CRYOSTIMULATION

POST-EXERCISE
RECOVERY
EFFECTS OF WHOLE-BODY
CRYOSTIMULATION EXPOSURE
– Written by Christophe Hausswirth, France

Elite athletes often train intensively of an organism which results in analgesic, Indeed, physical activity in a warm or
or compete over consecutive days. decreased swelling, pain modulating cold atmosphere ensures that the body and
Cumulative fatigue over such periods of immune and circulatory system reactions the mechanisms involved in temperature
training or competition can reduce athletic and may improve recovery after muscular regulation have to work harder. Although
performance. Adequate recovery between trauma injury. Definition is needed as to the very effective, these thermoregulatory
training sessions and/or competitive events precise context in which athletes may use mechanisms may not be able to cope with
is therefore essential to minimise the risk of this tool to optimise recovery in relation to extreme conditions.
fatigue and optimise performance. In this improving sleep patterns, optimising the They do, however, allow the body to
context, the use of whole-body cryotherapy parasympathetic system and increasing adapt to chronic exposure. Artificial cooling
(WBC) as a tool to aid recovery shows their general well-being. of ambient temperature is an evolving
benefits on some inflammatory parameters, Exercise-related stress is often increased technique, both to prepare athletes for
possible improvement of antioxidant status due to environmental conditions, competitions in difficult conditions and to
and improvements in mood and mild particularly those relating to temperature improve the body’s recovery capacity.
depression. Heating the body is supposed to changes. For every sporting activity
be beneficial to athletes' recovery, in treating there is an ideal ambient temperature. HISTORICAL BACKGROUND FOR WHOLE-
muscle pain and as part of rehabilitation Any deviation from this reference BODY CRYOSTIMULATION
after injury. It has been demonstrated that temperature will have a negative impact The first very low temperature cold
WBC stimulates the physiological reactions on performance. rooms appeared in Japan in 1989, when

72
Yamauchi used a cryogenic chamber to disorders such as anxiety and recovery with the kinetics of appearance
treat rheumatism. The indications for WBC depression3. of inflammatory and/or muscle injury
were subsequently extended to various WBC is also extensively used in markers. At INSEP (French National Institute
inflammatory conditions. WBC was then self-treatment or body hardening of Sport, Expertise and Performance) we
offered to treat pain and prevent post- against respiratory tract infections have been working for 4 years to help both
traumatic oedema, with exposure limited to and musculoskeletal pain4, as well as the medical and the performance-related
to 2 to 3 minutes. parasympathetic reactivation after recovery process.
One of the most well-established intensive exercise5.
physiological responses to cold exposure Sport and cold exposure
is triggered by the decrease in skin COLD ENVIRONMENT: THE CASE FOR In the sporting realm, WBC (in this
temperature, promptly stimulating WHOLE-BODY CRYOSTIMULATION- instance, more accurately defined as whole-
cutaneous receptors and their sensory CRYOTHERAPY body cryostimulation) has been used at
afferents to excite sympathetic adrenergic What is known today: a review of scientific temperatures ranging from -110°C to -160°C
fibres, in turn causing the constriction of data with the aim of limiting the spread of
local arterioles and venules. The resulting How well WBC restores biological muscle lesions after training or competing6.
decrease in blood flow to the periphery or constants following intensive training It has also been offered as a prophylactic
injured/inflammed tissues reduces local remains unclear. Studies are ongoing in the treatment to reduce the risk of muscle
metabolic processes, thereby attenuating field of athlete recovery. lesions during intense training periods and
the inflammatory response and the Although we still lack scientific hindsight to increase the antioxidant status after
formation of oedema around the injured on the link between recovery, sport and multiple exposures7. Despite the increasing
tissues1. cryostimulation, this paper summarises popularity of WBC in sport, few studies
Reported indications for using WBC the effects of WBC on some relevant have assessed its efficacy in accelerating the
include: parameters and practical applications. This recovery of the athlete2,8. Very recently, post-
• decreased joint pain and disorders, will help to identify possible applications exercise cold water immersion was shown
• improved general well-being, in the field of recovery in sport. The first to aid recovery by altering blood flow9 and
• decreased fatigue perception2 and parameter subjected to in-depth studies improving perceptions of recovery10, which
• reduced symptoms of psychiatric was inflammation; some studies associate may be reflected by changes in cardiac

