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Efficiency of a Whole-Body Cryotherapy protocol at -110 °C for hand rheumatoid arthritis: a controlled trial

Journal of Thermal Analysis and Calorimetry volume 147, pages 11159–11167 (2022)Cite this article

Abstract

While the recent literature on Whole-Body Cryotherapy pointed to its beneficial systemic effects on inflammatory markers in rheumatoid arthritis, it was not clear whether it could also have more localized effects, with the attainment of analgesic thresholds on hands that are usually protected during protocols. Twenty-five young, healthy subjects (12 males aged 25.1 ± 3.5 years and 13 females aged 23.5 ± 2.6 years) agreed to participate in this study. Two study groups were defined: (1) a control group with a hand fully gloved and (2) an experimental group with a partially ungloved hand during the WBC session. In both groups, the achievement of analgesic thresholds of skin temperature was established through thermal imaging, focused on the measurement of temperatures at the different joint locations. Using a new protocol with direct exposure of the hands during the last 40 s of a standard WBC session of 3 min at −110 °C made it possible to respect this risk/benefit balance. Infrared thermography analyses revealed that for all regions of interest (except MCP and IP, CMP for thumb), there was a clinically meaningful reduction of skin temperature in participants from the experimental group. The thermal analysis suggests that a protocol of Whole-Body Cryotherapy at −110 °C where hands must be ungloved during 40 s could be a useful tool for the management of hand rheumatoid arthritis by achieving local antalgic thresholds.

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Abbreviations

RA:

Rheumatoid arthritis

WBC:

Whole-Body Cryotherapy

ROI:

Region of interest

CMC:

Carpometacarpal

MCP:

Metacarpophalangeal

PIP:

Proximal interphalangeal

IP:

Interphalangeal

DIP:

Distal interphalangeal

References

  1. Mitchell DM, et al. Survival, prognosis, and causes of death in rheumatoid arthritis. Arthritis Rheum. 1986;29:706–14.

    Article  CAS  Google Scholar 

  2. Aletaha D, et al. Rheumatoid arthritis classification criteria: an American college of rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum. 2010. https://doi.org/10.1002/art.27584.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res. 2002. https://doi.org/10.1186/ar578.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Brennan FM, McInnes IB. Evidence that cytokines play a role in rheumatoid arthritis. J Clin Invest. 2008. https://doi.org/10.1172/JCI36389.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Alunno A, Carubbi F, Giacomelli R, Gerli R. Cytokines in the pathogenesis of rheumatoid arthritis: new players and therapeutic targets. BMC Rheumatol. 2017. https://doi.org/10.1186/s41927-017-0001-8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gatt A, et al. A comparison of thermographic characteristics of the hands and wrists of rheumatoid arthritis patients and healthy controls. Sci Rep. 2019. https://doi.org/10.1038/s41598-019-53598-0.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Horvath SM, Hollander JL. Intra-articular temperature as a measure of joint reaction. J Clin Invest. 1949. https://doi.org/10.1172/JCI102092.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hayes KW. Heat and cold in the management of rheumatoid arthritis. Arthritis Rheum. 1993. https://doi.org/10.1002/art.1790060308.

    Article  Google Scholar 

  9. Frontera WR, DeLisa JA, Basford J, Bockenek WL, Chae J, Robinson LR. DeLisa’s physical medicine and rehabilitation: principles and practice. 6th ed. Philadelphia: Wolters Kluwer; 2020.

    Google Scholar 

  10. Dȩbiec-Ba̧k A, Skrzek A, Podbielska H. Application of thermovision for estimation of the optimal and safe parameters of the whole body cryotherapy. J Therm Anal Calorim. 2013. doi:https://doi.org/10.1007/s10973-012-2741-4.

  11. Michnik A, Pokora I, Duch K, Sadowska-Krępa E. Differential scanning calorimetry reveals that whole-body cryostimulation in cross-country skiers can modify their response to physical effort. J Therm Anal Calorim. 2021. https://doi.org/10.1007/s10973-020-09285-8.

    Article  Google Scholar 

  12. Lubkowska A, Szyguła Z, Chlubek D, Banfi G. The effect of prolonged whole-body cryostimulation treatment with different amounts of sessions on chosen pro- and anti-inflammatory cytokines levels in healthy men. Scand J Clin Lab Invest. 2011. https://doi.org/10.3109/00365513.2011.580859.

