全身冷冻疗法(-110℃)对赛艇运动员体温及心血管系统参数的影响
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摘要
目的:研究全身冷冻疗法(WBC,-110℃)对赛艇运动员体温及心血管系统参数的影响以及体重指数(BMI)与总体表温度平均变化幅度(ΔT_(sk))是否存在相关性,评估WBC(-110℃)的安全性、有效性及影响因素。方法:30名男子赛艇运动员(21.9±3.9岁)和30名女子赛艇运动员(22.6±3.3岁)在-10℃和-60℃准备仓分别预适应30 s,然后进入-110℃干预仓暴露120 s,出仓后静坐于室温20℃的休息室自然复温30 min。测量和记录安静状态,WBC后即刻、5 min、15 min和30 min的体表不同部位温度、核心温度(口腔)、收缩压、舒张压和心率的变化。结果:(1)单次WBC(-110℃,120 s)后,所有受试者WBC后即刻、WBC后5 min、15 min和30 min的前额、上臂、前臂、股四头肌、腓肠肌及总体表温度均非常显著性低于WBC前(P<0.01);WBC后即刻记录到的最低体表温度部位是腓肠肌(10.7℃±4.9℃);女性受试者的总体表温度平均变化幅度(ΔT_(sk))大于男性(P<0.01)。单次WBC(-110℃,120 s)后核心温度(口腔)无显著性变化(P>0.05)。(2)ΔT_(sk)与总样本BMI存在负相关(r=-0.153,P<0.01);双变量的回归方程为ΔT_(sk)=27.3-0.54*BMI。(3)男性受试者单次WBC(-110℃,120 s)后即刻收缩压和舒张压急剧升高(P<0.01),WBC后5 min开始呈现下降趋势,WBC后30 min仍低于安静基础值(P<0.01)。女性受试者WBC后即刻收缩压和舒张压急剧升高(P<0.01),WBC后5 min收缩压开始呈现下降趋势,WBC后30 min仍低于安静基础值(P<0.01);但舒张压回落至安静基础值后不再发生变化(P>0.05)。(4)男性受试者单次WBC(-110℃,120 s)WBC后即刻心率出现明显下降(P<0.01),下降幅度为7.0±5.2次/分;WBC后继续呈下降趋势,WBC后30min仍低于安静基础值(P<0.01)。女性受试者WBC后即刻心率出现明显升高(P<0.01),升高幅度为7.3±4.7次/分;WBC后5 min开始呈下降趋势,WBC后30 min仍低于安静基础值(P<0.01)。结论:单次WBC(-110℃,120 s)能导致体表温度快速下降,女性赛艇运动员降温效果优于男性,该方法导致冻伤的危险性极小。BMI是影响WBC干预效果的重要因素之一,在选择干预方案时应充分考虑到人群体成分的差异因素。WBC升高血压作用持续时间较短,不会对血压正常的健康人群造成危害。受试者的性别、训练年限和竞技水平等可能会影响WBC干预后心率变化趋势。
Objective To investigate the impact of whole-body cryotherapy(-110℃) on thermal responses and circulatory parameters in rowing athletes and evaluate the safety,effect and influence factors of WBC(-110 °C) through looking for the correlation between the body mass index(BMI) andmean change range of the body surface temperature(Δ Tsk).MethodsSixty rowing athletes were included in the study,with 30 men(21.9 ± 3.9 years old) and 30 women(22.6 ± 3.3 years old). Subjects were preconditioned at chamber at-10℃ and-60℃ for 30 s separately,and then exposedto-110℃ for 120 s,followed by 30 min sitting at the rest room at 20 ℃ for natural re-warming.Skin temperatures in various places on the body and core temperature(oral) were measured at rest andthen immediately after the WBC as well as 5,15 and 30 minutes later. The systolic blood pressure,diastolic blood pressure and heart rate were recorded at the same time.ResultsThe forehead,upper arm,forearm, quadriceps, gastrocnemius and total surface temperature of all subjects immediately afterWBC,as well as 5,15 and 30 min after WBC were significantly lower than those before WBC(P<0.01). The lowest local skin temperature was in the calf(10.7℃ ± 4.9℃) immediately after WBC; theΔTskof female subjects was greater than males '(P<0.01). However,the acute WBC(-110 ℃,120 s) did not cause any significant changes in the core temperature(oral)(P>0.05). A negative correlation was found between the total sample BMI and Δequation for the bivariate being ΔTsk=27.3-0.54*BMI. The systolic and diastolic blood pressure of themale increased rapidly immediately after the acute WBC(-110 ℃,120 s)(P<0.01),and began toshow a downward trend 5 minutes laterlater(P<0.01). The systolic and diastolic blood pressure of the female increased rapidly immediately after acute WBC(-110 ℃,120 s)(P<0.01) too,and the systolic blood pressure began to show adownward trend 5 minutes later,and was lower than the baseline value 30 minutes later(P<0.01),but the diastolic blood pressure no longer changed after dropping to the baseline value(P>0.05). Theheart rate decreased significantly(P<0.01) in the male subjects after an acute WBC(-110 ℃,120 s) at 7.0 ± 5.2 beats/min; it continued to show a downward trend after WBC,and was lower than thebaseline value 30 min after(P<0.01). The heart rate of the female subjects increased significantly immediately after WBC(P<0.01) at 7.3 ± 4.7 beats/min,beginning to