Whole body cryotherapy with the cold chamber icelab -110 °C

Cold Therapy Health, warmly recommended.

Zimmer MedizinSysteme

Impulses for medicineWith more than 40 years experience, Zimmer MedizinSysteme is a leading supplier of systems solutions in cardiovascular diagnostics and physical therapy. As a medium-sized company we cultivate a special culture of close relationships with clients and employees. And it is exactly this that makes a decisive difference to our partners.

The CompanyWe use our competence and drive to promote human health, and in doing this we take our bearings equally from medical science, modern technology and the user’s needs. We pursue these principles with a wealth of ideas and commitment – and we have been doing so ever since the company was founded in 1969.

Zimmer MedizinSysteme

Research & DevelopmentWe have always held research and development in the highest regard. Each of our products is developed in strict accordance with scientific principles while still being based on clinical use. Close collaboration with universities and technology institutes distinguishes us as much as our habit of always peeking over the user’s shoulder. Scientific studies and practical experience complement each other to provide additional benefits for our clients in their everyday work routine.Medical advances, reliable technology, good design, user friendliness and an excellent standard of customer service are the typical features of all our systems. Made in GermanyWe are an independent medium-sized company located in Germany, with our headquarters in the innovative region of Ulm / Neu-Ulm. We consider certification of our company to be simply an outward expression of our quality-conscious mentality. All employees are obliged to follow our quality management plan, which covers everything from product development in our facilities to on-site client service. The legendary durability of Zimmer products is final add-on benefit for our clients in hospitals and practices.

Cold & Healthfulnessa well known context

- Hippokrates (460-377 v. Chr.)Natural cold mediators to strive for a pain-free state in operated area - French and German surgeons use ice and snow applications for amputation patients to reduce pain due to inflammations in military hospitals - 1853 – Development of an hand-operated compressor, with ether-air mixture was applied on the skin for analgesia prior to surgery - Msgr. Sebatian Kneip (1821 -1907)He spoke vehemently in favour of short and vigorous baths and gushes „the shorter the bath, the better the effect. Whoever remains for a minute in a cold bath, acts more sensibly and more surely than the one who remains inside for five minutes”. He recommended cold full baths for “hardening” and treating “febrile disease”, cold foot baths against sleeplessness … and 0.5-1 minute long half-filled baths for “chronic joint rheumatism”. This applications, can be seen as the precursor of today’s modern whole body cryotherapy…

History

T. Yamauchi (1980)The Japanese pioneer introduced the first whole body cryotherapy as treatment for rheumatoid arthritis Professor Reinhard Fricke (1984)German rheumatologist Fricke, having already extensive clinical experience with local cryotreatment, in 1984 he commissioned the first cryotherapy chamber outside Japan. Today whole body cryotherapy is accepted in the whole of Europe and beyond. Since the 1980’s a multitude of research has validated many additional fields of application for cryotherapy

History

References:

Platen, M.: Die Neue Heilmethode (Neubearbeitung). Deutsches Verlagshaus Bong u. Co., Berlin, Leipzig, Wien, Stuttgart, 1907, 1. Bd.Prof. Dr. sc. Med. Papenfuß, W.: Power from the Cold, Whole body cryotherapy at -110°C. Edition k, holder: Friedrich Kehrer, Regensburg, 2006, 1. edition in EnglishYamauchi, T.: Whole body Cryotherapy is a method of extreme cold -175°C treatment initially used for Rheumatoid Arthritis. Z.phys.Med.Klimatol. 15 (1986), S.311Fricke, R.: Lokale Kryotherapie und Ganzkörperkältetherapie bei -110°C. Vortrag Deutsche Kälte-Klima-Tagung, 1993

icelab -110°C whole body cryotherapy applications

In the next two chapters the content is lent mainly from Prof. Dr. sc. Med. Papenfuß, W.: Power from the Cold, Whole body cryotherapy at -110°C. Edition k, Regensburg, Wolfsegg, 2006

temperaturesduring whole body applications

temperature e levels and therapeutic effectiveness

-160 °C effective, butunnecessary

-110 °C to therapeutically-100 °C necessary level

-80 °C to therapeutic effect-60 °C unproved

Active Components of Whole BodyCryotherapy

• Relieves pain

• Inflammation inhibition, immunomodulation• Effect on skeletal musculature (regulation of tone, improvement in

circulation and metabolism, modification of neural activation)

• Improves the use and range-of-motion of affected joints and muscles

• Reduces / eliminates the itching and diminishes the skin changes associated with certain types of dermatitis.

• Regulation of the central activity level, psycho-physical performance enhancement, improvement of well being.