POST-EXERCISE RECOVERY TARGETED TOPIC 73

CRYOSTIMULATION

autonomic activity. WBC may also exert body cryostimulation (PBC) techniques has temperature required to elicit
important effects on post-exercise recovery not been thoroughly evaluated. physiological responses?
at the cardiovascular level. As exercise causes • Is head exposure required to induce
an intensity-dependent parasympathetic Comparison in different techniques of cold general modifications?
withdrawal and sympathetic increase, stimulation During WBC the entire body is exposed
a prompt recovery of parasympathetic Modern cryotherapy techniques to cold, including the face and neck, as
activity is desirable after exercise. Changes involve local, partial-body and whole- opposed to a PBC session. It has been
in cardiac parasympathetic activity as body exposures. WBC and PBC have been shown that the direct effect of cold on the
assessed by heart rate variability (HRV) developed very recently and many devices head alone, via face immersion in cold
analyses have emerged in the literature are commercially available. The major water (without breath holding) aided
as a global recovery index that reflects the differences in the two systems are: parasympathetic reactivation significantly
acute response of the body to exercise; an 1. the temperatures (-110°C vs -160°C for following exercise11. The results of a recent
elevated level of parasympathetic activity WBC and PBC, respectively), study conducted at INSEP showed that
allows rapid cardiodeceleration and faster 2. whether the head is exposed to the cold whatever the cryotherapy technique
recovery10,11. Stanley et al10 demonstrated stimulus (yes vs no for WBC and PBC, used, a single 3-minute cryostimulation
that both cold water immersion (5 minutes respectively), induced a strong autonomic response, as
in 14°C water) and contrast water therapy, 3. the source of cold stimulation rising plasma noradrenaline, systolic and
consisting of three cycles alternating (compressor vs nitrogen gas for WBC diastolic blood pressures reflected increased
immersion in cold (1 minute, 14.2°C) and and PBC, respectively). sympathetic activation and as the rise in
warm (2 minutes, 35.5°C) water, significantly The infrared studies of the temperature HRV indices suggested an augmentation of
aided post-exercise parasympathetic response to 3 minutes WBC exposure the parasympathetic control of heart rate.
reactivation compared to passive recovery reported that cold air on the entire human A likely greater parasympathetic activation
in trained endurance athletes. They also body was responsible for an obvious was observed with the greatest body cooling
reported that this effect was larger with drop off in skin temperature whereas obtained by exposing the whole body (WBC)
cold water immersion than contrast water central temperature did not exceed the to cold.
therapy, suggesting that combining a greater thermoregulation range during cryotherapy Contrary to localised cryotherapy
cold stimulus increased the effectiveness sessions13. Thermal mapping of the body obtained by the application of ice packs, cold
of water immersion. While various water could be influenced by local blood flow, towels or cold air-pulsed on a small body
immersion protocols have been shown to degenerative and inflammatory state of the region, the air-based cryotherapy modalities
accelerate post-exercise parasympathetic tissue. It was therefore previously reported examined in the present study14 involved
reactivation, the effect of dry air whole-body that an enhancement of skin temperature either complete body cooling (WBC) or
cryostimulation (range from -110°C to -160°C) profile could increase the diagnostic whole-body cooling excluding the head and
on post-exercise autonomic recovery is not sensitivity of infrared imaging in patients13. neck (PBC), inducing an important decrease
well-documented, even though this recovery The use of several types of cryostimulation in whole-body temperature (Figure 1). A very
method has become increasingly used in raises new questions such as: large reduction in Tskin (skin temperature)
high level sport3,8. Only one study reported • What is the optimal modality? of all body regions of interest was recorded
a significant increase in the HRV indices • What are the duration and minimum after the 3-minute cryostimulation, in
of parasympathetic activity following a
WBC session performed after exercise in
elite synchronised swimmers5. Similarly, in
resting conditions, Westerlund et al12 found
that a single session of WBC significantly
WBC reduces pro-
augmented HRV indices of parasympathetic
modulation in healthy non-athletic women,
inflammatory responses,
with a mean increase of approximately decreases pro-oxidant
molecular species and
50% in root mean square of the successive
differences and high frequency power. The

