Effect of Whole Body Cryotherapy with Spinal Decompression on Cervical Disc Herniation by Digital Infrared Thermal Imaging

Human body numerical simulation: An accurate model for a thigh subjected to a cold treatment

This article presents the development of a digital twin model of a thigh portion subjected to various thermal treatments. Two scenarios are investigated: cold water immersion (CWI) and whole body cryotherapy (WBC), for which the comparison of numerical results with experimental measurements validates the consistency of the developed model. The use of real geometry on a first subject demonstrates the high heterogeneity of the temperature field and the need for accurate geometry. A second subject with thicker adipose tissue highlights the impact of the subject's actual morphology on the validity of the treatment and the necessity to work with real geometry in order to optimize cold modalities and develop personalized treatments.

Individualising the exposure of -110°C whole body cryotherapy: The effects of sex and body composition

The purpose of this study was to investigate the effects of whole body cryotherapy (WBC) on a range of thermoregulatory measures. We also sought to examine the influence of sex and body composition. A convenience sample of 18 healthy participants (10 males and 8 females) (27±6yr) volunteered for this study. Temperature (core, tympanic, skin and mean body), heart rate, blood pressure, and thermal comfort and sensation were recorded pre- and post- (immediately and every 5min until 35min post) exposure to a single bout of WBC (30s at -60°C, 150s at 110°C). Anthropometric data (height, weight, body surface area, body mass index, fat mass and fat free mass) were also recorded. No significant differences in temperature (core, tympanic, skin and mean body), heart rate, blood pressure, or thermal comfort / sensation were observed between male and females at baseline. Immediately post WBC mean body (male:31.9±0.8°C; female:31.0±0.9°C; ∆ mean body temperature:0.9±0.1°C; P≤0.05, d=0.64) and mean skin (male:22.1±2.2°C; female:19.6±2.8°C; ∆ mean skin temperature:-2.5±0.6°C; d=0.99, P≤0.05) temperature was significantly different between sexes. Sex differences were also observed in regional skin temperature (male thigh, 20.8±1.1°C; female thigh, 16.7±1.1°C, ∆ mean thigh skin temperature:-4.1°C; d=3.72; male calf, 20.5±1.1°C; female calf, 18.2±1°C, ∆ mean calf skin temperature:-2.3±0.1°C; d=3.61; male arm, 21.7±1°C; female arm, 19±0.4°C, ∆ mean arm skin temperature: -2.7±0.3°C; d=3.54; P≤0.05). Mean arterial pressure was significantly different over time (P≤0.001) and between sexes (male 0mins:94±10mmHg; female 0mins:85±7mmHg; male 35mins:88±7mmHg; female 35mins:80±6mmHg; P≤0.05). Combined data set indicated a strong negative relationship between skin temperature and body fat percentage 35min' post WBC (r=-0.749, P≤0.001) and for core temperature and body mass index in males only (r=0.726, P≤0.05) immediately after WBC. There were no significant differences between sexes in any other variables (heart rate, tympanic and perceptual variables). We observed sex differences in mean skin and mean body temperature following exposure to whole body cryotherapy. In an attempt to optimise treatment, these differences should be taken into account if whole body cryotherapy is prescribed.

Repeated cryostimulation improves position sense and simple reaction time

[Purpose] Whole body cryotherapy has been shown to have many benefits, yet nothing is known if and how this modality can improve neuromuscular performance and retain those improvements. [Subjects and Methods] Joint position sense based on the bilateral knee joint matching test and simple reaction time was investigated in 25 young healthy adults who underwent an extended period of whole body cryostimulation. The measurements were taken at baseline and after 10, 20, and 30 whole body cryotherapy sessions, with three days elapsing after the last treatment, and comparing the results with 24 control subjects. [Results] Only when 20 sessions were completed did joint position sense and simple reaction time improve in the intervention group. After 30 sessions, the outcome was similar. Equal results were found at baseline and after 10 sessions in both groups, but the intervention group outstripped controls after 20 and 30 sessions in both joint position sense and simple reaction time. [Conclusion] These results indicate that the common standard of 10 sessions is insufficient, while approximately 20 sessions of whole body cryotherapy may efficiently enhance neuromuscular performance with an ability to sustain the effects for at least three days.

The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature

BACKGROUND CONTEXT

Cervical spine disc herniation is a disabling source of cervical radiculopathy. However, little is known about its course and prognosis. Understanding the course and prognosis of symptomatic cervical disc herniation is necessary to guide patients' expectations and assist clinicians in managing patients.

PURPOSE

To describe the natural history, clinical course, and prognostic factors of symptomatic cervical disc herniations with radiculopathy.

STUDY DESIGN

Systematic review of the literature and best evidence synthesis.

METHODS

A systematic search of MEDLINE, EMBASE, CINAHL, SportsDiscus, and the Cochrane Central Register of Controlled Trials from inception to 2013 was conducted to retrieve eligible articles. Eligible articles were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. The results from articles with low risk of bias were analyzed using best evidence synthesis principles.

RESULTS

We identified 1,221 articles. Of those, eight articles were eligible and three were accepted as having a low risk of bias. Two studies pertained to course and one study pertained to prognosis. Most patients with symptomatic cervical disc herniations with radiculopathy initially present with intense pain and moderate levels of disability. However, substantial improvements tend to occur within the first 4 to 6 months post-onset. Time to complete recovery ranged from 24 to 36 months in, approximately, 83% of patients. Patients with a workers' compensation claim appeared to have a poorer prognosis.

CONCLUSIONS

Our best evidence synthesis describes the best available evidence on the course and prognosis of cervical disc herniations with radiculopathy. Most patients with symptomatic cervical spine disc herniation with radiculopathy recover. Possible recurrences and time to complete recovery need to be further studied. More studies are also needed to understand the prognostic factors for this condition.

Anthropometric characteristics and sex influence magnitude of skin cooling following exposure to whole body cryotherapy

This study explored whether anthropometric measures influence magnitude of skin cooling following exposure to whole body cryotherapy (WBC). Height, weight, body fat percentage, and lean mass were measured in 18 male and 14 female participants. Body surface area, body surface area to mass ratio, body mass index, fat-free mass index, and fat mass index were calculated. Thermal images were captured before and after WBC (−60°C for 30 seconds, −110°C for 2 minutes). Skin temperature was measured at the chest, arm, thigh, and calf. Mean skin temperature before and after WBC and change in mean skin temperature (ΔT_sk) were calculated. ΔT_sk was significantly greater in females (12.07 ± 1.55°C) than males (10.12 ± 1.86°C; t(30) = −3.09, P = .004). A significant relationship was observed between body fat percentage and ΔT_sk in the combined dataset (P = .002, r = .516) and between fat-free mass index and ΔT_sk in males (P = .005, r = .622). No other significant associations were found. Skin response of individuals to WBC appears to depend upon anthropometric variables and sex, with individuals with a higher adiposity cooling more than thinner individuals. Effects of sex and anthompometrics should be considered when designing WBC research or treatment protocols.