decrease five minutes later andlower than the baseline value 30 minutes later(P<0.01).ConclusionAn acute WBC(-110 ℃,120 s) can induce a rapid decrease in the body surface temperature,with better effects on the female rowing athletes than the male,but hardly to cause the cold injury. BMI is one of the important factors affecting the effect of WBC. The body composition should be fully considered when choosing the WBC intervention program. The duration of WBC elevating blood pressure is short and it is harmless to peoplewith the normal blood pressure. The gendermay affect the changing trend of the heart rate after WBC.
Objective To investigate the impact of whole-body cryotherapy(-110℃) on thermal responses and circulatory parameters in rowing athletes and evaluate the safety,effect and influence factors of WBC(-110 °C) through looking for the correlation between the body mass index(BMI) andmean change range of the body surface temperature(Δ Tsk).MethodsSixty rowing athletes were included in the study,with 30 men(21.9 ± 3.9 years old) and 30 women(22.6 ± 3.3 years old). Subjects were preconditioned at chamber at-10℃ and-60℃ for 30 s separately,and then exposedto-110℃ for 120 s,followed by 30 min sitting at the rest room at 20 ℃ for natural re-warming.Skin temperatures in various places on the body and core temperature(oral) were measured at rest andthen immediately after the WBC as well as 5,15 and 30 minutes later. The systolic blood pressure,diastolic blood pressure and heart rate were recorded at the same time.ResultsThe forehead,upper arm,forearm, quadriceps, gastrocnemius and total surface temperature of all subjects immediately afterWBC,as well as 5,15 and 30 min after WBC were significantly lower than those before WBC(P<0.01). The lowest local skin temperature was in the calf(10.7℃ ± 4.9℃) immediately after WBC; theΔTskof female subjects was greater than males '(P<0.01). However,the acute WBC(-110 ℃,120 s) did not cause any significant changes in the core temperature(oral)(P>0.05). A negative correlation was found between the total sample BMI and Δequation for the bivariate being ΔTsk=27.3-0.54*BMI. The systolic and diastolic blood pressure of themale increased rapidly immediately after the acute WBC(-110 ℃,120 s)(P<0.01),and began toshow a downward trend 5 minutes laterlater(P<0.01). The systolic and diastolic blood pressure of the female increased rapidly immediately after acute WBC(-110 ℃,120 s)(P<0.01) too,and the systolic blood pressure began to show adownward trend 5 minutes later,and was lower than the baseline value 30 minutes later(P<0.01),but the diastolic blood pressure no longer changed after dropping to the baseline value(P>0.05). Theheart rate decreased significantly(P<0.01) in the male subjects after an acute WBC(-110 ℃,120 s) at 7.0 ± 5.2 beats/min; it continued to show a downward trend after WBC,and was lower than thebaseline value 30 min after(P<0.01). The heart rate of the female subjects increased significantly immediately after WBC(P<0.01) at 7.3 ± 4.7 beats/min,beginning to decrease five minutes later andlower than the baseline value 30 minutes later(P<0.01).ConclusionAn acute WBC(-110 ℃,120 s) can induce a rapid decrease in the body surface temperature,with better effects on the female rowing athletes than the male,but hardly to cause the cold injury. BMI is one of the important factors affecting the effect of WBC. The body composition should be fully considered when choosing the WBC intervention program. The duration of WBC elevating blood pressure is short and it is harmless to peoplewith the normal blood pressure. The gendermay affect the changing trend of the heart rate after WBC.
