{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:54:14Z","timestamp":1792684454345,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Integrative and Complementary Medicine"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by pain, stiffness, and progressive joint deformities. While pharmacological treatments remain the standard approach, adjunct therapies like whole-body cryotherapy (WBC) have gained attention for their potential benefits in reducing pain and inflammation. However, the effectiveness of WBC in AS remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A systematic search was conducted in PubMed, Scopus, Web of Science, and Embase for studies published up to November 2024. The study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO (CRD42024620792). Primary outcomes included disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score [ASDAS]) and pain intensity (VAS), while secondary outcomes assessed function (Bath Ankylosing Spondylitis Functional Index [BASFI]) and inflammation (C-reactive protein [CRP]). Effect sizes were calculated using Cohen\u2019s d, with heterogeneity evaluated through Cochrane\u2019s Q-test and Tau\n                      <jats:sup>2<\/jats:sup>\n                      variance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Five studies involving 310 patients met the inclusion criteria. Tau-squared was estimated as zero, indicating a common effect size across studies with no dispersion of true effects. Intervention protocols varied in temperature (\u221260\u00b0C to \u221210\u00b0C) and session duration (80 sec to 3 min). WBC significantly improved BASDAI (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), ASDAS (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.015), BASFI (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.006), and VAS pain scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.005), demonstrating a strong therapeutic effect. However, no significant impact was observed on CRP levels (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.684).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>WBC significantly improved pain, function, and disease activity in patients with AS. As a promising nonpharmacological adjunct therapy, further research is needed to optimize protocols and evaluate its tolerance and long-term efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27683605251385396","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T05:28:50Z","timestamp":1760419730000},"page":"134-142","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of Whole-Body Cryotherapy in Ankylosing Spondylitis: A Systematic Review with Meta-Analysis"],"prefix":"10.1177","volume":"32","author":[{"given":"Olfa","family":"Saidane","sequence":"first","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selma","family":"Bouden","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwar","family":"Ben Dhia","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Rouached","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawdha","family":"Tekaya","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aicha","family":"Ben Tekaya","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadli","family":"Dziri","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Abdelmoula","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia."},{"name":"Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000475"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00761-z"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14070"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2019.08.004"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-013-2280-9"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2017.10.011"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.07.013"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/409174"},{"issue":"3","key":"e_1_3_4_10_2","first-page":"295","article-title":"Effectiveness of different cryotherapies on pain and disease activity in active rheumatoid arthritis: A randomized single blinded controlled trial","volume":"24","author":"Hirvonen HE","year":"2006","unstructured":"Hirvonen HE, , Mikkelsson MK, , Kautiainen H, et al. 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