersion into 12 degrees C water up to the knees for 30 min, 20 times during 4 weeks = local cold adaptation - LCA) attenuated the initial increase in heart rate and blood pressure currently observed in control subjects immersed in cold water up to the knees. After LCA the initial skin temperature decrease tended to be lower, indicating reduced vasoconstriction. Heart rate and systolic blood pressure appeared to be generally lower during rest and during the time course of cooling in LCA humans, when compared to controls. All these changes seem to indicate attenuation of the sympathetic tone. In contrast, the sustained skin temperature in different areas of the body (finger, palm, forearm, thigh, chest) appeared to be generally lower in LCA subjects than in controls (except for temperatures on the forehead). Plasma levels of catecholamines (measured 20 and 40 min after the onset of cooling) were also not influenced by local cold adaptation. Locally cold adapted subjects, when exposed to whole body cold water immersion test, showed no change in the threshold temperature for induction of cold thermogenesis. This indicates that the hypothermic type of cold adaptation, typically occurring after systemic cold adaptation, does not appear after local cold adaptation of the intensity used. It is concluded that in humans the cold adaptation due to repeated local cooling of legs induces different physiological changes than systemic cold adaptation.
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Skin surface cooling improves orthostatic tolerance through a yet to be identified mechanism. One possibility is that skin surface cooling increases the gain of baroreflex control of efferent responses contributing to the maintenance of blood pressure. To test this hypothesis, muscle sympathetic nerve activity (MSNA), arterial blood pressure, and heart rate were recorded in nine healthy subjects during both normothermic and skin surface cooling conditions, while baroreflex control of MSNA and heart rate were assessed during rapid pharmacologically induced changes in arterial blood pressure. Skin surface cooling decreased mean skin temperature (34.9 +/- 0.2 to 29.8 +/- 0.6 degrees C; P < 0.001) and increased mean arterial blood pressure (85 +/- 2 to 93 +/- 3 mmHg; P < 0.001) without changing MSNA (P = 0.47) or heart rate (P = 0.21). The slope of the relationship between MSNA and diastolic blood pressure during skin surface cooling (-3.54 +/- 0.29 units.beat(-1).mmHg(-1)) was not significantly different from normothermic conditions (-2.94 +/- 0.21 units.beat(-1).mmHg(-1); P = 0.19). The slope depicting baroreflex control of heart rate was also not altered by skin surface cooling. However, skin surface cooling shifted the "operating point" of both baroreflex curves to high arterial blood pressures (i.e., rightward shift). Resetting baroreflex curves to higher pressure might contribute to the elevations in orthostatic tolerance associated with skin surface cooling.
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Cryotherapy is used in various clinical and sporting settings to reduce odema, decrease nerve conduction velocity, decrease tissue metabolism and to facilitate recovery after exercise induced muscle damage. The basic premise of cryotherapy is to cool tissue temperature and various modalities of cryotherapy such as whole body cryotherapy, cold spray, cryotherapy cuffs, frozen peas, cold water immersion, ice, and cold packs are currently being used to achieve this. However, despite its widespread use, little is known regarding the effectiveness of different cryotherapy modalities to reduce skin temperature.
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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.
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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 – infra-red 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.
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1.The changes which occur in a human body subjected to cryogenic temperatures are still not completely understood. Thus the aim of this study was to evaluate changes in blood circulation induced by a single exposure to very low temperature during whole-body cryostimulation of young and clinically healthy male subjects. Prior to the study, candidates underwent a medical examination in order to eliminate individuals with contraindications towards cryostimulation.2.The study included 40 young men aged 22±0.7 years, average body weight 76.65±7.8 kg and height 175.5±7.2 cm. The participants were exposed to extremely low temperatures in a cryogenic chamber. Each session lasted for 3 min at −130 °C and was preceded by 30 s of adaptation in a vestibule at −60 °C. Blood pressure and heart rate were measured before entering the chamber, immediately after exiting, and 10 and 20 min after exiting.3.Our results showed a significant increase in systolic blood pressure after cryostimulation (by an average of 21 mmHg in comparison with the initial level before cryostimulation) and an increase in diastolic blood pressure after the cryostimulation (by 9 mmHg). The increase in systolic blood pressure was accompanied by a significant decrease in heart rate (by about 10 bpm). Cryostimulation of the whole body is a stress factor and a stimulus for the body which significantly increases systolic blood pressure, but the changes are temporary and not harmful for normotensive individuals.
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Six mildly hypertensive subjects were exposed three times to −15 °C (wind 3.5 m/s) for 15 min. After an initial exposure for familiarisation, second and third exposures were arranged in a random double blind, crossover fashion after a week's ingestion of hydrochlorothiazide or placebo. Cold decreased skin temperatures, but not rectal temperature. Blood pressure increased 30/20 mmHg and heart rate decreased 12 beats/min by cold. Blood pressure seems to react in 3 min to changes in ambient temperature. The skin temperatures of uncovered body parts were apparently responsible for that. Hydrochlorothiazide did not affect either cardiovascular or thermal responses in cold.