Indications

• Inflamed and degenerative rheumatic joint diseases (rheumatoid arthritis, Bekhterev’s disease)

• Degenerative-rheumatic diseases (osteoarthritis of large and small joints, also before and after endoprostetic treatment, postoperative edemas)

• Cervical and lumbar vertebral syndrome (discopathies, lumbago, ischia syndrome), also pre- and postoperatively

• Chronic pain states, primary headaches, pain and stress processing defects (fibromyalgia)

• Disturbed regulation of muscular tone (spastic) with infantile cerebral palsy, multiple sclerosis, muscular strains and hardening

• Blunt traumas of the joint and the musculature

• Psoriasis without and with joint participation

Indications

• Atopic dermatitis (neurodermatitis), bronchial asthma

• Signs of muscular fatigue

• Disruptions of equilibrium, disruptions in movement coordination

• Disruptions in central activity levels (central sign of fatigue, burn-out syndrome, sympathicotonic, parasmpathicotonic and depressive reaction states, non-organic and pain-conditioned chronic sleep disorders)

• Central psycho-physical deterioration in performance and ability

• Immune reaction disorders, caused by extreme muscular demands, age or stress-dependent functional constraints of the immune system

• Primary hypotonic circulation disorders

Contra-indications

• Untreated high blood pressure over 160/100 mmHg

• Heart attack within the last 6 months

• Severe heart insufficiency

• Circulatory disorders, arterial disorders

• Ultra-sensitive cold disorders

• Polyneuropathies

• Kidney and bladder disorders

• Heart rhythm irregularities

Pain elimination, prevention of development of pain memory and accelerated reduction of inflammation, resulting in:

• timely elimination of reflexive muscular inactivation• prevention of longer pain- and inflammation – induced restriction in mobility

of the afflicted joints• improvement in local muscular perfusion and with that muscular metabolism• improved recruitment of motor units• decrease in defects in proprioception• prevention of atrophies in the muscle and in the collagenous connective

tissue• reduction in the risk of subsequent injuries• reduction of convalescence periods / periods away from training

Psychological equilibrium and regulation of sleep behaviour

icelab-inSports

Examples of injury-dependent indications

• Contusions (bruises) and effusions in the musculature ( with reflexive and / or sudden inhibition of muscular activity)

• Contusions near the joints, distortions (with tendon overstretching) and inflammatory joint processes (with reflexive as well as sudden inhibition of muscular activity)

• Painful tendon attachments (with accompanying inflammatory processes)• States following injury-conditioned surgical interventions, particularly at large joints• Reflexive muscle strains/hardening as a result of inflammation and pain• Muscular dysbalances and differences between the sides• Cramped and arrhythmic movements with impairment of respiratory function• Reactive psychological impairments, sleep disorders

icelab-inSports

• Recreation & relaxation• Versatile mental & physical prophylaxis• Regeneration & stress relief• Increase of motivation

icelab-inSpa

Whole Body Cryotherapy Conditions

Chambers: 2- or 3-chamber system-10 °C, -60 °C, -110 °C

Therapeutic temperature e: -110 °C to -115 °C

Therapy frequency: 1 – 3 applications / day & user

Exposure duration: 1,5 – 3 minutes

Number of Depending on indications, exposures: normally 20 – 40

Clothing: Commercially available bathing suit

Protection: Breathing and appendage protection

Medical basis of therapy according to Prof. Papenfuß

WBC as Adaption Therapy with pain treatment as example

Whole Body Cryotherapy

Repeated stimulus effects on neural structures in the body periphery

Establishment of homoeostasis in the interaction between peripheral and central nervous structures participating in the detection and pain

stimuli (pain perception)

Induction of a short-run inhibition in pain stimulus transmission

Initiation of longer-term processes for physiological regulation of pain processing

WBC as Means for Deleting Pain Memory (counter irritation)

Severe irritation of the cold sensors

Lasting pain freedomInduction of operant pain learning processesRegulation of inner feelingsResolution of social conflicts

Thermal excitation of the Aδ-afferents

Desensitization of the spinal cord neurons

Induction of inhibitory processes involved in pain stimulation (nociceptors) and propagation of pain stimuli to the brain

Desensitization of brain structures participating in the development of a pain memory

Reduction / elimination of the chronic pains

Application of WBC with Inflammation

Systemic / nerve-reflective mechanism of action of WBC

Modification of protective processes through interaction between nociception, thermoreception, inflammation and central-nervous processes

Regression of edemaPain reliefFunctional improvementReduction in autoaggression

Desensitization of nociceptors

Reduction of inflammations – dependent hyperperfusion through vasoconstriction (vascular toning)

Reduction of metabolismReduction of enzyme activity

Reduction in formation / release and inactivation of local inflammatory mediators and neurotransmitters

Reduction in muscular tone

Regulation of the CNS activity level.Influencing of components of the immune system

Immunomodulation

Regulation of stress processing and sleep behaviour

Reduction in neurogenic release of inflammatory mediators

Targets of WBC with Fibromyalgia

WBC

PainPain memory

Disrupted muscle relaxation increased tendency for muscular fatigue

Disruption of central activity level,sleep disorders and depressive moods

Disrupted muscular relaxationIncreased tendency for muscular fatigue

Orthostatic regulatory disruption

Organic causes with secondary fibromyalgia, also spinal diseases, inflammatory-rheumatic diseases, psoriasis