stabilises membranes,
resulting increase in venous pressure in
turn activates the baroreflex, responsible for

resulting in high-potential
reducing sympathetic nerve activity while
shifting autonomic heart rate control toward

beneficial effects on sports-

parasympathetic dominance. However, in
the case of healthy, recreationally active men
training only a few times per month, the
autonomic response to WBC has not been induced haemolysis and cell
investigated. Further, the influence of WBC
on blood parameters and subsequent cardiac tissue damage
and thermal responses compared to partial-

74
 Figure 1: Examples of thermograms obtained
immediately before (a, b) and after (c, d) a
partial-body cryostimulation session (A) and a
whole-body cryostimulation session (B). The
black shapes represent the different body
regions of interest for the front and back
facing subject (Hausswirth et al14).

In addition, since an increase in plasma

dopamine is typically related to sensations
of well-being and pleasure, we can suggest a
slightly greater effect of WBC in generating
positive feelings. A previous study reported
a significant increase in sensations of
well-being when an exhaustive treadmill
running protocol was followed by a WBC
session2.
During cryostimulation, cold-sensitive
cutaneous receptors excite the sympathetic
α-adrenergic fibres, responsible for a
peripheral vasoconstriction mechanism
through the release of noradrenaline.
Consequently, blood flow is redistributed
toward the core, resulting in increased
arterial pressure16. INSEP data suggested
that systolic and diastolic blood pressure
were very likely increased after WBC, but not
after PBC, pointing to a lower sympathetic
greater proportion with the WBC. The mean component). Given the lack of consensus on stimulation that may be related to the
decrease in Tskin was 13.7°C (i.e. -42.9%) the accuracy of HRV analysis in assessing smaller decrease in Tskin obtained after PBC.
for WBC and 8.3°C (i.e. -26.1%) for PBC. As sympathetic activity, we hypothesised Further, the decrease in Ttymp (tympanic
previously reported by Cholewka et al13, a that the activity of this component of the temperature) recorded with WBC, as well
larger decrease in Tskin was recorded in ANS was studied only through plasma as the stimulation of cold trigemino-cardiac
the legs and arms when compared with catecholamine concentrations, while reflex receptors located in the face may have
the torso and back (Figure 1). These authors the parasympathetic component was accentuated the parasympathetic response
reported a significant positive correlation studied through HRV analyses. Plasma after WBC, augmenting vagal output to
between the decrease in Tskin and the noradrenaline concentrations were likely the heart. As expected, the increase in
body mass index of individuals, indicating and probably increased after the PBC and blood pressure was associated with a large
that the effects of cryostimulation may be WBC sessions respectively, suggesting decrease in heart rate, that was greater
influenced by body composition. increased sympathetic nervous stimulation. after WBC (-15.2%) than PBC (-10.9%) likely
This increase in plasma noradrenaline was reinforced by the concomitant triggering of
Cold-related stimulation of the autonomic accompanied by a possible small increase the baroreflex which lowers the sympathetic
nervous system in plasma dopamine after WBC only, but no tone of the ANS, shifting to a predominance
HRV indices and blood catecholamines are response in plasma adrenaline was recorded of parasympathetic tone.
classically used to evaluate the modulation after PBC and WBC sessions. Similar We recently published a paper on the
of the autonomic nervous system (ANS) in findings (cold-induced increases in plasma effect of single WBC exposure on recovery
response to various stimuli such as cold or noradrenaline without any changes in in elite athletes5. To our knowledge, this is
physical exercise5,11. The parasympathetic plasma adrenaline) have been reported after the first time that WBC was investigated as
and sympathetic activities refer to the different modalities of cold exposure15. Since a recovery technique between two closely
cholinergic and adrenergic phases of noradrenaline mostly originates from the scheduled, sport-specific maximal exercise
the ANS, in reference to their respective sympathetic nerve endings and adrenaline bouts. The two most important findings of
neurotransmitters (i.e. acetylcholine for from the adrenal medulla, we can suggest this study were:
the parasympathetic component and that both cryostimulation techniques 1. using WBC shortly after a full-
catecholamines for the sympathetic activate the sympathetic nervous system. length synchronised swimming ballet

