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Sports Medicine (Auckland, N.Z.) Jul 2022Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed... (Meta-Analysis)
Meta-Analysis
Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression.
BACKGROUND
Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations.
OBJECTIVES
The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations.
STUDY DESIGN
Systematic review with meta-analysis and meta-regression.
METHODS
A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables.
RESULTS
Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06-0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004-0.43]), and reduced serum CK (SMD - 0.85 [95% CI - 1.61 to - 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD - 0.89 [95% CI - 1.48 to - 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29-1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise.
CONCLUSION
CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose-response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise.
FUNDING
Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training.
PROTOCOL REGISTRATION
Open Science Framework: 10.17605/OSF.IO/SRB9D.
Topics: Athletic Performance; Cold Temperature; Creatine Kinase; Humans; Immersion; Myalgia; Water
PubMed: 35157264
DOI: 10.1007/s40279-022-01644-9 -
PloS One 2015The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive... (Meta-Analysis)
Meta-Analysis Review
The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane's risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges' g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges' g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges' g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges' g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period.
Topics: C-Reactive Protein; Cryotherapy; Exercise; Humans; Interleukin-6; Lactic Acid; Myalgia; Physical Exertion
PubMed: 26413718
DOI: 10.1371/journal.pone.0139028 -
Journal of Sport Rehabilitation Jan 2021Clinical Scenario: Endurance sports require a great deal of physical training to perform well. Endurance training and racing stress the skeletal muscle, resulting in... (Review)
Review
Clinical Scenario: Endurance sports require a great deal of physical training to perform well. Endurance training and racing stress the skeletal muscle, resulting in exercise-induced muscle damage (EIMD). Athletes attempt to aid their recovery in various ways, one of which is through compression. Dynamic compression consists of intermittent pneumatic compression (IPC) devices, such as the NormaTec Recovery System and Recovery Pump. Clinical Question: What are the effects of IPC on the reduction of EIMD in endurance athletes following prolonged exercise? Summary of Key Findings: The current literature was searched to identify the effects of IPC, and 3 studies were selected: 2 randomized controlled trials and 1 randomized cross-over study. Two studies investigated the effect of IPC on delayed onset muscle soreness and plasma creatine kinase in ultramarathoners. The other looked at the impact of IPC on delayed onset muscle soreness in marathoners, ultramarathoners, triathletes, and cyclists. All studies concluded IPC was not an effective means of improving the reduction of EIMD in endurance-trained athletes. Clinical Bottom Line: While IPC may provide short-term relief of delayed onset muscle soreness, this device does not provide continued relief from EIMD. Strength of Recommendation: In accordance with the Strength of Recommendation Taxonomy, the grade of B is recommended based on consistent evidence from 2 high-quality randomized controlled trials and 1 randomized cross-over study.
Topics: Creatine Kinase; Humans; Intermittent Pneumatic Compression Devices; Muscle Fatigue; Myalgia; Physical Endurance; Randomized Controlled Trials as Topic; Running
PubMed: 33418535
DOI: 10.1123/jsr.2020-0364 -
Scandinavian Journal of Medicine &... Mar 2020This randomized controlled trial examined the effects of cold-water immersion (CWI), partial-body cryotherapy (PBC), or a passive control (CON) on physiological and... (Randomized Controlled Trial)
Randomized Controlled Trial
This randomized controlled trial examined the effects of cold-water immersion (CWI), partial-body cryotherapy (PBC), or a passive control (CON) on physiological and recovery variables following exercise-induced muscle damage (EIMD, 5 × 20 drop jumps) in females. Twenty-eight females were allocated to PBC (30 seconds at -60°C, 2 minutes at -135°C), CWI (10 minutes at 10°C), or CON (10 minutes resting). Muscle oxygen saturation (SmO ), cutaneous vascular conductance (CVC), mean arterial pressure (MAP), and local skin temperature were assessed at baseline and through 60 minutes (10-minute intervals), while delayed onset of muscle soreness (DOMS), muscle swelling, maximum voluntary isometric contraction (MVIC), and vertical jump performance (VJP) were assessed up to 72 hours (24-hour intervals) following treatments. SmO was lower in PBC (Δ-2.77 ± 13.08%) and CWI (Δ-5.91 ± 11.80%) compared with CON (Δ18.96 ± 1.46%) throughout the 60-minute follow-up period (P < .001). CVC was lower from PBC (92.7 ± 25.0%, 90.5 ± 23.4%) and CWI (90.3 ± 23.5%, 88.1 ± 22.9%) compared with CON (119.0 ± 5.1 and 116.1 ± 6.6%, respectively) between 20 and 30 minutes (P < .05). Mean skin temperature was lower from CWI vs PBC (between 10 and 40 minutes, P < .05). Mean skin temperature was higher in CON compared with CWI up to 60 minutes and compared with PBC up to 30 minutes (P < .05). DOMS was lower following both PBC and CWI compared with CON through 72-hour (P < .05), with no difference between groups. No main group differences for swelling, MVIC, and VJP were observed. In conclusion, CWI elicited generally greater physiological effects compared with PBC while both interventions were more effective than CON in reducing DOMS in females, but had no effect on functional measures or swelling.
