Whole-body cryostimulation in obesity. A scoping review

Pre-exercise cryotherapy reduces myoglobin and creatine kinase levels after eccentric muscle stress in young women

Introduction: The aim of this study was to investigate the effect of pre-exercise whole-body cryotherapy (WBC) on muscle damage indicators following eccentric treadmill exercise in young women. Methods: Twenty-seven participants underwent two 1-h downhill treadmill runs, replicating 60% of their maximal oxygen uptake, with a 4-week intermission for recovery and treatment application. In this intermission, one group underwent 20 sessions of WBC, delivered five times a week at -120°C for 3 min each, while the comparison group received no such treatment. Markers of muscle injury-serum myoglobin concentration, creatine kinase and lactate dehydrogenase activity and also uric acid, and cell-free DNA concentration-were measured before and after downhill runs. Results: The study observed a notable reduction in post-exercise myoglobin and CK levels in the WBC group after the second running session. Discussion: The results suggest that WBC can have a protective effects against muscle damage resulting from eccentric exercise.

Whole-Body Cryostimulation as an Adjunctive Treatment for Neurophysiologic Tinnitus and Associated Disorders: Preliminary Evidence from a Case Study

BACKGROUND

Tinnitus, which is often associated with reduced quality of life, depression, and sleep disturbances, lacks a definitive treatment targeting its pathophysiological mechanism. Inflammatory markers like TNF-α have been linked to tinnitus, thereby underlining the necessity for innovative therapies. This case study investigates the potential benefits of a multi-approach rehabilitation intervention involving whole-body cryostimulation (WBC) for a 47-year-old male suffering from chronic neurophysiologic tinnitus, who had underwent various unsuccessful treatments from 2005.

METHODS

the patient underwent a personalized, multidisciplinary rehabilitation intervention covering diet, pharmacotherapy, physiotherapy and physical activity classes tailored to the patient's needs and capacities, repetitive transcranial magnetic stimulation (rTMS), and whole-body cryostimulation (WBC).

RESULTS

The adjunctive WBC intervention resulted in a significant progressive improvement in tinnitus severity (tinnitus handicap inventory Δ% = -46.3%, VAS tinnitus score Δ% = -40%). Additional positive outcomes were noted in sleep quality (PSQI Δ% = -41.67%), emotional wellbeing (BDI Δ% = -41.2%), and quality of life (SF-36, WHO-5 Δ% = +16.5).

CONCLUSIONS

This study supports the existing literature suggesting the potential of WBC as an adjunct in a multi-approach intervention in ameliorating tinnitus severity and tinnitus-associated disorders. However, randomized controlled trials in larger populations, which specifically consider WBC's effects on tinnitus, are necessary to confirm these findings and to explore the mechanisms that underlie the observed improvements.

Evaluating safety risks of whole-body cryotherapy/cryostimulation (WBC): a scoping review from an international consortium

Over the two last decades, whole-body cryotherapy/cryostimulation (WBC) has emerged as an exciting non-pharmacological treatment influencing inflammatory events at a cellular and physiological level, which can result in improved sleep quality, faster neuromuscular recovery after high-intensity exercise, and chronic pain relief for patients suffering different types of diseases (fibromyalgia, rheumatism, arthritis). Some evidence even suggests that WBC has benefits on mental health (depression, anxiety disorders) and cognitive functions in both adults and older adults, due to increased circulating BDNF levels. Recently, some safety concerns have been expressed by influential public health authorities (e.g., FDA, INSERM) based on reports from patients who developed adverse events upon or following WBC treatment. However, part of the data used to support these claims involved individuals whose entire body (except head) was exposed to extreme cold vaporized liquid nitrogen while standing in a narrow bathtub. Such a procedure is known as partial-body cryotherapy (PBC), and is often erroneously mistaken to be whole-body cryotherapy. Although having similarities in terms of naming and pursued aims, these two approaches are fundamentally different. The present article reviews the available literature on the main safety concerns associated with the use of true whole-body cryotherapy. English- and French-language reports of empirical studies including case reports, case series, and randomized controlled trials (RCTs) were identified through searches of PubMed, Scopus, Cochrane, and Web of Science electronic databases. Five case reports and two RCTs were included for a total of 16 documented adverse events (AEs). A critical in-depth evaluation of these AEs (type, severity, context of onset, participant's medical background, follow-up) is proposed and used to illustrate that WBC-related safety risks are within acceptable limits and can be proactively prevented by adhering to existing recommendations, contraindications, and commonsense guidelines.

