Whole body cryotherapy (wbc) in the cold chamber icelab -110 °C

1. Whole body cryotherapy with the
cold chamber icelab -110 °C
Cold Therapy Health, warmly recommended.

2. Zimmer MedizinSysteme
Impulses for medicine
With 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 Company
We 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.

3. Zimmer MedizinSysteme
Research & Development
We 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 Germany
We 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.

4. Cold & Healthfulness
a 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…

5. 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

6. 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 English
Yamauchi, 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.311
Fricke, R.: Lokale Kryotherapie und Ganzkörperkältetherapie bei -110 C.
Vortrag Deutsche Kälte-Klima-Tagung, 1993

7. 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

8. temperatures
during whole body applications
temperature e levels and
therapeutic effectiveness
-160 C effective, but
unnecessary
-110 C to therapeutically
-100 C necessary level
-80 C to therapeutic effect
-60 C unproved

9. Active Components of Whole Body
Cryotherapy
• 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.

10. 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

11. 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

12. 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

13. 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

14. 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

15. • Recreation & relaxation
• Versatile mental & physical prophylaxis
• Regeneration & stress relief
• Increase of motivation
icelab-inSpa

16. 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

17. Medical basis of therapy
according to Prof. Papenfuß

18. 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

19. WBC as Means for Deleting Pain Memory
(counter irritation)
Severe irritation of the cold sensors
Lasting pain freedom
Induction of operant pain learning processes
Regulation of inner feelings
Resolution 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

20. 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 edema
Pain relief
Functional improvement
Reduction in autoaggression
Desensitization
of nociceptors
Reduction of inflammations –
dependent hyperperfusion through
vasoconstriction (vascular toning)
Reduction of metabolism
Reduction 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
Immunomodulation
Regulation of stress processing and
Reduction in
neurogenic release
of inflammatory
mediators

21. Targets of WBC with Fibromyalgia
WBC
Pain
Pain memory
Disrupted muscle relaxation
increased tendency for muscular fatigue
Disruption of central activity level,
sleep disorders and depressive moods
Disrupted muscular relaxation
Increased tendency for muscular fatigue
Orthostatic regulatory disruption
Organic causes with secondary fibromyalgia, also
spinal diseases, inflammatory-rheumatic

22. 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

23. 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 headaches
Tension headache
Cluster headache
Cervicogenic headache
Migraine
Medication- included headache
Combination 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

24. Post-traumatic pathophysiology
relevant for cryotherapy
Trauma (joints, soft parts, surgical intervention)
Inflammatory reaction in the injured area
Destruction of tissue integrity
Disrupted blood supply in the capillary areas
Increase in vascular permeability towards fluids and protein bodies
Cellular inflammatory reaction
Disrupted 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
Defective
Proprioception Connective tissue functions

25. 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

26. 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 behaviour
Stress 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)

27. The Product: icelab -110°C

28. icelab -110 °C Measurements
6,00m
2,8m
2,1m
Maximum abatement of floor by 13 cm (lower step to enter)
0,5m
distance
for
external
fans

29. 4,80m
2,8m
2,1m
icelab -110 °C Measurements
Maximum abatement of floor by 13 cm (lower step to enter)
0,5m
distance
for
external
fans

30. 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

31. Safety First !

32. Potential icelab-Operators

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

34. 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

35. 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 …

36. Thank you very much for your attention!
Your icelab-Team / Zimmer MedizinSysteme
Contact: icelab@zimmer.de