Background Cold therapies are a widely used self-care method among patients with arthritis, as an adjunct therapy. Several studies with cold administered locally or as a whole-body treatment have shown positive effects to pain (1) and general well-being (2). A new method for whole-body cold treatment has been introduced.
Objectives To evaluate the effects of a new cold treatment method on pain, sleep quality and mental status in the rehabilitation of inflammatory arthritis.
Methods 208 patients with inflammatory arthritis who participated three times in 5-day institutional rehabilitation groups in 2013-2014 (Rehabilitation Center Apila, Finland) where asked to participate in the study. The number of volunteers was 156 (75%). 121 participants (91 female) completed the study. The diagnoses of the patients were rheumatoid arthritis (65), spondylarthritis (44) and psoriatic arthritis (12). All the participants took part in the multidisciplinary rehabilitation program of the institution. Half of them were in treatment groups at the first period and in control groups half a year later at the second period, and vice versa. The cold treatment was carried out with Amandan-device (3) twice a day. Pain and sleep quality were assessed by a ten centimeter visual analogue scale (VAS). Mental status was assessed by DEPS (4) depression score. Body temperature, blood pressure, heart rate, use of occasional pain and sleep medication were recorded.
Results Mean skin temperature at sternum skin before and immediately after treatment was 34,8 C and 26,7 C, respectively. No difference was found in blood pressure and heart rate between treatment and control periods during the study. The mean pain (VAS) value was 3.4 at start in both periods. The differences in pain (VAS) between treatment and control periods were significant (2.0 vs 2.4, p=0.034 paired t-test) in the last measurement, when assessing the pain of the passed week as a whole. A trend can be seen to an increasing difference towards the end of the week (Fig.). There was a trend for a better sleep quality (VAS) during the treatment period (2.3 vs 2.7, p=0.058 paired t-test) when assessed the passed week as a whole. The mean depression scale (DEPS) values showed no difference between the periods (5.5 vs 5.0, p=0.1874 paired t-test, at start, and 4.5 vs 4.1 p=0.29 paired t-test, at the end). The last day 16%, 47%, 17% and 1% of the participants found the treatment very pleasant, pleasant, unpleasant or very unpleasant, respectively. No significant side effects were recorded.
Conclusions The new whole-body cold treatment method seems to offer a safe and effective option for pain self-treatment at home. Further study is needed to find out the effects on arthritis patients after a longer use.
Guillot X, Tordi N, Mourot L, Demougeot C, Dugué B, Prati C, Wendling D. Cryotherapy in inflammatory rheumatic diseases: a systematic review. Expert Rev Clin Immunol. 2014 Feb;10(2):281-94.
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Amandan is a new Finnish innovation for supplying cold therapy at home. It is equipped with nozzles which disperse water to mist particles. (www.amandan.fi).
Salokangas, R. K. R., Poutanen, O. and Stengård, E. (1995), Acta Psychiatrica Scandinavica, 92: 10–16.
Disclosure of Interest None declared