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The effect of whole-body cryotherapy (WBC) on rectal and skin temperatures was measured in healthy subjects before, during and after WBC exposure. WBC did not cause any significant change in rectal temperature. The lowest local skin temperatures were recorded in the forearm, 5.2 (2.8)°C, and in the calf, 5.3 (3.0)°C. WBC involves no risk for frostbites. After WBC, all skin temperatures recovered rapidly, indicating that the analgetic effects of WBC only occur during a limited period after the exposure.
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Cryotherapy 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 consists in the exposure to very cold air in special cryochambers. The air is maintained at temperatures between -110 and -160°C. The treatment was named whole-body cryotherapy (WBC). It consists in a brief exposure to extreme cold in a temperature-controlled chamber. It is applied to relieve pain and inflammatory symptoms caused by numerous disorders, particularly those associated with rheumatic conditions, and it is recommended for the treatment of arthritis, fibromyalgia and ankylosing spondylitis. The aim of this study was to investigate the effects of different treatment of WBC on blood pressure (BP) and heart rate (HR) parameters in adult subjects characterized from non-pathological values of BP. Eighty subjects (36 females, 44 males, age range 19-80 years) submitted to 4-17 WBC applications for a total of 816 treatments were recruited. Immediately before and after each WBC application systolic and diastolic BP and HR were measured and recorded. We did not find significant differences in BP and HR (p > 0.05). WBC seems to be safe with respect to unwanted BP and HR alterations for adult patients. An individual monitoring of subjects is recommended over the treatment, but pathological changes of circulatory parameters can be considered rare and occasional.
Article
Thermography and contact thermometry were used to study the influence of body mass index (BMI) on the lowering of skin temperature caused by whole-body cryotherapy. The study was performed using the Thermovision Camera AGEMA Type 470 and A40. The thermograms of the chosen regions of interests were performed before and immediately after whole-body cryotherapy in a research room outside a cryogenic chamber where the temperature was stabilized. As an additional measurement technique during whole-body cryotherapy, contact thermometry was performed using thermocouples Ni-Cr-Ni-Al stacked to the skin surface. The results obtained showed differences in the decrease of skin temperature of predetermined body parts. The largest temperature decrease was observed on the lower extremities. Some differences in the thermal response of similar body parts influenced by the extremely low temperature, with regard to the BMI of volunteers, were observed. This was also found in the results of contact thermometry studies. The statistical analysis confirmed the results of thermography and thermometry studies. The magnitude of skin temperature decrease due to the extremely low temperature used in whole-body cryotherapy may be connected to a patient's BMI.
Article
The purpose of this study was to investigate the effects of whole-body cryotherapy (WBC) on proprioceptive function, muscle force recovery following eccentric muscle contractions and tympanic temperature (T(TY) ). Thirty-six subjects were randomly assigned to a group receiving two 3-min treatments of -110 ± 3 °C or 15 ± 3 °C. Knee joint position sense (JPS), maximal voluntary isometric contraction (MVIC) of the knee extensors, force proprioception and T(TY) were recorded before, immediately after the exposure and again 15 min later. A convenience sample of 18 subjects also underwent an eccentric exercise protocol on their contralateral left leg 24 h before exposure. MVIC (left knee), peak power output (PPO) during a repeated sprint on a cycle ergometer and muscles soreness were measured pre-, 24, 48 and 72h post-treatment. WBC reduced T(TY) , by 0.3 °C, when compared with the control group (P<0.001). However, JPS, MVIC or force proprioception was not affected. Similarly, WBC did not effect MVIC, PPO or muscle soreness following eccentric exercise. WBC, administered 24 h after eccentric exercise, is ineffective in alleviating muscle soreness or enhancing muscle force recovery. The results of this study also indicate no increased risk of proprioceptive-related injury following WBC.
Article
In this article, the development of a system for online monitoring of a subject's physiological parameters and subjective workload regardless of location has been presented, which allows for studies on occupational health. In the sector of occupational health, modern acquisition systems are needed. Such systems can be used by the subject during usual daily routines without being influenced by the presence of an examiner. Moreover, the system's influence on the subject should be reduced to a minimum to receive reliable data from the examination. The acquisition system is based on a mobile handheld (or smart phone), which allows both management of the communication process and input of several dialog data (e.g., questionnaires). A sensor electronics module permits the acquisition of different physiological parameters and their online transmission to the handheld via Bluetooth. The mobile handheld and the sensor electronics module constitute a wireless personal area network. The handheld allows the first analysis, the synchronization of the data, and the continuous data transfer to a communication server by the integrated mobile radio standards of the handheld. The communication server stores the incoming data of several subjects in an application-dependent database and allows access from all over the world via a Web-based management system. The developed system permits one examiner to monitor the physiological parameters and the subjective workload of several subjects in different locations at the same time. Thereby the subjects can move almost freely in any area covered by the mobile network. The mobile handheld allows the popping-up of the questionnaires at flexible time intervals. This electronic input of the dialog data, in comparison to the manual documentation on papers, is more comfortable to the subject as well as to the examiner for an analysis. A Web-based management application facilitates a continuous remote monitoring of the physiological and the subjective data of the subject.
