developments in cryotherapy...the use of extremely low temperatures (below –100 c) applied for a...

Ass. Prof. Agata Stanek MD, PhD

President of Polish Society of Cryotherapy

Department and Clinic of Internal Diseases, Angiology and

Physical Medicine in Bytom of Medical University of Silesia

in Katowice

DEVELOPMENTS

IN CRYOTHERAPY

EUROPEAN CRYOGENICS DAYS, GENEVA 9-10.06.2016

COLD - HISTORY OF

THERAPEUTICAL APPLICATON

2500 B.C. – in Egypt- cold exerted

an anti-inflammatory effect and

alleviated injury pain;

in V B.C. Hippocrates used cold to

decrease swelling, bleeding and

pain;

in 1883 a Polish physicists

Karol Olszewski and Zygmunt

Wróblewski executed the first

condensing of nitrogen and

oxygen;

COLD - HISTORY OF


in 1978 T. Yamauchi in Japan –

created whole-body

cryotherapy;

for the first time in the world

he applied whole-body

cryotherapy in the treatment

of patients with

rheumatoid arthritis

COLD - HISTORY OF


in 1982 R. Fricke

in Germany-

used whole-

body cryotherapy

for the first time in

Europe;

COLD -COLD - HISTORY OF


In 1983 – Z. Zagrobelny –

Department of Physiotherapy of

University School of Physical

Education in Wroclaw – local

cryotherapy was applied for

patients first time in Poland;

Cryotherapy in Poland:

COLD - HISTORY OF


1989 Polish cryochamber

(second in Europe, third in the world)

Zbigniew Raczkowski –Institute of Low

Temperatures and Structural

Investigations of the Polish Scientific

Academy in Wroclaw; the creator of the

first Polish cryochamber

Cryotherapy in Poland:

COLD - HISTORY OF


MODERN CRYOMEDICINE

Cryogenic temperatures in medicine

CRYOTHERAPY

CRYOSURGERY

LOCAL

CRYOSTIMULATION

WHOLE-BODY

CRYOSTIMULATION

CRYOSTIMULATION

CRYOSURGERY

Cryosugery - interruption of

the continuity of tissues as

a result of freezing with a

view to their removal or

destruction.

CRYO-S MINI

Cryoflex device for cryosurgery

Cryosurgical treatment with usage of spray probe

The use of extremely low temperatures

(below –100°C) applied for a short time

(2-3 minutes) to stimulate physiological

reactions in the human body, in order to

achieve more effective pharmacological

treatment and kinesiotherapy. Sieroń A., Cieślar G., Stanek A. (eds). Cryotherapy. alpha-medica press, Bielsko-Biała, 2010

Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice.

Balneol. Pol., 2007, 49, 1, 107, 37-45.

Podbielska H., Stręk W., Biały D. (eds). Whole-body cryotherapy. Acta of Biomedical

Engineering. Indygo, Zahir Media, Wroclaw, 2007

Zagrobelny Z.(ed). Whole-body and local cryotherapy. Urban & Partner, Wroclaw, 2003

CRYOTHERAPY- DEFINITION

LOCAL CRYOTHERAPY

(CRYOSTIMULATION-

HYPERBARIC GASEOUS

LOCAL CRYOTHERAPY)

application

of the cold

to a selected

part of the

human body.

LOCAL

CRYOTHERAPY

ACCORDING TO THE KIND OF

COOLING MEDIUM LOCAL

CRYOTHERAPY IS DIVIDED

INTO:

1. Cryotherapy with liquid nitrogen.

2. Cryotherapy with carbon dioxide.

CRYO -T ELEPHANT devices for local

cryotherapy-cooling medium liquid nitrogen

(METRUM CRYOFLEX)

CRYO -T (METRUM CRYOFLEX)

device for local cryotherapy-cooling medium

liquid carbon dioxide

KRIOPOL R60

CREATOR

Application of cryogenic temperatures

for a short time (1-3 minutes) on the entire

body of the patient.

Whole-body cryotherapy is performed in

cryochambers

WHOLE-BODY

CRYOTHERAPY

Antechamber: acclimatisation to cryogenic temperature,

exposure duration 60 seconds, temperature -60°C.

