Inflammatory Rheumatic Disease - whole body cryotherapy - WBCT

Whole body cryotherapy: chronic rheumatoid arthritis and Ankylosing Spondylitis
( Morbus Bechterew )

Source: http://www.pjoes.com/pdf/19.1/167-175.pdf
Influence of Cryogenic Temperatures on Inflammatory Markers in Patients with
Ankylosing Spondylitis

Agata Stanek, Grzegorz Cieślar, Joanna Strzelczyk, Sławomir Kasperczyk, Karolina Sieroń-Stoltny, Andrzej Wiczkowski, Ewa Birkner, Aleksander Sieroń
Department and Clinic of Internal Diseases, Angiology and Physical Medicine,
Medical University of Silesia, Batorego 15, 41-902 Bytom, Poland
Department of Biology, Medical University of Silesia, Zabrze, Poland
Department of Biochemistry, Medical University of Silesia, Zabrze, Poland
Abstract
The aim of this study was to estimate the influence of cryogenic temperatures used for whole-body cryotherapy on inflammatory markers in patients with ankylosing spondylitis (AS) and healthy volunteers. The study involved 32 male persons: 16 patients with AS and 16 healthy volunteers. All subjects were exposed to a cycle of 10 daily procedures of whole-body cryotherapy at a temperature of -120°C lasting 2 minutes with subsequent kinesitherapy. In both groups, before and after a cycle of whole-body cryotherapy with subsequent kinesitherapy, serum C-reactive protein, fibrinogen, mucoprotein, soluble intercellular adhesion molecule-1 levels and erythrocyte sedimentation rate were estimated.
Conclusion Cryogenic temperatures used for whole-body cryotherapy as a component of complex treatment decreases levels of inflammatory markers both in patients with ankylosing spondylitis and healthy volunteers.
Full text on pjoes.com

Source http://www.ncbi.nlm.nih.gov/pubmed/19337708
Med Klin (Munich). 2009 Mar 15;104(3):192-6. Epub 2009 Apr 1.
Whole-Body Cryotherapy in Patients with Inflammatory Rheumatic Disease.
Kay-P. Braun, S. Brookman-Amissah, K. Geissler, D. Ast, Matthias May and Helmut Ernst
Background:
As yet, whole-body cryotherapy is especially used for the therapy of chronic inflammatory arthritis. An analgetic effect has been described in several studies. However, only few data exist concerning the long-term effects of this therapy.
Patients and Methods: A total of 60 patients with rheumatoid arthritis (n = 48), and ankylosing spondylitis (n = 12) was analyzed. Patients underwent treatment with whole-body cryotherapy twice a day. The average age was 55.7 ± 10.33. The study group consisted of 48 female and twelve male patients. The average number of therapeutic treatments with cryotherapy was 15.8 ± 8.37, the average follow-up 63.4 ± 63.48 days.
Results: 13 patients (21.7%) discontinued treatment because of adverse effects. For patients with rheumatoid arthritis, DAS28 (Disease Activity Score) and VAS (visual analog scale) were determined. A significant reduction of both parameters was found (DAS 3.9 ± 1.22 vs. 3.4 ± 1.08; p < 0.01; VAS 51.4 ± 16.62 vs. 37.9 ± 19.13; p < 0.01). BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) was analyzed for patients with ankylosing spondylitis, and also showed a significant reduction (4.4 ± 1.91 vs. 3.1 ± 1.34; p = 0.01).
Conclusion: Thus, whole-body cryotherapy is an effective option in the concept of treatment of inflammatory rheumatic diseases. The relief of pain allows an intensification of physiotherapy. A significant reduction of pain over a period of 2 months could be shown.  

Source: http://www.ncbi.nlm.nih.gov/pubmed/18548207
Med Klin (Munich). 2008 Jun 15;103(6):383-8.
Serial whole-body cryotherapy in the criostream for inflammatory rheumatic diseases.
Lange U, Uhlemann C, Müller-Ladner U.
Abteilung Rheumatologie, Klinische Immunologie, Physikalische Medizin und Osteologie (Innere Medizin mit Schwerpunkt Rheumatologie, Justus-Liebig-Universität Giessen), Kerckhoff-Klinik, Bad Nauheim.
Abstract
BACKGROUND AND PURPOSE: Local as well as whole-body cryotherapy is used to relieve pain and inflammation in rheumatic diseases. In comparison with a chamber-based whole-body cryotherapy, the novel criostream whole-body therapy (single-person cabin with cold air cooled by liquid nitrogen) as an innovative technique offers not only a rapid therapeutic effect but also a considerable reduction in costs. The aim of this study was to compare the effect of whole-body cryotherapy in the criostream on pain reduction, disease activity and pro-inflammatory cytokines (tumor necrosis factor-[TNF-]alpha and interleukin-[IL-]1), and improvement in functional scores.
PATIENTS AND METHODS: Ten patients with different active inflammatory rheumatic diseases (four patients with rheumatoid arthritis, three patients with ankylosing spondylitis, and three patients with psoriatic arthritis/spondylitis) underwent nine sessions of whole-body cryotherapy in 5 days for a short time period (at first 90 s, with step-up in each application to 2.5 min total time).
RESULTS: Pain and disease activity scores decreased significantly, and, subsequently, also the functional scores showed a significant amelioration. Furthermore, there was a significant reduction in TNF-alpha (p < 0.01) and IL-1 (p < 0.05). Side effects were reported only after the first application in two cases (headache and sensation of cold).
CONCLUSION: The criostream offers an elegant and, from the patient's point of view, attractive therapeutic agent in the multimodal treatment concept for inflammatory rheumatic diseases.  