    Article  PubMed  Google Scholar 

  13. Krueger M, Costello JT, Achtzehn S, Dittmar KH, Mester J. Whole-body cryotherapy (−110 °C) following high-intensity intermittent exercise does not alter hormonal, inflammatory or muscle damage biomarkers in trained males. Cytokine. 2019. https://doi.org/10.1016/j.cyto.2018.07.018.

    Article  PubMed  Google Scholar 

  14. Gizińska M, Rutkowski R, Romanowski W, Lewandowski J, Straburzyńska-Lupa A. Effects of whole-body cryotherapy in comparison with other physical modalities used with kinesitherapy in rheumatoid arthritis. Biomed Res Int. 2015. https://doi.org/10.1155/2015/409174.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jastrząbek R, Straburzyńska-Lupa A, Rutkowski R, Romanowski W. Effects of different local cryotherapies on systemic levels of TNF-α, IL-6, and clinical parameters in active rheumatoid arthritis. Rheumatol Int. 2013. https://doi.org/10.1007/s00296-013-2692-5.

    Article  PubMed  Google Scholar 

  16. Lange U, Uhlemann C, Müller-Ladner U. Serielle ganzkörperkältetherapie im criostream bei entzündlich-rheumatischen erkrankungen. Medizinische Klin. 2008. https://doi.org/10.1007/s00063-008-1056-5.

    Article  Google Scholar 

  17. Hirvonen H, Kautiainen H, Moilanen E, Mikkelsson M, Leirisalo-Repo M. The effect of cryotherapy on total antioxidative capacity in patients with active seropositive rheumatoid arthritis. Rheumatol Int. 2017. https://doi.org/10.1007/s00296-017-3771-9.

    Article  PubMed  Google Scholar 

  18. Guillot X, et al. Cryotherapy in inflammatory rheumatic diseases: a systematic review. Exp Rev Clin Immunol. 2014. https://doi.org/10.1007/s00296-017-3771-9.

    Article  Google Scholar 

  19. Braun KP, Brookman-Amissah S, Geissler K, Ast D, May M, Ernst H. Ganzkörperkryotherapie bei Patienten mit entzündlich-rheumatischen Erkrankungen. Medizinische Klin. 2009. https://doi.org/10.1007/s00063-009-1031-9.

    Article  Google Scholar 

  20. Stanek A, Cholewka A, Wielkoszyński T, Romuk E, Sieroń A. Whole-body cryotherapy decreases the levels of inflammatory, oxidative stress, and atherosclerosis plaque markers in male patients with active-phase ankylosing spondylitis in the absence of classical cardiovascular risk factors. Mediat Inflamm. 2018. https://doi.org/10.1155/2018/8592532.

    Article  Google Scholar 

  21. Stanek A, Cholewka A, Wielkoszyński T, Romuk E, Sieroń A. Decreased oxidative stress in male patients with active phase ankylosing spondylitis who underwent whole-body cryotherapy in closed cryochamber. Oxid Med Cell Longev. 2018. https://doi.org/10.1155/2018/7365490.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Stanek A, Cholewka A, Wielkoszyński T, Romuk E, Sieroń K, Sieroń A. Increased levels of oxidative stress markers, soluble CD40 ligand, and carotid intima-media thickness reflect acceleration of atherosclerosis in male patients with ankylosing spondylitis in active phase and without the classical cardiovascular risk factors. Oxid Med Cell Longev. 2017. https://doi.org/10.1155/2017/9712536.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Stanek A, Cholewka A, Sieron A. Changes in values of BASDAI and BASFI index in patients with ankylosing spondylitis underwent whole-body cryotherapy procedures performed in different types of cryochambers. Eur J Clin Invest. 2016;46:101.

    Article  Google Scholar 

  24. Stanek A, Cholewka A, Gadula J, Drzazga Z, Sieron A, Sieron-Stoltny K. Can whole-body cryotherapy with subsequent kinesiotherapy procedures in closed type cryogenic chamber improve BASDAI, BASFI, and some spine mobility parameters and decrease pain intensity in patients with ankylosing spondylitis? Biomed Res Int. 2015. https://doi.org/10.1155/2015/404259.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Vardasca R, Ring F, Plassmann P, Jones C. Thermal symmetry of the upper and lower extremities in healthy subjects. Thermol Int. 2012;22(2):53–60.

