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Influence of Postexercise Cooling on Muscle Oxygenation and Blood Volume Changes
Abstract
Purpose:
The aim of this study was to investigate the effects of postexercise cold water immersion (CWI) on tissue oxygenation and blood volume changes after intense exercise.
Methods:
Nine physically active men performed 30 min of continuous running (CR) at 70% of their maximal treadmill velocity (Vmax), followed by 10 bouts of intermittent running at Vmax. After exercise, one of the participants' legs was immersed in a cold water bath (10°C, CWI) to the level of their gluteal fold for 15 min. The contralateral leg remained outside the water bath and served as a control (CON). Vastus lateralis (VL) skin temperature (TskVL), VL oxygenation (tissue oxygenation index [TOI]), and blood volume changes (total hemoglobin [tHb] volume) were monitored continuously throughout exercise and CWI using near-infrared spectroscopy.
Results:
TskVL, TOI, and tHb were not significantly different between CON and CWI during continuous running and intermittent running, respectively (P > 0.05). In contrast, TskVL was significantly lower in CWI compared with CON throughout immersion, with peak differences occurring at the end of immersion (CON = 35.1 ± 0.6 vs CWI = 16.9°C ± 1.7°C, P < 0.001). tHb was significantly lower during CWI compared with CON at most time points, with peak differences of 20% ± 4% evident at the end of the 15-min immersion (P < 0.01). Likewise, TOI was significantly higher in CWI compared with CON, with peak differences of 2.5% ± 1% evident at the 12th min of immersion (P < 0.05).
Conclusions:
Postexercise cooling decreased microvascular perfusion and muscle metabolic activity. These findings are consistent with the suggested mechanisms by which CWI is hypothesized to improve local muscle recovery.
... Athletes competing in sports are exposed to physical stress, often multiple times each day, and especially during tournaments where they have to perform many times over a relatively short period of time. CWI could, according to some studies [96][97][98], play a role in preventing injuries and maintaining performance of athletes, when applied in the recovery period following a bout of exercise. A study by Leeder et al [96] compared competing professional athletes recovering with and without post exercise CWI, and assessed recovery using markers of sprint performance, muscle function, muscle soreness and measured biochemical markers associated with damage (creatine kinase (CK)), inflammation (IL-6 and C-Reactive Protein (CRP)) and oxidative stress (lipid hydroperoxides and activity of lipidsoluble antioxidants). ...
... The reduction in CK associated with reduced muscle damage may be due to reduced muscle blood flow [97]. Similar findings were found in another study, and may be explained by a decreased muscle metabolic activity without affecting the tissue oxygenation necessary for normal muscle recovery [98]. ...
... While many of the studies demonstrated significant effects of CWI on various physiological and biochemical parameters, the question as to whether these are beneficial or not for health is difficult to assess. One of the problems is that some of the studies involve passive CWI [46,47,52,54,56,58,61,[63][64][65]71,72,76,77,81,85,[96][97][98], while others deal with active CWI [42,45,50,55,57,62,[66][67][68][73][74][75]79,82,[86][87][88][89][90][93][94][95]. Many of the research studies were based on cold adapted winter swimmers [41,67,68,71,75,77,82,85,86,[88][89][90]94,95]. ...
This review is based on a multiple database survey on published literature to determine the effects on health following voluntary exposure to cold-water immersion (CWI) in humans. After a filtering process 104 studies were regarded relevant. Many studies demonstrated significant effects of CWI on various physiological and biochemical parameters. Although some studies were based on established winter swimmers, many were performed on subjects with no previous winter swimming experience or in subjects not involving cold-water swimming, for example, CWI as a post-exercise treatment. Clear conclusions from most studies were hampered by the fact that they were carried out in small groups, often of one gender and with differences in exposure temperature and salt composition of the water. CWI seems to reduce and/or transform body adipose tissue, as well as reduce insulin resistance and improve insulin sensitivity. This may have a protective effect against cardiovascular, obesity and other metabolic diseases and could have prophylactic health effects. Whether winter swimmers as a group are naturally healthier is unclear. Some of the studies indicate that voluntary exposure to cold water has some beneficial health effects. However, without further conclusive studies, the topic will continue to be a subject of debate.
... The time course of this cycle is dependent on the magnitude of damage (Huard et al. 2002;Paulsen et al. 2012). Based on what is known about the post-injury (McArdle and Jackson 1997;Abrams 1997;Huard et al. 2002) and post-exercise (Kendall and Eston 2002;Lapointe et al. 2002;Peake et al. 2005;Howatson and van Someren 2008) cellular response, it is at the secondary stage where the application of cryotherapy might be advantageous in diminishing the proliferation of initial damage (Knight 1995;Merrick 2002;Enwemeka et al. 2002;Bleakley et al. 2012b;Ihsan et al. 2013), reducing secondary muscle damage (Knight 1985(Knight , 1995Swenson et al. 1996;Merrick et al. 1999;Knight et al. 2000), and enhancing the regenerative response (Järvinen et al. 2005;Dykstra et al. 2009). As a result, the application of cryotherapy has been adopted for use not only by clinicians to treat injuries (Barnes 1979;Hubbard and Denegar 2004;Bleakley et al. 2004Bleakley et al. , 2011Collins 2008;Carvalho et al. 2010;Bleakley and Davison 2010a;Tiidus 2015;Page 2018), but also by athletes to facilitate recovery from exercise (Bishop et al. 2008;Robson-Ansley et al. 2009;Nédélec et al. 2012;Versey et al. 2013;Kovacs and Baker 2014;Dupuy et al. 2018;Peake 2019). ...
... However, the ability of cryotherapy to reduce muscle metabolism in humans has not been established. Only one study indirectly measuring muscle metabolism in humans has been able to demonstrate decreased muscle metabolic activity following post-exercise cooling (Ihsan et al. 2013). Similarly, in humans, there is only a handful of research that supports the use of cryotherapy for reducing the inflammatory response following exercise Ziemann et al. 2012;Guilhem et al. 2013) while most studies show no reduction in inflammation (Ingram et al. 2009;Pointon et al. 2011;Leeder et al. 2012;Pointon and Duffield 2012;Fragala et al. 2015;Peake et al. 2016). ...
... The mechanisms of cryotherapy were traditionally believed to be dependent on the cold induced vascular response, and that the cold-induced reductions in muscle blood flow were responsible for reducing muscle metabolism, inflammation, and the subsequent secondary damage (Swenson et al. 1996;Merrick et al. 1999;Knight et al. 2000;Ihsan et al. 2016). However, cryotherapy-induced reductions in muscle blood flow are based on techniques that only allow for the indirect inference of hemodynamic or volume changes within the limb (Fiscus et al. 2005;Vaile et al. 2010;Ihsan et al. 2013;Roberts et al. 2015a;Choo et al. 2018;Stephens et al. 2018). ...
Cryotherapy is utilized as a physical intervention in the treatment of injury and exercise recovery. Traditionally, ice is used in the treatment of musculoskeletal injury while cold water immersion or whole-body cryotherapy is used for recovery from exercise. In humans, the primary benefit of traditional cryotherapy is reduced pain following injury or soreness following exercise. Cryotherapy-induced reductions in metabolism, inflammation, and tissue damage have been demonstrated in animal models of muscle injury; however, comparable evidence in humans is lacking. This absence is likely due to the inadequate duration of application of traditional cryotherapy modalities. Traditional cryotherapy application must be repeated to overcome this limitation. Recently, the novel application of cooling with 15 °C phase change material (PCM), has been administered for 3-6 h with success following exercise. Although evidence suggests that chronic use of cryotherapy during resistance training blunts the anabolic training effect, recovery using PCM does not compromise acute adaptation. Therefore, following exercise, cryotherapy is indicated when rapid recovery is required between exercise bouts, as opposed to after routine training. Ultimately, the effectiveness of cryotherapy as a recovery modality is dependent upon its ability to maintain a reduction in muscle temperature and on the timing of treatment with respect to when the injury occurred, or the exercise ceased. Therefore, to limit the proliferation of secondary tissue damage that occurs in the hours after an injury or a strenuous exercise bout, it is imperative that cryotherapy be applied in abundance within the first few hours of structural damage.
... Thus providing confusing conclusions for sport medicine practitioners unsure on the differences that may exist between devices, settings and outcomes to ensure optimal applications can be applied. Previous literature reports decreases in SmO 2 following cold-water immersion [6,7] and it is suggested that compression aids the magnitude of cooling [8][9][10]. Conversely, isolated external compression is reported to increase SmO 2 [11,12]. ...
... Indicators of muscle metabolic activity can be noninvasively monitored by collating muscle oxygenation and haemodynamic, with such devices as MOXY sensors (MOXY, Swinco, and Zurich, Switzerland). Previously studies have demonstrated decreases SmO 2 following cooling applications of cold-water immersion [3,6,7]. Simultaneous dosages of compression (mmHg) and cryotherapy that cryo-compressive devices can offer are of interest in the management of sports injury or post-exercise recovery. ...
... Significant differences between Group (A) and Group (B) for Exposure Protocols 1 (high-compression), were displayed at immediately post time point only (p ≥ 0.05). 28.3 ± 0. 6 28.1 ± 0.8 28.5 ± 0.7 �������� ferences in Tsk compared to pre exposure data. �������� ferences in Tsk between immediately post exposure and 20 minutes post exposure data. ...
Background: The effectiveness of simultaneous compression and cooling applications that cryo-compressive devices offer are of interest in the management of sports injury or post-exercise recovery. Dose-response in terms of physiological parameter is required to inform current practice in the remit of sports medicine to help define optimal protocols for application. The current study aimed to investigate the physiological effects and perceptual responses of different cryo-compression dosages offered by two cryo-compressive devices over a rewarming period. Methods: Twenty-nine healthy male and female participants (male n=18; female n=11) volunteered (mean ± SD: age 22 ± 3.6 years, height 168.2 ± 8.6 cm, weight 67.4 ± 11.5 kg and thigh circumference 50.7 ± 6.7 cm). Objective measures included skin surface temperature, muscle oxygenation saturation, perceptual thermal comfort and sensation. Data were collected pre, immediately post intervention and over a 20-minute rewarming period. Participants were randomly assigned to either Group A (Game Ready®); B (Squid®) or C Control group. Intervention groups received different cryo-compressive protocols for testing, but both received 15-minutes of cooling. Results: Significant reductions in skin surface temperature were displayed across the intervention groups for all time-points (p≤0.05). Analysis of all data displayed a significant effect of time (p≤0.001) on muscle oxygenation. Collapse of the data indicated significant differences in muscle oxygenation across the different modalities and pressure (p≤0.05). Conclusion: Muscle oxygenation saturation and skin surface temperature responses differ depending on pressure dose in conjunction with cooling. Higher initial increases of muscle oxygenation saturation immediately post intervention correlate to higher levels of compression. Greater magnitudes of cooling can be achieved through the adjunct of compression. Dose-response relationships between cooling and simultaneous compression should be considered and are dependent on the therapeutic aim of treatment. In order to develop optimum protocols for management of either injury or recovery parameters further investigation is required of contemporary cryo-compressive devices.
... A reduced muscle metabolic demand can curtail further muscular damage mediated by reactive oxygen species (described in section 2.2.4) and is associated with reductions in muscle swelling (White & Wells, 2013). Using near infra-red spectroscopy (NIRS) to measure muscle oxygenation, Ihsan et al. (2013) were the first to demonstrate in vivo that post-exercise cooling can blunt muscle metabolism when applying cold water immersion as a recovery modality. NIRS measurements were subsequently used to demonstrate that WBC can also blunt muscle metabolism (Hohenauer et al., 2020;Selfe et al., 2014). ...
... Cold exposure effects on limb blood flow post-exercise can have implications for muscle recovery due to reductions in oedema, metabolism and hypoxic cell death (Ihsan et al., 2013;Mawhinney et al., 2013). Despite abundant literature on the effects of cold water immersion (CWI) on limb blood flow, only one study to date has used the Doppler technique to assess limb blood flow post-WBC (Mawhinney et al., 2017). ...
Whilst Whole Body Cryotherapy (WBC) has become an emerging tool for sport and exercise recovery, its overall efficacy remains contentious. This thesis addressed a variety of issues concerning the practice.
Firstly, the impact of single WBC interventions for treating exercise-induced muscle damage (EIMD) is unclear. Secondly, the influence of inter-individual factors on WBC outcomes post-exercise remains an under-investigated area. Therefore the first main study explored the effects of age and body fat content on responses to WBC following downhill running, a commonly utilised eccentric exercise model for inducing muscle damage. WBC participants underwent cryotherapy (3 minutes, −120°C) one hour post- downhill run and control (CON) participants passively recovered (20°C). Despite the presence of EIMD, WBC significantly blunted (p=0.04) the decrease in muscle torque 24 hours after the downhill run. This response was significantly influenced by age, with young participants (<40 years) retaining their muscle strength more than older participants (≥45 years). WBC may therefore attenuate EIMD and benefit muscle strength recovery following eccentrically biased exercise, particularly for young males.
A subsequent downhill run study investigated the influence of WBC timing post-exercise, a factor that could clarify optimal treatment usage. An additional objective was to compare the effects of WBC with cold water immersions (CWI) since the verdict regarding which cold modality is superior for recovery remains an on-going area of controversy. It was revealed that WBC 4 hours post-exercise was ineffective in treating EIMD markers, so applying WBC within one hour after exercise may be preferable to delaying by several hours. However, WBC was no more effective than CWI, meaning that the cost vs. reward implications of WBC treatments would need further reviewing.
Finally, the implications of repetitive WBC during training programmes require further evaluation due to the possibility of repetitive cold interfering with long term adaptations. The final study investigated the impact of two weekly WBC treatments on adaptations to a 6 week strength and endurance training programme. It was found that WBC participants significantly improved their muscle strength comparatively to the CON group. However WBC did not improve their jump height (p=0.23) in contrast to the CON group (p=0.01). In conclusion, repetitive WBC does not appear to blunt strength training adaptations, although there may be an interference effect in the development of explosive power.
... As mentioned previously, persistent vasodilation post-exercise combined with the loss of the skeletal muscle pump, leads to blood pooling in the extremities, decreasing venous return and consequently arterial pressure (Rowell, 1974). For example, vastus lateralis perfusion continues to elevate above exercising levels after cessation of 40 min of treadmill running in ∼24 • C (Ihsan et al., 2013). This post-exercise blood flow distribution may contribute to orthostatic hypotension, expected to be further exacerbated by the presence of skin thermoregulatory perfusion. ...
... This post-exercise blood flow distribution may contribute to orthostatic hypotension, expected to be further exacerbated by the presence of skin thermoregulatory perfusion. Furthermore, exposing an exercised leg to 15 min of 10 • C CWI reduced vastus lateralis total hemoglobin levels, suggesting that CWI may be capable of attenuating post-exercise microvascular perfusion (Ihsan et al., 2013). While a majority of the literature commenting on changes in post-exercise perfusion focus on cold water immersion, earlier reports utilized the simple application of an ice bag and yet still demonstrated attenuation of acute post-exercise perfusion elevation and edema compared to a noncooled control limb (Yanagisawa et al., 2004). ...
Athletes and certain occupations (e.g., military, firefighters) must navigate unique heat challenges as they perform physical tasks during prolonged heat stress, at times while wearing protective clothing that hinders heat dissipation. Such environments and activities elicit physiological adjustments that prioritize thermoregulatory skin perfusion at the expense of arterial blood pressure and may result in decreases in cerebral blood flow. High levels of skin blood flow combined with an upright body position augment venous pooling and transcapillary fluid shifts in the lower extremities. Combined with sweat-driven reductions in plasma volume, these cardiovascular alterations result in levels of cardiac output that do not meet requirements for brain blood flow, which can lead to orthostatic intolerance and occasionally syncope. Skin surface cooling countermeasures appear to be a promising means of improving orthostatic tolerance via autonomic mechanisms. Increases in transduction of sympathetic activity into vascular resistance, and an increased baroreflex set-point have been shown to be induced by surface cooling implemented after passive heating and other arterial pressure challenges. Considering the further contribution of exercise thermogenesis to orthostatic intolerance risk, our goal in this review is to provide an overview of post-exercise cooling strategies as they are capable of improving autonomic control of the circulation to optimize orthostatic tolerance. We aim to synthesize both basic and applied physiology knowledge available regarding real-world application of cooling strategies to reduce the likelihood of experiencing symptomatic orthostatic intolerance after exercise in the heat.
... The study by Roberts et al. supports this explanation, reporting elevated SmO 2 during post-exercise CWI due to increased blood volume from vasodilation [11]. Alternatively, Ihsan et al. proposed that reduced muscle metabolic activity during cooling could account for increased SmO 2 despite a reduced muscle blood flow [47]. These contradictory findings may arise from different haemodynamic responses induced by various exercise modalities (e.g., endurance vs resistance exercise [48]) and disparities in the immersion protocols. ...
This study compared the effects of cold water immersion (CWI) and hot water immersion (HWI) on muscle recovery following a muscle-damaging exercise protocol in women. Thirty healthy women (23.3 ± 2.9 years) were randomly assigned to either the CWI, HWI, or control (CON) groups. Participants completed a standardised exercise protocol (5 x 20 drop-jumps), followed by a 10 min recovery intervention (CWI, HWI, or CON) immediately and 120 min post-exercise. Physiological responses, including muscle oxygen saturation (SmO2), core and skin temperature, and heart rate, were assessed at baseline, immediately post-exercise, after the first recovery intervention (postInt), and during 30 min follow-up. Recovery was evaluated through maximal voluntary isometric contraction, muscle swelling, muscle soreness ratings, and serum creatine kinase at baseline, 24, 48, and 72 h post-exercise. A mixed-effects model was used to account for repeated measures over time. Results showed lower SmO2 values in the CWI compared to the HWI group at 20 min (Δ-6.76%, CI: −0.27 to −13.25, p = 0.038) and 30 min (Δ-9.86%, CI: −3.37 to −16.35, p = 0.001), and compared to CON at 30 min (Δ-7.28%, CI: −13.77 to −0.79, p = 0.022). Core temperature was significantly higher in the HWI than the CWI group (postInt and 30 min), while it was significantly lower in the CWI group than CON (30 min). CWI caused a substantial decrease in skin temperature compared to HWI and CON between postInt and 30 min follow-up (all p < 0.001). Skin temperature was higher in the HWI group compared to CON at postInt and throughout 30 min follow-up (all p < 0.001). No significant differences in recovery markers were observed between CWI and HWI groups, although HWI led to slightly higher creatine kinase levels (24 h and 72 h) and greater muscle swelling (24 h) compared to CON. Despite distinct acute physiological responses to CWI and HWI, neither improved subjective or objective recovery outcomes during the 72 h follow-up compared to CON in women following a muscle-damaging exercise protocol.
Trial registration number
NCT04902924 (ClinicalTrials.gov), SNCTP000004468 (Swiss National Clinical Trial Portal).
... The T CORE estimator has been shown to have a mean bias of − 0.10 ± 0.38 °C compared to a rectal sensor [42]. A small NIRS sensor (MOXY, Fortiori Design LLC, Hutchinson, MN USA) taped to the right RF measured muscle oxygenation (SmO 2 ) by using changes in light absorption qualities at 750 and 850 nm [15]. During all TTE testing T SKIN , T CORE , HR and SmO 2 were recorded continuously. ...
Purpose
Standard heat acclimation (HA) protocols (low-moderate intensity over a continuous 7–14 days) restore performance and thermoregulation but lack specificity and practicality for intermittent sports athletes. This study compared different pedal resistances in a 3-week intermittent sprint-based HA protocol.