POST-EXERCISE RECOVERY TARGETED TOPIC 75

CRYOSTIMULATION

1500 400
Prostaglandin (PGE2) concentrations (pg/ml)

Creatine kinase (CK) concentrations (U/I)

300
1000

200

500
100

0 0
Before WBC After WBC Before WBC After WBC

Figure 2: Variation in serum concentrations of muscle injury markers (prostaglandin and creatine kinase). The left panel shows a significant
reduction in prostaglandin PGE2 (P <0.0001) 'after WBC'. The right panel shows a significant reduction in creatine kinase (P <0.01) 'after
WBC'. Adapted from Banfi et al17 with permission from the Journal of Thermal Biology. WBC=whole-body cryotherapy.

resulted in a strong parasympathetic the authors did show that creatine kinase major finding was that a single exposure
reactivation in elite swimmers, yielding and PGE2 prostaglandin concentrations to WBC significantly alleviated markers of
two- to four-fold increases in vagal-related were significantly reduced after 5 days inflammation after strenuous exercise.
HRV indices compared to pre-exercise of WBC (Figure 2). No control group was 1. Delta IL-1ra increased 1 hour after
values within only 1 hour. included in this study. The authors explain exercise following WBC compared to passive
2. WBC exerted a significant that the drop in creatine kinase is likely to recovery,
influence on metabolic parameters of result from the stimulation of noradrenalin 2. Delta IL-1β was significantly
recovery and subsequent exercise, with a secretion during exposure to cold, an effect suppressed 1 hour after exercise following
larger clearance of plasma lactate and an demonstrated by Rønsen et al18. No assay of WBC, compared to passive recovery,
increase in maximal aerobic work output noradrenalin was performed in this study. 3. WBC minimised the decrease of
during the second ballet. The latter was only Banfi et al17 observed a reduction in PGE2 neutrophils 24 hours after exercise and
matched by the effects of active recovery. associated with reduced creatine kinase 4. C-reactive protein increase
levels. PGE2 is synthesised at the site of was strongly limited in the WBC group
Inflammatory marker responses inflammation, where it acts as a vasodilator compared to the passive recovery group at
Some authors have measured various in synergy with other mediators, such as 24 hours and until 48 hours after exercise.
markers of inflammation in subjects histamine and bradykinin. These mediators Data confirm that the treatment induces
exposed to very low temperatures. Banfi cause increased vascular permeability an anti-inflammatory protective effect and
et al7 showed that treating top-level rugby leading to oedema. Their reduction, after 5 suggest that WBC reduces time of recovery
players with WBC for 1 week led to reduced days of WBC, seems to be a good indicator by beneficial effects on immunological
rates of pro-inflammatory cytokines (IL- of improved muscle recovery. However, the parameters and the regeneration process
2 and IL-8) and increased levels of anti- absence of a control group in the study is a for elite athletes.
inflammatory cytokines (IL-10). This is flaw which makes it impossible to reliably
the only study in which the results can conclude on the efficacy of WBC in recovery. Hormonal responses
genuinely be related to recovery after This research does, however, offer some Most studies of WBC have focused on the
intense muscular exercise. According to suggestions as to the parameters likely to kinetics of biochemical markers and/or how
the authors, WBC should improve muscle favour (or not) improved recovery. various hormones evolve in response to
recovery, although they were unable to A recent study8 was conducted to exposure. It is widely believed that changes
measure to what extent. analyse the effect of two different recovery (or lack of changes) to endocrine parameters
In this 5-day study, 10 top-level rugby modalities on classical markers of exercise- are relevant topics for research on improved
players were placed in cryogenic chambers induced muscle damage and inflammation athlete recovery. In this context, a recent
at -60 C for 30 seconds, then at -110 °C for obtained after a simulated trail running study by Smolander et al19 compared
120 seconds. In addition, subjects followed race. We compared changes in immune cell WBC exposure (-110 °C for 2 minutes)
their normal 3-hour daily training without mobilisation and C-reactive protein level to cold-water immersion (0-2 °C for 20
changing their workload. While no as these are reliable indicators of acute seconds). The two groups were subjected to
significant difference was measured in terms performance deterioration, muscle damage weekly treatments over 12 weeks. Various
of immunoglobulin or C-reactive protein and/or inflammation routinely evaluated in hormones – growth hormone, prolactin
levels (two markers of acute inflammation), the general population and in athletes4,9. The and the thyroid hormones (TSH, T3 and T4)