引文
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[2] Bleakley CM,Bieuzen F,Davison GW,et al. Whole-bodycryotherapy:empirical evidence and theoretical perspectives[J]. Open access J Sports Med,2014,5:25-36.
[3] Zalewski P,Klawe JJ,Pawlak J,et al. Thermal and hemodynamic response to whole-body cryostimulation in healthy subjects[J]. Cryobiology,2013,66(3):295-302.
[4]周超彦,冯连世,韩照岐,等.全身冷冻疗法在运动医学中的应用研究进展[J].中国运动医学杂志,2012,31(1):82-87.
[5] Rymaszewska J,Tulczynski A,Zagrobelny Z,et al. Influence of whole body cryotherapy on depressive symptoms–preliminary report[J].Acta Neuropsychiatr,2003,15(3):122-128.
[6] Hirvonen H,Mikkelsson M,Kautiainen H,et al. Effectiveness of different cryotherapies on pain and disease activity in active rheumatoid arthritis. A randomised single blinded controlled trial[J]. Clin Exp Rheumatol,2006,24(3):295-301.
[7] Banfi G,Lombardi G,Colombini A,et al. Whole-bodycryotherapy in athletes[J]. Sports Med,2010,40(6):509-517.
[8] Miller E,Mrowicka M,Malinowska K,et al. Effects of thewhole-body cryotherapy on a total antioxidative status and activities of some antioxidative enzymes in blood of patients withmultiple sclerosis-preliminary study[J]. J Med Invest,2010,57(1,2):168-173.
[9] Hausswirth C, Louis J, Bieuzen F, et al. Effects ofwhole-body cryotherapy vs. far-infrared vs. passive modalities on recovery from exercise-induced muscle damage inhighly-trained runners[J]. Plos One, 2011, 6(12):e27749.
[10] Hausswirth C,Schaal K,Le Meur Y,et al. Parasympatheticactivity and blood catecholamine responses following a singlepartial-body cryostimulation and a whole-body cryostimulation[J]. Plos One,2013,8(8):e72658.
[11] Fonda B,De Nardi M,Sarabon N. Effects of whole-bodycryotherapy duration on thermal and cardio-vascular response[J]. J Therm Biol,2014,42:52-55.
[12] Savic M,Fonda B,Sarabon N. Actual temperature duringand thermal response after whole-body cryotherapy in cryo-cabin[J]. J Therm Biol,2013,38(4):186-191.
[13] Lepp?luoto J,Westerlund T,Huttunen P,et al. Effects oflong-term whole-body cold exposures on plasma concentrations of ACTH,beta-endorphin,cortisol,catecholaminesand cytokines in healthy females[J]. Scand J Clin Lab Inv,2008,68(2):145-153.
[14] Savalli L,Olave P,Sendin M,et al. Whole-body cryotherapy-110°C. Measure of skin and central temperature to thesportsman[J]. Sci ET Sports,2006,21(1):36-38.
[15] Smolander J,Westerlund T,Uusitalo A,et al. Lung functionafter acute and repeated exposures to extremely cold air(-110°C)during whole-body cryotherapy[J]. Clin Physiol FunctImaging,2006,26(4):232-234.
[16] Westerlund T,Oksa J,Smolander J,et al. Thermal responses during and after whole-body cryotherapy(-110°C)[J]. JTherm Biol,2003,28(8):601-608.
[17] D?biec-Bak A,Skrzek A,Podbielska H. Application of thermovision for estimation of the optimal and safe parameters ofthe whole body cryotherapy[J]. J ThermAnal Calorim,2013,111(3):1853-1859.
[18] Selfe J,Alexander J,Costello JT,et al. The Effect of ThreeDifferent(-135°C)Whole Body Cryotherapy Exposure Durations on Elite Rugby League Players[J]. Plos One,2014,9(1):e86420.
[19] Merrick MA,Jutte LS,Smith ME. Cold modalities with different thermodynamic properties produce different surface andintramuscular temperatures[J]. J Athl Training,2003,38(1):28-33.
[20] Costello JT,Culligan K,Selfe J,et al. Muscle,skin and coretemperature after-110°C cold air and 8°C water treatment[J].PlosOne,2012,7(11):e48190.
