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

Abstract

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.

Effectiveness of Recovery Strategies after Training and Competition in Endurance Athletes - an Umbrella Review

“…In addition, 4 out of 23 reviews reported that the research protocol was developed prior to the review and reported deviations from the protocol (item 2) [18, 19,25,31]. Therefore, most included reviews were not registered on websites such as The International Prospective Register of Systematic Reviews (PROSPERO) or Cochrane Central Register of Controlled Trials (CENTRAL).…”

“…Nineteen reviews focused on passive recovery, of which eight examined the effects of nutrition or nutrition supplements, six reviews conducted research on cryotherapy [21,23,29,31,33,35] and three reviews focused on the use of CG (see Table 1) [17,22,32].…”

“…Five [22,23,31,35,36] out of twenty-two reviews, focusing on massage [36], cryotherapy [23,31,35], and CG [22], compared recovery outcomes at different time points. Eight studies [43,47,49,52,[56][57][58][59] from these ve reviews examined the effects in endurance athletes 8 -24 h after the exercise and quali ed for further analysis.…”

Cold water immersion after a soccer match: Does the placebo effect occur?

“…CWI has become the most popular recovery strategy in soccer due to its ease of implementation and low cost. Despite the popularity of CWI and its increased use in soccer, the results of its benefits remain unclear and the data regarding its effectiveness are ambiguous ( Ihsan et al, 2016 ; Broatch et al, 2018 ; Moore et al, 2022 ). Indeed, some studies have demonstrated a beneficial effect of CWI on the recovery of physiological and physical parameters ( Wilcock et al, 2006 ; Ascensão et al, 2011 ; Elias et al, 2012 ; Bouzid et al, 2018 ).…”

Using Shear-Wave Elastography to Assess Exercise-Induced Muscle Damage: A Review

“…While some degree of muscle damage and the associated inflammation are considered to be paramount for optimal muscle adaptation [ 3 , 4 ], excessive muscle damage impairs athletic performance and makes further training more difficult [ 5 ]. An abundant body of research exists on mechanisms underlying muscle damage and its manifestations [ 6 ], as well as prevention and treatment strategies [ 7 , 8 , 9 ].…”