76
 WBC Figure 3: Variations in plasma noradrenalin concentrations
15 after 1, 4, 8 and 12 weeks of whole body cryotherapy.
Control group
*Significant difference from initial value (P <0.01).
10
* Adapted from Leppäluoto et al15 with permission from The
1st week
Scandinavian Journal of Clinical and Laboratory Investigation.
5

0
0 10 20 30 40
15
In this context, Nieman20 observed that
Plasma noradrenaline concentrations (nmol.l-1)

the immune response was impaired during

10 * 4th week repeated phases of prolonged high-intensity
exercise, and that athletes responded poorly
5
to bacterial and viral attacks, thus delaying
recovery. Excessive sensitivity to respiratory
0 tract infections seems to set in gradually,
0 10 20 30 40 although it is well-described that the risk
15 of respiratory infection follows a ‘J-shaped’
curve when plotted against training
* intensity, and that moderate exercise results
10 8th week in a low infection risk. Training is known to
improve the immune response to a certain
5 degree, while overtrained athletes have
reduced immune responses, in particular
0 immunoglobulins, ‘Natural Killer’ or ‘NK’
0 10 20 30 40 lymphocyte subgroups. While no study
discusses the kinetics of how the immune
15
system evolves after exposure to WBC
(mainly because the procedure is so novel)
10 * 12th week models involving swimming and immersion
in cold water have been used for the last few
5 years in Nordic countries and have provided
indications on how the immune system is
0 affected. This practice, which was developed
more on a cultural than on a scientific
0 10 20 30 40
basis, has always been empirically linked
to improved resistance to infections. In this
– were analysed. The authors concluded The authors explain that the increases in context, Dugué and Leppänen21 showed, in
that there were no significant variations noradrenaline levels recorded over the a study comparing populations swimming
in hormone levels for the WBC group. twelve weeks may play a role in relieving regularly in cold water or not, that plasma
Prolonged exposure to cold seems to have perceived pain, an effect seen in other studies IL-6 levels, monocytes and leukocytes
no effect on the concentrations of these using traumatising exercise. However, no were all higher in cold-water swimmers.
hormones. Based on this lack of effect of scale of pain perception was offered in this The authors concluded that the immune
WBC on hormone levels, we can conclude purely descriptive study, which involved system of cold-water swimmers controlled
that this procedure conforms to sporting straightforward cryostimulation by WBC the inflammatory response better and that
ethics. These results are supported by those exposure. repeated exposure to cold (by immersion
of another recent study by Banfi et al17, who or not) could explain the improvement in
indicated that, in a group of 10 athletes, Immune responses defence against infections. It could therefore
none of the haematological parameters (red For a number of years, the immune be suggested that repeated exposure in cold
blood cells, white blood cells, haematocrit, system has been of particular interest rooms (i.e. WBC) stimulates the immune
haemoglobin, platelets) were affected by to sports physiologists. The incidence of system and reduces susceptibility to
five 2-minute exposures over 1 week. In an upper respiratory tract infections in very infections in acclimatised individuals. New
earlier study, Leppäluoto et al15 showed that fit athletes initially helped doctors to detect studies on WBC should shed light on these
exposure to WBC (three times per week for overtraining syndrome. These intuitions hypotheses and offer insights into the
12 weeks) induced a significant increase were confirmed more recently by some very relationships between immunity, cold and
in plasma noradrenalin levels (Figure 3). well-run American and British studies. athlete recovery.