[21] Bleakley CM,Hopkins JT. Is it possible to achieve optimallevels of tissue cooling in cryotherapy?[J]. Phys Ther Rev,2010,15(4):344-350.
[22] Hammond LE,Cuttell S,Nunley P,et al. Anthropometriccharacteristics and sex influence magnitude of skin coolingfollowing exposure to whole body cryotherapy[J]. Biomed ResInt,2014,628724:1-7.
[23] Westerlund T,Oksa J,Smolander J,et al. Thermal responses during and after whole-body cryotherapy(-110 C)[J]. JTherm Biol,2003,28(8):601-608.
[24] Sessler DI. Temperature monitoring:the consequences andprevention of mild perioperative hypothermia[J]. South Afr JAnaesth Analg,2014,20(1):25-31.
[25] Smolander J,Mikkelsson M,Oksa J,et al. Thermal sensation and comfort in women exposed repeatedly to whole-bodycryotherapy and winter swimming in ice-cold water[J]. PhysBehav,2004,82(4):691-695.
[26] Zalewski P,Bitner A,Slomko J,et al. Whole-body cryostimulation increases parasympathetic out flow and decreases corebody temperature[J]. J Therm Biol,2014,45:75-80.
[27] Brazaitis M,Eimantas N,Daniuseviciute L,et al. Timecourse of physiological and psychological responses in humans during a 20-Day Severe-Cold–Acclimation programme[J]. PlosOne,2014,9(4):e94698.
[28] Ouellet V,LabbéSM,Blondin DP,et al. Brown adipose tissue oxidative metabolism contributes to energy expenditureduring acute cold exposure in humans[J]. J Clin Inv,2012,122(2):545-552.
[29] Otte JW,Merrick MA,Ingersoll CD,et al. Subcutaneous adipose tissue thickness alters cooling time during cryotherapy[J]. Arch Phys Med Rehab,2002,83(11):1501-1505.
[30] El-Brawany M,Nassiri D,Terhaar G,et al. Measurement ofthermal and ultrasonic properties of some biological tissues[J].J Med Eng Technol,2009,33(3):249-256.
[31] Lubkowska A,Suska M. The increase in systolic and diastolicblood pressure after exposure to cryogenic temperatures in normotensive men as a contraindication for whole-body cryostimulation[J]. J Therm Biol,2011,36(5):264-268.
[32] Lubkowska A,Szygula Z. Changes in blood pressure withcompensatory heart rate decrease and in the level of aerobiccapacity in response to repeated whole-body cryostimulationin normotensive,young and physically active men[J]. Int J Occup Med Environ Health,2010,23(4):367-375.
[33] Bonomi FG,De Nardi M,Fappani A,et al. Retraction note:impact of different treatment of whole-body cryotherapy oncirculatory parameters[J]. Arch Immunol Ther Exp,2012,60(5):401-401.
[34] Westerlund T,Smolander J,Uusitalo-Koskinen A,et al.The blood pressure responses to an acute and long-termwhole-body cryotherapy(-110°C)in men and women[J]. JTherm Biol,2004,29(6):285-290.
[35] Hodges GJ,Traeger JA,Tang T,et al. Role of sensory nervesin the cutaneous vasoconstrictor response to local cooling inhumans[J]. AM J Physiol Heart Circ Physiol,2007,293(1):784-789.
[36] Buchheit M,Simon C,Piquard F,et al. Effects of increasedtraining load on vagal-related indexes of heart rate variability:a novel sleep approach[J]. AM J Physiol Heart Circ Physiol,2004,287(6):2813-2818.
[37] Buchheit M,Voss S,Nybo L,et al. Physiological and performance adaptations to an in-season soccer camp in the heat:Associations with heart rate and heart rate variability[J].Scand J Med Sci Sports,2011,21(6):e477-e485.
[38] Buch AN,Coote JH,Townend JN. Mortality,cardiac vagalcontrol and physical training-what's the link?[J]. Exp Physiol,2002,87(4):423-435.
[39] Zalewski P,Tafil-Klawe M,Klawe J,et al. Influence of thewhole-body cryotherapy on the hemodynamic parameters inhealthy subjects[J]. Acta Bio-Optica Et Informatica Med,2009,15(3):209-214.
[40] Cappaert TA,Stone JA,Castellani JW,et al. National athletic trainers'association position statement:environmental coldinjuries[J]. J Athl Training,2008,43(6):640-658.
