Research findings -5. Whole-body cryo
4 August 2020 / 3 comments

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Every month ProCcare extracts the new research studies on water immersion and whole-body cryotherapy. These studies are the basis of our literature database and form the foundation of our ProCcare method. In each newsletter, we provide an overview of the new research studies. Additionally, we offer exciting insights that assist implementation based on the findings of two studies that we selected from the list.

Study: Louis, J. et al. The use of whole-body cryotherapy: time- and dose-response investigation on circulating blood catecholamines and heart rate variability. Eur. J. Appl. Physiol. (2020) DOI:10.1007/s00421-020-04406-5.

Method: forty healthy males were divided in4 groups being exposed to 5 consecutive 1 time per day WBC exposure to either-10°C(14°F)/-60°C (-76°F)/-110°C (-166°F)/ ambient temperature while measuring heart rate variability and blood catecholamines.

Primary findings by the authors:

-Mean weekly heart rate variability (RMSSD & HF) increased from pre to post only in the -110°C/-166°F.

-Significant rise in norepinephrine was found only after the first session WBC at -110°C/-166°F

-One -110°C/-166°F session is required to stimulate the autonomic nervous system. After five daily exposures, a lower autonomic response was recorded compared to day one, suggesting the development of cold habituation to WBC.

Comments by Dr. William. G. Emendorfer, CEO of the Norspring center for rejuvenation (

I find the paper on the use of WBC: time and dose-response investigation on circulating blood catecholamines and heart rate variability very interesting. The paper seems to confirm what many cryotherapy operators have anecdotally assumed to be the case. We have depended on a drop in skin temperature, observation, and interview of the client to assume that we have achieved the desired effect. We have believed that a treatment of -110°C/-166°F for 3minutes achieved the desired results.

I find it interesting that the desired skin temperature drop is achieved using-110C for 3 minutes and not at -60C or -10C. This paper seems to confirm the need for the head to be included in the cryotherapy treatment to achieve the maximin results. I have held this belief for several years. The paper confirms that a single WBC (including the head) session for three minutes at -110°C/-166°F, with a skin temperature drop of 42%, achieves the desired effects to stimulate the autonomic nervous system (ANS). We observe Vagus nerve stimulation and a significant impact on both the sympathetic and parasympathetic nervous systems. This reaction to the decrease in skin temperature creates the magical effects of cryotherapy treatments. I was also intrigued by the findings that dealt with the scheduling of treatments before the competition to maximize the desired outcomes. In the past, I have scheduled treatments before a competition but not following these protocols. I intend to incorporate these scheduling practices with our clients, preparing for competition.

I would find it interesting to study WBC treatments at -60°C/-76°F and -85°C/-121°Ffor periods longer than three minutes that achieve a skin temperature drop of42%. I am interested in finding if this will achieve the same desired results at a milder temperature for more extended periods. This would be a significant finding for WBC for personal (in-home) use, in that most of these units are -85°C/-121°Fchambers.

How to apply these findings in practice  (byProCcare): A reduction in skin temperature is the trigger for a cascade of physiological reactions, including the impact on the parasympathetic activity. This skin temperature reduction needs to be in the range of 15°C-20°C (25-35°F), equaling a drop of approximately 35-40%. Only the -110°C/-166°F condition seems to sufficient to reach these temperatures decreases. It would very helpful if whole-body cryo research start focussing on the effect of different dosages and resultant effect as there are many different technologies out there reaching different temperatures: would, for example, an exposure of 4 minutes at -60°C/-76°Freach comparable effects as 3 minutes at -110°C/-166°F? Possibly using a dose measure combining the duration and temperature would help to standardize the dose and make comparisons possible. One way of calculating the dose could be:

Whole-body cryo dose = 1- (exposure temperature * exposure duration) / 10000

Exposure temperature Exposure duration WBC cryo dose
-110°C/-166°F 3 minutes 2,98
-60°C/ -76°F 3 minutes 2,08
-60°C/-76°F 4 minutes 2,44

Measuring skin temperature reduction using a thermal image is highly advisable to validate your protocol settings. Remember, each individual will respond differently based on factors like gender, body composition, skin type, etc. This means that protocol X might be sufficient for client A, but not for client B. Next, the protocol setting should be changed over time to prevent cold habituation. Although the physiological response will be similar, the response will be smaller due to cold habituation leading to more minor effects. Think about increasing the dose every second session by increasing the temperature a few degrees or increasing the treatment duration with 3-5 seconds. Helping your client requires continuously monitoring the results following each session and adapting the protocol settings as such, things we take into account with ourCustoRec® software.

Published studies in May/ June 2020:

  1. Aloulou, A. et al. Effect of an Innovative Mattress and Cryotherapy on Sleep after an elite Rugby Match. Med Sci Sports Exerc (2020)doi:10.1249/MSS.0000000000002403.
  2. Bogard, F. et al. Critical Evaluation of Whole-Body Cryostimulation Protocol in RaceHorses. J. Equine Vet. Sci. 88, 102944 (2020).
  3. Codella, R., Nardi, M. D., Delbarba, S., Facheris, C. & Luzi, L. 2022-P: Partial-BodyCryotherapy Acutely Augments Resting Metabolism in Obese Women. Diabetes69, (2020).
  4. Hammond, L., Mitchell, K. & Cuttell, S. Ventilatory responses to whole body cryotherapy.Journal of Thermal Biology 91, 102633 (2020).
  5. Louis, J. et al. The use of whole-body cryotherapy: time- and dose-response investigation on circulating blood catecholamines and heart rate variability. Eur. J. Appl. Physiol.(2020) DOI:10.1007/s00421-020-04406-5.
  6. Yerezhep, D., Minikaev, A., Zhignovskaia, D., Pronin, V. & Yerezhep, A. Numerical analysis of the heat flux density of the whole-body cryotherapy (WBC) object coming from the skin. IOP Conf. Ser.: Mater. Sci. Eng. 826,012019 (2020).
  7. Yerezhep, D., Minikaev, A., Zhignovskaia, D., Pronin, V. & Yerezhep, A. The study of thermal processes of the skin of the object of the whole-body cryotherapy (WBC)using numerical analysis. IOP Conf. Ser.: Mater. Sci. Eng. 826,012018 (2020).
  8. Vasilenok, A. V. et al. The cost of liquid nitrogen for WBCsessions. IOP Conf. Ser.: Mater.Sci. Eng. 826, 012014(2020).
  1. Was this study done using a cryo sauna or cryo chamber? LN2 or electric? I understand that most of the body’s thermo receptors are found in the upper body (head/neck area) but if thats the case, then why do I constantly see people getting into electric cryo chambers with shirts on, as well as a beanie cap covering their head/ears? Wouldn’t that lessen the effects of stimulation? Just curious about this. I utilize an Impact Cryo sauna and we recommend our athletes to have as much skin exposed as possible for the best effect and stimulation.

  2. Thanks for your comments and questions, Nick. The study was performed in a cryo-chamber (Zimmer- electric). They used the pre-room 1, which is at -10C, pre-room 2, which is at -60C, and the treatment room which is at -110C. During the study, the participants were wearing shorts and PPE, so no t-shirts, of which you are right: people should not be advised to wear t-shirts, it is indeed about exposing as much skin as possible during exposure. Hope this helps!

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