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September 27, 2016 23:01

Cryotherapy : mechanism of action and the method of

Cryotherapy (Greek krooq-ice.) - A complex of physiotherapy-related effects on the skin cold.

cryotherapy uses local and general hypothermia.

  • Local cryotherapy (Cryomassage) - a therapeutic effect on the organs and tissues of cold factors that reduce the tissue temperature is not below the limits of their krioustoychivosti (5-10 ° C) and do not lead to the body's thermoregulation
  • significant change in total hypothermia (extreme cryotherapy, aerocryotherapy) - short-term effects on the skin of the patient a gaseous medium, the temperature of which ranges from -20 to -170 ° C.

History

heals and rejuvenating cold baths prescribed to their patients Hippocrates, Galen and Avicenna.The ancients believed that, once in the extreme cold conditions, the body mobilizes all its hidden reserves.Therefore, "morozyaschie" procedure used to relieve pain and inflammation relief.That included in the cold strength of self-healing, early in the XX.German doctor confirmed Sebastian Kneipp.He jumped into the icy

Danube, to cure yourself of hectic pneumonia.Kneipp called hardening of one of the main areas of physiotherapy.Since then swimming in the ice-hole was a symbol of good health.Since the mid 70-ies of the last century, Japanese scientist Toshima Yamauchi, observing patients with rheumatoid arthritis, found that the cold has a positive effect on the joints.After exposure to the body temperature in the cold for many hours is increased, and thus favorable changes occur in the blood and joint fluid.The cold causes the body to develop "antirheumatic" hormones.

Japanese proposed to use for the treatment of rheumatism air cooled to -100 ...- 180 ° C. When the cryogenic technology development allowed use in medicine like ultra-low and ultra-low temperature, physiotherapy with ice, dry cold air and liquid nitrogen are widelyspread in Japan, Germany and Poland.In Russia, cryotherapy has become known only in the late 80's - early 90-ies of the last century.There are currently already well studied destructive (destroying abnormal tissue), analgesic, decongestant, anti-inflammatory, healing and revitalizing effects of ultra-low temperature.Crossing the scope of medicine and enriched with the latest technologies, come cryotherapy and aesthetic cosmetology.

Today, scientists believe that the future of cryotherapy in temperatures reaching up to -196 ° C

main mechanisms of action of cryotherapy

  1. Effect on cell and tissue structure.

Local cryotherapy:

  • local level slowing of metabolic processes in tissues-cooled;
  • decrease in oxygen consumption of (and need for) and nutrients;
  • decrease in activity of muscle spindles, muscle contractile ability;
  • increase viscosity of the synovial fluid.

Cryotherapy:

  • improved pairing process phosphorylation in skeletal muscle;
  • activation of tissue respiration in adipose tissue
  1. Influence of the neuroendocrine system, metabolism.

General hypothermia.

central thermo sensors Activation leads to the release of pituitary hormones and catecholamines, which stimulate the catabolic processes in the tissues and accumulate corticosteroids activate reparative regeneration in the inflammatory foci.

  1. Effects on the cardiovascular system.

When cryotherapy identified a number of protective reactions:

  • Vasoconstriction (aimed at preserving the heat),
  • expansion of the lumen of blood vessels within 1-3 hours after cryotherapy, depending on the dose of cooling (heat buildup contributes to enhanced).

process of narrowing and expansion of vessels in the skin are characteristic rhythmic fluctuations, which prevent ischemic tissue damage.

  • after local cryotherapy cold there (reactive) hyperemia, in the mechanism of which is a reflex excitation of adrenergic sympathetic fibers.The underlying tissues increases noradrenaline, which causes a pronounced and prolonged vasoconstriction of the microvasculature and increasing blood viscosity.These changes contribute to the reduction of hematocrit and blood flow.

Reactive hyperemia is characterized by individual differences, which depend on the local characteristics (skin thickness) and on constitutional features (age, overall heat balance of the procedure, and others.).

  1. Impact on the neuro-muscular system.

When cryotherapy excitement skin receptors there.With long-term cooling is their inhibition and partial paralysis by blocking the conduction of nociceptive and tactile fibers of the underlying tissue.Thus, the patient feels cold at first, then a burning sensation and tingling, then the pain, which is replaced by anesthesia and analgesia.Analgesic effect is realized due to a sharp decrease in the conduction of nerve tissue, activating endorphinergic braking systems, neutralization of chemical reactions to acetylcholine, histamine, prostaglandins, and others.