Proper chamber: exposure duration 2-3minutes,

temperature below -110°C.

The exposure duration depends on individual cryogenic

temperature tolerance.

Sieroń A., Cieślar G., Stanek A. (eds). Cryotherapy. alpha-medica press, Bielsko-Biała, 2010

Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice. Balneol. Pol., 2007, 49, 1, 107,

37-45.

Podbielska H., Stręk W., Biały D. (eds). Whole-body cryotherapy. Acta of Biomedical Engineering. Indygo, Zahir Media,

Wroclaw, 2007


WHOLE-BODY

CRYOTHERAPY

CRYOTHERAPY CHAMBER –WROCŁAW TYPE

(CREATOR)

TWO - CHAMBER SYSTEM

Antechamber

Temp.-60°C

Proper chamber

Temp. -110° C

CRYOCHAMBER WITH COLD RETENTION

(CRYOFLEX METRUM)

EXAMPLE OUTFITS FOR WHOLE - BODY

CRYOTHERAPY

Endocrine system- increased beta-endorphins

secretion;

Neuronal system - functional exclusion of sensory

receptors and their junctions with proprioceptors;

decreased nerve transmission in sensory fibres,

reduction the activity of free nerve endings, raising

the pain threshold, over-ride the pain sensation -

known as the pain gate theory;

Wawrowska A.: Wpływ ogólnoustrojowej krioterapii organizm osób zdrowych i chorych reumatycznych ze

szczególnym uwzględnieniem stężeń wybranych hormonów, beta-endorfin, 6-ketoPGF1. Praca Dokorska

AWF, Wrocław 1992.

Bauer J., Skrzek A.: Fizjologiczne podstawy krioterapii. Acta Bio-Opt. Inform. Med.., 1997,3,(2-4), 115-120.

Sieroń A., Rykaczewska-Czerwińska M., Klimkiewicz T., Jakrzewska H., Jagodziński L., Birkner E., Wiśniowska

B., Plech A. Antinociceptive effect in rats induced by the cooling of their whole body. Acta Bio-

Opt.Inform.Med., 2002,8,153-155;

ANALGESIC EFFECT

Metabolic action (among others

decreased concentrations of histamine

and lactate in inflammatory changed

tissues).


Stanek A., Cholewka A., Cieślar G., Rosmus-Kuczia I., Drzazga Z., Sieroń A. Estimation of analgesic action of

whole-body cryotherapy in patients with ankylosing spondylitis..Fizjoter. Pol., 2011, 1, 4, 49-55.


ANALGESIC EFFECT

reduction of nerve transmission

and reactivity of peripheral

sensomotor nerve endings

decreased muscle tone;

increased muscle power;

Bilińska M., Rudkowska-Brzecka A., Marytnów R., Brzecki A.: Badania elektromiograficzne w

ocenie siły mięśniowej po krioterapi u chorych z reumatoidalnym zapaleniem stawów.

Przegl. Lek., 1993, 50, (1-2), 12-13.

Schroder D., Anderson M.: Kryo-und-Theromtherapie: Grundlagen und praktische

Adwendung.Harausgegeben von Bernd Gaupel, Gustav Fischer verlag, Stuttgarrt-Jena-New

York 1995.

NEURO-MUSCULAR

EFFECT

ANTIOEDEMATOUS

EFFECTarterial hyperemia of periarticular

oedemas,

increased capillary filtration,

improvement of lymphatic vessels

patency draining intercellular space.

Gregorowicz H., Zagrobelny Z. Krioterapia ogólnoustrojowa wskazania i przeciwwskazania,

przebieg zabiegu i jego skutki fizjologiczne i kliniczne. Acta Bio-Opt. Inform. Med., 1998, 4,119-

131.

Kalmus P., Włodarczyk K., Pinkowska I., Piotrowska E., Szulicka A. Wyniki leczenia

reumatoidalnego zapalenia stawow zabiegami krioterapeutycznymi i peloidowymi. Baln.

Pol.,1999, 41,83-91.