POST-EXERCISE RECOVERY TARGETED TOPIC 77

CRYOSTIMULATION

Median
25%-75%
180 240
Min-max
* *
160 * 230
**

Total antioxidative status (µmol/l)

220
Total oxidative status (µmol/l)

140
210
**
120 200

190
100

180
80
170

60 160

40 150
Rest 30 min after Next Rest 30 min after Next
cryostimulation morning cryostimulation morning

Figure 4: a) Variations in plasma total oxidant status in resting subjects 30 minutes after cryostimulation and the next morning. *Significant
difference between 30 min after cryostimulation and next morning (P <0.05). b) Variation in plasma total antioxidant status in resting
subjects 30 minutes after cryostimulation and the following morning. *Significant difference between resting and 30 minutes after
cryostimulation (P <0.05); **Significant difference between 30 min after cryostimulation and next morning (P <0.01). Adapted from
Lubkowska et al7 with permission from the Journal of Thermal Biology.

Antioxidant status responses level was still significantly lower compared symptoms of depression. Given these
Physical exercise is known to be to the basal level before WBC exposure. In results, the authors recently published
characterised by an increase in oxygen addition, total antioxidant status values another study, similar to their previous
consumption, and consuming high levels were significantly lower 30 minutes after work, which included a control group of 34
of oxygen is associated with increased exposure to cold, but did not differ from patients3. After 3 weeks, the HRSD scores for
free radical production. Modulation of basal values the next day. However, in the 26 patients suffering from depression
oxygenated free radical production plays a athletes, cryostimulation is combined were reduced by 34.6% in the WBC group,
clear role in muscle recovery after exercise. with physical exercises as part of regular versus only 2.9% in the control group. One
High intensity exercise and/or exercise training, and it is therefore difficult to know neurobiological hypothesis states that
involving many eccentric movements are to what extent lipid peroxidation is the depression results from a deregulation of
stressors, producing metabolic by-products result of training and/or cryostimulation6. the hypothalamic-pituitary-adrenal axis.
with significant effects on cellular structures. The authors relate the improved mood
Oxygen-derived free radical species Responses for depressive symptoms regulation and HRSD scores to this axis.
involved in oxidative stress are of various Some studies investigated the somatic In addition, WBC may also has positive
structures, but all are extremely reactive and psychological effects of cold and effects on patients’ biological rhythms.
compounds which, once produced, will seemed to reach a consensus on mood These results could provide some help for
oxidise various cellular components. This alterations. Somatic and psychological the temporary psychological problems
oxidation can lead to cellular dysfunction parameters seem somewhat removed from frequently encountered by athletes during
and inflammatory disorders. A recent the topic of recovery in sport, but they can training.
study by Dugué et al22 showed increased obviously play an indirect role. Thus, the first
total plasma antioxidant capacity after studies on the subject showed that a short CONCLUSIONS
36 cold room sessions over 12 weeks (three exposure to WBC improved sleep, sense of Published studies concentrate
times per week). These results contradict relaxation and mood, and that these effects on physiological, biochemical and
the authors’ initial hypothesis that values can persist for hours or even days. In a more haematological parameters affected by
would be significantly reduced, and explain recent study, Rymaszewska et al3 studied WBC. It reduces proinflammatory responses,
the improved protection. A single study the effects of WBC (-150 °C, 160 seconds, 10 decreases pro-oxidant molecular species
investigated the effects of a WBC session times over 2 weeks) in 23 depressed patients and stabilises membranes, resulting in
(at -130°C) on the pro-oxidant/antioxidant on anti-depressant treatment. Using the high-potential beneficial effects on sports-
ratio7. Plasma total oxidant status was 21 items on the Hamilton Rating Scale for induced haemolysis and cell tissue damage,
significantly decreased 30 minutes after Depression (HRSD), the authors concluded which is characteristic of heavy physical
exposure to WBC for 3 minutes (Figure 4). that WBC exposure had a positive effect exercise. Conversely, WBC does not influence
The following day, the total oxidant status on HRSD scores, and thus helped alleviate hormonal responses, with the exception of