  1. Regulation of muscle tone.

With long-term (more than 10 minutes) cooling in the temperature range of about 0 ° C or short-term, but intense cooling (up to -180 ° C) there is muscle relaxation (a decrease in muscle spasm).It should be borne in mind that the impact of different types of cryotherapy almost does not change the temperature of the muscles and nerve trunks, and antispasmodic effect is realized through the skin eksteroretseptorny The device and the autonomic system.Functional activity of the skin exteroreceptors becomes minimum while cooling the skin up to 13 ° C. Therefore, the skin cooling to 12-15 ° C is optimal for the removal of muscle spasm.When cryotherapy is more pronounced inhibition of the autonomic functions of the system than the local (eg, application of ice).

With the help of short-term exposure (at least 10 min), moderately low temperatures (around 0 ° C), by increasing the degree of coupling of cellular respiration and oxidative phosphorylation in adipose tissue and skeletal muscle is achieved by increased muscle tone.It is noted an increase in strength and muscle endurance

  1. Effect on inflammation and immunological responses.

Cooling inflammatory focus inhibits the activity of proteases released from lysosomes and prevents the multiplication of microorganisms in the wound.This reduces the alteration and swelling of damaged tissues;activates tissue regeneration in venous ulcers and nonhealing wounds;accelerated necrolysis and cleansing of necrotic wounds of dead tissue;slows the absorption of toxic products in burn wounds.As a result of accelerated differentiation of fibroblasts and formation of granulation tissue, and then there is the restructuring of scarring.In patients with immune defects on the background reduce the clinical signs of inflammation slows differentiation of T-lymphocytes and destroyed immunoglobulins G and M.

main curative effects of cryotherapy are: analgesic, anesthetic, hemostatic, anti-inflammatory (decongestant), reparative-regenerative, vasoconstrictor, desensitizing,relaxing, sedative.

Indications for cryotherapy

  • chronic dermatoses (psoriasis, atopic dermatitis, eczema, urticaria, etc.);
  • rosacea, rosacea (in remission);
  • seborrheic dermatitis;
  • acne;
  • hypertrophic, atrophic, pigmented scars, post-acne;
  • atrophic skin changes (including due to the prolonged use of corticosteroids);
  • hyperpigmentation (post-traumatic, efelidy);
  • alopecia,
  • care for "mature" skin age;
  • for dehydrated skin care;
  • skin preparation for cosmetic procedures (kriopiling);
  • skin after dermabrasion treatment, thermal and electrocautery, laser therapy and hair removal (to remove excess heat, reduce redness and tension, inflammation, prevent, reduce discomfort);
  • cellulite treatment, reduction of localized fat deposits;
  • treatment of sagging, atopic skin of the hands, hips, abdomen;
  • reshaping and breast elasticity;
  • rehabilitation after plastic surgery, liposuction;
  • application after injecting practices (mesotherapy, elektrolipoliz);
  • first aid for burns (allows you to terminate the high-agent and thus significantly reduces the zone of necrosis);
  • treatment of burn wounds at a later date (such as an analgesic, anti-inflammatory, kelloidoprotektornoe means for stimulation of reparative processes);
  • chronic fatigue syndrome, depression

cryotherapy

  1. techniques using moderately low temperatures:
    • ice baths;
    • massage ice cubes;
    • ice packs;
    • local cold baths;
    • kriopaketov applications (batch cryotherapy);
    • imposition of cold dressings and bandages;
    • cold mud applications;
    • cryotherapy and krioapplikatsiya using termoelektrichskih devices;
    • chloroethyl alcohol and blockade;
    • krimoterapiya ( "carbonic snow").
  2. Methods of using extremely low temperatures:
    • Cryomassage, kriopunkturnoe effects using kriokateterov and kriozoidov on devices in which the gas mixture is "blown out" under pressure 3,5-5 bar;
    • cryosauna (cryochamber).
  3. Combined (combined) methods using cryo
    • cryotherapy + exercise (Kholodov bandages; vibrating massage + cold exposure);
    • cryotherapy + controlled compression of the affected area;
    • cryotherapy + hyperbaric oxygen therapy;
    • cryotherapy + UFO;
    • krioelsktroterapiya (cryotherapy + pulse currents of low frequency).

procedure for the appointment cryonics procedures

Local cryotherapy can be assigned without a medical examination.Cryotherapy is prescribed only after medical examination: examination of the therapist or physiotherapist (elektrokardiologicheskoe examination, general clinical analysis of blood and urine).

Before the procedure, cryotherapy usually explore the body's response to cold.In this test of the "ice sample" is used more often, "xolod-pressure" and others. For example, are testing a piece of ice the imposition of 2 or 3 cm 3 on the forearm.At the same time expressed the reaction was considered a contraindication for cryotherapy.A more reliable method is to sample temperature using a special computer systems.