ANTIOEDEMATOUS

EFFECTcryogenic temperatures accelerate

lymphatic flow but they do not

influence lymph formation

the lymphatic flow acceleration is

long lasting but it appears only at

the end of the exposure cycle (10

daily exposures)

Sieroń A., Pastuszka A., Marniok B., Wiśniowska B., Jagodziński L., Ślusarczyk K., Cieślar G.,

Stanek A. Influence of low temperatures on lymph formation and flow velocity in mice. Thermology

Int.,2004,14,127-130

ANTIINFLAMMATORY

EFFECT

inflammatory parameters:

ESR (erythrocyte sedimentation rate),

CRP (C-reactive protein), seromucoid,

IL-2,IL-8,IL-10, sICAM;

Stanek A., Cieślar G., Strzelczyk K., Kasperczyk S., Wiczkowski A., Birkner E., Sieroń A.: Influence of

cold on inlammatory markers in patients with ankylosing spodylitis and healthy volunteers. Polish

Journal of Environmental Study, 2010,19,1, 167-175.

Banfi G., Melegati G., Barassi A., Dogliotti G., d’Eril G., Dugue B., Corsi M. Effects of whole-body

cryotherapy on serum mediators of inflammation and serum muscle enzyme in athtes. J.Thermal Biol.,

2008, 34,55-59.

beneficial influence on the

prooxidant-antioxidant

balance

Stanek A. Influcence of whole-body cryotherpy on antioxidant status in patients with ankylosing

spondylitis. Thesis, Medical University of Silesia, 2004

Lubkowska A., Chudecka M., Klimek A., Szyguła Z., Frączek B.: Acute effect of a single whole-body

cryostimulation on prooxidant-antioxidant balance in blood of healthy, young men. J Thermal. Biol.,

2008, 33, 464-467

Mila-Kierzenkowska C., Wozniak A., Wozniak B., Drewa G., Rakowski A., Jurecka A., Rajewski R. Whole-

body cryostimulation in kayaker women: a study of the effect of cryogenic temperatures on oxidative

stress after the exercise. J. Sports Med. Phys. Fitness, 2009, 49, (2), 201-207.

ANTIINFLAMMATORY

EFFECT

cellular and humoral immunity

prostaglandins and cytokins;

number and percentage of

lymphocytes: CD3, CD4, CD8, CD19,

CD56(NK);

Zagrobelny Z., Halawa B., Kuliczkowski K., Frydecka I., Grgorowicz H.: Wpływ ogólnoustrojowej

krioterapii w komorze niskotemperaturowej oraz leczenia ruchem na subpopulacje limfocytów we

krwi obwodowej u chorych na chorobę zwyrodnieniową stawów i reumatoidalne zapalenie

stawów. Reumatologia, 1996, 34,763-771.

IMMUNE SYSTEM

HORMONAL SYSTEM

- adrenaline, noradrenaline, cortisol, B-

endorphine, testosterone (in males);

thyrothrophic hormone, thyroid hormones,

growth hormone, follicular hormone,

luteinizing hormone and 6-ketoPGF1

(prostaglandin metabolite causing

vasodilatation effect of blood vessels)

Wawroska A.: Wpływ ogólnoustrjowej krioterapii na organizm osób zdrowych i chorych reumatycznych ze

szczególnym uwzględniem stężeń wybranych hormonów, beta-endorfin, 6-ketoPGF1. Praca Dokorska AWF,

Wroclaw 1992.

Smolander J., Leppäluoto J., Westerlund T., Oksa J., Dugue B., Mikkelsson M., Ruokonen A. Effects of repeated

whole-body cold exposures on serum concentrations of growth hormone, thyrotropin, prolactin and thyroid

hormones in healthy women. Cryobiology, 2009, 58, (3), 275-278.

CIRCULATORY

SYSTEM

MICROCIRCULATION MACROCIRCULATION

MICROCIRCULATION

I phase: - contraction of

precapillary sphincters

skin precapillary

flow;

- opening of arteriovenous

anastomoses

oxygenated blood flow

back through veins to

the left atrium of the

heart;Bauer J., Skrzek A. Fizjologiczne podstawy krioterapii. Acta Bio-

Opt.Inform.Med., 1997,3,115-120.