[2] Bleakley CM,Bieuzen F,Davison GW,et al. Whole-bodycryotherapy:empirical evidence and theoretical perspectives[J]. Open access J Sports Med,2014,5:25-36.
[3] Zalewski P,Klawe JJ,Pawlak J,et al. Thermal and hemodynamic response to whole-body cryostimulation in healthy subjects[J]. Cryobiology,2013,66(3):295-302.
[4]周超彦,冯连世,韩照岐,等.全身冷冻疗法在运动医学中的应用研究进展[J].中国运动医学杂志,2012,31(1):82-87.
[5] Rymaszewska J,Tulczynski A,Zagrobelny Z,et al. Influence of whole body cryotherapy on depressive symptoms–preliminary report[J].Acta Neuropsychiatr,2003,15(3):122-128.
[6] Hirvonen H,Mikkelsson M,Kautiainen H,et al. Effectiveness of different cryotherapies on pain and disease activity in active rheumatoid arthritis. A randomised single blinded controlled trial[J]. Clin Exp Rheumatol,2006,24(3):295-301.
[7] Banfi G,Lombardi G,Colombini A,et al. Whole-bodycryotherapy in athletes[J]. Sports Med,2010,40(6):509-517.
[8] Miller E,Mrowicka M,Malinowska K,et al. Effects of thewhole-body cryotherapy on a total antioxidative status and activities of some antioxidative enzymes in blood of patients withmultiple sclerosis-preliminary study[J]. J Med Invest,2010,57(1,2):168-173.
[9] Hausswirth C, Louis J, Bieuzen F, et al. Effects ofwhole-body cryotherapy vs. far-infrared vs. passive modalities on recovery from exercise-induced muscle damage inhighly-trained runners[J]. Plos One, 2011, 6(12):e27749.
[10] Hausswirth C,Schaal K,Le Meur Y,et al. Parasympatheticactivity and blood catecholamine responses following a singlepartial-body cryostimulation and a whole-body cryostimulation[J]. Plos One,2013,8(8):e72658.
[11] Fonda B,De Nardi M,Sarabon N. Effects of whole-bodycryotherapy duration on thermal and cardio-vascular response[J]. J Therm Biol,2014,42:52-55.
[12] Savic M,Fonda B,Sarabon N. Actual temperature duringand thermal response after whole-body cryotherapy in cryo-cabin[J]. J Therm Biol,2013,38(4):186-191.
[13] Lepp?luoto J,Westerlund T,Huttunen P,et al. Effects oflong-term whole-body cold exposures on plasma concentrations of ACTH,beta-endorphin,cortisol,catecholaminesand cytokines in healthy females[J]. Scand J Clin Lab Inv,2008,68(2):145-153.
[14] Savalli L,Olave P,Sendin M,et al. Whole-body cryotherapy-110°C. Measure of skin and central temperature to thesportsman[J]. Sci ET Sports,2006,21(1):36-38.
[15] Smolander J,Westerlund T,Uusitalo A,et al. Lung functionafter acute and repeated exposures to extremely cold air(-110°C)during whole-body cryotherapy[J]. Clin Physiol FunctImaging,2006,26(4):232-234.
[16] Westerlund T,Oksa J,Smolander J,et al. Thermal responses during and after whole-body cryotherapy(-110°C)[J]. JTherm Biol,2003,28(8):601-608.
[17] D?biec-Bak A,Skrzek A,Podbielska H. Application of thermovision for estimation of the optimal and safe parameters ofthe whole body cryotherapy[J]. J ThermAnal Calorim,2013,111(3):1853-1859.
[18] Selfe J,Alexander J,Costello JT,et al. The Effect of ThreeDifferent(-135°C)Whole Body Cryotherapy Exposure Durations on Elite Rugby League Players[J]. Plos One,2014,9(1):e86420.
[19] Merrick MA,Jutte LS,Smith ME. Cold modalities with different thermodynamic properties produce different surface andintramuscular temperatures[J]. J Athl Training,2003,38(1):28-33.
[20] Costello JT,Culligan K,Selfe J,et al. Muscle,skin and coretemperature after-110°C cold air and 8°C water treatment[J].PlosOne,2012,7(11):e48190.