Article
To examine the effects of thermal stress on the blood pressure variability and the arterial baroreceptor-cardiac reflex during orthostatic stress, 11 male volunteers underwent whole body thermal stress using a cool or hot water-perfused suit during 5 min of 70° head-up tilt (HUT). The spontaneous variability in arterial pressure was quantified by power spectrum analysis. The sensitivity of the arterial baroreceptor-cardiac reflex was calculated from the spontaneous changes in beat-to-beat arterial pressure and heart rate (f c). During supine rest the variability of arterial pressure decreased during cooling, while it remained unchanged during heating. The variability increased with HUT; it was greater (P
Article
We studied how, sympathetic response to cold exposure determines thermoregulatory function. Three female and seven male volunteers (age, 23.2+/-1.9 years) were exposed to abrupt local cooling and gradual systemic cooling with recording of microneurographic skin sympathetic nerve activity tSSNA), skill temperatures (Ts), tympanic temperature (Tty), skin blood flow measured by laser Doppler flowmetry, and sweating rate measured with a ventilated capsule. Local cooling induced an abrupt vasoconstrictor SSNA increase and Tty rise. There was a significant positive correlation between the increase in the vasoconstrictor SSNA and the change rate of Tty. Systemic cooling at 0.2 degrees C/min enhanced SSNA but gradually decreased Tty, and a significant negative correlation was observed between them. A 10-min delay separated the SSNA rise from the subsequent Tty rise following local cooling. A delay of less than 1 min preceded the SSNA increase after the Tty fall induced by systemic cooling. These findings suggested that subjects with a good SSNA response to cold stress can maintain core temperature, but 10 min is necessary to raise the core temperature by reducing heat loss from the skin surface. In contrast. vasoconstrictor SSNA responds linearly to a fall in core temperature with a delay of less than 1 min.
Article
Autonomic assessment has played an important role in elucidating the role of the autonomic nervous system in diverse clinical and research settings. The techniques most widely used in the clinical setting entail the measurement of an end-organ response to a physiological provocation. The non-invasive measures of cardiovascular parasympathetic function involve the analysis of heart rate variability while the measures of cardiovascular sympathetic function assess the blood pressure response to physiological stimuli. Prolonged tilt-table testing, with or without pharmacological provocation, has become an important tool in the investigation of a predisposition to neurally mediated (vasovagal) syncope. Frequency domain analyses of heart rate and blood pressure variability, microneurography, occlusion plethysmography, laser Doppler imaging and flowmetry, and cardiac sympathetic imaging are currently research tools but may find a place in the clinical assessment of autonomic function in the future.
Article
A new method and apparatus for non-disruptive blood pressure (BP) recording in the finger based on the vascular unloading technique is introduced. The instrument, in contrast to intermittent set point readjustments of the conventional vascular unloading technique, delivers BP without interruptions, thus refining the Penáz' principle. The method is based on concentrically interlocking control loops for correct long-term tracing of finger BP, including automatic set point adaptation, light control and separate inlet and outlet valves for electro-pneumatic control. Examples of long-term BP recordings at rest and during autonomic function tests illustrate the potential of the new instrument.
Article
In whole body cryotherapy the whole human body is exposed to low temperature below -100 degrees C in a special room called cryogenic chamber for a very short period of time (2-3 minutes). The impact of cold can cause many different biochemical and physiological reactions of the organism. The skin temperature response due to whole body cryotherapy was studied by means of infrared measurements. The thermograms of chosen body parts of patients suffering from low back pain were performed before and after whole body cooling on the 1(st), 5(th) and the last (10(th)) day of medical treatment. Infrared imaging performed after cold impact owing to the enhancement of the skin temperature profile may reveal a slight decrease of the inflammatory states as a result of the 10 sessions of cryotherapy.
Muscle, skin and core temperature after À 110 °C cold air and 8 °C water treatment Effects of whole body cryotherapy and cold water immersion on knee skin temperature
• J T Costello
• K Culligan
• J Selfe
• A E Donnelly
Costello, J.T., Culligan, K., Selfe, J., Donnelly, A.E., 2012b. Muscle, skin and core temperature after À 110 °C cold air and 8 °C water treatment. PLoS One 7 (11), e48190. Costello, J.T., Donnelly, A.E., Karki, A., Selfe, J., 2014. Effects of whole body cryotherapy and cold water immersion on knee skin temperature. Int. J. Sports Med. 35 (1), 35–40.
Impact of different treatment of whole-body cryotherapy on circulatory parameters
• F G Bonomi
• M Nardi
• A Fappani
• I V Zan
• G Banfi
Bonomi, F.G., Nardi, M., Fappani, A., Zan, I.V., Banfi, G., 2012. Impact of different treatment of whole-body cryotherapy on circulatory parameters. Arch. Immunol. Ther. Exp. 60, 145-150.
Heart rate variability. Standards of measurement, physiological interpretation and clinical use
Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology, 1996. Heart rate variability. Standards of measurement, physiological interpretation and clinical use. Eur. Heart J. 17, 354-381.