Methods
Fourteen physically active adults were assigned to a sprint pedal resistance training group (TG): 0.075 kg/kg (7.5TG, 6 males, 1 female) or 0.085 kg/kg (8.5TG, 5 males, 2 females). Participants completed baseline incremental time to exhaustion test (TTE), continued with own training for 3 weeks before post-control TTE, then carried out 6 × 15 s cycle sprints with 30 s recovery followed by 30 min low intensity cycling thrice weekly for 3 weeks before completing post-HA TTE test. Testing and HA were completed at 38 °C and 30% relative humidity.
Results
Both groups improved TTE from baseline to post-HA (7.5TG: 9.6% ± 10.8%, 8.5TG: 7.4% ± 3.1%) and post-control to post-HA (7.5TG: 11.0% ± 11.7%, 8.5TG: 6.7% ± 3.9%). Maximal power improved from baseline to post-HA (7.5TG: 293 ± 40 W vs. 321 ± 46 W, 8.5TG: 318 ± 90 W vs. 339 ± 96 W), while only 7.5TG improved maximal power from post-control to post-HA (289 ± 42 W vs. 321 ± 46 W). From baseline to post-HA and post-control to post-HA, only 7.5TG increased time till maximum skin temperature (460 ± 76 s vs. 509 ± 75 s, 461 ± 72 s vs. 509 ± 75 s, respectively) and minimum core-skin gradient (461 ± 71 s vs. 510 ± 74 s, 455 ± 75 s vs. 510 ± 74 s, respectively), while exercising core temperature remained unchanged in both groups. Both groups increased sweat rate (7.5TG: 7.0 ± 3.4 mg/cm ² /min vs. 9.6 ± 4.1 mg/cm ² /min, 8.5TG: 5.7 ± 3.6 mg/cm ² /min vs. 8.3 ± 4.3 mg/cm ² /min). Only 7.5TG delayed the onset of blood lactate accumulation from baseline to post-HA (259 ± 126 s vs. 354 ± 86 s).
Conclusion
Intermittent sprint-based HA improves TTE performance and sweat rate while a lighter sprint pedal resistance offers, greater thermal adaptation and fatigue tolerance.
... Severe and/or prolonged cooling can have deleterious effects, such as hypothermia, coldinjuries, and impaired physical performance (Cahill et al., 2011;Fudge et al., 2015). Exposure to CWI induces acute physiological adjustments, including increased whole-body metabolic heat production (Castellani et al., 1998), reduced muscle metabolic activity (Ihsan et al., 2013), reduced femoral artery blood flow and increased cutaneous vasoconstriction , reduced muscle and core temperatures (Brazaitis et al., 2014b), and decreased nerve conduction velocity (Algafly and George, 2007). These adjustments are influenced by the duration of exposure, water temperature, and the type of immersion (e.g., single, or intermittent) (Brazaitis et al., 2011;Brazaitis et al., 2014b;. ...
... Whilst its ergogenic effect on prolonged exercise in the heat has been established [11], CWI might result in substantial discomfort and strong shivering response [12]. Moreover, CWI can drastically decrease muscle temperature, blood flow, and motor neuron conductance velocity [13], increase metabolic inertia [14], resulting in a shift toward anaerobic metabolism during subsequent exercise [15]. As such, CWI is likely detrimental to intense exercise efforts [16,17]. ...
This study compared the effects of precooling via whole-body immersion in 25°C CO2-enriched water (CO2WI), 25°C unenriched water (WI) or no cooling (CON) on 10-km cycling time trial (TT) performance. After 30 min of precooling (CO2WI, CON, WI) in a randomized, crossover manner, 11 male cyclists/triathletes completed 30-min submaximal cycling (65%VO2peak), followed by 10-km TT in the heat (35°C, 65% relative humidity). Average power output and performance time during TT were similar between conditions (p = 0.387 to 0.833). Decreases in core temperature (Tcore) were greater in CO2WI (-0.54 ± 0.25°C) than in CON (-0.32 ± 0.09°C) and WI (-0.29 ± 0.20°C, p = 0.011 to 0.022). Lower Tcore in CO2WI versus CON was observed at 15th min of exercise (p = 0.050). Skin temperature was lower in CO2WI and WI than in CON during the exercise (p < 0.001 to 0.031). Only CO2WI (1029 ± 305 mL) decreased whole-body sweat loss compared with CON (1304 ± 246 mL, p = 0.029). Muscle oxygenation by near-infrared spectroscopy (NIRS), thermal sensation, and thermal comfort were lower in CO2WI and WI versus CON only during precooling (p < 0.001 to 0.041). NIRS-derived blood volume was significantly lower in CO2WI and WI versus CON during exercise (p < 0.001 to 0.022). Heart rate (p = 0.998) and rating of perceived exertion (p = 0.924) did not differ between conditions throughout the experiment. These results suggested that CO2WI maybe more effective than WI for enhanced core body cooling and minimized sweat losses.
... Roberts et al. [55]), which reported no change in MSO 2 in the vastus lateralis during CWI up to the umbilical level at 10°C for 10 min. In contrast, an increase in MSO 2 in the vastus lateralis has been reported during leg immersion at 10°C for 15 min (Ihsan et al. [56]). This discrepancy is attributed to differences in the test protocol. ...
Thermogenesis is well understood, but the relationships between cold water immersion (CWI), the post-CWI rewarming and the associated physiological changes are not. This study investigated muscle and systemic oxygenation, cardiorespiratory and haemodynamic responses, and gastrointestinal temperature during and after CWI. 21 healthy men completed randomly 2 protocols. Both protocols consisted of a 48 minutes heating cycling exercise followed by 3 recovery periods (R1-R3), but they differed in R2. R1 lasted 20 minutes in a passive semi-seated position on a physiotherapy table at ambient room temperature. Depending on the protocol, R2 lasted 15 minutes at either ambient condition (R2_AMB) or in a CWI condition at 10 °C up to the iliac crest (R2_CWI). R3 lasted 40 minutes at AMB while favouring rewarming after R2_CWI. This was followed by 10 minutes of cycling. Compared to R2_AMB, R2_CWI ended at higher VȮ 2 in the non-immersed body part due to thermogenesis (7.16(2.15) vs. 4.83(1.62) ml.min-1 .kg-1) and lower femoral artery blood flow (475(165) vs. 704(257) ml.min-1) (p<0.001). Only after CWI, R3 showed a progressive decrease in vastus and gastrocnemius medialis O 2 saturation, significant after 34 minutes (p<0.001). As blood flow did not differ from the AMB protocol, this indicated local thermogenesis in the immersed part of the body. After CWI, a lower gastrointestinal temperature on resumption of cycling compared to AMB (36.31(0.45) vs. 37.30(0.49) °C, p<0.001) indicated incomplete muscle thermogenesis. In conclusion, the rewarming period after CWI was non-linear and metabolically costly. Immersion and rewarming should be considered as a continuum rather than separate events. Keywords:-Thermoregulation-Cold-water immersion-Muscle oxygenation-Oxygen uptake-Core temperature-Cardiocirculatory system-Metabolic kinetics Abbreviation AMB = Ambient temperature (°C) ATP = Adenosine triphosphate BAT = Brown adipose tissue CWI = Cold-water immersion FAD = Femoral Artery Diameter (mm) FABF = Femoral Artery Blood Flow (ml.min-1) FABV = Femoral Artery Blood Velocity (cm.s-1) T GI = Gastrointestinal temperature (°C) NST = Non-shivering thermogenesis Q̇c = Cardiac output (L.min-1) RER = Respiratory exchange ratio MSO 2 GM = Muscle oxygen saturation of the Gastrocnemius Medialis muscle (%) MSO 2 VM = Muscle oxygen saturation of the Vastus Medialis muscle (%) ST = shivering thermogenesis UCP1 = uncoupling protein 1 VĖ = Ventilation (L.min-1) VĊO 2 = Relative carbon dioxide output (ml.min-1 .kg-1) VȮ 2 = Relative oxygen uptake (ml.min-1 .kg-1) VT1 = First ventilatory threshold VT2 = Second ventilatory threshold
... It is possible that CWI may inhibit through thermoreceptors afferent feedback from the muscle (22) and therefore enhance subsequent muscle performance, but this would occur similarly in both precooling and mid-cooling conditions. From a physiological perspective, cooling muscle may hinder perfusion and O 2 delivery in the muscle (14,23) and actually slow down the recovery process. However, previous work has shown that faster pH normalization was observed up to 60 minutes after the exhaustive exercise (26). ...
Baláš, J, Kodejška, J, Procházková, A, Knap, R, and Tufano, JJ. Muscle cooling before and in the middle of a session: there are benefits on subsequent localized endurance performance in a warm environment. J Strength Cond Res XX(X): 000–000, 2023—Localized cold-water immersion (CWI) has been shown to facilitate recovery in the middle of a session of exhaustive repeated forearm contractions. However, it has been suggested that these benefits may be attributed to “precooling” the muscle before an activity, as opposed to cooling a previously overheated muscle. Therefore, this study aimed to determine how precooling and mid-cooling affects localized repeated muscular endurance performance in a warm environment. Nineteen subjects completed a familiarization session and 3 laboratory visits, each including 2 exhaustive climbing trials separated by 20 minutes of recovery: PRE CWI (CWI, trial 1; passive sitting [PAS], trial 2); MID CWI (PAS, trial 1; CWI, trial 2); and CONTROL (PAS, trial 1; PAS, trial 2). Climbing trial 1 in PRE CWI was 32 seconds longer than in CONTROL ( p = 0.013; d = 0.46) and 47 seconds longer than in MID CWI ( p = 0.001; d = 0.81). The time of climbing trial 2 after PAS (PRE CWI and CONTROL) was very similar (312 vs. 319 seconds) irrespective of the first trial condition. However, the time of the second trial in MID CWI was 43 seconds longer than in PRE CWI ( p < 0.001; d = 0.63) and 50 seconds longer than in CONTROL ( p < 0.001; d = 0.69). In warm environments, muscle precooling and mid-cooling can prolong localized endurance performance during climbing. However, the effectiveness of mid-cooling may not be as a “recovery strategy” but as a “precooling” strategy to decrease muscle temperature before subsequent performance, delaying the onset of localized heat-induced neuromuscular fatigue.
... This difference could be related to difference in the temperature of ice compared with cold water, which is in the range of 9−10°C. Second, we (Roberts et al. 2015a) and others (Ihsan et al. 2013) have demonstrated that cold water immersion reduces muscle temperature at a depth of 3 cm and microvascular perfusion at a depth of 1−2 cm. Because animal muscles are smaller than human muscles, icing or cold water immersion may produce more extensive changes in muscle temperature and blood flow throughout animal muscles compared with human muscles. ...
Cold water immersion is often used to recover from exercise in the belief that it reduces muscle soreness and inflammation. However, no data currently exist to support this notion—at least in humans. We compared the effects of cold water immersion versus active recovery on neutrophil and macrophages, pro‐inflammatory cytokines, neurotrophic and growth factors, heat shock proteins and transcription factors in muscle after resistance exercise. In a randomized cross‐over design, 10 active men performed resistance exercise using one leg on separate days. On one day, they immersed their lower body in cold water (10°C) for 10 min after exercise. On the other day they cycled at a low‐intensity for 10 min after exercise. Muscle biopsies were collected from each leg before, 2, 24 and 48 h after exercise. Exercise induced a strong inflammatory response, as indicated by increases in neutrophil and macrophage counts and IL‐1β, TNF‐α, IL‐6 and MCP‐1 mRNA (P<0.05). Growth arrest and DNA damage‐inducible 45 protein (Gadd 45) mRNA also increased markedly (P<0.05). As evidence of hyperalgesia, nerve growth factor (NGF) and glial cell‐line derived neurotrophic factor (GDNF) mRNA increased after exercise (P<0.05). The protein abundance of Forkhead box class O (FOXO) and αB‐crystallin in the cytosolic fraction of muscle homogenates decreased after exercise (P<0.05), indicating nuclear translocation. Despite these robust responses, there were no significant differences in any of these factors between the two trials. Therefore, contrary to popular belief, cold water immersion did not attenuate inflammation or markers of soreness in muscle after intense resistance exercise.
... Although no study found PBMT effects on muscle oxygenation in athletes, some inferences can be made about the effects of previous applications of PBMT on peripheral muscle oxygenation. The observed increase in HHb, without changes in O 2 Hb during the first and second TTE, can be associated with an increased need for oxygen tissue extraction (e.g., speeding of HHb kinetics) to meet the increased metabolic demands during exercise [37] and with increased muscle blood flow (e.g., increase in tHb after PBMT [13]). However, an enhanced muscle O 2 supply might also result in slower [HHb] kinetics, as previously reported [38]. ...
The goal of this study was to investigate the effects of photobiomodulation therapy (PBMT) on performance, oxygen uptake (VO2) kinetics, and lower limb muscle oxygenation during three successive time-to-exhaustions (TTEs) in cyclists. This was a double-blind, randomized, crossover, placebo-controlled trial study. Sixteen cyclists (~23 years) with a cycling training volume of ~460 km/week volunteered for this study. In the first session, cyclists performed a maximal incremental test to determine maximal oxygen uptake and maximal power output (POMAX). In the following sessions, cyclists performed three consecutive TTEs at POMAX. Before each test, PBMT (135 J/thigh) or a placebo (PLA) was applied to both thighs. VO2 amplitude, O2 deficit, time delay, oxyhemoglobin (O2Hb), deoxyhemoglobin (HHb), and total hemoglobin (tHb) were measured during tests on the right vastus lateralis. The PBMT applied before three successive TTE increased performance of the first and second TTE (~10–12%) tests, speed of VO2 and HHb kinetics during the first test, and increased peripheral muscle oxygenation (increase in HHb and tHb) in the first and second exhaustion tests. However, the PBMT effects were attenuated in the third TTE, as performance and all the other outcomes were similar to the ones from the PLA intervention. In summary, PBMT application increased the first and second successive TTEs, speed of VO2, and muscle oxygenation.
... Several studies have already evaluated that microvascular perfusion and muscle metabolic activity were reduced following cold-water immersion (CWI) protocols [18,19,50]. However, physiological responses to cold water immersion and WBC or PBC exposures may differ as the stimuli are quite different and for the time being, no information on the effects of PBC on the previously mentioned variables is available. ...
This study aimed to investigate the effect of partial-body cryostimulation (PBC) on microvascular responsiveness and muscular metabolic O2 consumption rate (m V˙ O2). Twenty healthy young adults (ten males and ten females) underwent post-occlusive reactive hyperaemia (PORH) test at the flexor digitorum superficialis area before and after a 3-min PBC session and a 3-min control session. Using near-infrared spectroscopy, occlusion and reperfusion slopes were calculated: oxyhemoglobin ([HbO2]) decrease rate ([HbO2] slope 1), deoxyhaemoglobin ([HHb]) increase rate ([HHb] slope 1), [HbO2] increase rate ([HbO2] slope 2), and [HHb] increase rate ([HHb] slope 2. Using HbO2 kinetics during the occlusion, m V˙ O2 was also calculated to characterize myocytes' metabolic O2 consumption. HbO2 slope 1 value was lower after PBC than before PBC (-0.15 ± 0.08 vs -0.24 ± 0.11 s-1; respectively; P < 0.05) in male participants only. A lower [HHb] slope 1 was also observed after PBC compared to before PBC (0.18 ± 0.10 vs 0.24 ± 0.16 s-1; P < 0.05) with no interaction for sex categories. m V˙ O2 was significantly lower after PBC than before (pre values 14.75 ± 3.94 vs 18.47 ± 5.73 μMO2Hb.s-1; respectively; P < 0.01) with no interaction between sex categories. No changes in the calculated slope 2 were observed. These findings suggest that a single session of PBC reduces the muscular metabolic O2 needs at rest; however, it does not alter the vascular ability to provide O2 to the myocytes.
... For instance, the cold temperature and the hydrostatic pressure cause vasoconstriction of arterioles, which decreases blood perfusion to the skeletal musculature that is exposed to the water (Wilcock et al. 2006;Mawhinney et al. 2013Mawhinney et al. , 2017. The physiological alterations that follow include decreased metabolic activity (Ihsan et al. 2013), infiltration of localized immune cells (Lee et al. 2005), and quickened parasympathetic rebound (Buchheit et al. 2009). ...
Purpose
The study aimed to investigate the effect of repeated cold-water immersion (CWI) after high-intensity interval exercise sessions on cardiac-autonomic modulation, neuromuscular performance, muscle damage markers, and session internal load.
Methods
Twenty-one participants underwent five sessions of high-intensity interval exercise (6–7 bouts of 2 min; pause of 2 min) over a two-week period. Participants were allocated randomly into either a group that underwent CWI (11-min; 11 °C) or a group that performed passive recovery after each exercise session. Before the exercise sessions were performed, countermovement jump (CMJ) and heart rate variability were recorded (i.e., rMSSD, low and high frequency power and its ratio, SD1 and SD2). Exercise heart rate was calculated by recording the area under the curve (AUC) response. Internal session load was evaluated 30 min after each session. Blood concentrations of creatine kinase and lactate dehydrogenase were analyzed before the first visit and 24 h after the last sessions.
Results
The CWI group presented higher rMSSD than the control group at each time point (group-effect P = 0.037). The SD1 was higher in CWI group when compared to the control group following the last exercise session (interaction P = 0.038). SD2 was higher in CWI group compared to the control group at each time point (group-effect P = 0.030). Both groups presented equal CMJ performance (P > 0.05), internal load (group-effect P = 0.702; interaction P = 0.062), heart rate AUC (group-effect P = 0.169; interaction P = 0.663), and creatine kinase and lactate dehydrogenase blood concentrations (P > 0.05).
Conclusion
Repeated post-exercise CWI improves cardiac-autonomic modulation. However, no differences in neuromuscular performance, muscle damage markers, or session internal load were demonstrated between the groups.
... Previous studies have demonstrated cryotherapy as an effective strategy for relieving fatigue symptoms after exercise [21,22]. In the previous study, the mean body temperature and heart rate after 15 minutes of cold-water immersion (CWI) protocols were compared with passive rest. ...
Background:
After high-intensity exercises, the body's core temperature increases, affecting the body's metabolism, increasing thermal stress and muscle fatigue. The most popular technique to maximize post-workout recovery is cryotherapy. However, the cooling effect may vary depending on the body part being cooled since body tissues do not process the same perfusion.
Objective:
This study investigates the effects of hand cooling on human body functional recovery and exercise ability improvement by comparing normal rest and rest with hand cooling gloves after high-intensity exercise.
Methods:
Thirty healthy subjects participated in this study wherein they exercised and used normal rest for one session and hand cooling rest for the next. Blood lactate concentration, heart rate recovery rate, VO2 max measurement, and the degree of recovery of muscle strength, muscular endurance, and muscle fatigue were investigated in both groups to determine the efficacy of hand cooling gloves for postexercise recovery.
Results:
When hands were cooled after exercise, blood lactate concentration and body temperature significantly decreased, and cardiopulmonary function, muscle strength, and muscular endurance significantly recovered.
Conclusion:
Using hand cooling gloves after exercise could attenuate core temperature elevation and improve postexercise recovery. It could also effectively improve athletic performance without using large-scale facilities.