Inflammation Research
SpringerLink, December 18, 2009
Source: http://www.springerlink.com/content/e57788851110vx16/about/
Cryotherapy decreases histamine levels in the blood of patients with rheumatoid arthritis
E. Wojtecka-Lukasik, K. Ksiezopolska-Orlowska, E. Gaszewska, O. Krasowicz-Towalska,
P. Rzodkiewicz, D. Maslinska, D. Szukiewicz and S. Maslinski
Author Affiliations
Institute of Rheumatology Department of Biochemistry Warsaw Poland
Institute of Rheumatology Department of Rehabilitation Warsaw Poland
Medical Research Centre Department of Developmental Neuropathology Warsaw Poland
Medical University of Warsaw Department of Pathophysiology Warsaw Poland
From the issue entitled "Papers given at the 38th annual meeting of the European Histamine Research Society, Fulda (Germany), May 13-16, 2009"
Abstract Introduction. Conventional physiotherapy (electrotherapy, magnetic fields), kinesitherapy, and whole-body cryotherapy (plus kinesitherapy) are used to relieve pain and inflammation or to improve function in rheumatic diseases. The aim of this study was to investigate the effects of different physiotherapies and cryotherapy on biochemical blood parameters of patients with rheumatoid arthritis (RA) and osteoarthritis (OA).
Materials and methods. Twenty patients with RA and 17 patients with OA received whole-body cryotherapy at -140 to -160°C for 2 to 3 min, once daily for 4 weeks. The second group of patients (24 with RA and 28 with OA) received conventional physiotherapy for 4 weeks. We measured the parameters of neutrophil activation (respiratory burst, calprotectin) and markers of cartilage metabolism [N-acetyl-beta-D-hexosaminidase (NAHase), ectonucleotide pyrophosphohydrolase (NTPPHase)] twice: before and 3 months after cryotherapy or physiotherapy.
Results. We showed, for the first time, that cryotherapy significantly reduced (P < 0.001) histamine levels in the blood of patients with RA. The effect was long-lasting (for at least 3 months). The levels of blood histamine in patients with OA were not changed significantly. Cryotherapy also downregulated the respiratory burst of PMNs and NAHase activity and upregulated calprotectin levels and the activity of NTPPHase. However, these changes were not statistically significant. In contrast, there were no significant changes in histamine levels or the other biochemical parameters measured in groups of patients treated only with physiotherapy and kinesitherapy.
Conclusion. It may be concluded that the beneficial clinical effects of cryotherapy in RA patients are in part due to the action on the production, release, or degradation of histamine.

Source: http://www.ncbi.nlm.nih.gov/pubmed/10832164
Whole-body cryotherapy in rehabilitation of patients with rheumatoid diseases.
Metzger D, Zwingmann C, Protz W, Jäckel WH.
Hochrhein-Institut für Rehabilitationsforschung, Department für Epidemiologie und Sozialmedizin, Bad Säckingen.
Abstract. Cryotherapy as a whole-body cold therapy (with cold air cooled by addition of nitrogen blown on the patients in an open cabin) for treatment of inflammatory rheumatic diseases already started in Bad Säckingen in 1986. In 1996, a new cold chamber (this time a closed chamber without any addition of nitrogen) based on compressor technology was introduced. The aim of our study was to test whether significant pain relief could be achieved by means of this cold therapy. Furthermore, we were interested in the practicability and acceptance of this new technique. Wellbeing during the treatment application and pain level were assessed using verbal and numerical rating scales. The sample consisted of 120 consecutive patients (75% women, age: 30-67 yrs, M = 52.6 yrs). These patients were suffering from primary fibromyalgia (40.7%), rheumatoid arthritis (17.3%), chronic low back pain (16.4%), ankylosing spondylitis (10.9%), osteoarthritis (9.1%), secondary fibromyalgia (3.6%) and other autoimmune diseases (1.8%) (mean duration of symptoms: 4 yrs). The patients were treated 2.5 minutes on average in the main chamber (mean temperature: -105 degrees C). The patients' statements concerning their pain level were analyzed by means of analyses of variance with repeated measures and paired-sample t-tests.
RESULTS: The pain level after application of the cold therapy decreases significantly. The pain reduction lasts about 90 minutes. The initial pain level decreases during the whole time of treatment, no significant improvement, though, can be shown from the middle to the end of the four-weeks treatment. According to the results of our study, there is evidence that the whole-body cold therapy generates important short-term effects and somewhat weaker effects over the treatment period as a whole. Short-term pain reduction facilitates intensive application of physiotherapy and Occupational Therapy. The treatment procedure is practicable, and all in all well tolerated. From the patients' point of view, whole-body cold therapy is an essential part of the rehabilitation programme.


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