Components of Osteoarthritis & Effects of WBC

Whole body cryotherapy

Improvement in nutrient and oxygen supply to cartilage cells (feedback effect due to promotion of joint mobility)

Wear signs in the joint cartilage

Promoting factors

Induction of chronic inflammatory processes Restriction of chronic inflammation

Pain relief / elimination Interruption of the development of a pain memory

Chronic pains

Impairment of muscular and connective tissue functions

Mobility restrictions

Improvement in perfusion / Regulation of muscular tone / Elimination of defects in proprioception and with that improvement in unsure gaits and coordination defects

Reduction / elimination of blockade of diseased joints caused by inflammation and pain

Chronic pains as an indication for WBC

NotesPain denotation

Therapy is indicated. Counter irritation. Reserve judgment with anamnestic signs of a cold-reactive pain reinforcement. Interruption with cold incompatibility or pain reinforcement. Combination with relaxation exercises is advisory, endurance exercises / sport with migraine. If pain reinforcement occurs directly in response to cold further diagnostics are advised! Cluster headache: cold preferred with secondary chronic cluster headache. No whole body cryotherapy for cluster affliction and migraine attack.For medication-induced headache medications should be stopped before the cold application. No headache treatment by whole body cold application without medical supervision! Cold therapy for prophylactic reasons may be useful.

Counter-irritation. Muscle detoning. Combination with active mobilization therapy programs.

Restriction of the inflammatory processes.Improvement in mobility.

Counterirritation possible. The stump does not have to be exposed directly to the cold action.

Pain treatment and improvement in mobility are primary aspects. Check that the patient has a secure gait in the cryochamber.!Do not permit excessive burdening after pain reduction!

Primary headachesTension headacheCluster headacheCervicogenic headacheMigraineMedication- included headacheCombination headache(tension headache and migraine)

Back pains without organic findings

Pains after operations on the postural and locomotory apparatus

Phantom and stump pains

Primary osteoporosis

Post-traumatic pathophysiology relevant for cryotherapy

Trauma (joints, soft parts, surgical intervention)

Inflammatory reaction in the injured areaDestruction of tissue integrityDisrupted blood supply in the capillary areasIncrease in vascular permeability towards fluids and protein bodiesCellular inflammatory reactionDisrupted oxygen supply

Edema, pain, disorders in tissue metabolism

Reflexive / sudden inhibition of muscular activity

Immobilizationn

Danger of a lasting- Reflexive / sudden inhibition of musculature with threatening atrophy,- muscular dysbalances and difference between the two body halves,- coordination defects,- functional reduction in the connective tissue with a loss in elasticity and tissue degradation,- chronic pains and- psychological alteration.

DefectiveProprioception Connective tissue functions

WBC and psycho-physical enhancement of performance

Whole body cold exposure

Improvement in cardio-vascular performance

Increase in muscular perfusion, optimization of muscular metabolism, activation of motor units

Adaptation of body temperature regulation

Regulation of central activity level

Muscular resistance to fatigue

Muscular capacity to regenerate

Muscular performance

Energy consumption for cooling

Energy supply for sporting activities

Psycho-physical stability

Possible targets of WBC: immune disorders caused by high psycho-physical demands

Muscle perfusion

Accelerated removal of metabolic products from the musculature

Regulation of the Central activity level

Sleep behaviourStress processing

Reduced filling of stress hormones

Effects of whole body cold application

Improvement in the capacity to regenerate

Shortening / acceleration / prevention of the first phase of immune defence (activity of macrophages and inflammatory initiators

Prevention of repeated interruptions between the first and second phases of immune defence and the long-lasting immunological disorder (specific B- and T-lymphocyte activity)

The Product: icelab -110°C

icelab -110 °C Measurements

6,00m

2,8m

2,1m

Maximum abatement of floor by 13 cm (lower step to enter)

0,5m distanceforexternal fans

4,80m

2,8m

2,1m

icelab -110 °C Measurements

Maximum abatement of floor by 13 cm (lower step to enter)

0,5m distanceforexternal fans

Advantages of 3-chamber system

• Low energy consumption• Constant therapy temperature e at -110°C• No icing and less snow appearance• Virtually no fog• Less cooling time required - between therapy applications

Safety First !

Potential icelab-Operators

Potential Operator Segments

Principally you can divide the market in three customer segments, plus others. • icelab-MEDICAL• icelab-inSpa• icelab-inSports

icelab-MEDICAL

• Hospitals, clinics, rehabilitation, rheumatologic centres, doctors practice, … • Health establishments, health resorts (esp. focused on pain, rheumatism,

asthma)• Institution for handicapped• Self-help organisations and groups

icelab-inSports

• Sports medicine (sports injuries, rehabilitation centres …)• Peak Sports (Clubs, training installations …)• Fitness Clubs

icelab-Med-Wellness

• Spa & Med, Spa, luxury hotels• Beauty facilities and institutions• Highly frequented pools, hot springs, metropolitan areas and

holiday destinations …

Thank you very much for your attention!

Your icelab-Team / Zimmer MedizinSysteme

Contact: icelab@zimmer.de