Topics: Adult; Cold Temperature; Cryotherapy; Female; Humans; Immersion; Isometric Contraction; Muscle, Skeletal; Myalgia; Skin Temperature; Water; Young Adult
PubMed: 31677292
DOI: 10.1111/sms.13593 -
Sports Medicine (Auckland, N.Z.) Apr 2016Cold water immersion (CWI) is a technique commonly used in post-exercise recovery. However, the procedures involved in the technique may vary, particularly in terms of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Cold water immersion (CWI) is a technique commonly used in post-exercise recovery. However, the procedures involved in the technique may vary, particularly in terms of water temperature and immersion time, and the most effective approach remains unclear.
OBJECTIVES
The objective of this systematic review was to determine the efficacy of CWI in muscle soreness management compared with passive recovery. We also aimed to identify which water temperature and immersion time provides the best results.
METHODS
The MEDLINE, EMBASE, SPORTDiscus, PEDro [Physiotherapy Evidence Database], and CENTRAL (Cochrane Central Register of Controlled Trials) databases were searched up to January 2015. Only randomized controlled trials that compared CWI to passive recovery were included in this review. Data were pooled in a meta-analysis and described as weighted mean differences (MDs) with 95% confidence intervals (CIs).
RESULTS
Nine studies were included for review and meta-analysis. The results of the meta-analysis revealed that CWI has a more positive effect than passive recovery in terms of immediate (MD = 0.290, 95% CI 0.037, 0.543; p = 0.025) and delayed effects (MD = 0.315, 95% CI 0.048, 0.581; p = 0.021). Water temperature of between 10 and 15 °C demonstrated the best results for immediate (MD = 0.273, 95% CI 0.107, 0.440; p = 0.001) and delayed effects (MD = 0.317, 95% CI 0.102, 0.532; p = 0.004). In terms of immersion time, immersion of between 10 and 15 min had the best results for immediate (MD = 0.227, 95% 0.139, 0.314; p < 0.001) and delayed effects (MD = 0.317, 95% 0.102, 0.532, p = 0.004).
CONCLUSIONS
The available evidence suggests that CWI can be slightly better than passive recovery in the management of muscle soreness. The results also demonstrated the presence of a dose-response relationship, indicating that CWI with a water temperature of between 11 and 15 °C and an immersion time of 11-15 min can provide the best results.
Topics: Cold Temperature; Cryotherapy; Humans; Myalgia; Randomized Controlled Trials as Topic; Time Factors
PubMed: 26581833
DOI: 10.1007/s40279-015-0431-7 -
Journal of Applied Physiology... Sep 2019The present study aims to investigate effects of caffeine ingestion and sex difference on muscle performance, delayed-onset muscle soreness (DOMS), and various... (Randomized Controlled Trial)
Randomized Controlled Trial
The present study aims to investigate effects of caffeine ingestion and sex difference on muscle performance, delayed-onset muscle soreness (DOMS), and various biomarkers under exercise-induced muscle damage (EIMD). Twenty (10 male and 10 female) healthy elite college athletes were recruited. Participants ingested either caffeine (6 mg/kg) or a placebo in a randomized, double-blind, and counterbalanced fashion at 24 and 48 h following EIMD. Muscle performance, DOMS, and blood samples were taken an hour before and an hour after supplementation. Caffeine ingestion restored impaired maximal voluntary isometric contractions (MVIC: 10.2%; MVIC: 7.2%, both < 0.05) during EIMD across both sexes. Following caffeine ingestion during MVIC, while affected by EIMD, an interaction was found in DOMS and serum K (both < 0.05), with males showing greater attenuation (21.5 and 16.9%, respectively) compared with females (4.6 and 1.3%, respectively). DOMS demonstrated an inverse correlation with MVIC after caffeine ingestion both overall and among male athletes ( -0.34 and -0.54, respectively; < 0.05) but not among female athletes ( -0.11; > 0.05) under EIMD. In addition, caffeine ingestion increased postexercise serum glucose and lactate concentrations across both sexes (both < 0.05). This is the first study to show that male athletes, compared with female athletes, experience a greater reduction in DOMS during enhanced MVIC when caffeine was consumed, suggesting men might receive greater ergogenic effects from caffeine when affected by EIMD. Furthermore, caffeine ingestion was able to restore impaired muscle power among elite collegiate athletes across both sexes. Exercise-induced muscle damage (EIMD) reduces anaerobic/aerobic performance and increases delayed-onset muscle soreness (DOMS) during exercise. We show that acute caffeine supplementation at a dosage of 6 mg/kg seems to facilitate recovery of anaerobic muscle power and attenuate DOMS after EIMD across both sexes. Furthermore, male athletes, compared with female athletes, when caffeine was prescribed, experience a greater reduction in DOMS with better restoration of impaired maximal voluntary isometric contractions. This suggests that male athletes might benefit from the ergogenic effect of acute caffeine supplementation after the onset of EIMD.