Whole-Body Cryotherapy Alters Circulating MicroRNA Profile in Postmenopausal Women

The incidence of metabolic syndrome (MetS) increases with age, especially in women. The role of microRNAs (miRs) in the regulation of metabolism is postulated. The aim of the study is to identify miRs that may be markers of MetS and to assess changes in miRs expression as a result of 10 and 20 whole-body cryotherapy treatments (WBC; 3 min, -120 °C) in postmenopausal women with MetS (M-60, BMI 30.56 ± 5.38 kg/m2), compared to healthy postmenopausal (H-60, BMI 25.57 ± 2.46 kg/m2) and healthy young women (H-20, BMI 22.90 ± 3.19 kg/m2). In a fasting state, before 1 WBC and after 10 WBCs, as well as 20 WBCs, the expression of miR-15a-5p, miR-21-5p, miR-23a-3p, miR-146a-5p, miR-197-3p, miR-223-3p, fasting blood glucose (FBG) and blood lipid profile were determined. miR-15a-5p and miR-21-5p were down-regulated in M-60, while miR-23a-3p and miR-197-3p were up-regulated, and miR-223-3p down-regulated in M-60 and H-60, compared to H-20. Significant positive correlations between up-regulated (mostly for miR-23-3p and miR-197-3p) and significant negative correlations between down-regulated (mostly for miR-15a-5p) miRs and markers of body composition as well as metabolic disorders were observed. After 20 WBCs, miR-15a-5p expression was up-regulated in all groups. In H-60, down-regulation of miR-197-3p expression occurred after 10 WBCs and 20 WBCs. Following 10 WBCs, FBG decreased in all groups, which intensified in M-60 post-20 WBCs. In our research, it has been shown that miR-23a-3p and miR-197-3p are accurate markers of MetS and MetS risk factors, while miR-15a-5p and miR-23a-3p are precise markers of body composition disorders. WBC is an effective treatment for up-regulating miR-15a-5p and lowering glucose levels in young and postmenopausal women and down-regulating miR-197-3p expression in postmenopausal women. It may be an adjunctive effective treatment method in MetS and hyperglycemia.

The use of cellulose, chitosan and hyaluronic acid in transdermal therapeutic management of obesity: A review

Obesity is a clinical condition with rising popularity and detrimental impacts on human health. According to the World Health Organization, obesity is the sixth most common cause of death worldwide. It is challenging to combat obesity because medications that are successful in the clinical investigation have harmful side effects when administered orally. The conventional approaches for treating obesity primarily entail synthetic compounds and surgical techniques but possess severe adverse effects and recurrences. As a result, a safe and effective strategy to combat obesity must be initiated. Recent studies have shown that biological macromolecules of the carbohydrate class, such as cellulose, hyaluronic acid, and chitosan, can enhance the release and efficacy of medications for obesity but due to their short biological half-lives and poor oral bioavailability, their distribution rate is affected. This helps to comprehend the need for an effective therapeutic approach via a transdermal drug delivery system. This review focuses on the transdermal administration, utilizing cellulose, chitosan, and hyaluronic acid via microneedles, as it offers a promising solution to overcome existing therapy limitations in managing obesity and it also highlights how microneedles can effectively deliver therapeutic substances through the skin's outer layer, bypassing pain receptors and specifically targeting adipose tissue.

The Use of Cryotherapy in Cosmetology and the Influence of Cryogenic Temperatures on Selected Skin Parameters—A Review of the Literature

Cryotherapy is becoming an increasingly popular method used in medicine, physiotherapy, and cosmetology. It is used in the form of whole-body cryotherapy (WBC) and local cryotherapy. It is a tool for achieving analgesic and anti-inflammatory effects. Since the beginning of its use, its influence on the mental state has also been pointed out. The aim of this study was to analyze the available literature on the effect of cryogenic temperatures on the skin and the mechanisms induced by such a stimulus and its influence on well-being. A literature search of keywords or phrases was performed in PubMed®. Various effects of WBC on skin characteristics (hydration, pH, level of transepidermal water loss), mechanisms of anti-inflammatory effects, and effects on adipocytes were shown. Research on the impact of individual skin characteristics is not consistent. Positive effects on the reduction of inflammation and oxidative stress have been noted. Cryotherapy is also successfully used in dermatology to treat lentil spots, actinic keratosis, and ingrown toenails, remove viral warts, or relieve itching in atopic dermatitis. The results of the review also indicate the effectiveness of WBC as an adjunctive treatment for obesity. The number of papers available on the direct effects of WBC on the skin is still limited, despite the fact that it represents the first contact of the human body with cryogenic temperatures. Available data show that cold as a physical stimulus can be a safe and useful tool in cosmetology.

