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      WHOLE-BODY CRYOSTIMULATION: A REHABILITATION BOOSTER

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          Abstract

          A growing body of work suggests that whole-body cryostimulation (WBC) could play a role as a promising adjuvant therapy in various conditions of rehabilitation interest. In fact, WBC is currently being used to relieve symptoms in rheumatoid arthritis, fibromyalgia, ankylosing spondylitis, depression and anxiety, multiple sclerosis, sleep disturbances, muscle soreness after strenuous physical exercise, post-Covid syndrome and obesity. WBC is not only a symptomatic physical therapy but rather represents an “adaptation therapy” because of the repeated shock-like cryogenic cold stimulus over the entire body surface that induces reactions in the autonomic, endocrine, circulatory, neuromuscular and immunological systems, resulting in an adaptation that contributes to the restoration of the homeostatic state. Therefore, based on the existing evidence, WBC can be described as follows:

          • a “training method” for the autonomic nervous system;

          • a novel anti-inflammatory and antioxidant treatment;

          • a treatment with beneficial effects on body composition and adipose tissue.

          In our opinion, the powerful effects of thermal stress on the physiological responses of the human body present unique features that could potentially be exploited to boost rehabilitation outcomes in various conditions. Therefore, we believe it is important to highlight the potential use of WBC for medical use and emphasize its relevance in the field of rehabilitation with the aim of stimulating scientific studies on the efficacy of WBC as an adjuvant treatment in various conditions of rehabilitation interest.

          LAY ABSTRACT

          A growing body of work suggests that whole-body cryostimulation (WBC) could play a role as a promising adjuvant therapy in various conditions of rehabilitation interest, as it can act as

          • a “training method” for the autonomic nervous system;

          • a novel anti-inflammatory and antioxidant treatment;

          • a treatment with beneficial effects on body composition and adipose tissue.

          Therefore, we want to highlight the potential use of WBC for medical use and its relevance in the field of rehabilitation with the aim of stimulating scientific studies on the efficacy of WBC as an adjuvant treatment in various conditions of rehabilitation interest.

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          Most cited references23

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          Short-term Cold Acclimation Recruits Brown Adipose Tissue in Obese Humans.

          Recruitment of brown adipose tissue (BAT) has emerged as a potential tool to combat obesity and associated metabolic complications. Short-term cold acclimation has been shown not only to enhance the presence and activity of BAT in lean humans but also to improve the metabolic profile of skeletal muscle to benefit glucose uptake in patients with type 2 diabetes. Here we examined whether short-term cold acclimation also induced such adaptations in 10 metabolically healthy obese male subjects. A 10-day cold acclimation period resulted in increased cold-induced glucose uptake in BAT, as assessed by [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography. BAT activity was negatively related to age, with a similar trend for body fat percentage. In addition, cold-induced glucose uptake in BAT was positively related to glucose uptake in visceral white adipose tissue, although glucose uptake in visceral and subcutaneous white adipose tissue depots was unchanged upon cold acclimation. Cold-induced skeletal muscle glucose uptake tended to increase upon cold acclimation, which was paralleled by increased basal GLUT4 localization in the sarcolemma, as assessed through muscle biopsies. Proximal skin temperature was increased and subjective responses to cold were slightly improved at the end of the acclimation period. These metabolic adaptations to prolonged exposure to mild cold may lead to improved glucose metabolism or prevent the development of obesity-associated insulin resistance and hyperglycemia.
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            Exercise training-induced modification in autonomic nervous system: An update for cardiac patients.

            Patients with cardiovascular disease show autonomic dysfunction, including sympathetic activation and vagal withdrawal, which leads to fatal events. This review aims to place sympathovagal balance as an essential element to be considered in management for cardiovascular disease patients who benefit from a cardiac rehabilitation program. Many studies showed that exercise training, as non-pharmacologic treatment, plays an important role in enhancing sympathovagal balance and could normalize levels of markers of sympathetic flow measured by microneurography, heart rate variability or plasma catecholamine levels. This alteration positively affects prognosis with cardiovascular disease. In general, cardiac rehabilitation programs include moderate-intensity and continuous aerobic exercise. Other forms of activities such as high-intensity interval training, breathing exercises, relaxation and transcutaneous electrical stimulation can improve sympathovagal balance and should be implemented in cardiac rehabilitation programs. Currently, the exercise training programs in cardiac rehabilitation are individualized to optimize health outcomes. The sports science concept of the heart rate variability (HRV)-vagal index used to manage exercise sessions (for a goal of performance) could be implemented in cardiac rehabilitation to improve cardiovascular fitness and autonomic nervous system function.
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              Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature

              Nowadays, whole-body cryotherapy is a medical physical treatment widely used in sports medicine. Recovery from injuries (e.g., trauma, overuse) and after-season recovery are the main purposes for application. However, the most recent studies confirmed the anti-inflammatory, anti-analgesic, and anti-oxidant effects of this therapy by highlighting the underlying physiological responses. In addition to its therapeutic effects, whole-body cryotherapy has been demonstrated to be a preventive strategy against the deleterious effects of exercise-induced inflammation and soreness. Novel findings have stressed the importance of fat mass on cooling effectiveness and of the starting fitness level on the final result. Exposure to the cryotherapy somehow mimics exercise, since it affects myokines expression in an exercise-like fashion, thus opening another possible window on the therapeutic strategies for metabolic diseases such as obesity and type 2 diabetes. From a biochemical point of view, whole-body cryotherapy not always induces appreciable modifications, but the final clinical output (in terms of pain, soreness, stress, and post-exercise recovery) is very often improved compared to either the starting condition or the untreated matched group. Also, the number and the frequency of sessions that should be applied in order to obtain the best therapeutic results have been deeply investigated in the last years. In this article, we reviewed the most recent literature, from 2010 until present, in order to give the most updated insight into this therapeutic strategy, whose rapidly increasing use is not always based on scientific assumptions and safety standards.
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                Author and article information

                Journal
                J Rehabil Med Clin Commun
                J Rehabil Med Clin Commun
                JRM-CC
                Journal of Rehabilitation Medicine - Clinical Communications
                Medical Journals Sweden AB
                2003-0711
                19 September 2022
                2022
                : 5
                : 2810
                Affiliations
                [1 ]Orthopedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, San Giuseppe Hospital, Verbania, Italy
                [2 ]Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, Turin, Italy
                [3 ]Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano, IRCCS, San Giuseppe Hospital, Verbania, Italy
                [4 ]Department of Neurosciences, University of Turin, Turin, Italy
                [5 ]Department of Food, Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
                Author notes
                Correspondence address: Capodaglio Paolo, Orthopedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, San Giuseppe Hospital, Verbania, Italy. E-mail: p.capodaglio@ 123456auxologico.it
                Article
                JRMCC-5-2810
                10.2340/jrmcc.v5.2810
                9495643
                5945e7cd-280b-4245-b04c-7e602ff20c7f
                © Published by Medical Journals Sweden, on behalf of the Foundation for Rehabilitation Information

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/)

                History
                : 15 July 2022
                Categories
                Original Report

                whole-body cryostimulation,rehabilitation,low-grade inflammation,oxidative stress,cryotherapy

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