[21] Bleakley CM,Hopkins JT. Is it possible to achieve optimallevels of tissue cooling in cryotherapy?[J]. Phys Ther Rev,2010,15(4):344-350.
[22] Hammond LE,Cuttell S,Nunley P,et al. Anthropometriccharacteristics and sex influence magnitude of skin coolingfollowing exposure to whole body cryotherapy[J]. Biomed ResInt,2014,628724:1-7.
[23] Westerlund T,Oksa J,Smolander J,et al. Thermal responses during and after whole-body cryotherapy(-110 C)[J]. JTherm Biol,2003,28(8):601-608.
[24] Sessler DI. Temperature monitoring:the consequences andprevention of mild perioperative hypothermia[J]. South Afr JAnaesth Analg,2014,20(1):25-31.
[25] Smolander J,Mikkelsson M,Oksa J,et al. Thermal sensation and comfort in women exposed repeatedly to whole-bodycryotherapy and winter swimming in ice-cold water[J]. PhysBehav,2004,82(4):691-695.
[26] Zalewski P,Bitner A,Slomko J,et al. Whole-body cryostimulation increases parasympathetic out flow and decreases corebody temperature[J]. J Therm Biol,2014,45:75-80.
[27] Brazaitis M,Eimantas N,Daniuseviciute L,et al. Timecourse of physiological and psychological responses in humans during a 20-Day Severe-Cold–Acclimation programme[J]. PlosOne,2014,9(4):e94698.
[28] Ouellet V,LabbéSM,Blondin DP,et al. Brown adipose tissue oxidative metabolism contributes to energy expenditureduring acute cold exposure in humans[J]. J Clin Inv,2012,122(2):545-552.
[29] Otte JW,Merrick MA,Ingersoll CD,et al. Subcutaneous adipose tissue thickness alters cooling time during cryotherapy[J]. Arch Phys Med Rehab,2002,83(11):1501-1505.
[30] El-Brawany M,Nassiri D,Terhaar G,et al. Measurement ofthermal and ultrasonic properties of some biological tissues[J].J Med Eng Technol,2009,33(3):249-256.
[31] Lubkowska A,Suska M. The increase in systolic and diastolicblood pressure after exposure to cryogenic temperatures in normotensive men as a contraindication for whole-body cryostimulation[J]. J Therm Biol,2011,36(5):264-268.
[32] Lubkowska A,Szygula Z. Changes in blood pressure withcompensatory heart rate decrease and in the level of aerobiccapacity in response to repeated whole-body cryostimulationin normotensive,young and physically active men[J]. Int J Occup Med Environ Health,2010,23(4):367-375.
[33] Bonomi FG,De Nardi M,Fappani A,et al. Retraction note:impact of different treatment of whole-body cryotherapy oncirculatory parameters[J]. Arch Immunol Ther Exp,2012,60(5):401-401.
[34] Westerlund T,Smolander J,Uusitalo-Koskinen A,et al.The blood pressure responses to an acute and long-termwhole-body cryotherapy(-110°C)in men and women[J]. JTherm Biol,2004,29(6):285-290.
[35] Hodges GJ,Traeger JA,Tang T,et al. Role of sensory nervesin the cutaneous vasoconstrictor response to local cooling inhumans[J]. AM J Physiol Heart Circ Physiol,2007,293(1):784-789.
[36] Buchheit M,Simon C,Piquard F,et al. Effects of increasedtraining load on vagal-related indexes of heart rate variability:a novel sleep approach[J]. AM J Physiol Heart Circ Physiol,2004,287(6):2813-2818.
[37] Buchheit M,Voss S,Nybo L,et al. Physiological and performance adaptations to an in-season soccer camp in the heat:Associations with heart rate and heart rate variability[J].Scand J Med Sci Sports,2011,21(6):e477-e485.
[38] Buch AN,Coote JH,Townend JN. Mortality,cardiac vagalcontrol and physical training-what's the link?[J]. Exp Physiol,2002,87(4):423-435.
[39] Zalewski P,Tafil-Klawe M,Klawe J,et al. Influence of thewhole-body cryotherapy on the hemodynamic parameters inhealthy subjects[J]. Acta Bio-Optica Et Informatica Med,2009,15(3):209-214.
[40] Cappaert TA,Stone JA,Castellani JW,et al. National athletic trainers'association position statement:environmental coldinjuries[J]. J Athl Training,2008,43(6):640-658.