... Exposure to CWI induces acute physiological adjustments, including increased whole-body metabolic heat production (Castellani et al., 1998), reduced muscle metabolic activity (Ihsan et al., 2013), reduced femoral artery blood flow and increased cutaneous vasoconstriction (Mawhinney et al., 2017), reduced muscle and core temperatures (Brazaitis et al., 2014b), and decreased nerve conduction velocity (Algafly and George, 2007). These adjustments are influenced by the duration of exposure, water temperature, and the type of immersion (e.g., single, or intermittent) Brazaitis et al., 2014b;Castellani and Young, 2016). ...
Background: We investigated the impact of moderate muscle cooling induced by single and intermittent/prolonged cold-water immersions (CWI) on muscle force and contractility in unfatigued state and during the development of fatigue resulting from electrically induced contractions.
Methods: Twelve young males participated in this study consisting of two phases [single phase (SP) followed by intermittent/prolonged phase (IPP)], with both phases including two conditions (i.e., four trials in total) performed randomly: control passive sitting (CON) and cold-water immersions (10°C). SP-CWI included one 45 min-bath (from 15 to 60 min). IPP-CWI included three baths (45 min-bath from 15 to 60 min, and 15 min-baths from 165 to 180 min and from 255 to 270 min), with participants sitting at room temperature the rest of the time until 300 min. Blood pressure and intramuscular (Tmu) temperature were assessed, and neuromuscular testing was performed at baseline and 60 min after baseline during SP, and at baseline, 60, 90, 150 and 300 min after baseline during IPP. A fatiguing protocol (100 electrical stimulations) was performed after the last neuromuscular testing of each trial.
Results: In unfatigued state, SP-CWI and IPP-CWI reduced electrically induced torque at 100 Hz (P100) but not at 20 Hz (P20), and increased P20/P100 ratio. The changes from baseline for P100 and P20/P100 ratio were lower in IPP-CWI than SP-CWI. Both cold-water immersion conditions slowed down muscle contraction and relaxation, and reduced maximal isokinetic contraction torque, but the changes from baseline were lower after IPP-CWI than SP-CWI. cold-water immersions did not impair maximal voluntary isometric contraction. During the fatiguing protocol, torque fatigue index and the changes in muscle contractile properties were larger after IPP-CWI than SP-CWI, but were in the same range as after CON conditions. The differences of muscle contractile function between SP-CWI and IPP-CWI were accompanied by a lower reduction of superficial Tmu and a smaller increase in systolic blood pressure after IPP-CWI than SP-CWI.
Conclusion: IPP-CWI induces a less pronounced fast-to-slow contractile transition compared to SP-CWI, and this may result from the reduced vasoconstriction response and enhanced blood perfusion of the superficial muscle vessels, which could ultimately limit the reduction of superficial Tmu.
... This is despite evidence of decreased indirect markers of skeletal muscle damage (i.e., CK efflux and muscle soreness, Figure 4); a plausible recovery mechanism related to the attenuation of secondary muscle damage and soreness (Ihsan et al., 2016). Indeed, CWI is an effective method to decrease tissue temperature, blood flow and metabolism, all of which would be beneficial in limiting the inflammatory response (Choo et al., 2018;Ihsan et al., 2013). On the other hand, CWI-mediated attenuation in inflammatory response, muscle damage biomarkers or enhanced recovery of muscle strength/power is not a universal finding (Jakeman et al., 2009). ...
This review evaluated the effect of CWI on the temporal recovery profile of physical performance, accounting for environmental conditions and prior exercise modality. Sixty-eight studies met the inclusion criteria. Standardised mean differences were calculated for parameters assessed at <1, 1-6, 24, 48, 72 and ≥96 h post-immersion. CWI improved short-term recovery of endurance performance (p = 0.01, 1 h), but impaired sprint (p = 0.03, 1 h) and jump performance (p = 0.04, 6h). CWI improved longer-term recovery of jump performance (p < 0.01-0.02, 24 h and 96 h) and strength (p < 0.01, 24 h), which coincided with decreased creatine kinase (p < 0.01-0.04, 24-72 h), improved muscle soreness (p < 0.01-0.02, 1-72 h) and perceived recovery (p < 0.01, 72 h). CWI improved the recovery of endurance performance following exercise in warm (p < 0.01) and but not in temperate conditions (p = 0.06). CWI improved strength recovery following endurance exercise performed at cool-to-temperate conditions (p = 0.04) and enhanced recovery of sprint performance following resistance exercise (p = 0.04). CWI seems to benefit the acute recovery of endurance performance, and longer-term recovery of muscle strength and power, coinciding with changes in muscle damage markers. This, however, depends on the nature of the preceding exercise.
... Also, it may decrease the passive leakage of intracellular substances utilized as subliminal indicators of muscle injury, such as decreased CK efflux. Prolonged analgesia may result from intravascular fluid shifts due to vasoconstriction, thus facilitating nutrient and waste transport, as well as reducing muscle edema (Cheung et al., 2003;Ihsan et al., 2013;Yanagisawa et al., 2014). In addition, there were inadequate data on the other biochemical indicators such as CRP and IL-6, and thus meta-analyses were difficult to conduct. ...
Cold water immersion (CWI) is very popular as a method reducing post-exercise muscle stiffness, eliminating fatigue, decreasing exercise-induced muscle damage (EIMD), and recovering sports performance. However, there are conflicting opinions as to whether CWI functions positively or negatively. The mechanisms of CWI are still not clear. In this systematic review, we used meta-analysis aims to examine the effect of CWI on fatigue recovery after high-intensity exercise and exercise performance. A total of 20 studies were retrieved and included from PubMed, PEDro and Elsevier databases in this review. Publication years of articles ranged from 2002 to 2022. In selected studies including randomized controlled trials (RCTs) and Crossover design (COD). Analyses of subjective indicators such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE), and objective indicators such as countermovement jump (CMJ) and blood plasma markers including creatine kinase(CK), lactate/lactate dehydrogenase(LDH), C-reactive protein(CRP), and IL-6 were performed. Pooled data showed as follows: CWI resulted in a significant decline in subjective characteristics (delayed-onset muscle soreness and perceived exertion at 0 h); CWI reduced countermovement jump(CMJ) significantly at 0 h, creatine kinase(CK) was lowered at 24 h, and lactate at 24 and 48 h. There was no evidence that CWI affects C-reactive protein(CRP) and IL-6 during a 48-h recovery period. Subgroup analysis revealed that different CWI sites and water temperatures have no effect on post-exercise fatigue recovery. Recommended athletes immersed in cold water immediately after exercise, which can effectively reduce muscle soreness and accelerate fatigue recovery.
... (ref. 98) Os sujeitos imergiram em água fria (10°C), durante 15 minutos, uma perna até ao nível da prega glútea, funcionando a outra, não imersa, como controlo (CON). A temperatura cutânea sobre o músculo vasto externo diminuiu com a IAF (CON = 35,1°C ± 0,6°C vs. IAF = 16,9°C ± 1,7°C, p<0,001), a concentração de hemoglobina também diminuiu com a IAF, com significado estatístico, em relação ao CON, e o índice de oxigenação tecidular aumentou (p<0,05). ...
“Os autores realizaram uma análise da literatura médica publicada sobre os efeitos na sa.de humana após a imersão voluntária em água fria (IAF), tendo encontrado 104 estudos. ... tem sido considerada na literatura médica como promotora da sa.de: melhoria da imunidade, tratamento da depressão, melhoria da circulação periférica, aumento da líbido, queima de calorias e redução do stress. Outros referem os benefícios na diminuição do colesterol pela ativação da gordura castanha e diminuição da inflamação autoimune. ... O efeito da IAF regular sobre a pressão arterial também foi estudado num grupo de 28 habituais nadadores no inverno. ... Existe também resposta hormonal à IAF. A hormona adrenocorticotrófica (ACTH) e os níveis de cortisol parecem diminuir significativamente após um curto período de exposição regular à água fria. ... os autores referem que a IAF poderia ser útil para o funcionamento e crescimento do cérebro, pois é uma atividade bastante stressante para o corpo, que causa libertação de noradrenalina, beta-endorfina e a libertação sináptica de noradrenalina no cérebro ... Até que tenhamos evidências científicas mais concretas, o tema continuar. sendo assunto de debate. ... Contudo, e dentro da opinião pessoal, não parece ser sensato e adequado temperaturas da água á volta dos 7-9 graus C, com exposições mais ou menos longas, preferindo-se temperaturas um pouco mais elevadas (12-14 graus C), e duração de imersão que varie entre 5 a 8 minutos.”
... The temperature can change due to stress and physical effort, where the thermoregulation is expressed due to the increase in temperature (18). These changes would be explained due to the redirection of blood flow to the exercised location, causing peripheral vasoconstriction in the muscles (16). ...
This study aimed to evaluate the local temperature, lactate, and blood glucose in three strength training methods. The study included 12 male subjects; (22.15 ± 5.77 years, 76.85 ± 9.15 kg, 1.72 ± 0.09 m), with minimum of 12 months of strength training experience, and all participated in the three training methods: the occlusion training (Kaatsu); the tension training (Tension); and the traditional training (Traditional). The Kaatsu training consisted in 3 sets of 10RM with occlusion device in both arms inflated to a 130% occlusion pressure. In addition, the tension method was performed with 30% of 1RM and the traditional training, consisted in 10 repetitions with 80% RM. Regarding the temperature variation, differences were observed between the Kaatsu and Traditional methods in relation to Tension (p = .049, η 2 p = 0.187). While for blood glucose (p = .351, η 2 p = 0.075) and lactate (p = .722, η 2 p = 0.022) there were no differences between the methods. Regarding the temperature (°C) measured by thermography and asymmetry, the right side showed a decrease in the post-test, in relation to the pre-test, in all methods (p < .05, η 2 p > 0.150). The left (p = .035, η 2 p = 0.301) and right (p = .012, η 2 p = 0.324) sides showed a decrease in temperature, in the post-test in relation to the pre-test, in the Kaatsu and traditional method. In asymmetry, the three methods showed an increase in the post-test in relation to the pre-test (p = .042, η 2 p = 0.158). In conclusion, tension method seems to stimulate greater heat production than the other methods. This information can help coaches to choose among these training methods according to the desired physiological response.
... Presumably, increases of SmO 2 values can be observed when a muscle has a higher intramuscular temperature, (Weerapong et al., 2005) associated with the alteration and ability to dilate the microvessels during a sustained hyperemic response, (Mayeur et al., 2011) clinically reflected in the transit distance between the capillaries and muscle fibers that facilitate the supply of oxygen to the muscle. (Ihsan et al., 2013) Also, this difference indicates that there is a higher MO 2 Asy (O-F). In female players, only a slower recovery time in the DL as compared to the NDL was affected according to Ryan et al., and this could indicate that there is a better oxidative capacity in the NDL, which is explained by the ratio of SmO 2 recovery time constants to phosphocreatine (PCr). ...
Purpose: It has been hypothesized that sports injury risk is explained by muscle metabolism. The objective was to evaluate the muscle oxygen saturation slopes (ΔSmO2 slopes) and muscle oxygenation asymmetry (MO2Asy) at rest and to study their associations with injuries during the pre-season. Methods: A total of 16 male and 10 female footballers participated in this study. Injuries were diagnosed and classified by level of severity during the pre-season. The workload was also evaluated using the rate of perceived exertion × training time, from which the accumulated loads. The SmO2 was measured at rest in the gastrocnemius muscle using the arterial occlusion method in the dominant and non-dominant legs. The repeated measures ANOVA, relative risk, and binary logistic regression were applied to assess the probability of injury with SmO2 and workload. Results: Higher MO2Asy and ΔSmO2 Slope 2 were found among footballer who suffered high-severity injuries and those who presented no injuries. In addition, an MO2Asy greater than 15% and an increase in accumulated load were variables that explained a greater probability of injury. Conclusion: This study presents the new concept of muscle oxygenation asymmetry in sports science and its possible application in injury prevention through the measurement of SmO2 at rest.
... We and others have conducted a number of studies using continuous Doppler ultrasound assessments of the femoral artery alongside simultaneous measures of cutaneous blood flow, and demonstrated that limb blood flow at rest and after exercise can be markedly reduced by cold-water immersion (4)(5)(6). These findings are consistent with other studies, which used venous occlusion plethysmography (7) and near infrared spectroscopy (4,8,9). However, the aforementioned techniques are limited by their inability to provide a direct assessment of perfusion changes within the muscle and therefore permit only qualitative and indicative interpretations of the efficacy of cold-water immersion. ...
Purpose:
The muscle perfusion response to post-exercise cold water immersion (CWI) is not well understood. We examined the effects of graded post-exercise CWI upon global and regional quadriceps femoris muscle perfusion using positron emission tomography (PET) and [15O]H2O.
Methods:
Using a matched-group design, 30 healthy men performed cycle ergometer exercise at 70% V[Combining Dot Above]O2peak to a core body temperature of 38 °C, followed by either 10 min of CWI at 8 °C, 22 °C or seated rest (control). Quadriceps muscle perfusion, thigh and calf cutaneous vascular conductance (CVC), intestinal, muscle, and local skin temperatures, thermal comfort, mean arterial pressure, and heart rate were assessed at pre-, post-exercise and following CWI.
Results:
Global quadriceps perfusion was reduced beyond the pre-defined minimal clinically relevant threshold (0.75 mL·100 g·min-1) in 22 °C water versus control (difference [95% confidence interval (CI)]: -2.5 mL·100 g·min-1 [-3.9 to -1.1]). Clinically relevant decreases in muscle perfusion were observed in the rectus femoris (-2.0 mL·100 g·min-1 [-3.0 to -1.0]) and vastus lateralis (VL; -3.5 mL·100 g·min-1 [-4.9 to -2.0]) in 8 °C water, and in the vastus lateralis (-3.3 mL·100 g·min-1 [-4.8 to -1.9]) in 22 °C water versus control. The mean effects for vastus intermedius and vastus medialis perfusion were not clinically relevant. Clinically relevant decreases in thigh and calf CVC were observed in both cooling conditions.
Conclusions:
The present findings revealed that less noxious CWI (22 °C) promoted clinically relevant post-exercise decreases in global quadriceps muscle perfusion whereas noxious cooling (8 °C) elicited no effect.
... Ihsan et al. concluded that post-exercise cooling decreased microvascular perfusion and muscle metabolic activity. These findings are consistent with the suggested mechanisms by which CWI is hypothesized to improve local muscle recovery (Ihsan et al., 2013). We observed an increase in PI after PBC in the present study as reported in other studies (Hohenauer et al., 2019). ...
This research aims to describe and compare the effects of partial-body cryotherapy (PBC) and cold-water immersion (CWI) on the physiological responses of soccer players after cycling in a hot and humid environment. Sixteen elite soccer players participated in three experiments, and received CWI (13°C for 15 min), PBC (110°C−140°C for 3 min), and CON (room temperature: 21°C ± 2°C), respectively, after aerobic and anaerobic cycling in a hot and humid environment (temperature: 35°C–38°C; humidity: 60%–70%). Heart rate (HR), blood lactate (BLa-), perfusion index (PI), oxygen saturation (SaO 2 ), core temperature (Tc), skin temperature (Ts), and rating of perceived exertion (RPE) were assessed at baseline and through 20 min (5-min intervals). HR was lower in CWI than CON after 20 min ( p < .05). SaO 2 was higher in CWI than PBC and CON between 10 and 20 min ( p < .05). Tc was lower from CWI and PBC than CON between 10 and 20 min ( p < .05). Ts was lower in PBC than CWI between 15 and 20 min ( p < .05). RPE was lower in PBC than CON 20 min after the exercise ( p < .05). No main group differences for BLa- and PI were observed. The physiological effects of PBC are generally similar to CWI. Compared with CON, both CWI and PBC could promote the recovery of physiological indexes within 20 min of exercise in a hot and humid environment. However, PBC can lead to a decrease in SaO 2 due to excessive nitrogen inhalation.
... Over the last decade, work shifted towards understanding the central roles that postimmersion changes in muscle temperature (reduction up to − 6.4 °C; Freitage et al. 2021), and limb and cutaneous blood flow (20-30% reduction vascular conductance; Gregson et al. 2011) play in influencing the recovery process. Later studies made use of technological advances to progress earlier work in this area assessing cooling-induced changes in muscle blood flow per se (Ihsan et al. 2013;Mawhinney et al. 2020;Choo et al. 2018). Recent advances in the field of cellular and molecular physiology have also enabled regulatory mechanisms in human skeletal muscle to be studied, developing our insight into important pathways involved in endurance (Joo et al. 2016;Ihsan et al. 2015) and strength (Roberts et al. 2015;Fyfe et al. 2019;Peake et al. 2020) adaptation after cold-water exposure. ...
For centuries, cold temperatures have been used by humans for therapeutic, health and sporting recovery purposes. This application of cold for therapeutic purposes is regularly referred to as cryotherapy. Cryotherapies including ice, cold-water and cold air have been popularised by an ability to remove heat, reduce core and tissue temperatures, and alter blood flow in humans. The resulting downstream effects upon human physiologies providing benefits that include a reduced perception of pain, or analgesia, and an improved sensation of well-being. Ultimately, such benefits have been translated into therapies that may assist in improving post-exercise recovery, with further investigations assessing the role that cryotherapies can play in attenuating the ensuing post-exercise inflammatory response. Whilst considerable progress has been made in our understanding of the mechanistic changes associated with adopting cryotherapies, research focus tends to look towards the future rather than to the past. It has been suggested that this might be due to the notion of progress being defined as change over time from lower to higher states of knowledge. However, a historical perspective, studying a subject in light of its earliest phase and subsequent evolution, could help sharpen one's vision of the present; helping to generate new research questions as well as look at old questions in new ways. Therefore, the aim of this brief historical perspective is to highlight the origins of the many arms of this popular recovery and treatment technique, whilst further assessing the changing face of cryotherapy. We conclude by discussing what lies ahead in the future for cold-application techniques.
... Results from the meta-regression show that shorter duration CWI (~ 12 min) may positively influence endurance performance more than longer durations (14-15 min) 24 h after exercise. It is also possible that the temperature of the immersions influenced the null results seen, as lower immersion temperatures result in decreased muscle temperature which leads to decreased blood flow, swelling and oedema [99]; all but one study used a temperature of 15 ℃, and meta-regression was therefore not possible due to the lack of variation. The very low GRADE rating for this timepoint indicates the high level of variability amongst the studies. ...
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.
... The most reported mechanisms associated with benefits of CWI were cardiovascular alterations in blood flow and constriction of blood vessels. To date, a significant amount of work has demonstrated reduced limb blood flow, or reduced blood volume, across the exercised muscle following CWI [47,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70]. However, more recent data [71] employing positron emission tomography (PET) with an oxygen-15-labelled water radiotracer ([ 15 O]H 2 O) suggests that application of noxious water temperatures (< 8 °C) may actually result in less pronounced reductions in muscle perfusion compared with less noxious (15 °C) immersion (under resting conditions). ...
This survey sought to establish current use, knowledge and perceptions of cold-water immersion (CWI) when used for recovery. 111 athletes, coaches and support practitioners completed the anonymous online survey, answering questions about their current CWI protocols, perceptions of benefits associated with CWI and knowledge of controlling mechanisms. Respondents were largely involved in elite sport at international, national and club level, with many having used CWI previously (86%) and finding its use beneficial for recovery (78%). Protocols differed, with the duration of immersion one aspect that failed to align with recommendations in the scientific literature. Whilst many respondents were aware of benefits associated with CWI, there remains some confusion. There also seems to be a gap in mechanistic knowledge, where respondents are aware of benefits associated with CWI, but failed to identify the underlying mechanisms. This identifies the need for an improved method of knowledge transfer between scientific and applied practice communities. Moreover, data herein emphasises the important role of the ‘support practitioner’ as respondents in this role tended to favour CWI protocols more aligned to recommendations within the literature. With a significant number of respondents claiming they were made aware of CWI for recovery through a colleague (43%), the importance of knowledge transfer and context being appropriately applied to data is as important as ever. With the firm belief that CWI is useful for recovery in sport, the focus should now be on investigating the psychophysiological interaction and correct use of this methodology.