Gregorowicz H.: Wpływ krioterapii ogólnoustrojowej na wybrane wskaźniki hemodynamiczne i wentylacji płuc w

schorzeniach reumatycznych. Praca Doktorska AM, Wrocław, 1992.

MICROCIRCULATION

II phase: - vasodilatation of capillary vessels,

closure of arteriovenous anastomoses,

hiperperfusion of tissues oxygen

supply to tissues with inflammatory changes,

lactate and histamine concentrations pain

reduction

Bauer J., Skrzek A. Fizjologiczne podstawy krioterapii. Acta Bio-Opt.Inform.Med., 1997,3,115-120.

Gregorowicz H.: Wpływ krioterapii ogólnoustrojowej na wybrane wskaźniki hemodynamiczne i wentylacji płuc

w schorzeniach reumatycznych. Praca Doktorska AM, Wrocław, 1992.

MACROCIRCULATION

blood pressure, heart rate,

left ventricular contractility;

in literature there are no

cases of arrhythmias,

electrocardiographic

symptoms of myocardial

ischemia;

Jagodziński L., Cieślar G., Stanek A., Puszer M., Bilska A., Wiśniowska B., Romuk E., Skrzep-Poloczek E., Birkner E., Sieroń A.: Ocena

frakcji wyrzutowej lewej komory serca u pacjentów z zesztywniającym zapaleniem stawów kręgosłupa poddanych krioterapii

ogólnoustrojowej. Balneol. Pol., 2003, 45, (3-4), 40-44.

Jonderko G., Końca A., Rosmus-Kuczia I., Nowicki L.: Wpływ krioterapii miejscowej gazem chłodzącym i lodem na elektrokardiogram i

ciśnienie tętnicze krwi u chorych na reumatoidalne zapalenie stawów. Ann.Acad. Med.Siles., 1991,24,131-138.

Zagrobelny Z., Halawa B., Negrusz-Kawecka M., Spring A., Gregorowicz H., Wawrowska A., Rozwadowski G.: Zmiany hormonalne i

hemodynamiczne wywołane schładzeniem całego ciała chorych na reumatoidalne zapalenie stawów. Pol. Arch. Med. Wewn., 1992,87,34-40.

AND ALSO….

WHOLE – BODY

CRYOTHERAPHY

beneficial influence on the

psyche (decreased level of

fear, anxiety, excitability;

increased perception).

Rymaszewska J., Biały D., Zagrobelny Z., Kiejna A. The influence of whole-body

cryotherapy on mental health. Psychiatr.Pol., 2000,34,64-653;

Rymaszewska J., Ramsey D., Chładzińska-Kiejna S. Whole-body cryotherapy as adjunct

treatment of depressive syndrome and anxiety disorders. Arch. Immunol. Ther.

Exp.,2008,56,63-68.

WHAT MORE

Cryotherapy prior to

kinesiotherapy facilitates

the intensification of

training and its duration

severalfold.Sieroń A., Cieślar G., Stanek A. (eds). Cryotherapy. alpha-medica press, Bielsko-Biała, 2010

Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice. Balneol.

Pol., 2007, 49, 1, 107, 37-45.

Podbielska H., Stręk W., Biały D. (eds). Whole-body cryotherapy. Acta of Biomedical Engineering.

Indygo, Zahir Media, Wroclaw, 2007


Cryotherapy

Reduced stimulus threshold

Analgesia Reduced tendon reflexes

Reduced pain Reduced muscular tone

Prolonged relaxation

Improvement of motion range

Physical rehabilitation (kinesiotherapy)

Knight K.L. Cryotherapy in sport injury management, Human Kinetics: Champaingn, 1995.

CRYOTHERAPY - clinical indications:

I. Disorders of motion system

II. Neurological system disorders

III. Wellness

IV. Depressive syndrome

V. Sports medicine

DISORDERS OF MOTION SYSTEM:

inflammatory diseases of motor system

(f.e. reumatoid arthritis, ankylosing

spondylitis);

degenerative diseases of joints and the

spine;

inflammatory lesions of the joints of

metabolic origin (e.g. gouty diathesis);

Sieroń A., Cieślar G., Stanek A. (eds). Cryotherapy. alpha-medica press, Bielsko-Biała, 2010.