Schemes perform procedures

Cryomassage, aerokriomassazh.Cryo carried out using liquid nitrogen (heavy colorless liquid with a boiling point of -193 ...- 210 ° C at one atmosphere pressure).Today it is widely practice two parallel method of cryotherapy.The first is a patch, which is mounted on a wooden shaft.This structure is lowered into the tank, the so-called "dewar", a long neck which should not be tightly closed.There is liquid nitrogen.A cotton applicator dipped in liquid nitrogen, and made a face massage.Lightly massaging gently applicator quickly carried on the skin.Feeling light burning and tingling soon after the procedure disappear, and the skin becomes elastic.The second method of cryomassage more modern, in this case, a special apparatus - krioraspylitel kriodestruktory and with different attachments, including Teflon.

equipment allows dosed, uniform cooling of the skin.It sprayed from the nozzle unit composition (same as liquid nitrogen, called "kriogentom", which has a temperature of up to -180 ° C).Time exposure to the skin for approximately 2-3 minutes at 1 dm2 at the minimum intensity of the jet.The artisan can increase the temperature of -50 ...- 80 ° C depending on the individual characteristics of the patient's skin -.. Its thickness, the degree of fading, color, age, etc. can be used Cryomassage 15-20 min before virtually any cosmetic procedures.This will improve its effectiveness as a short-term exposure to cold activates the capillary microcirculation and metabolic processes.

Kriopiling.When the procedure is carried out kriopilipga gushirovanie liquid nitrogen until flaking.This peeling well tolerated, it has a strong whitening, moisturizing and analgesic (often administered after plastic surgery, burns, bruises and scars of post-acne).The course of 5 to 15 treatments, 1-2 times per week is recommended for patients with severe signs of skin dehydration.

Treatment of seborrhea and window.Good results are obtained cryospray in the cases of different forms of seborrhea and acne in conjunction with the general methods of treatment.Especially shows the use of liquid nitrogen in severe and widespread forms of acne (phlegmonous, conglobata, acne keloid).In this case the liquid nitrogen used in the form of deep freezing tushirovanie and inflammatory infiltrates.Tushirovanie conduct large-diameter applicator, which at the end of a wooden stick cotton swab firmly fixed length of 7-10 cm (in the form of "reeds").The applicator is wetted by liquid nitrogen, a parallel to the surface of the treated area, and a continuous rotary motion, under light pressure of the right hand is moved over the surface of the affected until the evanescent whitening patient feels a burning sensation and feeling cold.After the disappearance of a sense of burning procedure is repeated 2-3 times within 5-10 minutes.After 5-6 hours, there is a persistent skin redness that lasts 24-36 hours, the skin gradually darkens, on the 3rd day appears lamellar peeling and darkened layers of the epidermis is completely rejected in 5-6 days.Separate large inflammatory infiltrates acne, festering atheroma and hypertrophic scars is further treated with liquid nitrogen to achieve more deep freezing.In outbreaks, exposed to more applications, often bubbles are formed, followed by formation of scabs, which fall off after 8-10 days.In the future treatment sessions are held 2 times a week with less exposure, causing a weaker phenomenon reactive inflammation of the skin.On the appointed course of 10-15 procedures.

treatment of rosacea.In the treatment of rosacea Cryomassage liquid nitrogen spend more lightly across the surface of the affected skin.Some nodular and pustular elements are frozen in addition to short-term exposure - up to 10-15 seconds.Sessions are repeated 1-2 times a week on the course should be 10-15 procedures, depending on the prevalence From process.

treatment of some forms of alopecia.When seborrhea of ​​the scalp with hair loss phenomena, as well as in cases of alopecia areata, liquid nitrogen has a beneficial effect on the condition of simultaneous application of the general methods of influence on the body in general (restorative treatment, vitamin, etc.).Liquid nitrogen is used in these cases in the form of massage scalp.This applicator is arranged parallel to the skin surface and light circular movements massage the scalp down the hair partings.The duration of each treatment plot - 5.3 s, to a small skin whitening, appears after the cryomassage persistent erythema.The procedure takes an average of 10-20 minutes (Cryomassage entire scalp).In alopecia areata treatment is carried out with liquid nitrogen only focus baldness intermittently for 1-2 minutes.The procedure is repeated through the 2-3days, need 15-20 procedures to course.After a month break, the course of treatment must be repeated.Displaying 2-3 courses.It should be remembered that the low temperature of liquid nitrogen is dry and brittle hair, so in the course of treatment should be carefully monitor sebaceous excretions.