... Unfortunately, the causes that can lead to CWI and TWI more efficient to reducing blood lactate remain unclear. Despite the differences between the two studies, we assumed that the similar results in our study may have been caused by the vasoconstrictive effect caused by CWI can reduce muscle temperature, and because of this it can reduce blood flow (perfusion), muscle metabolism, inflammation and edema [21,41,42]. However, since we did not measure muscle, skin, and core temperatures, future studies are expected to use these physiological parameters to better elucidate these aspects of recovery modalities in futsal players. ...
This study examined the effects of cold-water immersion group (CWI), foam rolling group (FR), and a slow jogging group (SJR) on creatine kinase activity (CK), blood lactate concentration, perceptual measures (PM) and anaerobic performance after exhibition game in futsal players. 24 male futsal athletes, were recruited into the study; 8 participants were assigned to the CWI group were given cold-water recovery, 8 to the FR group were given roller exercises, and another 8 to the SJR group were given slow jogging recovery. All of the groups required to completed a 20-m sprint test was determined before and 24-h after recovery interventions. Creatine kinase (CK) activity was assessed at the pre-sprint test and in 24-h after recovery interventions, and blood lactate concentration in the pre-sprint test, immediately after the match, immediately after recovery interventions, and 15-min after recovery interventions. The total quality recovery (TQR), and visual analog-scale (VAS) was evaluated in pre- and after recovery interventions. CWI group were significantly to reducing blood lactate concentration compared with SJR group in immediately after recovery (3.13 ± 0.46 vs 3.76 ± 0.26, p = 0.026), and 15-min after recovery interventions (1.91 ± 0.37 vs 2.36 ± 0.29, p = 0.007). No prominent differences were detected in all three groups to reducing CK activity in 24-h after recovery interventions. Post-hoc comparisons showed that TQR values in 24-h after recovery interventions of the CWI group were significantly higher compared with RF and SJR groups (all p < 0.001). VAS values were significantly lower in the CWI group than RF (p = 0.002), and SJR (p < 0.001) groups in 24-h after recovery interventions. CWI group more efficient in reducing blood lactate concentration compared with SJR group at immediately after recovery, and 15-min after recovery interventions.
... This is supported by D' Souza et al. (2018) demonstrating increased muscle capillarity following 12 weeks of resistance training with regular CWI application with concomitant decreases in muscle mass reported in other companion papers (Roberts et al., 2015;Peake et al., 2017). Reductions in muscle blood flow and metabolism during CWI may reduce O 2 supply and utilization (Ihsan et al., 2013;Mawhinney et al., 2013Mawhinney et al., , 2020Choo et al., 2016), triggering compensatory adaptation involving decreased muscle mass and microvascular expansion to maintain perfusion capacity. Further support for such a phenotypic response can be derived from rodent and human models of cold-acclimation. ...
In the last decade, cold water immersion (CWI) has emerged as one of the most popular post-exercise recovery strategies utilized amongst athletes during training and competition. Following earlier research on the effects of CWI on the recovery of exercise performance and associated mechanisms, the recent focus has been on how CWI might influence adaptations to exercise. This line of enquiry stems from classical work demonstrating improved endurance and mitochondrial development in rodents exposed to repeated cold exposures. Moreover, there was strong rationale that CWI might enhance adaptations to exercise, given the discovery, and central role of peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) in both cold- and exercise-induced oxidative adaptations. Research on adaptations to post-exercise CWI have generally indicated a mode-dependant effect, where resistance training adaptations were diminished, whilst aerobic exercise performance seems unaffected but demonstrates premise for enhancement. However, the general suitability of CWI as a recovery modality has been the focus of considerable debate, primarily given the dampening effect on hypertrophy gains. In this mini-review, we highlight the key mechanisms surrounding CWI and endurance exercise adaptations, reiterating the potential for CWI to enhance endurance performance, with support from classical and contemporary works. This review also discusses the implications and insights (with regards to endurance and strength adaptations) gathered from recent studies examining the longer-term effects of CWI on training performance and recovery. Lastly, a periodized approach to recovery is proposed, where the use of CWI may be incorporated during competition or intensified training, whilst strategically avoiding periods following training focused on improving muscle strength or hypertrophy.
... The potential short-term benefits of CWI are nevertheless thought to be primarily mediated by the local vasoconstriction and increased hydrostatic pressure attributed to the cold water temperature and depth associated with CWI, respectively (Wilcock et al., 2006). These factors are thought to exert various physiological effects, including decreased metabolic activity (Ihsan et al., 2013), altered hormonal responses (Earp et al., 2019), infiltration of immune cells (Lee et al., 2005), and reduced limb blood flow (Gregson et al., 2011;Mawhinney et al., 2013Mawhinney et al., , 2017. Ultimately, these purported short-term benefits of CWI are theorized to enhance physiological adaptations to exercise training by improving the quantity and/or quality of subsequent training sessions (Barnett, 2006). ...
Post-exercise cold-water immersion (CWI) is a popular recovery modality aimed at minimizing fatigue and hastening recovery following exercise. In this regard, CWI has been shown to be beneficial for accelerating post-exercise recovery of various parameters including muscle strength, muscle soreness, inflammation, muscle damage, and perceptions of fatigue. Improved recovery following an exercise session facilitated by CWI is thought to enhance the quality and training load of subsequent training sessions, thereby providing a greater training stimulus for long-term physiological adaptations. However, studies investigating the long-term effects of repeated post-exercise CWI instead suggest CWI may attenuate physiological adaptations to exercise training in a mode-specific manner. Specifically, there is evidence post-exercise CWI can attenuate improvements in physiological adaptations to resistance training, including aspects of maximal strength, power, and skeletal muscle hypertrophy, without negatively influencing endurance training adaptations. Several studies have investigated the effects of CWI on the molecular responses to resistance exercise in an attempt to identify the mechanisms by which CWI attenuates physiological adaptations to resistance training. Although evidence is limited, it appears that CWI attenuates the activation of anabolic signaling pathways and the increase in muscle protein synthesis following acute and chronic resistance exercise, which may mediate the negative effects of CWI on long-term resistance training adaptations. There are, however, a number of methodological factors that must be considered when interpreting evidence for the effects of post-exercise CWI on physiological adaptations to resistance training and the potential underlying mechanisms. This review outlines and critiques the available evidence on the effects of CWI on long-term resistance training adaptations and the underlying molecular mechanisms in skeletal muscle, and suggests potential directions for future research to further elucidate the effects of CWI on resistance training adaptations.
... Indeed, during the PBC session, ΔO 2 Hb decreased while ΔHHb increased. Cold exposure, regardless of the cryostimulation technique, is well known to induce a decrease in muscle, limbic, and skin blood flow, due to vasoconstriction [61][62][63][64] . However, this phenomenon is still poorly understood at the brain level. ...
We assessed the effects of a 3-min partial-body cryostimulation (PBC) exposure-where the whole body is exposed to extreme cold, except the head-on cognitive inhibition performance and the possible implications of parasympathetic cardiac control and cerebral oxygenation. In a randomized controlled counterbalanced cross-over design, eighteen healthy young adults (nine males and nine females) completed a cognitive Stroop task before and after one single session of PBC (3-min exposure at − 150 °C cold air) and a control condition (3 min at room temperature, 20 °C). During the cognitive task, heart rate variability (HRV) and cerebral oxygenation of the prefrontal cortex were measured using heart rate monitoring and near-infrared spectroscopy methods. We also recorded the cerebral oxygenation during the PBC session. Stroop performance after PBC exposure was enhanced (562.0 ± 40.2 ms) compared to pre-PBC (602.0 ± 56.4 ms; P < 0.042) in males only, accompanied by an increase (P < 0.05) in HRV indices of parasympathetic tone, in greater proportion in males compared to females. During PBC, cerebral oxygenation decreased in a similar proportion in males and females but the cerebral extraction (deoxyhemoglobin: ΔHHb) remained higher after exposure in males, only. These data demonstrate that a single PBC session enhances the cognitive inhibition performance on a Stroop task in males, partly mediated by a greater parasympathetic cardiac control and greater cerebral oxygenation. The effects of PBC on cognitive function seem different in females, possibly explained by a different sensitivity to cold stimulation.
... The suggested mechanisms contributing to the reduction effect of CWI on muscle damage include hydrostatic pressure causes by CWI that results in an increase in the osmotic slope and clearing [14,18,32]. Also, hydrostatic pressure and vasoconstriction can increase central venous pressure and volume, thereby eliminating debris [16,17,23]. The results related to lactate in this research were accordant with others, and the majority of those have revealed that CWI is not an efficient treatment for lactate evacuation. ...
Study aim : To investigate the effect of cold water immersion (CWI) on muscle damage indexes after simulated soccer activity in young soccer players.
Material and methods : Eighteen professional male soccer players were randomly divided into two groups: CWI (n = 10, age 19.3 ± 0.5, body mass index 22.2 ± 1.3) and control (n = 8, age 19.4 ± 0.8, body mass index 21.7 ± 1.5). Both groups performed a simulated 90-minute soccer-specific aerobic field test (SAFT ⁹⁰ ). Then, the CWI group subjects immersed themselves for 10 minutes in 8°C water, while the control group subjects sat passively for the same time period. Blood samples were taken before, immediately after, 10 minutes, 24 hours and 48 hours after the training session in a fasted state. Blood lactate, creatine kinase (CK) and lactate dehydrogenase (LDH) enzyme levels were measured.
Results : Lactate, CK and LDH levels increased significantly after training (p < 0.001). There were significant interactions between groups and subsequent measurements for CK (p = 0.0012) and LDH (p = 0.0471). There was no significant difference in lactate level between the two groups at any aforementioned time.
Conclusion : It seems that CWI after simulated 90-minute soccer training can reduce the values of muscle damage indexes in soccer players.
... Measurements were carried out with the portable NIRS sensor (MOXY, Fortiori Design LLC, Hutchinson, MN USA). NIRS uses at modified form of the Beer−Lambert law to determine micro-molar changes in tissue oxyhemoglobin, deoxyhemoglobin, and total hemoglobin using differences in light absorption characteristics at 750 and 850 nm, calculated in terms of the index tissue saturation or SmO2 (TSI, expressed in % and calculated as oxyhemoglobin/(oxyhemoglobin + deoxyhemoglobin) × 100) [18]. These data were averaged based on 1 s, and a moving average (3 s) was applied to smooth the signal with the Golden Cheetah (version 3.4). ...
Muscle oxygen consumption could provide information on oxidative metabolism in women soccer players. Therefore, the objective of this study was to analyze muscle oxygenation dynamics during repeated sprint ability (RSA): (8 sprint × 20 s recovery) by near-infrared spectroscopy (NIRS). The sample was made up of 38 professional women soccer players. To measure the external load, the best time, worst time, average time, individual speed, sprint decrement, and power were assessed. In connection with the internal load, the desaturation (sprint) and re-saturation (recovery) rates, as well as the oxygen extraction (∇%SmO2) in the gastrocnemius muscle and maximum heart rate (%HRmax) were measured. A repeated measures statistic was applied based on the inter-individual response of each subject from the baseline versus the other sprints, with linear regression and nonlinear regression analyses between variables. There was an increase in the SmO2: desaturation rate after four sprints (Δ = 32%), in the re-saturation rate after six sprints (Δ = 89%), and in ∇%SmO2 after four sprints (Δ = 72.1%). There was a linear association between the rates of desaturation and re-saturation relationships and the worst time (r = 0.85), and a non-linear association between ∇%SmO2 and speed (r = 0.89) and between ∇%SmO2 and the sprint decrease (r = 0.93). The progressive increase in SmO2 during RSA is a performance limitation to maintain a high speed; it depends on the capacity of fatigue resistance. Therefore, monitoring the muscle oxygenation dynamics could be a useful tool to evaluate the performance in women soccer players.
... reduced sensation of DOMS (Figure 3), independent of muscle damage. Indeed, perception of DOMS seems to be important to the recovery of exercise performance, as muscle pain independent of muscle damage has been shown to impair force generating capacity (Graven-Nielsen et al., 2002) Accordingly, CWI has been suggested to modulate the sensation of DOMS, and by extension muscle function, through limiting oedema (Ihsan et al., 2013;Choo et al., 2016) and/or through activating cutaneous receptors that mediate analgesia (Knowlton et al., 2013;Ihsan et al., 2016). Counterintuitive to the notion of recovery, CWI resulted in moderate and large decrements in POST-R for 5-m and 10-m sprint performances, respectively (Figure 1). ...
Objective: The aim of the present study was to examine the effect of Cold Water Immersion (CWI) on the recovery of physical performance, hematological stress markers and perceived wellness (i.e., Hooper scores) following a simulated Mixed Martial Arts (MMA) competition. Methods: Participants completed two experimental sessions in a counter-balanced order (CWI or passive recovery for control condition: CON), after a simulated MMAs competition (3 x 5-min MMA rounds separated by 1-min of passive rest). During CWI, athletes were required to submerge their bodies, except the trunk, neck and head, in the seated position in a temperature-controlled bath (similar to 10 degrees C) for 15-min. During CON, athletes were required to be in a seated position for 15-min in same room ambient temperature. Venous blood samples (creatine kinase, cortisol, and testosterone concentrations) were collected at rest (PRE-EX, i.e., before MMAs), immediately following MMAs (POST-EX), immediately following recovery (POST-R) and 24 h post MMAs (POST-24), whilst physical fitness (squat jump, countermovement-jump and 5- and 10-m sprints) and perceptual measures (well-being Hooper index: fatigue, stress, delayed onset muscle soreness (DOMS), and sleep) were collected at PRE-EX, POST-R and POST-24, and at PRE-EX and POST-24, respectively. Results: The main results indicate that POST-R sprint (5- and 10-m) performances were 'likely to very likely' (d = 0.64 and 0.65) impaired by prior CWI. However, moderate improvements were in 10-m sprint performance were 'likely' evident at POST-24 after CWI compared with CON (d = 0.53). Additionally, the use of CWI 'almost certainly' resulted in a large overall improvement in Hooper scores (d = 1.93). Specifically, CWI 'almost certainly' resulted in improved sleep quality (d = 1.36), stress (d = 1.56) and perceived fatigue (d = 1.51), and 'likely' resulted in a moderate decrease in DOMS (d = 0.60). Conclusion: The use of CWI resulted in an enhanced recovery of 10-m sprint performance, as well as improved perceived wellness 24-h following simulated MMA competition.
... Limited scope of this study's research questions do not include consideration of published mechanisms by which CWI may affect recovery from exercise in stressful environments: reduced thermal strain and hyperthermia-induced fatigue (Ingram et al. 2009;Peiffer et al. 2009;Ihsan et al. 2016); vasoconstriction that reduces swelling and aids in metabolite removal Ingram et al. 2009;Bleakley and Davison 2010;Hausswirth et al. 2012;Pointon et al. 2012); reduced cardiovascular strain by redistributing blood flow from the periphery (Vaile et al. 2011;Ihsan et al. 2013); and central nervous system effects (Al Haddad et al. 2010). All of these potential mechanisms can support reduced exerciseinduced muscle damage (Bailey et al. 2007;Goodall and Howatson 2008;Vaile et al. 2008;Ascensao et al. 2011;Pointon et al. 2011) and inflammation (Vaile et al. 2008;Rowsell et al. 2009;Ascensao et al. 2011). ...
Cold water immersion (CWI) purportedly reduces inflammation and improves muscle recovery after exercise, yet its effectiveness in specific contexts (ultraendurance) remains unclear. Thus, our aim was to study hematological profiles, systemic inflammation, and muscle damage responses to a specific post-race CWI (vs. control) during recovery after the Ironman World Championship, a culmination of ∼100 000 athletes competing in global qualifying Ironman events each year. Twenty-nine competitors were randomized into either a CWI or control (CON) group. Physiological parameters and blood samples were taken at pre-race, after intervention (POST), and 24 (+1DAY) and 48 hours (+2DAY) following the race. Muscle damage markers (plasma myoglobin, serum creatine kinase) were elevated at POST, +1DAY, and +2DAY, while inflammatory cytokines interleukin (IL)-6, IL-8, and IL-10 and total leukocyte counts were increased only at POST. CWI had no effect on these markers. Numbers of the most abundant circulating cell type, neutrophils, were elevated at POST more so in CWI (p < 0.05, vs. CON). Despite that neutrophil counts may be a sensitive marker to detect subtle effects, CWI does not affect recovery markers 24- and 48-hours post-race (vs. CON). Overall, we determined that our short CWI protocol was not sufficient to improve recovery.
Novelty:Ironman World Championship event increased circulating muscle damage markers, inflammatory markers, and hematological parameters, including circulating immune cell sub-populations that recover 24–48 hours after the race.
12-min CWI post-ultraendurance event affects the absolute numbers of neutrophils acutely, post-race (vs. CON), but does not impact recovery 24- and 48-hours post-race.
... Prolonging the duration of tissue cooling has previously been suggested as a critical component in reducing the secondary muscle damage response 19,20 and mitigating the overall extent of tissue damage. [21][22][23][24] A longer duration of cooling can be achieved by utilizing phase change material (PCM) packs that freeze at 15°C. The influence of three hours of PCM cooling on muscle temperature, core temperature, and the cardiovascular response has recently been established and compared with a temperature matched CWI protocol. ...
Runners commonly utilise cryotherapy as part of their recovery strategy. Cryotherapy has been ineffective in mitigating signs and symptoms of muscle damage following marathon running and is limited by its duration of application. Phase change material (PCM) packs can prolong the duration of cooling. This study aimed to test the efficacy of prolonging the duration of cooling using PCM on perceptual recovery, neuromuscular function, and blood markers following a marathon run. Thirty participants completed a marathon run and were randomised to receive three hours of 15°C PCM treatment covering the quadriceps or recover without an intervention (control). Quadriceps soreness, strength, counter‐movement jump (CMJ) height, creatine kinase (CK), and high sensitivity c‐reactive protein (hsCRP) were recorded at baseline, 24, 48 and 72 hours after the marathon. Following the marathon strength decreased in both groups (P<0.0001), with no difference between groups. Compared to baseline, strength was reduced 24 (P=0.004) and 48 hours after the marathon (P=0.008) in the control group, but only 24 hours (P=0.028) in the PCM group. Soreness increased (P<0.0001) and CMJ height decreased (P<0.0001) in both groups, with no difference between groups. Compared to baseline, CMJ height was not reduced on any days in the PCM group but was reduced in the control group 24 (P<0.0001) and 48 hours (P=0.003) after the marathon. CK and hsCRP increased in both groups (P<0.0001). Although the marathon run induced significant muscle damage, prolonging the duration of cooling using PCM did not accelerate the resolution of any dependent variables.
... The proposed effects of CWI have been attributed to local vasoconstriction and hydrostatic pressure caused by cold water temperature and water depth [1], respectively. These effects may contribute to physiological alterations such as decreases in metabolic activity [6], hormone secretion [7], infiltration of immune cells [8], and limb blood flow [9][10][11]. Although there is no consensus [12,13], these alterations may acutely decrease markers associated with exercise-induced muscle damage and inflammation [3,7,[14][15][16], reduce delayed onset muscle soreness (DOMS) [14,17,18], and maintain muscle function [16,19,20], thereby improving muscle recovery. ...