Stanek A., Cholewka A., Gaduła J., Drzazga Z., Sieroń A., Sieroń-Stołtny K.. Can whole-body cryotherapy with

subsequent kinesiotherapy procedures in closed type cryogenic chamber improve BASDAI, BASFI, some spine

mobility parameters and decrease pain intensity in patients with ankylosing spondylitis? BioMed Res Int 2015, Vol.

2015, Article ID 404259, 11 pages


DISORDERS OF THE MOTION SYSTEM:

posttraumatic and overloading

lesions,

discopathy,

osteoporosis,

fibromyalgia syndrome;


Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice. Balneol. Pol.,

2007, 49, 1, 107, 37-45.

Podbielska H., Stręk W., Biały D. (eds). Whole-body cryotherapy. Acta of Biomedical Engineering.

Indygo, Zahir Media, Wroclaw, 2007


diseases of the central nervous

system with muscle spasticity

multiple sclerosis

radicular syndromes

diseases of the peripheral nervous

system

NEUROLOGICAL SYSTEM DISORDERS:

SPORTS MEDICINE :The benefits observed are:

reduction of pain

increase in muscle strength

inhibition of inflammatory

processes

reduction in the regeneration

phase

reduction of posttraumatic

treatment

enhancement of sports

performance

overall faster return to training

Biały D., Zimmer K., Zagrobelny Z. Krioterapia ogólnoustrojowa w sporcie. Med.Sport.,1999, 15,21-

24.

Swenson C., Sward L., Karlsson J. Cryotherapy in sport medicine. Scand. J. Med.Sci. Sport.,

1996,6,193-200.

Future

development

FUTURE CRYOTHERAPY -

health and well - being

More and more frequently

cryotherapy is used to improve

health, harden and revitalize the

body and prevent stress-related

diseases and their consequences

www.cryowellness.com,

www.criomed.com.

Stanek A., Sieroń A. Contemporary whole-body cryotherapy in biological

renewal. Ann. Acad. Med. Siles., 2012, 66, 4, 64-70

http://www.cryowellness.com/

http://www.criomed.com/

FUTURE - SKIN

Whole-body

cryotherapy helps to

reduce the

appearance of

cellulite and loose

skin as a result of

aging, weight lost,

post liposuction as

well as prevents

wrinkles.

www.cryowellness.com

CELLULITE - BEFORE AND AFTER WHOLE-BODY CRYOTHERAPY

www.onkocet.eu

STRICT CONTRAINDICATIONS

TO CRYOTHERAPY:

cold intolerance,

cryoglobulinemia,

cryofibrinogenemia,

Raynaud’s phenomena,

cold urticaria, Sieroń A., Cieślar G., Stanek A. (eds). Cryotherapy. alpha-medica press, Bielsko-Biała, 2010

Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice. Balneol. Pol., 2007, 49, 1,

107, 37-45.


Wroclaw, 2007


STRICT CONTRAINDICATIONS

TO CRYOTHERAPY:

venous thromboemolism,

hypothyreosis,

local disorders of blood supply,


Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice. Balneol. Pol., 2007, 49, 1,

107, 37-45.

Podbielska H., Stręk W., Biały D. (eds). Whole-body cryotherapy. Acta of Biomedical Engineering. Indygo, Zahir

Media, Wroclaw, 2007


STRICT CONTRAINDICATIONS TO

CRYOTHERAPY:

considerable anemia,

claustrophobia,

cachexia,

hypothermia,

cancer diseaseSieroń A., Cieślar G., Stanek A. (eds). Cryotherapy. alpha-medica press, Bielsko-Biała, 2010

Stanek A., Cieślar G., Sieroń A. Therapeutic aplication of cryotherapy in clinical practice. Balneol. Pol., 2007, 49, 1, 107, 37-

45.


Wroclaw, 2007


developments in cryotherapy...the use of extremely low temperatures (below –100 c) applied for a...

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