78
testosterone, estradiol, noradrenaline and only 1 hour post-exercise. In addition to Published data are generally not
myocardial cell metabolism. Interleukin the desirable effects of WBC identified controversial, but further studies are
concentrations are modified by WBC, which in sport, future research should aim to necessary to confirm the existing
induces anti-inflammatory responses. determine whether the strong influence of observations. Standardisation of exposure
In the context of recovery between two WBC on parasympathetic reactivation at times and the number of treatments during
training sessions, it has been shown that a the cardiac level could present additional each cycle could improve data comparison.
single session of WBC performed shortly benefits over longer periods, as fatigue Due to the impact on the parasympathetic
after a maximal exercise exerts a strong accumulation during periods of intensified reactivation, we suggest that further studies
influence on parasympathetic reactivation, training has been associated with changes conducted on sleep efficacy be performed
yielding a two- to four-fold augmentation in the autonomic modulation of heart rate in order to speed-up the recovery of elite
of pre-exercise vagal-related HRV indices, in athletes. athletes.

References
performance and limb blood flow. Br J 17. Banfi G, Melegati G, Barassi A, Dogliotti
1. Paddon-Jones DJ, Quigley BM. Effect of Sports Med 2011; 45:825-829. G, Melzi d’Eril G, Dugué B, Massimiliano
cryotherapy on muscle soreness and M et al. Effects of whole-body cryotherapy
strength following eccentric exercise. Int J 10. Stanley J, Buchheit M, Peake JM. The
effect of post-exercise hydrotherapy on on serum mediators of inflammation
Sports Med 1997; 18:588-593. and serum muscle enzymes in athletes. J
subsequent exercise performance and
2. Hausswirth C, Louis J, Bieuzen F, Pournot heart rate variability. Eur J Appl Physiol Therm Biol 2009; 34:55-59.
H, Fournier J, Fillard JR et al. Effects of 2012; 112:951-961. 18. Rønsen O, Børsheim E, Bahr R, Klarlund
whole-body cryotherapy vs. far-infrared Pedersen B, Haug E, Kjeldsen-Kragh J et
vs. passive modalities on recovery from 11. Al Haddad H, Laursen PB, Ahmaidi S,
Buchheit M. Influence of cold water al. Immuno-endocrine and metabolic
exercise-induced muscle damage in responses to long distance ski racing
highly-trained runners. PLoS One 2011; face immersion on post-exercise
parasympathetic reactivation. Eur J Appl in world-class male and female cross-
6:e27749. country skiers. Scand J Med Sci Sports
Physiol 2010; 108:599-606.
3. Rymaszewska J, Ramsey D, Chladzinska- 2004; 14:39-48.
Kiejna S. Whole-body cryotherapy as 12. Westerlund T, Uusitalo A, Smolander J,
Mikkelsson M. Heart rate variability in 19. Smolander J, Leppäluoto J, Westerlund T,
adjunct treatment of depressive and Oksa J, Dugué B, Mikkelson M et al. Effects
anxiety disorders. Arch Immunol Ther women exposed to very cold air (-110°C)