Background: Cold-water immersion (CWI) is one of the main recovery methods used in sports, and is commonly utilized as a means to expedite the recovery of performance during periods of exercise training. In recent decades, there have been indications that regular CWI use is potentially harmful to resistance training adaptations, and, conversely, potentially beneficial to endurance training adaptations. The current meta-analysis was conducted to assess the effects of the regular CWI use during exercise training on resistance (i.e., strength) and endurance (i.e., aerobic exercise) performance alterations.
Methods: A computerized literature search was conducted, ending on November 25, 2019. The databases searched were MEDLINE, Cochrane Central Register of Controlled Trials, and SPORTDiscuss. The selected studies investigated the effects of chronic CWI interventions associated with resistance and endurance training sessions on exercise performance improvements. The criteria for inclusion of studies were: (1) being a controlled investigation; (2) conducted with humans; (3) CWI performed at ≤15 °C; (4) being associated with a regular training program; and (5) having performed baseline and post training assessments.
Results: Eight articles were included before the review process. A harmful effect of CWI associated with resistance training was verified for one-repetition maximum, maximum isometric strength, and strength endurance performance (overall standardized mean difference [SMD] = − 0.60; Confidence interval of 95% [CI95%] = − 0.87, − 0.33; p < 0.0001), as well as for Ballistic efforts performance (overall SMD = − 0.61; CI95% = − 1.11, − 0.11; p = 0.02). On the other hand, selected studies verified no effect of CWI associated with endurance training on time-trial (mean power), maximal aerobic power in graded exercise test performance (overall SMD = − 0.07; CI95% = − 0.54, 0.53; p = 0.71), or time-trial performance (duration) (overall SMD = 0.00; CI95% = − 0.58, 0.58; p = 1.00).
Conclusions: The regular use of CWI associated with exercise programs has a deleterious effect on resistance training adaptations but does not appear to affect aerobic exercise performance.
Trial Registration: PROSPERO CRD42018098898.
The therapeutic application of any modality that removes heat from the body and results
in a decrease in tissue temperature may come under the umbrella term of ‘cryotherapy’.
Commonly used in sport for injury, rehabilitation, and recovery for readiness to perform,
the typical rationale for its use is a reduction in perception of pain, or muscle soreness
among other physiological responses. To facilitate the recovery process from sports injury,
cryotherapeutic modalities are often applied with the intention to positively control and
affect metabolic and inflammatory processes, with the aim of aiding in the healing process,
not preventing it altogether. That said, debates concerning the use of cryotherapy within
early stages of an injury are prevalent in recent literature. Although, this is predominantly
due to a lack of understanding of the multifaceted responses that underpin its beneficial
use within a sporting context. Consequently, optimal cooling protocols for the recovery
of sport injury are limited, despite supporting evidence for its use. Yet it is known that
modalities and protocols differ in the responses they can achieve.
Recent applied research (Alexander et al., 2021; Alexander et al, 2021a) has demonstrated
that several variables affect the optimisation of cooling protocols for injury recovery
including, although not limited to the thermodynamic properties of cooling modes, dose
exposure, compression adjunct, phase change and markers of performance. Adaptations
to these variables have shown to affect biomechanical, biochemical, physiological and
psychological responses synchronously. Therefore, we cannot consider the impact of
cryotherapy on one of these response without the other when devising optimal applications
for sport injury recovery. Consequently, for cryotherapy to be effective as a treatment
modality in the use of sport injury, its ability to reduce tissue temperature within a safe
therapeutic range combined with practitioner decision-making around application
timing and modality choice is key. Several advancements in cooling technologies and
protocols from our work and others have been developed to offer a better understanding
of the multifaceted response to cryotherapy for sport injury recovery. Furthermore, to
maximise the effectiveness of its use within the applied setting, our research continues
to investigate the individualisation of cryotherapeutic protocols in consideration of the
underlying mechanisms to optimally affect the physiological, biomechanical, biochemical
and psychological responses most appropriately within elite sport populations. The aim of
this short review is however to provide a contemporary critical discussion on the current
approaches of cooling modalities in the recovery from injury within a sporting context.
Physical Activity 3(1) 2025: 00—00 | https://doi.org/10.63020/pa.2025.3.1.00
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Healthy aging is a crucial goal in aging societies of the western world, with various lifestyle strategies being employed to achieve it. Among these strategies, hydrotherapy stands out for its potential to promote cardiovascular and mental health. Cold water therapy, a hydrotherapy technique, has emerged as a lifestyle strategy with the potential capacity to evoke a wide array of health benefits. This review aims to synthesize the extensive body of research surrounding cold water therapy and its beneficial effects on various health systems as well as the underlying biological mechanisms driving these benefits. We conducted a search for interventional and observational cohort studies from MEDLINE and EMBASE up to July 2024. Deliberate exposure of the body to cold water results in distinct physiological responses that may be linked to several health benefits. Evidence, primarily from small interventional studies, suggests that cold water therapy positively impacts cardiometabolic risk factors, stimulates brown adipose tissue and promotes energy expenditure—potentially reducing the risk of cardiometabolic diseases. It also triggers the release of stress hormones, catecholamines and endorphins, enhancing alertness and elevating mood, which may alleviate mental health conditions. Cold water therapy also reduces inflammation, boosts the immune system, promotes sleep and enhances recovery following exercise. The optimal duration and temperature needed to derive maximal benefits is uncertain but current evidence suggests that short-term exposure and lower temperatures may be more beneficial. Overall, cold water therapy presents a potential lifestyle strategy to enhancing physical and mental well-being, promoting healthy aging and extending the healthspan, but definitive interventional evidence is warranted.
Introduction
Some experts recommend that ambulant hypothermic patients should be rewarmed, fed, and not permitted to exercise for 30 min because of concerns that afterdrop can cause cardiac instability. We investigated the outcome of ambulant hypothermic patients in a case series from mountain rescue teams in Great Britain.
Methods
A questionnaire was used to collect information on a series of adult patients with a clinical diagnosis of mild hypothermia. All patients were alert on the AVPU scale and evacuated by walking from the mountain. The outcome measures were survival or a change in management because of medical deterioration during evacuation.
Results
A series of 108 eligible cases were reported over a 5-year period. When rescuers arrived on the scene, 98 (91%) patients were stationary, and 10 (9%) were still mobile. Thirty-eight (39%) of the stationary cases were walked immediately off the mountain without any on-scene delay. In the remaining 60 (61%) stationary cases, the decision was taken to delay evacuation to provide food, drinks, and additional clothing. In 3 cases, the use of heat packs indicated an intention to actively rewarm. In cases where the on-scene time was reported, 27 (79%) were known to be mobile again within 20 min. All patients survived, and no adverse medical events occurred in all 108 cases.
Conclusions
In this study, no adverse events occurred because of immediate mobilization, suggesting that in these cases, there appears to be minimal risk of early activity.
Cryotherapy has garnered significant attention in several medical and high-level sport performance domains. Although it is necessary to evaluate this technique’s efficacy in recovery processes, numerous studies have shown its usefulness in improving physical performance. Multiple physiological and psychological mechanisms have been identified. The present chapter explores the complex interplay between cryotherapy and its effects on vascular and haemodynamic factors.
Disuse is associated with reduced muscle oxygen saturation (SmO2). Improving oxygen delivery to tissues is important for healing, preventing muscle atrophy, and reducing the risk of deep vein thrombosis. Mobility devices are used during disuse periods to ambulate and protect the injured limb. This study examined SmO2 in walking and ambulation with various mobility devices. Thirty-eight participants randomly completed four, ten-minute trials which included: (1) walking, (2) medical kneeling scooter (MKS), (3) hands-free crutch (HFC), and (4) axillary crutch (AC). During each trial, near infrared spectroscopy sensors were placed on the vastus lateralis (VL), biceps femoris (BF), and lateral gastrocnemius (LG) of the right limb. Compared to walking, all mobility devices showed a decline in SmO2 in the VL of ∼10% (mean ± SD; 75% ± 12%–65% ± 17%, P < 0.05). In the BF, SmO2 declined ∼9% in AC compared to walking (76% ± 12%–67% ± 17%, P = 0.025). In the LG, SmO2 declined in AC (64% ± 16%) compared to MKS (70% ± 15%, P = 0.005). There were no differences in LG SmO2 compared to walking (69% ± 13%) in MKS (P > 0.05) or HFC (65% ± 15%, P > 0.05). In young, healthy volunteers, the use of mobility devices altered muscle oxygenation in several muscles. AC reduced muscle oxygenation in the VL, BF, and LG; while MKS and HFC maintained BF and LG muscle oxygenation at a level consistent with ambulatory walking.
Context:
Cold-water immersion (CWI) is reported to reduce tissue metabolism post immersion, yet there is a lack of physiologic data regarding muscle metabolic response to its application. Near-infrared Spectroscopy (NIRS) is a non-invasive optical technique that can inform upon muscle haemodynamics and tissue metabolism.
Objective:
The purpose of our study was to investigate the effects of CWI at two different water temperatures (10°C and 15°C) upon NIRS calculated measurements of muscle oxygen consumption (mVO2).
Design:
A randomised, crossover design.
Setting:
University Sports Rehabilitation Centre.
Participants:
Eleven long-distance runners (age; 23.4 ± 3.4 years, mean adipose tissue thickness; 6.7 ± 2.7 mm) (NCAA Division 2), adult males.
Main outcome measure(s):
mVO2 was calculated pre and post immersion at both 10°C and 15°C. Changes in tissue oxyhaemoglobin (O2Hb), deoxyhaemoglobin (HHb), total haemoglobin (tHb), haemoglobin difference (Hbdiff) and tissue saturation index (TSI %) were measured during both 20 minute immersion temperatures.
Results:
There was a significant decrease in mVO2 following both the 10°C and 15°C immersion (P = 0.001). During the 20 min immersion at both temperatures there was a significant main effect of time for O2Hb (P = 0.001)), HHb (P = 0.009) tHb (P = 0.001), and Hbdiff (P = 0.020), in which they decreased over the course of the 20 min immersion. Post-hoc pairwise comparisons showed these changes occurred within the final 5 minutes of immersion for tHb and O2Hb.
Conclusions:
Our results demonstrated that a 20 min CWI at 10°C and 15°C led to a significant reduction in mVO2. The reduction in mVO2 was greater following 10°C immersion. The reduction in mVO2 suggests a decrease in muscle metabolic activity i.e. O2 utilisation following CWI. Calculating mVO2 via the NIRS-occlusion technique may offer further insight into muscle metabolic responses, beyond what is attainable from observing the NIRS primary signals.
3 ﻫﺪاﯾﺘﯽ ﻣﻬﺪي ، 4 زرﮐﺶ ،ﻣﺮﯾﻢ 5 1 داﻧ ﮐﯿﺶ اﻟﻤﻠﻞ ﺑﯿﻦ ﭘﺮدﯾﺲ ورژﺷﯽ ﻓﯿﺰﯾﻮﻟﻮژي دﮐﺘﺮي داﻧﺸﺠﻮي. ﺗﻬﺮان ﺸﮕﺎه 2 ﺗﻬﺮان داﻧﺸﮕﺎه اﺳﺘﺎد. 3 ﺗﻬﺮان داﻧﺸﮕﺎه داﻧﺸﯿﺎر. 4 ﺑﻬﺸﺘﯽ ﺷﻬﯿﺪ ﭘﺰﺷﮑﯽ ﻋﻠﻮم داﻧﺸﮕﺎه داﻧﺸﯿﺎر. 5 ﺑﻬﺸﺘﯽ ﺷﻬﯿﺪ ﭘﺰﺷﮑﯽ ﻋﻠﻮم داﻧﺸﮕﺎه رﯾﺰ درون ﻏﺪد ﻣﻮﻟﮑﻮﻟﯽ و ﺳﻠﻮﻟﯽ ﺗﺤﻘﯿﻘﺎت ﻣﺮﮐﺰ ﮐﺎرﺷﻨﺎس. ﻣﻘﺎﻟﻪ: درﯾﺎﻓﺖ ﺗﺎرﯾﺦ 13 / 10 / 93 ﻣﻘﺎﻟﻪ: ﭘﺬﯾﺮش ﺗﺎرﯾﺦ 26 / 11 / 93 ﭼﮑﯿﺪه ﻫﺪف: ﺷﻨﺎ ﺑـﻪ ﺗﻮﺟـﻪ ﺑـﺎ اﺳـﺖ. ﻗﺮارﮔﺮﻓﺘﻪ ورزﺷﮑﺎران ﺗﻮﺟﻪ ﻣﻮرد زا آﺳﯿﺐ و ﺷﺪﯾﺪ ﺗﻤﺮﯾﻨﺎت از ﭘﺲ ﺑﺎزﯾﺎﻓﺖ ﺑﻪ ﺑﺨﺸﯿﺪن ﺳﺮﻋﺖ ﺑﺮاي ﺳﺮد آب در وري ور ﻓﻌﺎﻟﯿﺖ از ﭘﺲ ﺳﺮد آب در ﺷﻨﺎوري ﺗﺎﺛﯿﺮ ﺑﺮرﺳﯽ ﭘﮋوﻫﺶ اﯾﻦ از ﻫﺪف ﺗﺮﻣﯿﻢ، روﻧﺪ در اﻟﺘﻬﺎﺑﯽ ﻫﺎي ﭘﺎﺳﺦ ﻧﻘﺶ و اي ﻣﺎﻫﻮاره ﻫﺎي ﺳﻠﻮل اﻫﻤﯿﺖ زﺷﯽ ﺑﺮ اﺳﻨﺘﺮﯾﮏ ژن ﺑﯿﺎن MyoD ، اي ﻣﺎﻫﻮاره ﻫﺎي ﺳﻠﻮل ﺳﺎزي ﻓﻌﺎل ﺷﺎﺧﺺ ﻋﻨﻮان ﺑﻪ CK و آﺳﯿﺐ ﻣﺴﺘﻘﯿﻢ ﻏﯿﺮ ﺷﺎﺧﺺ ﻋﻨﻮان ﺑﻪ IL-6 و IL-10 ﺑﻌﻨﻮان ﺑﻮد. ﻧﺮ ﻫﺎي ﻣﻮش در اﻟﺘﻬﺎﺑﯽ ﻫﺎي ﺷﺎﺧﺺ ﺷﻨﺎﺳﯽ: روش 30 وزﻧﯽ )داﻣﻨﻪ وﯾﺴﺘﺎر وﻧﮋاد ﺳﺎﻟﻢ ﺟﻮان ﻣﻮش ﺳﺮ 10 ± 300 درﭘﻨﺞ ﺗﺼﺎدﻓﯽ ﻃﻮر ﺑﻪ ﮔﺮم( ﻋ ﺑﻪ ﺗﺎﯾﯽ ﺷﺶ ﮔﺮوه ﻣـﺪت ﺑـﻪ اﺳﻨﺘﺮﯾﮏ ورزﺷﯽ ﻓﻌﺎﻟﯿﺖ ﭘﺮوﺗﮑﻞ ﻫﺎ آزﻣﻮدﻧﯽ و ﺑﻮد ﺗﺠﺮﺑﯽ ﺗﺤﻘﯿﻖ ﻃﺮح ﺷﺪﻧﺪ. اﻧﺘﺨﺎب ﻧﻤﻮﻧﻪ ﻨﻮان 90 اﺟـﺮا را دﻗﯿﻘـﻪ زﻣﺎﻧﯽ ﻫﺎي دروﻫﻠﻪ ﮔﺮوه دو ﮐﺮدﻧﺪ. 3 و 48 ﻫﻤﺮاه ﺑﻪ ﻓﻌﺎﻟﯿﺖ از ﺑﺎزﯾﺎﻓﺖ ﺳﺎﻋﺖ 10 زﻣـﺎﻧﯽ ﻫـﺎي دوره ﻫﻤـﺎن ﺑﺎ ﮔﺮوه دو و ﺳﺮد ّب آ در ﺷﻨﺎوري دﻗﯿﻘﻪ ﺷﻨ ﺑﺪون ﺑﺎزﯾﺎﻓﺖ ژن ﺑﯿﺎن ﺗﻐﯿﯿﺮات ﺷﺪﻧﺪ. ﺑﺮرﺳﯽ ﮐﻨﺘﺮل ﻋﻨﻮان ﺑﻪ ﮔﺮوه ﯾﮏ و ﺳﺮد آب در ﺎوري MyoD اﺳﮑﻠﺘﯽ ﻋﻀﻠﻪ در FHL ﺳﺮﻣﯽ ﺳﻄﻮح و CK ، IL-6 و IL-10 اﻓﺰار ﻧﺮم ﺑﺎ ژن ﺑﯿﺎن ﻫﺎي داده ﺷﺪ. ﻣﻘﺎﯾﺴﻪ ﮔﺮوه ﭼﻬﺎر در Rest آزﻣﻮن از اﺳﺘﻔﺎده ﺑﺎ ﺳﺮﻣﯽ ﻫﺎي داده و T ﺷـﺪ. ﺗﺤﻠﯿـﻞ و ﺗﺠﺰﯾـﻪ ﻣﺴﺘﻘﻞ ﻧﺘﺎﯾﺞ: ﻧﺸ ﻧﺘﺎﯾﺞ داد ﺎن mRNA MyoD ﺳﻄﻮح و ﯾﺎﻓﺖ اﻓﺰاﯾﺶ ﺳﺮد آب در ﺷﻨﺎوري ﺑﺎ ﻫﻤﺮاه اﺳﻨﺘﺮﯾﮏ ورزﺷﯽ ﻓﻌﺎﻟﯿﺖ از ﭘﺲ ﺳﺎﻋﺖ ﺳﻪ ﮔﺮوه در IL-6 و IL-10 ﺗﻐﯿﯿﺮات وﻟﯽ داﺷﺘﻨﺪ دار ﻣﻌﻨﯽ ﮐﺎﻫﺶ ﺳﺮد آب در ﺷﻨﺎوري ﺑﺪون اﺳﻨﺘﺮﯾﮏ ﻓﻌﺎﻟﯿﺖ ﺑﻌﺪاز ﺳﺎﻋﺖ ﺳﻪ ﮔﺮوه ﺑﻪ ﻧﺴﺒﺖ ﮔﺮوه اﯾﻦ در CK ﻣﻌﻨـﯽ د ﻣﻌﻨﯽ ﻧﺒﻮد.ﺗﻐﯿﯿﺮ دار در اري mRNA MyoD و Ck, IL-6, IL-10 در ﺳﺮﻣﯽ 48 ﻧﺸﺪ. ﻣﺸﺎﻫﺪه ﺷﻨﺎوري ﺑﺎ ﻫﻤﺮاه اﺳﻨﺘﺮﯾﮏ ﻓﻌﺎﻟﯿﺖ از ﭘﺲ ﺳﺎﻋﺖ ﺑﺤﺚ ﮔﯿﺮي: ﻧﺘﯿﺠﻪ و ﮐـﺎﻫﺶ و اي ﻣـﺎﻫﻮاره ﻫﺎي ﺳﻠﻮل ﺳﺎزي ﻓﻌﺎل ﻣﻮﺟﺐ ﺑﺎزﯾﺎﻓﺖ زﻣﺎن در ﺳﺮد آب از اﺳﺘﻔﺎده اﺣﺘﻤﺎﻻ ﺗﺤﻘﯿﻖ اﯾﻦ ﻫﺎي ﯾﺎﻓﺘﻪ اﺳﺎس ﺑﺮ او درﻓﺎز اﻟﺘﻬﺎﺑﯽ ﻫﺎي ﭘﺎﺳﺦ ﺷﻮد. ﻣﯽ اﺳﻨﺘﺮﯾﮏ ورزﺷﯽ ﻓﻌﺎﻟﯿﺖ از ﭘﺲ آﺳﯿﺐ ﻟﯿﻪ واژه ﮐﻠﯿﺪ ﻫﺎ : زا آﺳﯿﺐ ورزﺷﯽ ﻓﻌﺎﻟﯿﺖ-اي ﻣﺎﻫﻮاره ﻫﺎي ﺳﻠﻮل ﻓﻌﺎﻟﯿﺖ-اﻟﺘﻬﺎب ﺳﺮد، آب در ﺷﻨﺎوري The effect of cold water immersion after eccentric exercise on myogenic, inflammatory and muscle damage responses In FHL skeletal muscle in rats Abstract Purpose: cold water immersion is considered to accelerate the recovery from damaging exercise for athletes. Given the importance of satellite cells and the role of inflammatory responses in regeneration process, the purpose of this study was to investigate the effect of cold water immersion on MyoD gene expression as an activation marker of satellite cells, CK as an indirect marker of damage and IL-6, IL-10 as inflammatory markers after eccentric exercise in male rats. Methods: 30 young and healthy male Wistar rats (Weight range= 300±10) were assigned randomly in 5 groups each consisting of 6 subjects. It was an experimental research and subjects participated in eccentric exercise protocol (90min). Then they were compared in tow groups with and without cold water immersion (10min), in 3 and 48 hours after exercise in changes of MyoD gene expression in FHL skeletal muscle and the level of serum CK,IL-6 and IL-10. We used Rest software for analyzing MyoD gene expression and independent T test for analyzing serum data's. Results: Results showed that mRNA MyoD has been increased three hours after eccentric exercise in cold water immersion group and the level of IL-6, IL-10 decreased significantly in that group in compare with the group of three hours after eccentric exercise without cold water immersion. There is no significant change in CK. There was no significant changes in mRNA MyoD and serum CK,IL-6,IL-10 in 48 hour after eccentric exercise and cold water immersion. Conclusion: Based on findings of the present study, cold water during recovery may cause the activation of satellite cells and decrease the inflammatory responses after eccentric exercise in early phase of damage.