Topics: Anaerobiosis; Athletes; Biomarkers; Caffeine; Central Nervous System Stimulants; Double-Blind Method; Female; Humans; Isometric Contraction; Male; Myalgia; Sex Characteristics; Young Adult
PubMed: 31219772
DOI: 10.1152/japplphysiol.01108.2018 -
Journal of Athletic Training Apr 2020Among sports-recovery methods, cold-water immersion (CWI), contrast-water therapy (CWT), and whole-body cryotherapy (WBC) have been applied widely to enhance recovery...
CONTEXT
Among sports-recovery methods, cold-water immersion (CWI), contrast-water therapy (CWT), and whole-body cryotherapy (WBC) have been applied widely to enhance recovery after strenuous exercise. However, the different timing effects in exercise-induced muscle damage (EIMD) after these recovery protocols remain unknown.
OBJECTIVE
To compare the effects of CWI, CWT, and WBC on the timing-sequence recovery of EIMD through different indicator responses.
DESIGN
Crossover study.
SETTING
Laboratory.
PATIENTS OR OTHER PARTICIPANTS
Twelve male middle- and long-distance runners from the Beijing Sport University (age = 21.00 ± 0.95 years).
INTERVENTION(S)
Participants were treated with different recovery methods (control [CON], CWI, CWT, WBC) immediately postexercise and at 24, 48, and 72 hours postexercise.
MAIN OUTCOME MEASURE(S)
We measured perceived sensation using a visual analog scale (VAS), plasma creatine kinase (CK) activity, plasma C-reactive protein (CRP) activity, and vertical-jump height (VJH) pre-exercise, immediately postexercise, and at 1, 24, 48, 72, and 96 hours postexercise.
RESULTS
For the VAS score and CK activity, WBC exhibited better timing-sequence recovery effects than CON and CWI ( < .05), but the CWT demonstrated better effects than CON ( < .05). The CRP activity was lower after WBC than after the other interventions ( < .05). The VJH was lower after WBC than after CON and CWI ( < .05).
CONCLUSIONS
The WBC positively affected VAS, CK, CRP, and VJH associated with EIMD. The CWT and CWI also showed positive effects. However, for the activity and timing-sequence effect, CWT had weaker effects than WBC.
Topics: Athletic Injuries; Cross-Over Studies; Cryotherapy; Humans; Hydrotherapy; Immersion; Male; Muscle, Skeletal; Myalgia; Pain Measurement; Running; Treatment Outcome; Young Adult
PubMed: 32160058
DOI: 10.4085/1062-6050-529-18 -
Nutrients Oct 2018This study investigated the effect of branched-chain amino acid (BCAA) supplementation on recovery from eccentric exercise. Twenty males ingested either a BCAA... (Randomized Controlled Trial)
Randomized Controlled Trial
This study investigated the effect of branched-chain amino acid (BCAA) supplementation on recovery from eccentric exercise. Twenty males ingested either a BCAA supplement or placebo (PLCB) prior to and following eccentric exercise. Creatine kinase (CK), vertical jump (VJ), maximal voluntary isometric contraction (MVIC), jump squat (JS) and perceived soreness were assessed. No significant ( > 0.05) group by time interaction effects were observed for CK, soreness, MVIC, VJ, or JS. CK concentrations were elevated above baseline ( < 0.001) in both groups at 4, 24, 48 and 72 hr, while CK was lower ( = 0.02) in the BCAA group at 48 hr compared to PLCB. Soreness increased significantly from baseline ( < 0.01) in both groups at all time-points; however, BCAA supplemented individuals reported less soreness ( < 0.01) at the 48 and 72 hr time-points. MVIC force output returned to baseline levels ( > 0.05) at 24, 48 and 72 hr for BCAA individuals. No significant difference between groups ( > 0.05) was detected for VJ or JS. BCAA supplementation may mitigate muscle soreness following muscle-damaging exercise. However, when consumed with a diet consisting of ~1.2 g/kg/day protein, the attenuation of muscular performance decrements or corresponding plasma CK levels are likely negligible.
Topics: Amino Acids, Branched-Chain; Creatine Kinase; Dietary Supplements; Double-Blind Method; Exercise; Humans; Male; Muscle Contraction; Muscle, Skeletal; Myalgia; Resistance Training; Young Adult
PubMed: 30275356
DOI: 10.3390/nu10101389 -
Journal of Rehabilitation Medicine Feb 2022To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis.
OBJECTIVE
To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis.
METHODS
Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers.
RESULTS
A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first.
CONCLUSION
Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness.
Topics: Cryotherapy; Hot Temperature; Humans; Myalgia; Network Meta-Analysis; Pain Management
PubMed: 34636405
DOI: 10.2340/jrm.v53.331 -
Zeitschrift Fur Rheumatologie Aug 2015
Topics: Humans; Myalgia; Myositis; Rheumatic Diseases; Rheumatology
PubMed: 26169746
DOI: 10.1007/s00393-014-1545-2