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Effects of different local cryotherapies on systemic levels of TNF-α, IL-6, and clinical parameters in active rheumatoid arthritis

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Abstract

Cryotherapies are frequently used to supplement the rehabilitation of patients with rheumatoid arthritis (RA) owing to their analgesic and anti-inflammatory effects. Forty patients with active RA were recruited and received 10 days of comprehensive therapy with different local cryotherapies. None of the respondents were subjected to biological treatment. They were divided into two groups according to the therapy received: nitrogen vapour at −160 °C (group I) or cold airflow at −30 °C (group II). Levels of tumour necrosis factor α (TNF-α), interleukin 6 (IL-6), disease activity score (DAS28), and functional variables were used to assess the outcomes. After the therapy, both groups exhibited similar improvements. Significant reduction in TNF-α level (nitrogen: p < 0.01; cold air: p < 0.05) and no change in IL-6 were observed. DAS28, the clinical severity of pain, duration of morning stiffness, degree of self-reported fatigue, and health assessment questionnaire (HAQ) scores improved significantly. In addition, the active range of knee extension, time, and the number of steps in the 50-m walk test also clearly got better in both groups. The 10-day comprehensive therapies including different local cryotherapies for the patients with RA cause significant decrease in TNF-α systemic levels, meaningly improve DAS28, HAQ scores, and some functional parameters, but do not change IL-6 levels. However, there were no differences in the effectiveness of either cryotherapy.

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References

  1. Scott DL, Wolfe F, Huizinga TWJ (2010) Rheumatoid arthritis. Lancet 376:1094–1108

    Article  PubMed  Google Scholar 

  2. Pollard L, Choy EH, Scott DL (2005) The consequences of rheumatoid arthritis: quality of life measures in the individual patient. Clin Exp Rheumatol 23(Suppl 39):S43–S52

    PubMed  CAS  Google Scholar 

  3. Robinson V, Brosseau L, Casimiro L et al (2002) Thermotherapy for treating rheumatoid arthritis. Cochrane Database Syst Rev 2:CD002826

    PubMed  Google Scholar 

  4. Vliet Vlieland TPM, Pattison D (2009) Non-drug therapies in early rheumatoid arthritis. Best Pract Res Clin Rheumatol 23:103–116

    Article  PubMed  Google Scholar 

  5. Demoulin C, Vanderthommen M (2012) Cryotherapy in rheumatic diseases. Joint Bone Spine 79:117–118

    Article  PubMed  Google Scholar 

  6. Hayes KW (1993) Heat and cold in the management of rheumatoid arthritis. Arthritis Care Res 6:156–166

    Article  PubMed  CAS  Google Scholar 

  7. Hirvonen HE, Mikkelsson MK, Kautiainen H et al (2006) Effectiveness of different cryotherapies on pain and disease activity in active rheumatoid arthritis. A randomized single blinded controlled trial. Clin Exp Rheumatol 24:295–301

    PubMed  CAS  Google Scholar 

  8. Oosterveld FG, Rasker JJ (1994) Treating arthritis with locally applied or cold. Semin Arthritis Rheum 24:82–90

    Article  PubMed  CAS  Google Scholar 

  9. Kröling P, Mühlbauer M (1992) Einfluss von Eisbeutel, Kaltluft und N2-Kaltgas auf die gelenknahe elektrische Schmerzschwelle. Phys Rehab Kur Med 2:1–6

    Article  Google Scholar 

  10. Korman P, Straburzyńska-Lupa A, Romanowski W et al (2011) Temperature changes in rheumatoid hand treated with nitrogen vapors and cold air. Rheumatol Int. doi:10.1007/s00296-011-2078-5

    PubMed  Google Scholar 

  11. Fricke R, Richter C, Fricke B, Frye K, Moheb A (1998) Cytokine reduction and immunomodulation without stress provoking by whole body cryotherapy at −110°C in rheumatoid arthritis and ankylosing spondylitis. Reumatologia 38:191

    Google Scholar 

  12. Straub RH, Pongratz G, Hirvonen H, Pohjolainen T, Mikkelsson M, leirisalo-Repo M (2009) Acute cold stress in rheumatoid arthritis inadequately activates stress response and induces an increase of interleukin 6. Ann Rheum Dis 68:522–578