1. Zusammenfassung 1.1. Hintergrund Die Kryotherapie ist ein etabliertes Verfahren zur Prävention und Therapie akuter und überlastungsbedingter Muskelverletzungen. Insbesondere das Verfahren der Kaltwasserimmersionstherapie (CWI), dessen klinische Wirksamkeit anhand sys-tematischer Metaanalysen wissenschaftlich belegt ist, wird zur Optimierung der Muskelregeneration in vielen Sportarten regelhaft angewandt. Die zugrundelie-genden physiologischen Wirkungsweisen sowie die Effekte auf die Skelettmuskula-tur, einschließlich Veränderungen der muskulären Steifigkeit, sind jedoch weitest-gehend ungeklärt. Ziel dieser Studie war es, den Einfluss einer Kaltwasserimmersi-onstherapie auf die passive Muskelsteifigkeit zu untersuchen. 1.2. Material und Methoden Insgesamt wurden 30 gesunde Sporttreibende in drei Gruppen (jeweils n=10) ran-domisiert aufgeteilt: 1) Nach-Belastung (Post-ESU) -Gruppe: Belastung und CWI; 2) Kontroll-Gruppe: Belastung ohne CWI; 3) Vor-Belastung (Pre-ESU) -Gruppe: CWI ohne Belastung. Die passive Muskelsteifigkeit wurde mittels Acoustic radiation force impulse (ARFI) Elastosonographie anhand der Scherwellen-Geschwindigkeit (SWV, m/s), jeweils im M. rectus femoris (RF) und M. vastus intermedius (VI) be-stimmt. Die Messwerte des Ausgangsniveaus (t0) wurden gruppenspezifisch mit den Werten nach der Belastung (t1, für Post-ESU-Gruppe und Kontroll-Gruppe) nach CWI (t2, für Post-ESU-Gruppe und Pre-ESU-Gruppe bzw. Kontrollzeit für Kon-troll-Gruppe) und 60 min nach Intervention (t3, für alle Gruppen) verglichen. Die Be-lastung erfolgte auf einem Fahrradergometer (t=20 min. bei 70% Wmax), die CWI erfolgte bei 12 °C (15 min., sitzend bis Bauchnabelhöhe); für die Kontrollgruppe sitzend (Raumluft, 21 °C). 1.3. Ergebnisse Die Ergebnisse der vorliegenden Arbeit wurden veröffentlicht in: Huettel, M. et al., Effects of Pre- and Post-Exercise Cold-Water Immersion Therapy on Passive Muscle Stiffness. Sportverletz Sportschaden, 2019 [1]. In der Post-ESU-Gruppe zeigte sich kein signifikanter Unterschied zwischen den Messzeitpunkten: Belastung (t1: RF 1,63 m/s; VI 1.54 m/s), CWI (t2: RF 1,63 m/s; VI: 1,53 m/s;) und 60 min. nach Intervention (t3: RF 1,72 m/s; VI 1,61 m/s). In der Kontroll-Gruppe konnte eine signifikante Abnahme der SWV zwischen dem Ausgangsniveau t0 und t1 im VI beobachtet werden, (VI: 1,37 m/s; p=0.004) (RF: 1,59 m/s; p=0,084). Zum Zeitpunkt t2 und t3 konnte keine signifikante Änderung festgestellt werden. Eine signifikante Abnahme der SWV konnte in der Pre-ESU-Gruppe zwischen Ausgangsniveau (t0) und post-CWI (t2) im VI festgestellt werden (p=0,027). 1.4. Schlussfolgerung Die vorliegende Studie zeigt in Abhängigkeit des Anwendungszeitpunktes unter-schiedliche Einflüsse einer CWI auf die Muskelsteifigkeit. Insgesamt kann festge-halten werden, dass bei der Anwendung nach Belastung kein signifikanter Effekt der CWI auf die Muskelsteifigkeit festgestellt werden konnten. Die unterschiedli-chen Effekte, abhängig vom Zustand vor oder nach Belastung, müssen bei der Durchführung bedacht werden, um einen möglichen präventiven und regenerativen Nutzen gewährleisten zu können.
Introducción: El desarrollo de dispositivos portátiles de espectroscopia de infrarrojo cercano no invasivo (NIRS) ha permitido que las mediciones de oxígeno muscular se realicen fuera de un entorno de laboratorio para investigar cambios musculares locales en pruebas campo para guiar el entrenamiento. En general, durante el ejercicio los NIRS portátiles utiliza la saturación de oxígeno muscular (SmO2) como parámetro principal para el estudio de la hemodinámica porque proporciona información sobre el rendimiento y el metabolismo muscular durante el ejercicio. Un uso novedoso de NIRS portátil, es la medición de la oxigenación muscular en reposo a través del método de oclusión arterial (AOM). AOM consiste en realizar breves oclusiones arteriales para conocer el consumo de oxígeno muscular en reposo (mVO2). En la actualidad, AOM es una técnica para obtener información de la capacidad oxidativa del músculo en reposo, lo cual significa que el atleta no realiza ningún esfuerzo físico. Sin embargo, existe poca literatura científica de cómo está implicado el mVO2 en el proceso de entrenamiento.
Por otro lado, el monitoreo de la acumulación de fatiga pre y post competencia es importante dentro de la planificación del entrenamiento. Uno de los roles de los científicos del deporte es conocer el perfil de fatiga y recuperación con el fin de optimizar los procesos de entrenamiento para buscar un mejor rendimiento deportivo. Pero existen limitaciones, debido a que el estudio de la fatiga es un fenómeno multifactorial que envuelve diferentes mecanismos fisiológicos. En cuanto a la relación que pueda tener NIRS portátil y la medición de SmO2 con la fatiga dentro de un contexto deportivo se desconoce, debido a que es una variable que no se ha puesto en práctica en el deporte, pero con un gran potencial.
En el contexto de la salud, existen numerosas investigaciones que han asociado la SmO2 a enfermedades cardiovasculares, respiratorias y metabólicas como el sobrepeso y obesidad, que son patologías que afectan la entrega de oxígeno durante la actividad física. Uno de los factores claves para prescribir el ejercicio físico es conocer las zonas de metabólica, es decir la intensidad de ejercicio donde existen cambios metabólicos y que se aplica según el objetivo de la sesión de entrenamiento en personas que realizan actividad física para la salud.
Por último, existen algunos vacíos científicos de la aplicación de NIRS portátil en contextos de fatiga, rendimiento y salud. Por lo tanto, con esta tesis podemos brindar nuevos aportes científicos del metabolismo muscular a través de la medición de la SmO2 en reposo y durante el ejercicio, necesario para conocer estados de condición física de un deportista, fatiga, recuperación y la prescripción de ejercicio de ejercicio físico.
Objetivos: La tesis presenta como objetivo general: Utilizar la saturación de oxígeno muscular y estudiar su implicación en la fatiga, rendimiento y salud.
Para realizar el objetivo general se llevó a cabo los siguientes objetivos específicos: 1. Examinar la relación de la saturación de oxígeno muscular en reposo con marcadores de fatiga en futbolistas femeninos. 2. Interpretar el rol de la saturación de oxígeno muscular como un marcador de rendimiento deportivo durante una prueba de alta intensidad (sprint-repetidos) en futbolistas femeninos. 3. Evaluar los cambios de oxigenación muscular en reposo después de un periodo de entrenamiento y correlacionarlos con la composición corporal y la potencia de salto en futbolistas. 4. Comparar y correlacionar los parámetros fisiológicos en función de la saturación de oxígeno muscular por zonas metabólicas durante una prueba de esfuerzo en personas con sobrepeso/obesidad y normo-peso.
Métodos: Los cuatro objetivos de esta tesis fueron investigados con cuatro estudios científicos. Los participantes fueron futbolistas femeninos y masculinos que competían en segunda y tercera división respectivamente, y mujeres con sobrepeso/obesidad y normo-peso. En todas las pruebas se utilizó un NIRS portátil marca MOXY colocado en el músculo gastrocnemio y músculo vasto lateral. El primer estudio consistió en medir marcadores de fatiga neuromuscular, escalas psicológicas y marcadores sanguíneos utilizados para medir fatiga a nivel biológico. En conjunto se midió la prueba de oxígeno muscular en reposo (mVO2 y SmO2) mediante la técnica AOM. Todas las mediciones se realizaron pre, post y post 24 h tras un partido de futbol femenino. El segundo estudio consistió en que los futbolistas femeninos realizaran una prueba de sprint repetidos, donde se evaluó la frecuencia cardiaca, velocidad y SmO2 en conjunto. El tercer estudio consistió en observar cambios de SmO2 en reposo después de un periodo de pretemporada en jugadores de futbol y relacionarlo con la composición corporal y la potencia de salto. El cuarto estudio consistió en realizar una prueba de esfuerzo incremental con detección de zonas metabólicas: fatmax, umbrales de entrenamiento VT1 y VT2 y potencia aeróbica máxima para compararlo y relacionarlo con la SmO2.
Resultados y Discusión: En base a los objetivos de la tesis: Primero, en las jugadoras de futbol se encontró un aumento de mVO2 y SmO2 en reposo a las 24 h post partido oficial [(mVO2: 0.75 ± 1.8 vs 2.1± 2.7 μM-Hbdiff); (SmO2: 50 ± 9 vs 63 ± 12 %)]. Principalmente, este aumento es resultado de la correlación de la vasodilatación mediada por el flujo sanguíneo y el trasporte de oxígeno muscular que es un mecanismo implicado en los procesos de recuperación de la homeostasis del músculo esquelético y la restauración del equilibrio metabólico. El aumento del consumo de oxígeno se relacionó con la disminución de la potencia de salto (r= −0.63 p <0.05) y el aumento del lactato deshidrogenada (LDH) (r = 0.78 p <0.05) como marcadores de fatiga. Seguidamente en el segundo estudio, encontramos que la disminución del rendimiento durante una prueba de sprint repetidos, comienza con el aumento gradual de la SmO2, debido al cambio de la presión intramuscular y la respuesta hiperémica que conlleva, mostrando una disminución en la respuesta inter-individual [desaturación desde el cuarto sprint (Δ= 32%) y re-saturación después del sexto sprint (Δ= 89%)]. Además, la extracción de oxígeno por parte del músculo tiene una asociación no-lineal con la alta velocidad (r = 0.89 p <0.05) y con la fatiga mostrada el % decremento del sprint (r = 0.93 p <0.05).
En el estudio 3 se encontró que la dinámica de SmO2 en reposo es sensible a cambios después de un periodo de pretemporada (SmO2-Pendiente de recuperación: 15 ± 10 vs. 5 ± 5). Asimismo, se mostró que la SmO2 en reposo está relacionado paralelamente con el porcentaje de grasa del cuerpo (r= 0,64 p <0.05) y una relación inversa con la potencia de salto a una sola pierna (r = -0,82 p<0.01). Esto significa que a través del entrenamiento se mejoró el metabolismo y hemodinámica muscular con un tránsito más rápido del oxígeno muscular, y se asoció a las mejoras del peso corporal, somatotipo, CMJ y SLCMJ.
En el cuarto estudio, basado en los parámetros fisiológicos de una prueba de esfuerzo para prescribir ejercicio: se encontró una relación entre la SmO2 y el VO2max durante la zona fatmax y VT1 (r=0,72; p=0,04) (r=0,77; p=0,02) en mujeres con normo-peso. Sin embargo, en el grupo sobrepeso obesidad no se encontró ninguna correlación ni cambios de SmO2 entre cada zona metabólica.
Conclusión: La investigación de esta tesis ha demostrado avances en la medición de la SmO2. El uso de mVO2 y SmO2 en reposo es una variable de carga de trabajo que se puede utilizar para el estudio de la fatiga después de un partido de futbol femenino. Asimismo, la SmO2 en reposo puede ser interesante tomarlo en cuenta como un parámetro de rendimiento en futbolistas. Siguiendo el contexto, en el rendimiento durante una prueba de sprint repetidos, la SmO2 debe interpretarse basado en la respuesta individual del porcentaje de extracción de oxígeno muscular (∇%SmO2). El aporte de ∇%SmO2 es un factor de rendimiento limitado por la capacidad de velocidad y soporte de la fatiga de los futbolistas femeninos. Respecto a los aspectos de salud y prescripción del ejercicio, proponemos utilizar la SmO2 como un parámetro fisiológico para controlar y guiar el entrenamiento en zonas fatmax y VT1, pero solo en mujeres normo-peso. En patologías metabólicas como el sobrepeso y obesidad se necesitan más estudios. Como conclusión general, esta tesis muestra nuevas aplicaciones prácticas de cómo utilizar la SmO2 y su implicación en la fatiga, en contraste la adaptación al entrenamiento, pruebas de rendimiento y prescripción de la actividad física para la salud.
Background
Cold therapy has the disadvantage of inducing vasoconstriction in arterial and venous capillaries. The effects of carbon dioxide (CO 2 ) hot water depend mainly on not only cutaneous vasodilation but also muscle vasodilation. We examined the effects of artificial CO 2 cold water immersion (CCWI) on skin oxygenation and muscle oxygenation and the immersed skin temperature.
Subjects and Methods
Fifteen healthy young males participated. CO 2 -rich water containing CO 2 >1,150 ppm was prepared using a micro-bubble device. Each subject’s single leg was immersed up to the knee in the CO 2 -rich water (20 °C) for 15 min, followed by a 20-min recovery period. As a control study, a leg of the subject was immersed in cold tap-water at 20 °C (CWI). The skin temperature at the lower leg under water immersion (T sk -WI) and the subject’s thermal sensation at the immersed and non-immersed lower legs were measured throughout the experiment. We simultaneously measured the relative changes of local muscle oxygenation/deoxygenation compared to the basal values (Δoxy[Hb+Mb], Δdeoxy[Hb+Mb], and Δtotal[Hb+Mb]) at rest, which reflected the blood flow in the muscle, and we measured the tissue O 2 saturation (S t O 2 ) by near-infrared spectroscopy on two regions of the tibialis anterior (TA) and gastrocnemius (GAS) muscles.
Results
Compared to the CWI results, the Δoxy[Hb+Mb] and Δtotal[Hb+Mb] in the TA muscle at CCWI were increased and continued at a steady state during the recovery period. In GAS muscle, the Δtotal[Hb+Mb] and Δdeoxy[Hb+Mb] were increased during CCWI compared to CWI. Notably, S t O 2 values in both TA and GAS muscles were significantly increased during CCWI compared to CWI. In addition, compared to the CWI, a significant decrease in T sk at the immersed leg after the CCWI was maintained until the end of the 20-min recovery, and the significant reduction continued.
Discussion
The combination of CO 2 and cold water can induce both more increased blood inflow into muscles and volume-related (total heme concentration) changes in deoxy[Hb+Mb] during the recovery period. The T sk -WI stayed lower with the CCWI compared to the CWI, as it is associated with vasodilation by CO 2 .
In the last decade the study of the human brain and muscle energetics underwent a radical change, thanks to the progressive introduction of noninvasive techniques, including near-infrared (NIR) spectroscopy (NIRS). This review summarizes the most recent literature about the principles, techniques, advantages, limitations, and applications of NIRS in exercise physiology and neuroscience. The main NIRS instrumentations and measurable parameters will be reported. NIR light (700-1000 nm) penetrates superficial layers (skin, subcutaneous fat, skull, etc.) and is either absorbed by chromophores (oxy- and deoxyhemoglobin and myoglobin) or scattered within the tissue. NIRS is a noninvasive and relatively low-cost optical technique that is becoming a widely used instrument for measuring tissue O-2 saturation, changes in hemoglobin volume and, indirectly, brain/muscle blood flow and muscle O-2 consumption. Tissue O-2 saturation represents a dynamic balance between O-2 supply and O-2 consumption in the small vessels such as the capillary arteriolar and venular bed. The possibility of measuring the cortical activation in response to different stimuli, and the changes in the cortical cytochrome oxidase redox state upon O-2 delivery changes, will also be mentioned.
The aim of this investigation was to elucidate the efficacy of repeated cold water immersions (CWI) in the recovery of exercise induced muscle damage. A randomised group consisting of eighteen males, mean ± s age, height and body mass were 24 ± 5 years, 1.82 ± 0.06 m and 85.7 ± 16.6 kg respectively, completed a bout of 100 drop jumps. Following the bout of damaging exercise, participants were randomly but equally assigned to either a 12 min CWI (15 ± 1 °C; n = 9) group who experienced immersions immediately post-exercise and every 24 h thereafter for the following 3 days, or a control group (no treatment; n = 9). Maximal voluntary contraction (MVC) of the knee extensors, creatine kinase activity (CK), muscle soreness (DOMS), range of motion (ROM) and limb girth were measured pre-exercise and then for the following 96 h at 24 h increments. In addition MVC was also recorded immediately post-exercise. Significant time effects were seen for MVC, CK, DOMS and limb girth (p < 0.05) indicating muscle damage was evident, however there was no group effect or interaction observed showing that CWI did not attenuate any of the dependent variables (p > 0.05). These results suggest that repeated CWI do not enhance recovery from a bout of damaging eccentric contractions. Key pointsCryotherapy, particularly cold water immersions are one of the most common interventions used in order to enhance recovery post-exercise.There is little empirical evidence demonstrating benefits from cold water immersions. Research evidence is equivocal, probably due to methodological inconsistencies.Our results show that the cryotherapy administered did not attenuate any markers of EIMD or enhance the recovery of function.We conclude that repeated cold water immersions are ineffective in the recovery from heavy plyometric exercise and suggest athletes and coaches should use caution before using this intervention as a recovery strategy.