Post-stroke low-frequency whole-body vibration improves cognition in middle-aged rats of both sexes

Low-frequency whole-body vibration (WBV; 40 Hz), a low impact form of exercise, intervention for a month following moderate transient middle-cerebral artery occlusion (tMCAO) reduces infarct volume and improves motor function in reproductively senescent, middle-aged female rats. Since post-stroke cognitive decline remains a significant problem, the current study aims to investigate the efficacy of WBV in ameliorating post-tMCAO cognitive deficits and to determine the underlying putative mechanism(s) conferring benefits of WBV in middle-aged rats. Middle-aged rats of both sexes were randomly assigned to tMCAO (90 min) or sham surgery followed by exposure to either WBV (twice a day for 15 min each for 5 days a week over a month) or no WBV treatment groups. Following the last WBV treatment, rats were tested for hippocampus-dependent learning and memory using a water maze followed by harvesting brain and blood samples for histopathological and inflammatory marker analyses, respectively. Results show that post-tMCAO WBV significantly lessens cognitive deficits in rats of both sexes. Post-tMCAO WBV significantly decreased circulating pro-inflammatory cytokines and increased serum levels of irisin, a muscle-derived hormone that may play a role in brain metabolism and inflammation regulation, which suggests putative beneficial mechanisms of WBV.

Is Whole-Body Cryostimulation an Effective Add-On Treatment in Individuals with Fibromyalgia and Obesity? A Randomized Controlled Clinical Trial

Pain severity, depression, and sleep disturbances are key targets for FM rehabilitation. Recent evidence suggests that whole-body cryostimulation (WBC) might be an effective add-on treatment in the management of FM. The purpose of this study was to evaluate the effects of an add-on WBC intervention to a multidisciplinary rehabilitation program on pain intensity, depressive symptoms, disease impact, sleep quality, and performance-based physical functioning in a sample of FM patients with obesity. We performed a randomized controlled trial with 43 patients with FM and obesity undergoing a multidisciplinary rehabilitation program with and without the addition of ten 2-min WBC sessions at −110 °C over two weeks. According to our results, the implementation of ten sessions of WBC over two weeks produced additional benefits. Indeed, both groups reported positive changes after the rehabilitation; however, the group that underwent WBC intervention had greater improvements in the severity of pain, depressive symptoms, disease impact, and quality of sleep. On the contrary, with respect to performance-based physical functioning, we found no significant between-group differences. Our findings suggest that WBC could be a promising add-on treatment to improve key aspects of FM, such as pain, depressive symptoms, disease impact and poor sleep quality.

Whole-Body Cryostimulation in Fibromyalgia: A Scoping Review

Currently, all available therapies for the control and management of fibromyalgia (FM) are mostly focused on relieving patients’ symptoms and improving their quality of life. The purpose of this review is to provide an up-to-date overview of the evidence supporting the beneficial effects of whole-body cryostimulation (WBC) in patients with FM and evidence-based guidance on the possible adjuvant use of WBC in the treatment of FM. We searched the most recent literature by retrieving 10 eligible studies, 4 of which were abstracts only, from a total of 263 records. Thermal stress caused by cryostimulation induces an analgesic effect, improving pain, redox balance, and inflammatory symptoms in an exercise-mimicking fashion. In addition, it reduces the feeling of fatigue, improves mood, and reduces mental health deterioration with positive consequences on depressive states and improved sleep quality. Although the studies included in this review are not of sufficient quality and quantity to draw definitive conclusions about the effectiveness of WBC in FM, initial evidence indicates WBC as a promising add-on option in the multidisciplinary treatment of FM, due to its rapid action and high patients’ compliance. The application of WBC protocols has the potential to expand therapeutic options for the treatment of FM and related disorders; however, larger, high-quality primary studies are still needed.