    Article  Google Scholar 

  13. Lange U, Uhlemann Ch, Müller-ladner U (2008) Serielle Ganzkörperkältetherapie im criostream bei entzündlich-rheumatischen Erkrankungen. Med Klin 103(6):383–388

    Article  Google Scholar 

  14. Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  15. Prevoo ML, van’t Hof MA, Kuper HH et al (1995) Modified disease activity scores that include twenty-eight-joint counts. Arthritis Rheum 38:44–48

    Article  PubMed  CAS  Google Scholar 

  16. Bruce B, Fries JF (2005) The health assessment questionnaire (HAQ). Clin Exp Rheumatol 23(Suppl 39):S14–S18

    PubMed  CAS  Google Scholar 

  17. Lea RD, Gerhard JJ (1995) Range of motion measurements. J Bone Joint Surg Am 77:784–798

    PubMed  CAS  Google Scholar 

  18. Fransen M, Crosbie J, Edmonds J (2003) Isometric muscle force measurement for clinicians treating patients with osteoarthritis of the knee. Arthritis Rheum 49:29–35

    Article  PubMed  Google Scholar 

  19. Edgren CS, Radwin RG, Irwin CB (2004) Grip force vectors for varying handle diameters and hand sizes. Hum Factors 46:244–251

    Article  PubMed  Google Scholar 

  20. Marino F, Sockler JM, Fry JM (1998) Thermoregulatory, metabolic and sympathoadrenal responses to repeated brief exposure to cold. Scand J Clin Lab Invest 58:537–545

    Article  PubMed  CAS  Google Scholar 

  21. Rhind SG, Castellani JW, Brenner IKM, Shepard RJ et al (2001) Intracellular monocyte and serum cytokine expression is modulated by exhausting exercise and cold exposure. Am J Physiol Regul Integr Comp Physiol 291:R66–R75

    Google Scholar 

  22. Pool AJ, Axford JS (2001) The effects of exercise on the hormonal and immune systems in rheumatoid arthritis. Rheumatology 40:610–614

    Article  PubMed  CAS  Google Scholar 

  23. Sobieska M, Stratz T, Samborski W, Hrycaj P, Mennet P, Müller W (1993) Interleukin-6 (IL-6) after whole body cryotherapy and local hot mud pack treatment. Eur J Phys Med Rehabil Vol 3(5):205

    Google Scholar 

  24. Dugué B, Leppänen E (2000) Adaptation related to cytokines in man: effects of regular swimming in ice-cold water. Clin Physiol 20(2):114–121

    Article  PubMed  Google Scholar 

  25. Janský L, Pospísilová D, Honzová S, Ulicný B, Srámek P, Zeman V, Kamínková J (1996) Immune system of cold-exposed and cold-adapted humans. Eur J Appl Physiol Occup Physiol 72(5–6):445–450

    Article  PubMed  Google Scholar 

  26. Nadler SF, Weingand K, Kruse RJ (2004) The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician 7:395–399

    PubMed  Google Scholar 

  27. Metzger D, Zwingmann C, Protz W et al (2000) Whole body cryotherapy in rehabilitation of patients with rheumatoid diseases—pilot study. Rehabilitation 39:93–100

    Article  PubMed  CAS  Google Scholar 

  28. Neuberger BG, Press AN, Lindsley HB et al (1997) Effects of exercise on fatigue, aerobic fitness, and disease activity measures in person with rheumatoid arthritis. Res Nurs Health 20:195–204

    Article  PubMed  CAS  Google Scholar 

  29. Minnock P, FitzGerald O, Bresnihan B (2003) Women with established rheumatoid arthritis perceive pain as the predominant impairment of health status. Rheumatology 42:995–1000

    Article  PubMed  CAS  Google Scholar 

  30. Wolfe F, Hawley DJ, Cathey MA (1991) Clinical and health status measures over time: prognosis and outcome assessment in rheumatoid arthritis. J Rheumatol 18:1290–1297