This study examined the effects of cold water immersion (CWI) on recovery of neuromuscular function following simulated team-sport exercise in the heat. Ten male team-sport athletes performed two sessions of a 2 × 30-min intermittent-sprint exercise (ISE) in 32°C and 52% humidity, followed by a 20-min CWI intervention or passive recovery (CONT) in a randomized, crossover design. The ISE involved a 15-m sprint every minute separated by bouts of hard running, jogging and walking. Voluntary and evoked neuromuscular function, ratings of perceived muscle soreness (MS) and blood markers for muscle damage were measured pre- and post-exercise, immediately post-recovery, 2-h and 24-h post-recovery. Measures of core temperature (Tcore), heart rate (HR), capillary blood and perceptions of exertion, thermal strain and thirst were also recorded at the aforementioned time points. Post-exercise maximal voluntary contraction (MVC) and activation (VA) were reduced in both conditions and remained below pre-exercise values for the 24-h recovery (P < 0.05). Increased blood markers of muscle damage were observed post-exercise in both conditions and remained elevated for the 24-h recovery period (P < 0.05). Comparative to CONT, the post-recovery rate of reduction in Tcore, HR and MS was enhanced with CWI whilst increasing MVC and VA (P < 0.05). In contrast, 24-h post-recovery MVC and activation were significantly higher in CONT compared to CWI (P = 0.05). Following exercise in the heat, CWI accelerated the reduction in thermal and cardiovascular load, and improved MVC alongside increased central activation immediately and 2-h post-recovery. However, despite improved acute recovery CWI resulted in an attenuated MVC 24-h post-recovery.
This study examined the effects of cold therapy (COLD) on recovery of voluntary and evoked contractile properties following high-intensity, muscle-damaging and fatiguing exercise. Ten resistance-trained males performed 6 × 25 maximal concentric/eccentric muscle contractions of the dominant knee extensors (KE) followed by a 20-min recovery (COLD v control) in a randomized cross-over design. Voluntary and evoked neuromuscular properties of the right KE, ratings of perceived muscle soreness (MS) and pain, and blood markers for muscle damage were measured pre- and post-exercise, and immediately post-recovery, 2, 24 and 48-h post-recovery. Exercise resulted in decrements in voluntary and evoked torque, increased MS and elevated muscle damage markers (p < 0.05). Measures of maximal voluntary contraction (MVC) or voluntary activation (VA) were not significantly enhanced by COLD (p > 0.05). Activation of right KE decreased post-exercise with increased activation of biceps femoris (BF) (p < 0.05). However, no significant differences were evident between conditions of activation of KE and hamstrings at any time point (p > 0.05). No significant differences were observed between conditions for creatine kinase or asparate aminotransferase (p > 0.05). However, perceptual ratings of pain were significantly (p < 0.05) lower following COLD compared to control. In conclusion, following damage to the contractile apparatus, COLD did not significantly hasten the recovery of peripheral contractile trauma. Despite no beneficial effect of COLD on recovery of MVC, perceptions of pain were reduced following COLD.
The aim of this study was to assess the effects of a single session of cold or thermoneutral water immersion after a one-off match on muscular dysfunction and damage in soccer players. Twenty-male soccer players completed one match and were randomly divided into cryotherapy (10 min cold water immersion, 10°C, n = 10) and thermoneutral (10 min thermoneutral water immersion, 35°C, n = 10) groups. Muscle damage (creatine kinase, myoglobin), inflammation (C-reactive protein), neuromuscular function (jump and sprint abilities and maximal isometric quadriceps strength), and delayed-onset muscle soreness were evaluated before, within 30 min of the end, and 24 and 48 h after the match. After the match, the players in both groups showed increased plasma creatine kinase activity (30 min, 24 h, 48 h), myoglobin (30 min) and C-reactive protein (30 min, 24 h) concentrations. Peak jump ability and maximal strength were decreased and delayed-onset muscle soreness increased in both groups. However, differential alterations were observed between thermoneutral water and cold water immersion groups in creatine kinase (30 min, 24 h, 48 h), myoglobin (30 min), C-reactive protein (30 min, 24 h, 48 h), quadriceps strength (24 h), and quadriceps (24 h), calf (24 h) and adductor (30 min) delayed-onset muscle soreness. The results suggest that cold water immersion immediately after a one-off soccer match reduces muscle damage and discomfort, possibly contributing to a faster recovery of neuromuscular function.
The purpose of the present study was to compare the effects of cold water immersion (CWI) and active recovery (ACT) on resting limb blood flow, rectal temperature and repeated cycling performance in the heat. Ten subjects completed two testing sessions separated by 1 week; each trial consisted of an initial all-out 35-min exercise bout, one of two 15-min recovery interventions (randomised: CWI or ACT), followed by a 40-min passive recovery period before repeating the 35-min exercise bout. Performance was measured as the change in total work completed during the exercise bouts. Resting limb blood flow, heart rate, rectal temperature and blood lactate were recorded throughout the testing sessions. There was a significant decline in performance after ACT (mean (SD) -1.81% (1.05%)) compared with CWI where performance remained unchanged (0.10% (0.71%)). Rectal temperature was reduced after CWI (36.8°C (1.0°C)) compared with ACT (38.3°C (0.4°C)), as was blood flow to the arms (CWI 3.64 (1.47) ml/100 ml/min; ACT 16.85 (3.57) ml/100 ml/min) and legs (CW 4.83 (2.49) ml/100 ml/min; ACT 4.83 (2.49) ml/100 ml/min). Leg blood flow at the end of the second exercise bout was not different between the active (15.25 (4.33) ml/100 ml/min) and cold trials (14.99 (4.96) ml/100 ml/min), whereas rectal temperature (CWI 38.1°C (0.3°C); ACT 38.8°C (0.2°C)) and arm blood flow (CWI 20.55 (3.78) ml/100 ml/min; ACT 23.83 (5.32) ml/100 ml/min) remained depressed until the end of the cold trial. These findings indicate that CWI is an effective intervention for maintaining repeat cycling performance in the heat and this performance benefit is associated with alterations in core temperature and limb blood flow.
The effect of low blood flow at onset of moderate-intensity exercise on the rate of rise in muscle oxygen uptake was examined. Seven male subjects performed a 3.5-min one-legged knee-extensor exercise bout (24 +/- 1 W, mean +/- SD) without (Con) and with (double blockade; DB) arterial infusion of inhibitors of nitric oxide synthase (N(G)-monomethyl-l-arginine) and cyclooxygenase (indomethacin) to inhibit the synthesis of nitric oxide and prostanoids, respectively. Leg blood flow and leg oxygen delivery throughout exercise was 25-50% lower (P < 0.05) in DB compared with Con. Leg oxygen extraction (arteriovenous O(2) difference) was higher (P < 0.05) in DB than in Con (5 s: 127 +/- 3 vs. 56 +/- 4 ml/l), and leg oxygen uptake was not different between Con and DB during exercise. The difference between leg oxygen delivery and leg oxygen uptake was smaller (P < 0.05) during exercise in DB than in Con (5 s: 59 +/- 12 vs. 262 +/- 39 ml/min). The present data demonstrate that muscle blood flow and oxygen delivery can be markedly reduced without affecting muscle oxygen uptake in the initial phase of moderate-intensity exercise, suggesting that blood flow does not limit muscle oxygen uptake at the onset of exercise. Additionally, prostanoids and/or nitric oxide appear to play important roles in elevating skeletal muscle blood flow in the initial phase of exercise.
This study compared the effect of 5, 10 and 20 min of cold-water (14 degrees C) immersion on rectal and muscle temperature and neuromuscular function. Twelve cyclists performed four cycling time-to-exhaustion trials in hot conditions (40 degrees C and 40%rh), followed 25 min later by cold-water immersion for 5, 10 or 20 min or 20 min in room temperature (24 degrees C; control). Rectal temperature was measured continuously, and muscle temperature was measured before, immediately after and 45 min after the time-to-exhaustion-test, as well as before and after water immersion. Sixty-second maximal voluntary isometric torque and isokinetic torque of the knee extensors were measured before, immediately after and 55 min after time-to-exhaustion-test. A greater rate of decrease in rectal temperature was observed in all water immersion conditions 45-80 min after time-to-exhaustion-test compared with control. Compared with control, muscle temperature 45 min after time-to-exhaustion-test was lower for all water immersion conditions; however, muscle temperature was lower for the 10- and 20-min conditions compared with 5 min. Isometric torque measured 55 min after time-to-exhaustion-test was lower for all conditions. Isokinetic torque was lower for all conditions immediately and 55-min post-time-to-exhaustion-test. Of the durations measured, 5 min of cold-water immersion appeared as the most appropriate duration for reducing rectal temperature but limiting decreases in muscle temperature.
The purpose of this study was to examine the effectiveness of a single bout of cold-water immersion on recovery from exercise-induced muscle damage. Eighteen physically active female volunteers (age 19.9 (+/-0.97 years), height 1.66 (+/-0.05 m), mass 63.7 (+/-10 kg), completed 10 sets of 10 counter-movement jumps to induce muscle damage and were randomly allocated to a control or treatment group. The treatment group was given a single 10-min bout of lower limb cold-water immersion therapy at 10 degrees C immediately following damage-inducing exercise. Indicators of muscle damage (plasma creatine kinase activity, perceived soreness and maximal voluntary contraction of the quadriceps) were assessed immediately prior to counter-movement jumps, and at 1, 24, 48, 72 and 96 h, following the damaging exercise. Significant (p = 0.05) time effects were recorded on all indicators of muscle damage, but there were no significant group or group x time interaction effects found on any of the measured variables. The results indicate that a single bout of cold-water immersion after a damaging bout of exercise has no beneficial effects on the recovery from exercise-induced muscle damage.
Unlabelled:
We examined the mechanisms of enhanced insulin sensitivity in 9 male healthy athletes (age, 25 +/- 1 yr; maximal aerobic power [VO2max], 57.6 +/- 1.0 ml/kg per min) as compared with 10 sedentary control subjects (age, 28 +/- 2 yr; VO2max, 44.1 +/- 2.3 ml/kg per min). In the athletes, whole body glucose disposal (240-min insulin clamp) was 32% (P < 0.01) and nonoxidative glucose disposal (indirect calorimetry) was 62% higher (P < 0.01) than in the controls. Muscle glycogen content increased by 39% in the athletes (P < 0.05) but did not change in the controls during insulin clamp. VO2max correlated with whole body (r = 0.60, P < 0.01) and nonoxidative glucose disposal (r = 0.64, P < 0.001). In the athletes forearm blood flow was 64% greater (P < 0.05) than in the controls, whereas their muscle capillary density was normal. Basal blood flow was related to VO2max (r = 0.63, P < 0.05) and glucose disposal during insulin infusion (r = 0.65, P < 0.05). The forearm glucose uptake in the athletes was increased by 3.3-fold (P < 0.01) in the basal state and by 73% (P < 0.05) during insulin infusion. Muscle glucose transport protein (GLUT-4) concentration was 93% greater in the athletes than controls (P < 0.01) and it was related to VO2max (r = 0.61, P < 0.01) and to whole body glucose disposal (r = 0.60, P < 0.01). Muscle glycogen synthase activity was 33% greater in the athletes than in the controls (P < 0.05), and the basal glycogen synthase fractional activity was closely related to blood flow (r = 0.88, P < 0.001).
In conclusion:
(a) athletes are characterized by enhanced muscle blood flow and glucose uptake. (b) The cellular mechanisms of glucose uptake are increased GLUT-4 protein content, glycogen synthase activity, and glucose storage as glycogen. (c) A close correlation between glycogen synthase fractional activity and blood flow suggests that they are causally related in promoting glucose disposal.
We investigated whether fatigue during prolonged exercise in uncompensable hot environments occurred at the same critical level of hyperthermia when the initial value and the rate of increase in body temperature are altered. To examine the effect of initial body temperature [esophageal temperature (Tes) = 35.9 +/- 0.2, 37.4 +/- 0. 1, or 38.2 +/- 0.1 (SE) degrees C induced by 30 min of water immersion], seven cyclists (maximal O2 uptake = 5.1 +/- 0.1 l/min) performed three randomly assigned bouts of cycle ergometer exercise (60% maximal O2 uptake) in the heat (40 degrees C) until volitional exhaustion. To determine the influence of rate of heat storage (0.10 vs. 0.05 degrees C/min induced by a water-perfused jacket), four cyclists performed two additional exercise bouts, starting with Tes of 37.0 degrees C. Despite different initial temperatures, all subjects fatigued at an identical level of hyperthermia (Tes = 40. 1-40.2 degrees C, muscle temperature = 40.7-40.9 degrees C, skin temperature = 37.0-37.2 degrees C) and cardiovascular strain (heart rate = 196-198 beats/min, cardiac output = 19.9-20.8 l/min). Time to exhaustion was inversely related to the initial body temperature: 63 +/- 3, 46 +/- 3, and 28 +/- 2 min with initial Tes of approximately 36, 37, and 38 degrees C, respectively (all P < 0.05). Similarly, with different rates of heat storage, all subjects reached exhaustion at similar Tes and muscle temperature (40.1-40.3 and 40. 7-40.9 degrees C, respectively), but with significantly different skin temperature (38.4 +/- 0.4 vs. 35.6 +/- 0.2 degrees C during high vs. low rate of heat storage, respectively, P < 0.05). Time to exhaustion was significantly shorter at the high than at the lower rate of heat storage (31 +/- 4 vs. 56 +/- 11 min, respectively, P < 0.05). Increases in heart rate and reductions in stroke volume paralleled the rise in core temperature (36-40 degrees C), with skin blood flow plateauing at Tes of approximately 38 degrees C. These results demonstrate that high internal body temperature per se causes fatigue in trained subjects during prolonged exercise in uncompensable hot environments. Furthermore, time to exhaustion in hot environments is inversely related to the initial temperature and directly related to the rate of heat storage.
Cryotherapy is an effective treatment for acute sports injury to soft tissue, although the effect of cryotherapy on exercise-induced muscle damage is unclear. The aim of this study was to assess the effects of cold water immersion on the symptoms of exercise-induced muscle damage following strenuous eccentric exercise. After performing a bout of damage-inducing eccentric exercise (eight sets of five maximal reciprocal contractions at 0.58 rad x s(-1)) of the elbow flexors on an isokinetic dynamometer, 15 females aged 22.0+/-2.0 years (mean +/- s) were allocated to a control group (no treatment, n = 7) or a cryotherapy group (n = 8). Subjects in the cryotherapy group immersed their exercised arm in cold water (15 degrees C) for 15 min immediately after eccentric exercise and then every 12 h for 15 min for a total of seven sessions. Muscle tenderness, plasma creatine kinase activity, relaxed elbow angle, isometric strength and swelling (upper arm circumference) were measured immediately before and for 3 days after eccentric exercise. Analysis of variance revealed significant (P < 0.05) main effects for time for all variables, with increases in muscle tenderness, creatine kinase activity and upper arm circumference, and decreases in isometric strength and relaxed elbow angle. There were significant interactions (P<0.05) of group x time for relaxed elbow angle and creatine kinase activity. Relaxed elbow angle was greater and creatine kinase activity lower for the cryotherapy group than the controls on days 2 and 3 following the eccentric exercise. We conclude that although cold water immersion may reduce muscle stiffness and the amount of post-exercise damage after strenuous eccentric activity, there appears to be no effect on the perception of tenderness and strength loss, which is characteristic after this form of activity.
In the last decade the study of the human brain and muscle energetics underwent a radical change, thanks to the progressive introduction of noninvasive techniques, including near-infrared (NIR) spectroscopy (NIRS). This review summarizes the most recent literature about the principles, techniques, advantages, limitations, and applications of NIRS in exercise physiology and neuroscience. The main NIRS instrumentations and measurable parameters will be reported. NIR light (700-1000 m) penetrates superficial layers (skin, subcutaneous fat, skull, etc.) and is either absorbed by chromophores (oxy- and deoxyhemoglobin and myoglobin) or scattered within the tissue. NIRS is a noninvasive and relatively low-cost optical technique that is becoming a widely used instrument for measuring tissue O2 saturation, changes in hemoglobin volume and, indirectly, brain/muscle blood flow and muscle O2 consumption. Tissue O2 saturation represents a dynamic balance between O2 supply and O2 consumption in the small vessels such as the capillary, arteriolar, and venular bed. The possibility of measuring the cortical activation in response to different stimuli, and the changes in the cortical cytochrome oxidase redox state upon O2 delivery changes, will also be mentioned.
While ice and compression wraps are commonly used to treat musculoskeletal injuries, the literature describing intramuscular temperatures has not addressed the combination of ice and compression wraps. The purpose of this study was to evaluate intramuscular temperatures at three sites on the anterior thigh (skin surface, 1 cm below the fat layer, and 2 cm below the fat layer) using both ice and compression wraps. Temperatures were recorded in 11 subjects with an isothermex, using implantable and surface thermocouples. Each subject was tested under four conditions: control, compression only, ice only, and ice + compression according to a balanced Latin square. Surface and intramuscular temperatures were recorded at 30 second intervals during 5 minutes of preapplication, 30 minutes application, and 20 minutes postapplication. A repeated measures ANOVA and Duncan post hoc tests were used to evaluate peak temperature differences between the treatment conditions and the depths of measurement. Both ice alone and ice + compression produced significant cooling at all three depths (F(6,60) = 168.5, p<.0005). Likewise, during the 20-minute postapplication period, these temperatures did not return to their preapplication levels. The compression-only condition produced significant warming at the skin surface, but did not have any effect on intramuscular temperature. At all depths, the ice + compression condition produced significantly cooler temperatures than ice alone. We suggest that compression increases the effectiveness of ice in reducing tissue temperatures. Therefore, ice combined with compression should be more effective than ice alone in reducing the metabolism of injured tissue. This provides an additional rationale for combining ice with compression in treating acute musculoskeletal injuries.
Recovery from exercise can be an important factor in performance during repeated bouts of exercise. In a tournament situation, where athletes may compete numerous times over a few days, enhancing recovery may provide a competitive advantage. One method that is gaining popularity as a means to enhance post-game or post-training recovery is immersion in water. Much of the literature on the ability of water immersion as a means to improve athletic recovery appears to be based on anecdotal information, with limited research on actual performance change. Water immersion may cause physiological changes within the body that could improve recovery from exercise. These physiological changes include intracellular-intravascular fluid shifts, reduction of muscle oedema and increased cardiac output (without increasing energy expenditure), which increases blood flow and possible nutrient and waste transportation through the body. Also, there may be a psychological benefit to athletes with a reduced cessation of fatigue during immersion. Water temperature alters the physiological response to immersion and cool to thermoneutral temperatures may provide the best range for recovery. Further performance-orientated research is required to determine whether water immersion is beneficial to athletes.