    Google Scholar 

  26. Cho YJ, Lim YH, Yun JM, Yoon HJ, Park M. Sex- and age-specific effects of energy intake and physical activity on sarcopenia. Sci Rep. 2020. https://doi.org/10.1038/s41598-020-66249-6.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Banfi G, et al. Effects of whole-body cryotherapy on serum mediators of inflammation and serum muscle enzymes in athletes. J Therm Biol. 2009. https://doi.org/10.1016/J.JTHERBIO.2008.10.003.

    Article  Google Scholar 

  28. Costello JT, Donnelly AE, Karki A, Selfe J. Effects of whole body cryotherapy and cold water immersion on knee skin temperature. Int J Sports Med. 2014. https://doi.org/10.1055/s-0033-1343410.

    Article  PubMed  Google Scholar 

  29. Hammond LE, Cuttell S, Nunley P, Meyler J. Anthropometric characteristics and sex influence magnitude of skin cooling following exposure to whole body cryotherapy. Biomed Res Int. 2014. https://doi.org/10.1155/2014/628724.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Stanek A, et al. Whole-body cryostimulation as an effective method of reducing oxidative stress in healthy men. Adv Clin Exp Med. 2016. https://doi.org/10.17219/ACEM/65980.

    Article  PubMed  Google Scholar 

  31. Stanek A, Cholewka A, Romuk E, Sieron A. Whole-body cryostimulation decreases lipofuscin concentration in healthy subjects. Eur J Clin Invest. 2016;46:125.

    Google Scholar 

  32. Cholewka A, Drzazga Z. Comparison of some parameters of two-stepped cryogenic chamber and chamber with lingering cold. Biomed Eng Acta Indygo. 2006;11:103–10.

    Google Scholar 

  33. Ring EFJ, Ammer K. The technique of infrared imaging in medicine. Thermol Int. 2000. https://doi.org/10.1088/978-0-7503-1143-4ch1.

    Article  Google Scholar 

  34. Costello JT, McInerney CD, Bleakley CM, Selfe J, Donnelly AE. The use of thermal imaging in assessing skin temperature following cryotherapy: a review. J Therm Biol. 2012. https://doi.org/10.1016/j.jtherbio.2011.11.008.

    Article  Google Scholar 

  35. Polidori G, et al. Infrared thermography for assessing skin temperature differences between partial body cryotherapy and whole body cryotherapy devices at −140 °C. Infrared Phys Technol. 2018. https://doi.org/10.1016/j.infrared.2018.07.025.

    Article  Google Scholar 

  36. Cholewka A, Stanek A, Sieroń A, Drzazga Z. Thermography study of skin response due to whole-body cryotherapy. Skin Res Technol. 2012. https://doi.org/10.1111/J.1600-0846.2011.00550.X.

    Article  PubMed  Google Scholar 

  37. Cholewka A, Stanek A, Wójcik M, Sieroń-Stołtny K, Drzazga Z. Does local cryotherapy improve thermal diagnosis similar to whole-body cryotherapy in spinal diseases? J Therm Anal Calorim. 2017. https://doi.org/10.1007/S10973-016-5453-3/FIGURES/5.

    Article  Google Scholar 

  38. Matos F, Neves EB, Norte M, Rosa C, Reis VMH, Vilaça-Alves J. The use of thermal imaging to monitoring skin temperature during cryotherapy: a systematic review. Infrared Phys Technol. 2015. https://doi.org/10.1016/j.infrared.2015.09.013.

    Article  Google Scholar 

  39. Coyne MD, Kesick CM, Doherty TJ, Kolka MA, Stephenson LA. Circadian rhythm changes in core temperature over the menstrual cycle: Method for noninvasive monitoring. Am J Physiol Regul Integr Comp Physiol. 2000. https://doi.org/10.1152/ajpregu.2000.279.4.r1316.

    Article  PubMed  Google Scholar 

  40. Bartelink ML, Wollersheim H, Theeuwes A, Van Duren D, Thien T. Changes in skin blood flow during the menstrual cycle: the influence of the menstrual cycle on the peripheral circulation in healthy female volunteers. Clin Sci. 1990. https://doi.org/10.1042/cs0780527.

    Article  Google Scholar 

  41. White MD, Bosio CM, Duplantis BN, Nano FE. Human body temperature and new approaches to constructing temperature-sensitive bacterial vaccines. Cell Mol Life Sci. 2011. https://doi.org/10.1007/s00018-011-0734-2.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Chudecka M, Lubkowska A. Thermal maps of young women and men. Infrared Phys Technol. 2015. https://doi.org/10.1016/j.infrared.2015.01.012.