    PubMed  CAS  Google Scholar 

  31. Ward M, Leigh P (1993) The relative importance of pain and functional disability to patients with rheumatoid arthritis. J Rheumatol 20:1494–1499

    PubMed  CAS  Google Scholar 

  32. Sokka T, Kankainen A, Hannonen P (2000) Scores for functional disability in patients with rheumatoid arthritis are correlated at higher levels with pain scores than with radiographic scores. Arthritis Rheum 43:386–389

    Article  PubMed  CAS  Google Scholar 

  33. Welsing PM, van Gestel AM, Swinkels HL et al (2001) The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum 44:2009–2017

    Article  PubMed  CAS  Google Scholar 

  34. Lemmey AB, Marcora SM, Chester K et al (2009) Effects of high-intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial. Arthritis Rheum 61:1726–1734

    Article  PubMed  Google Scholar 

  35. Brorsson S, Hilliges M, Sollerman C et al (2009) A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis. J Rehabil Med 41:338–342

    Article  PubMed  Google Scholar 

  36. Westerlund T, Oksa J, Smolander J et al (2009) Neuromuscular adaptation after repeated exposure to whole-body cryotherapy (−110°C). J Therm Biol 34:226–231

    Article  Google Scholar 

  37. Matschke V, Thom JM, Lemmey AB et al (2012) Adverse changes in tendon–muscle physiology and physical function caused by an isolated acute rheumatoid knee effusion: a case study. Arthrit Care Res 64:117–121

    Article  Google Scholar 

  38. Ferrucci L, Guralnik JM, Buchner D et al (1997) Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the women’s health and aging study. J Gerontol A Biol Sci Med Sci 52:M275–M285

    Article  PubMed  CAS  Google Scholar 

  39. Häkkinen A, Kautiainen H, Hannonen P et al (2006) Muscle strength, pain, and disease activity explain individual subdimensions of the health assessment questionnaire disability index, especially in women with rheumatoid arthritis. Ann Rheum Dis 65:30–34

    Article  PubMed  Google Scholar 

  40. McKenna F, Wright V (1985) Pain and rheumatoid arthritis. Ann Rheum Dis 44:805–806

    Article  PubMed  CAS  Google Scholar 

  41. Wessel J (2004) The effectiveness of hand exercises for persons with rheumatoid arthritis: a systemic review. J Hand Ther 17:174–180

    Article  PubMed  Google Scholar 

  42. Van Den Ende CHM, Vliet Vlieland TPM, Munneke M et al (1998) Dynamic exercise therapy in rheumatoid arthritis: a systemic review. Br J Rheumatol 37:677–687

    Article  PubMed  Google Scholar 

  43. Bodur H, Yιlmaz Ö, Keskin D (2006) Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int 26:541–544

    Article  PubMed  Google Scholar 

  44. Ekdal C, Eberhardt K, Andersson SI et al (1988) Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of the Stanford Health Assessment Questionnaire. Scand J Rheumatol 17:263–271

    Article  Google Scholar 

  45. Eberhardt K, Sandqvist G, Geborek P (2008) Hand function tests are important and sensitive tools for assessment of treatment response in patients with rheumatoid arthritis. Scand J Rheumatol 37:109–112

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Physiotherapy, University School of Physical Education, Królowej Jadwigi str. 27/39, 61871, Poznań, Poland

    Robert Jastrząbek, Anna Straburzyńska-Lupa & Radosław Rutkowski

  2. Rheumatological Centre in Śrem, Mickiewicza str. 95, 63100, Śrem, Poland

    Anna Straburzyńska-Lupa & Wojciech Romanowski

Authors
  1. Robert Jastrząbek
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  2. Anna Straburzyńska-Lupa
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  3. Radosław Rutkowski
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  4. Wojciech Romanowski
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Correspondence to Anna Straburzyńska-Lupa.

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Jastrząbek, R., Straburzyńska-Lupa, A., Rutkowski, R. et al. Effects of different local cryotherapies on systemic levels of TNF-α, IL-6, and clinical parameters in active rheumatoid arthritis. Rheumatol Int 33, 2053–2060 (2013). https://doi.org/10.1007/s00296-013-2692-5

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  • DOI: https://doi.org/10.1007/s00296-013-2692-5

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