Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis

Abstract

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 CEN-TRAL (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). 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. Key PointsCold water immersion (CWI) can be slightly better than passive recovery in management of muscle soreness.The findings suggest a dose-response relationship, indicating that CWI at a temperature between 11 and 15°C for 11-15 min can provides the best results for both immediate and delayed effects.A potential risk of bias was identified by methodological quality assessment of the studies included, identifying a need for higher-quality studies to affirm that the dose-response relationship of the results can be reliably reproduced.

Cryotherapy: biochemical alterations involved in reduction of damage induced by exhaustive exercise

“…After the exhaustion protocol, the animals of SEP+CWI were immediately put in a tank with controlled temperature (12°C) for 12 min following the protocol previously described by Machado et al (15). The water depth was controlled so that the animal had the whole body submerged (except the head) without needing to swim to stay on the surface, that is, with the four paws resting on the floor of the tank.…”

“…Despite extensive research on CWI, the results are still controversial, which is explained by the diversity of the protocols used in research (5,11,14,15). Such diversity promotes different physiological and biochemical mechanisms triggered by CWI that are not clearly described.…”

The Effectiveness of Whole Body Cryotherapy Compared to Cold Water Immersion: Implications for Sport and Exercise Recovery

“…The data overwhelmingly shows a positive effect from CWI on reducing DOMS. This holds true 24, 48, and even 72 hours post-exercise across most of the literature (Bleakley et al, 2012;Leeder et al, 2012;Machado et al, 2016). Multiple reviews (Bleakley et al, 2012;Machado et al, 2016) and meta-analyses (Leeder et al, 2012;Machado et al, 2016) have drawn conclusions from dozens of studies that CWI is very effective and strongly reduces DOMS.…”

“…This holds true 24, 48, and even 72 hours post-exercise across most of the literature (Bleakley et al, 2012;Leeder et al, 2012;Machado et al, 2016). Multiple reviews (Bleakley et al, 2012;Machado et al, 2016) and meta-analyses (Leeder et al, 2012;Machado et al, 2016) have drawn conclusions from dozens of studies that CWI is very effective and strongly reduces DOMS. The four individual CWI studies (White et al, 2014;Glasgow et al, 2014;Goodall & Howatson, 2008; not showing improvements in DOMS compared to a control are because the results proved to be statistically insignificant.…”

Resistance training reduces systolic blood pressure in metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

“…A PEDro score of 7 or greater was considered of 'high quality', studies with a score of 5 or 6 were considered of 'moderate quality' and those with a score of 4 or less were deemed of 'poor quality'. [21][22][23] Any disagreements in the scoring of trials were resolved consensually. Methodological quality was not an inclusion criterion.…”