    Article  Google Scholar 

  43. Heil K, Thomas R, Robertson G, Porter A, Milner R, Wood A. Freezing and non-freezing cold weather injuries: a systematic review. Br Med Bull. 2016. https://doi.org/10.1093/bmb/ldw001.

    Article  PubMed  Google Scholar 

  44. Bleakley CM, Hopkins JT. Is it possible to achieve optimal levels of tissue cooling in cryotherapy? Phys Therapy Rev. 2013. https://doi.org/10.1179/174328810X12786297204873.

    Article  Google Scholar 

  45. Bugaj R. The cooling, analgesic, and rewarming effects of ice massage on localized skin. Phys Ther. 1975. https://doi.org/10.1093/ptj/55.1.11.

    Article  PubMed  Google Scholar 

  46. Polidori G, et al. Should whole body cryotherapy sessions be differentiated between women and men? A preliminary study on the role of the body thermal resistance. Med Hypotheses. 2018. https://doi.org/10.1016/j.mehy.2018.08.017.

    Article  PubMed  Google Scholar 

  47. Polidori G, et al. Preliminary study on the effect of sex on skin cooling response during whole body cryostimulation (−110 °C): modeling and prediction of exposure durations. Cryobiology. 2020. https://doi.org/10.1016/j.cryobiol.2020.10.014.

    Article  PubMed  Google Scholar 

  48. Isii Y, Matsukawa K, Tsuchimochi H, Nakamoto T. Ice-water hand immersion causes a reflex decrease in skin temperature in the contralateral hand. J Physiol Sci. 2007. https://doi.org/10.2170/physiolsci.RP007707.

    Article  PubMed  Google Scholar 

  49. Korman P, Straburzyńska-Lupa A, Romanowski W, Trafarski A. Temperature changes in rheumatoid hand treated with nitrogen vapors and cold air. Rheumatol Int. 2012. https://doi.org/10.1007/s00296-011-2078-5.

    Article  PubMed  Google Scholar 

  50. Martin G, Roth G, Elkins E, Krusen F. Cutaneous temperature of the extremities of normal subjects and of patients with rheumatoid arthritis. Arch Phys Med Rehabil. 1946;27:665–82.

    CAS  PubMed  Google Scholar 

  51. Pauk J, Ihnatouski M, Wasilewska A. Detection of inflammation from finger temperature profile in rheumatoid arthritis. Med Biol Eng Comput. 2019. https://doi.org/10.1007/s11517-019-02055-1.

    Article  PubMed  Google Scholar 

  52. Pauk J, Wasilewska A, Ihnatouski M. Infrared thermography sensor for disease activity detection in rheumatoid arthritis patients. Sensors. 2019. https://doi.org/10.3390/s19163444.

    Article  PubMed  PubMed Central  Google Scholar 

  53. De Resende Guimarães MFB, et al. High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study. Adv Rheumatol. 2019. https://doi.org/10.1186/s42358-019-0089-1.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank the volunteers for their willingness to participate in this study.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Faculty of Exact and Natural Sciences, MATIM, University of Reims Champagne-Ardenne, Reims, France

    Guillaume Polidori, Fabien Bogard, Sébastien Murer & Fabien Beaumont

  2. C2S, Cognition Health and Society, University of Reims Champagne-Ardenne, Reims, France

    Fabien Legrand

  3. Cryotera, 2 Rue Jules Méline, 51430, Bezannes, France

    Bastien Bouchet

  4. Rheumatology Department, Maison Blanche Hospital, Reims University Hospital, Reims, France

    Jean-Hugues Salmon & Loïs Bolko

Authors
  1. Guillaume Polidori
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  2. Fabien Bogard
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  3. Fabien Legrand
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Correspondence to Sébastien Murer.

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No permission from the local ethics committee was obtained since only biomedical/clinical studies require this approval according to French law. However, the research participants provided written informed consent and the study was conducted in line with the principles of the Helsinki Declaration and its following amendments.

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Polidori, G., Bogard, F., Legrand, F. et al. Efficiency of a Whole-Body Cryotherapy protocol at -110 °C for hand rheumatoid arthritis: a controlled trial. J Therm Anal Calorim 147, 11159–11167 (2022). https://doi.org/10.1007/s10973-022-11339-y

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Keywords

  • Whole-Body Cryotherapy
  • Protocol
  • Hand rheumatoid
  • Arthritis
  • Antalgic threshold