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Methodology of whole-body cryotherapy procedures
 
Patients for whole-body cryotherapy procedures have to be examined by a doctor. Doctorís preliminary qualification should based on collected medical history, physical examination including: blood pressure and pulse rate taking, urologic evaluation, as well as electrocardiographic investigation. On the basis of obtained data possible contraindications disqualifying patient from such a form of treatment are evaluated.
For each patient qualified for whole-body cryotherapy therapeutic parameters and individual programme of kinesitherapy are determined, and also treatment record is created with noted down blood pressure taken before and after each procedure, number and duration of procedures, changes in therapeutic parameters of cryotherapy or course of kinesitherapy performed afterwards, as well as subjective feelings of patients and possible complications and side effects of procedure.
 
Patients admitted for the whole-body cryotherapy are instructed how to behave during a procedure. Special attention is paid to the way of breathing in the proper
chamber during the procedure. Inhaling should be two times shorter than exhaling due to decompression of cooled air in lungs. Non-compliance with the recommendation may lead to serious breathing depression. Moreover, it is forbidden to touch other patients or rub own skin.
 
How patients should dress it
 
Cryogenic temperatures (-110 C to -160 C) applied during a procedure in a proper
chamber require protecting parts of the body mostly exposed to low temperatures
against injury. Hands are protected by gloves, while shanks and feet by woolen kneelength
socks. Moreover, feet are protected by wooden clogs. Then auricles are protected
by a cap or headband. During a procedure women, wear swimming costumes and
men shorts. Such dress allows for contact of bigger body area with cold air. Mouths
are protected by gauze-lined surgical masks. Standard wear for patients of both sexes
worn during the whole-body cryotherapy procedure.
 
 
Treatment
 
Before each procedure control blood pressure is measured and written down in the treatment minute. Immediately before entering a cryochamber patients dry their skin with towel in order to remove sweat, as sweat drops turn into ice crystals in a chamber. Next, patient accompanied by a therapist dressed up in the cold-protecting wear enter a preliminary chamber called pre-chamber with temperature of - 60C. Adaptation time to low temperature is up to 30 seconds. Here, a therapist once more instructs how to behave during a procedure. Then, through linking doors patients enter one by one without any assistance a proper chamber where temperature ranges from -110C to -160C. Only patients with walking difficulties enter a proper chamber with staff assistance.
 
Temperature and time of staying in chamber depend on patientís individual reaction to the cold and are individually determined by a doctor supervising cryotherapy. Duration of a single procedure ranges from 60 to 180 seconds and a standard therapeutic cycle most often includes ten procedures.
 
 
Therapeutic applications
 
Local and whole-body cryotherapy is currently applied in the treatment of many diseases such as:
 
  •  diseases of the locomotor system of various etiology,
  • diseases of the central and peripheral nervous system,
  • diseases of the mental origin neurosis and depression syndrome,
  • diseases of the autoimmunological origin, and in sports medicine and widely understood spa and wellness.
 
Diseases of locomotor sytem
 
The largest group of patients qualified for cryotherapy procedures are patients with diseases of locomotor system of various etiopathogenesis and symptomatology. The main groups of locomotor system diseases with substantiated beneficial influence of the treatment with cold are the following diseases;
 
  •  diseases of the locomotor system of autoimmunological origin: e.g. rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and Reiterís syndrome,
  • diseases of soft tissues with accompanying dysfuction of the locomotor system of autoimmunological origin: e.g. myositis, fibromyosis and collagenosis,
  • diseases of the locomotor system related to non-specific inflammatory process: periarticulartendinitis, periarticular inflammation of joint capsules and muscles,
  • spondyloarthrosis and peripheral arthrosis along with secondary inflammatory reaction,
  • diseases of the locomotor system of metabolic origin: e.g. gout,
  • diseases related to disorder of the calcium and phosphate metabolism with loss of the osseous mass: osteoporosis of various etiopathogenesis,
  • disease of the locomotor system caused by trauma and overloading: traumatic Sudeckís atrophy (Reflex Sympathetic Dystrophy Syndrome)
  • diseases of intervertebral disk,
  • diseases of the locomotor system caused by injury of the central and/or peripheral nervous system: e.g. spastic paresis,
  • diseases of the locomotor system of fibromyalgia type.
 
 Diseases of nervous system:
 
  •  radicular syndromes,
  • multiple sclerosis
  • spastic paresis.

 

Biological regeneration of overloaded muscles

 
Professional sport:
 
  • adjunctive biological regeneration (biostimulating effect),
  • adjunctive endurance and strength training,
  • acceleration of post-endurance restitution,
  • prophylaxis of locomotor system overloading,
  • adjunctive post-traumatic treatment of soft tissues and joints (contusion, hematomas, distortion),
  • adjunctive treatment of overloading syndromes in muscles, muscle attachments, joints and spine.
 
 
Contraindications for applying cryotherapy
 
 
Although therapy using low temperature is a relatively safe method, we have to bear in mind these conditions in which using low temperature may produce adverse health results. During qualification of patients following parameters should be taken into account: patientís age, existing diseases, nutritional status, efficiency of blood vessels, time of exposure to the cold and its intensity, drugs taken by patients, drinking alcohol, individual sensitivity to the cold effect. All those parameters determine possibility of safe application of cryogenic procedures and may be a reason for patientís disqualification for cryotherapy procedures.
According to the present knowledge, absolute contraindications for applying cryotherapy are:
 
  • cold intolerance,
  • cryoglobulinemia,
  • cryofibrynogemia,
  • Raynaudís disease,
  • thrombotic, embolic and inflammatory lesions in the venous system,
  • some diseases of central nervous system,
  • neuropathies of sympathetic system,
  • mental diseases restricting communication with patient,
  • claustrophobia,
  • taking some drugs, particularly neuroleptic drugs and alcohol,
  • hypothyroidism,
  • local disorders of blood supply,
  • open wounds and ulcerations,
  • advanced stage of anemia,
  • organism cachexy and hypothermia,
  • neoplastic disease,
  • active tuberculosis,
  • acute disease of respiratory system,
  • diseases of cardiovascular system including:
  • unstable angina and advanced stage of stable angina,
  • defects in valvular apparatus in form of semilunar aortic valve stenosis and mitral
  • valve stenosis,
  • other diseases of cardiac muscle and valvular apparatus in stage of circulatory failure,
  • cardiac rhythm disorder, among them , sinus tachycardia above 100/minute,
  • arterio-venous shunts in lungs.
  • except for absolute contraindications, there also are relative contraindications age above 65 years, excessive emotional instability that is expressed, among others in form of hyperhidrosis.
 
"Cryotherapy. Theoretical bases, biological effects, clinical applications"
Edited by: Aleksander Sieroń, Grzegorz Cieślar and Agata Stanek
by Alfamedica-press 2010 

 

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