during whole-body cryotherapy. J Therm of repeated whole-body cold exposures on
Exp (Warsz) 2008; 56:63-68. serum concentration of growth hormone,
Biol 2006; 31:342-346.
4. Banfi G, Lombardi G, Colombini A, thyrotropin, prolactin and thyroid
Melegati G. Whole-body cryotherapy in 13. C
holewka A, Drzazga Z, Kajewski B, hormones in healthy women. Cryobiology
athletes. Sports Med 2010; 40:509-517. Bogucki R, Wisniowska B. Thermal 2009; 58:275-278.
imaging of skin body surface due to
5. Schaal K, Le Meur Y, Bieuzen F, Petit O, whole-body cryotherapy - preliminary 20. Nieman DC. Exercise, infection, and
Hellard P, Toussaint JF et al. Effect of report. Phys Med 2004; 1:81-83. immunity. Int J Sports Med 1994;
recovery mode on post-exercise vagal 15:S131-S141.
reactivation in elite synchronized Hausswirth C, Schaal K, Le Meur Y,
14.
Bieuzen F, Filliard JR, Volondat M et al. 21. Dugué B, Leppänen E. Adaptation related
swimmers. Applied Physiology, Nutrition, to cytokines in man: effect of regular
and Metabolism 2013; 38:126-133. Parasympathetic activity and blood
catecholamine responses following a swimming in ice-cold water. Clin Physiol
6. Swenson C, Swärd L, Karlsson J. single partial-body cryostimulation and 2000; 20:114-121.
Cryotherapy in sports medicine. Scand J a whole-body cryostimulation. PlosOne 22. Dugué B, Smolander J, Westerlund T, Oksa
Med Sci Sports 1996; 6:193-200. 2013; 8:e72658. J, Nieminen R, Moilanen E et al. Acute and
7. Lubkowska A, Chudecka M, Klimek A, 15. Leppäluoto J, Westerlund T, Huttunen P, long-term effects of winter swimming
Szyguła Z, Fraczek B. Acute effect of a Oksa J, Smolander J, Dugué B et al. Effects and whole-body cryotherapy on plasma
single whole-body cryostimulation or of long-term whole-body cold exposures antioxidative capacity in healthy women.
prooxidant-antioxidant balance in blood on plasma concentrations of ACTH, beta- Scand J Clin Lab Invest 2005; 65:395-402.
of healthy, young men. J Therm Biol 2008; endorphin, cortisol, catecholamines and
33:464-467. cytokines in healthy females. Sca J Clin
8. Pournot H, Bieuzen F, Louis J, Mounier R, Lab Invest 2008; 68:145-153.
Christophe Hausswirth, Ph.D.
Fillard JR, Barbiche E et al. Time-course of Lubkowska A, Szyguła Z. Changes in
16. Head of the Research Department
changes in inflammatory response after blood pressure with compensatory heart
whole-body cryotherapy multi exposures Director of the Laboratory of Sport,
rate decrease and in the level of aerobic
following severe exercise. PLoS One 2011; Expertise and Performance
capacity in response to repeated whole-
6: e22748. body cryostimulation in normotensive, INSEP – French National Institute of Sport,
9. Vaile J, O'Hagan C, Stefanovic B, Walker young and physically active men. Int J Expertise and Performance
M, Gill N, Askew CD. Effect of cold Occup Med Environ Health 2010; 23:367- Paris, France
water immersion on repeated cycling 375. Contact: [email protected]

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