This study independently examined the effects of three hydrotherapy interventions on the physiological and functional symptoms of delayed onset muscle soreness (DOMS). Strength trained males (n = 38) completed two experimental trials separated by 8 months in a randomised crossover design; one trial involved passive recovery (PAS, control), the other a specific hydrotherapy protocol for 72 h post-exercise; either: (1) cold water immersion (CWI: n = 12), (2) hot water immersion (HWI: n = 11) or (3) contrast water therapy (CWT: n = 15). For each trial, subjects performed a DOMS-inducing leg press protocol followed by PAS or one of the hydrotherapy interventions for 14 min. Weighted squat jump, isometric squat, perceived pain, thigh girths and blood variables were measured prior to, immediately after, and at 24, 48 and 72 h post-exercise. Squat jump performance and isometric force recovery were significantly enhanced (P < 0.05) at 24, 48 and 72 h post-exercise following CWT and at 48 and 72 h post-exercise following CWI when compared to PAS. Isometric force recovery was also greater (P < 0.05) at 24, 48, and 72 h post-exercise following HWI when compared to PAS. Perceived pain improved (P < 0.01) following CWT at 24, 48 and 72 h post-exercise. Overall, CWI and CWT were found to be effective in reducing the physiological and functional deficits associated with DOMS, including improved recovery of isometric force and dynamic power and a reduction in localised oedema. While HWI was effective in the recovery of isometric force, it was ineffective for recovery of all other markers compared to PAS.
The present study investigated the effects of three hydrotherapy interventions on next day performance recovery following strenuous training. Twelve cyclists completed four experimental trials differing only in 14-min recovery intervention: cold water immersion (CWI), hot water immersion (HWI), contrast water therapy (CWT), or passive recovery (PAS). Each trial comprised five consecutive exercise days of 105-min duration, including 66 maximal effort sprints. Additionally, subjects performed a total of 9-min sustained effort (time trial - TT). After completing each exercise session, athletes performed one of four recovery interventions (randomly assigned to each trial). Performance (average power), core temperature, heart rate (HR), and rating of perceived exertion (RPE) were recorded throughout each session. Sprint (0.1 - 2.2 %) and TT (0.0 - 1.7 %) performance were enhanced across the five-day trial following CWI and CWT, when compared to HWI and PAS. Additionally, differences in rectal temperature were observed between interventions immediately and 15-min post-recovery; however, no significant differences were observed in HR or RPE regardless of day of trial/intervention. Overall, CWI and CWT appear to improve recovery from high-intensity cycling when compared to HWI and PAS, with athletes better able to maintain performance across a five-day period.
It has been suggested that a critically high body core temperature may impair central neuromuscular activation and cause fatigue. We investigated the effects of passive hyperthermia on maximal isometric force production (MVC) and voluntary activation (VA) to determine the relative roles of skin (T
sk) and body core temperature (T
c) on these factors. Twenty-two males [V̇O2max=64.2 (8.9) ml kg−1 min−1, body fat=8.2 (3.9)%] were seated in a knee-extension myograph, then passively heated from 37.4 to 39.4°C rectal temperature (T
re) and then cooled back to 37.4oC using a liquid conditioning garment. Voluntary strength and VA (interpolated twitch) were examined during an isometric 10-s MVC at 0.5°C intervals during both heating and cooling. Passive heating to a T
c of 39.4oC reduced VA by 11 (11)% and MVC by 13 (18)% (P<0.05), but rapid skin cooling, with a concomitant reduction in cardiovascular strain [percentage heart rate reserve decreased from 64 (11)% to 29 (11)%] and psychophysical strain did not restore either of these measures to baseline. Only when cooling lowered T
c back to normal did VA and MVC return to baseline (P<0.05). We conclude that an elevated T
c reduces VA during isometric MVC, and neither T
sk nor cardiovascular or psychophysical strain modulates this response. Results are given as mean (SD) unless otherwise stated.
This study examined the effect of a 5-min cold-water immersion (14 degrees C) recovery intervention on repeated cycling performance in the heat.
10 male cyclists performed two bouts of a 25-min constant-paced (254 (22) W) cycling session followed by a 4-km time trial in hot conditions (35 degrees C, 40% relative humidity). The two bouts were separated by either 15 min of seated recovery in the heat (control) or the same condition with 5-min cold-water immersion (5th-10th minute), using a counterbalanced cross-over design (CP(1)TT(1) --> CWI or CON --> CP(2)TT(2)). Rectal temperature was measured immediately before and after both the constant-paced sessions and 4-km timed trials. Cycling economy and Vo(2) were measured during the constant-paced sessions, and the average power output and completion times were recorded for each time trial.
Compared with control, rectal temperature was significantly lower (0.5 (0.4) degrees C) in cold-water immersion before CP(2) until the end of the second 4-km timed trial. However, the increase in rectal temperature (0.5 (0.2) degrees C) during CP(2) was not significantly different between conditions. During the second 4-km timed trial, power output was significantly greater in cold-water immersion (327.9 (55.7) W) compared with control (288.0 (58.8) W), leading to a faster completion time in cold-water immersion (6.1 (0.3) min) compared with control (6.4 (0.5) min). Economy and Vo(2) were not influenced by the cold-water immersion recovery intervention.
5-min cold-water immersion recovery significantly lowered rectal temperature and maintained endurance performance during subsequent high-intensity exercise. These data indicate that repeated exercise performance in heat may be improved when a short period of cold-water immersion is applied during the recovery period.
Cold water immersion reduces exercise-induced muscle damage. Benefits may partly arise from a decline in limb blood flow; however, no study has comprehensively investigated the influence of different degrees of cooling undertaken via cold water immersion on limb blood flow responses.
To determine the influence of cold (8°C) and cool (22°C) water immersion on lower limb and cutaneous blood flow.
Controlled laboratory study.
Nine men were placed in a semireclined position and lowered into 8°C or 22°C water to the iliac crest for two 5-minute periods interspersed with 2 minutes of nonimmersion. Rectal and thigh skin temperature, deep and superficial muscle temperature, heart rate, mean arterial pressure, thigh cutaneous blood velocity (laser Doppler), and superficial femoral artery blood flow (duplex ultrasound) were measured during immersion and for 30 minutes after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure).
Reductions in rectal temperature (8°C, 0.2° ± 0.1°C; 22°C, 0.1° ± 0.1°C) and thigh skin temperature (8°C, 6.2° ± 0.5°C; 22°C, 3.2° ± 0.2°C) were greater in 8°C water than in 22°C (P < .01). Femoral artery conductance was reduced to a similar extent immediately after immersion (~30%) and 30 minutes after immersion (~40%) under both conditions (P < .01). In contrast, there was less thigh cutaneous vasoconstriction during and after immersion in 8°C water compared with 22°C (P = .01).
These data suggest that immersion at both temperatures resulted in similar whole limb blood flow but, paradoxically, more blood was distributed to the skin in the colder water. This suggests that colder temperatures may be associated with reduced muscle blood flow, which could provide an explanation for the benefits of cold water immersion in alleviating exercise-induced muscle damage in sports and athletic contexts.
Colder water temperatures may be more effective in the treatment of exercise-induced muscle damage and injury rehabilitation because of greater reductions in muscle blood flow.
Thesis (M.A.)--Indiana State University, 1992. "Presented to the School of Graduate Studies Department of Physical Education." Includes bibliographical references (leaves 90-96).
In this study, we assessed the physiological changes after exercising or cooling skeletal muscles on the basis of the apparent diffusion coefficient (ADC) values in magnetic resonance (MR) diffusion-weighted images (DWIs). DWIs of the ankle dorsiflexors were acquired with a 1.5-T MR device before and after exercising (22 subjects) or cooling (19 subjects). The exercise comprised a 5-min walk with the ankles dorsiflexed and a 30-time ankle dorsiflexion. Cooling (0 degrees C) of the ankle dorsiflexors was performed for 30 min. ADC values were calculated as ADC1-reflecting diffusion and perfusion and ADC2-approximating the true diffusion coefficient of the ankle dorsiflexors before and after exercising or cooling. ADC1 and ADC2 significantly increased with exercise and decreased with cooling (P < 0.05). Considering both diffusion and perfusion, ADC values allowed us to evaluate the intramuscular changes induced by exercising or cooling in terms of the motion of water molecules and microcirculation.
This study examined the effect of a short cold water immersion (CWI) intervention on rectal and muscle temperature, isokinetic strength and 1-km cycling time trial performance in the heat. Ten male cyclists performed a 1-km time trial at 35.0+/-0.3 degrees C and 40.0+/-3.0% relative humidity, followed by 20 min recovery sitting in either cold water (14 degrees C) for 5 min or in 35 degrees C air (control); a second 1-km time trial immediately followed. Peak and mean cycling power output were recorded for both time trials. Rectal and muscle temperature, and maximal isokinetic concentric torque of the knee extensors were measured before and immediately after the first and second time trials. Rectal temperature was not different between cold water immersion and control conditions at any time points. After the second time trial, however, muscle temperature was significantly lower (-1.3+/-0.7 degrees C) in cold water immersion compared with the control trial. While peak and mean power decreased from the first to second time trial in both conditions (-86+/-54 W and -24+/-16 W, respectively), maximal isokinetic concentric torque was similar between conditions at all time points. The 5 min cold water immersion intervention lowered muscle temperature but did not affect isokinetic strength or 1-km cycling performance.
1. Intramuscular glyconeogenesis from lactate after intense exercise was examined by using the one-legged knee extension model which enables evaluation of metabolism in a well-defined muscle group. 2. In seven subjects measurements of leg blood flow and arterial-venous differences of various substrates were performed in individuals after intense, exhaustive knee extensor exercise lasting 3.0 min. Muscle glycogen and lactate concentrations were determined in the quadriceps muscle immediately after exercise and three times during 1 h of recovery. 3. Muscle glycogen increased from 93.7 +/- 6.7 (+/- S.E.M.) to 108.8 +/- 8.1 mmol (kg wet wt)-1 during the recovery period. Muscle lactate was 27.1 +/- 2.1 mmol (kg wet wt)-1 at the end of exercise and decreased to 14.5 +/- 2.1, 6.7 +/- 1.1, and 3.0 +/- 0.5 mmol (kg wet wt)-1 after 3, 10 and 60 min of recovery, respectively. 4. More than two-thirds of the lactate that accumulated in the muscle during the intense exercise was released into the blood. It was estimated that between 13 and 27% of the lactate could have been converted to glycogen. This corresponded to a glycogen resynthesis rate from lactate of 0.17-0.34 and 0.002 mmol glucosyl units min-1 (kg wet wt)-1 for the first 10 and last 50 min of recovery, respectively. 5. The O2 debt of the leg was 1.5 l of which the resynthesis of ATP, creatine phosphate (CP) and glycogen and reloading of haemoglobin (Hb) and myoglobin (Mb) only could account for one-third. It is proposed that the elevated oxygen uptake during recovery is linked to the metabolic use of intramuscular triacylglycerol.
To study the physiologic basis of variability of physical performance in the laboratory, ten male subjects were studied once a week, during a 9-12 month period. Previously, the reference maximal work load attained (Wref) was determined in each subject. The test protocol of the actual study was based on the individual Wref and started at 70% Wref for 5 min whereupon the work load was increased by 5% Wref every 2.5 min to exhaustion. The maximal work load attained (Wmax) was considered as the test performance. Heart rate, respiratory variables, oxygen uptake (VO2), and blood lactate concentration were determined at each work load. The rate of perceived exertion during submaximal and maximal work was also scored. In all subjects, Wmax and VO2max varied randomly, while the coefficient of variation in VO2max (4.20% - 11.35%) exceeded that in Wmax (2.95%-6.83%). No seasonal influences on VO2 max and Wmax were observed. In all subjects the physiologic variables, when plotted as a function of external work load, were shifted to the right with higher Wmax values and to the left with lower Wmax values. With lower Wmax values, the rate of perceived exertion during submaximal work tended to increase. The results suggest that the magnitude of physiologic responses to exercise is related to relative work load and that variability of physical performance is related to changes in gross mechanical efficiency.
There is a great demand for perceptual effort ratings in order to better understand man at work. Such ratings are important complements to behavioral and physiological measurements of physical performance and work capacity. This is true for both theoretical analysis and application in medicine, human factors, and sports. Perceptual estimates, obtained by psychophysical ratio-scaling methods, are valid when describing general perceptual variation, but category methods are more useful in several applied situations when differences between individuals are described. A presentation is made of ratio-scaling methods, category methods, especially the Borg Scale for ratings of perceived exertion, and a new method that combines the category method with ratio properties. Some of the advantages and disadvantages of the different methods are discussed in both theoretical-psychophysical and psychophysiological frames of reference.
The use of cryotherapy, i.e. the application of cold for the treatment of injury or disease, is widespread in sports medicine today. It is an established method when treating acute soft tissue injuries, but there is a discrepancy between the scientific basis for cryotherapy and clinical studies. Various methods such as ice packs, ice towels, ice massage, gel packs, refrigerant gases and inflatable splints can be used. Cold is also used to reduce the recovery time as part of the rehabilitation programme both after acute injuries and in the treatment of chronic injuries. Cryotherapy has also been shown to reduce pain effectively in the post-operative period after reconstructive surgery of the joints. Both superficial and deep temperature changes depend on the method of application, initial temperature and application time. The physiological and biological effects are due to the reduction in temperature in the various tissues, together with the neuromuscular action and relaxation of the muscles produced by the application of cold. Cold increases the pain threshold, the viscosity and the plastic deformation of the tissues but decreases the motor performance. The application of cold has also been found to decrease the inflammatory reaction in an experimental situation. Cold appears to be effective and harmless and few complications or side-effects after the use of cold therapy are reported. Prolonged application at very low temperatures should, however, be avoided as this may cause serious side-effects, such as frost-bite and nerve injuries. Practical applications, indications and contraindications are discussed.
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We studied the interrelationship between blood flow, glycogen synthesis, and glucose and lipid utilization in 14 healthy men. A 4-h euglycemic insulin clamp with indirect calorimetry and muscle biopsies were done after a glycogen depletion (exercise) and after a resting day (control). In spite of the exercise induced decrease in leg muscle glycogen content (28% in the basal state, 22% after hyperinsulinemia, P < 0.05 in both as compared with the control study), basal or insulin stimulated glycogen synthase activity remained unchanged. In the basal state, glucose oxidation was 54% lower (P < 0.001) and lipid oxidation 108% higher (P < 0.001) after the glycogen depletion as compared with that in the control study. During the post-depletion insulin clamp, the glucose oxidation rate was 17% lower (P < 0.02) and lipid oxidation 169% higher (P < 0.01), while the whole body total glucose disposal was similar in both studies. Baseline forearm blood flow was similar and increased equally by over 40% during both insulin clamp studies (P < 0.05). Basal glucose extraction after glycogen depletion study was one third of that in the control study (P < 0.05). Both basal and insulin stimulated leg muscle glycogen content correlated inversely with basal forearm blood flow (r = -0.69, P < 0.01 and r = -0.82, P < 0.001, respectively) and basal lipid oxidation (r = -0.54, P < 0.05 and r = -0.64, P < 0.01, respectively) after glycogen depletion. Basal glycogen synthase fractional activity correlated positively with forearm blood flow (r = 0.78, P < 0.001) and forearm glucose uptake (r = 0.71, P < 0.05) during the insulin infusion.
In conclusion:
1) the unchanged insulin sensitivity in the face of glycogen depletion is probably a result of increased lipid oxidation, and 2) blood flow is related inversely to muscle glycogen content and directly to glycogen synthase activity.
This study investigated changes in intramuscular pressure (IMP) and surface electromyographic (EMG) parameters (mean frequency of the power spectrum, f(mean); and signal amplitude denoted as root mean square, RMS) during contractions to fatigue at 25 and 70% of maximal voluntary contraction (MVC). Parameters were recorded simultaneously from the vastus lateralis muscle during knee extension. A significant decrease in f(mean) occurred with time at both contraction levels; however, the rate of decline (slope) was greater at 70% MVC. RMS increased throughout the contractions at both levels, with the relative increase being significantly greater for 25% MVC. IMP increased during 25% MVC but did not change during the 70% MVC contraction. IMP at rest was significantly higher post-contractions than it was pre-contractions at 25% MVC (21.1 vs. 8.0 mmHg, P < 0.01) and 70% MVC (13.7 vs. 8.6 mmHg, P < 0.01). Consequently, post-contraction IMP was higher at 25% MVC than at 70% MVC (P < 0.01). IMP changes throughout the fatiguing contractions correlated negatively with f(mean) and positively with RMS at both MVC levels; however, these correlations were better at 25% MVC. The extent of intramuscular water accumulation is discussed as a major cause of the difference in IMP changes between 25% and 70% MVC. Significant differences in the rate of change for all parameters between high vs. low contraction levels may suggest a common mechanism governing changes in IMP and EMG fatigue indicators.
The purpose of this study was to document the presence of secondary injury in skeletal muscle, to quantify it, and to determine whether it is altered by acute cryotherapy.
Crush injuries to the triceps surae of 19 adult male Sprague-Dawley rats were either treated continuously with ice for 5 h (N = 10) or received no ice treatment (N = 9). After treatment, tissues were assayed for the reduction of triphenyltetrazolium chloride (TTC) to triphenylformazan (formazan red). TTC reduction is indicative of oxidative function and serves as an indicator of cellular damage.
A significantly lower TTC reduction rate was seen in both cold-treated injured tissue (6.59 +/- 1.01 microg x mg(-1) x h(-1)) and nontreated injured tissue (4.48 +/- 0.79 microg x mg(-1) x h(-1)) compared with uninjured controls (ice group = 7.94 +/- 1.49 microg x mg(-1) x h(-1), no-ice group = 6.62 +/- 0.75 microg x mg(-1) x h(-1)). These data indicate that crushing of muscle tissue produces injury measurable with the TTC reduction assay. Additionally, in crush-injured tissues, a significantly lower TTC reduction rate was seen in untreated tissues (4.48 +/- 0.79 microg x mg(-1) x h(-1)) compared with ice treated tissues (6.59 +/- 1.01 microg x mg(-1) x h(-1)), indicating that cryotherapy reduces the magnitude of secondary injury.
From these data, it can be concluded that secondary injury occurs after primary crush injury and that secondary injury is retarded by acute treatment with 5 h of continuous cryotherapy.
Head-out water immersion at thermoneutral temperature (34-35 degrees C) increases cardiac output for a given O2 consumption, leading to a relative hyperperfusion of peripheral tissues. To determine if subjects immersed in water at a colder temperature show similar responses and to explore the significance of the hyperperfusion, cardiovascular functions were investigated (impedance cardiography) on 10 men at rest and while performing exercise on a leg cycle ergometer (delta M = approximately 95 W.m-2) in air and in water at 34.5 degrees C and 30 degrees C, respectively. In subjects resting in water, the cardiac output increased by approximately 50% compared to that in air, mainly due to a rise in stroke volume. The stroke volume change tended to be greater in 30 degrees C water than in 34.5 degrees C water, and this was due to a greater increase in cardiac preload, as indicated by a significantly greater left ventricular end-diastolic volume. Arterial systolic pressure rose slightly during water immersion. Arterial diastolic pressure remained unchanged in 34.5 degrees C water, but it rose in 30 degrees C water. The total peripheral resistance fell 37% in 34.5 degrees C water and 32% in 30 degrees C water. Both in air and in water, mild exercise increased the cardiac output, and this was mainly due to an increase in heart rate. Since, however, the stroke volume increased with water immersion, cardiac output at a given work load appeared to be significantly higher in water than in air. The arterial pressures did not decrease with water immersion, despite a marked reduction in total peripheral resistance. These results suggest that 1) during cold water immersion, peripheral vasoconstriction provides an additional increase in cardiac preload, leading to a further increase in the stroke volume compared to that of the thermoneutral water immersion, 2) the mechanism of cardiovascular adjustment during dynamic exercise is not changed by the persistent increase in cardiac preload in water immersion, and 3) a relatively high cardiac output during water immersion is to maintain a proper arterial pressure in the face of reduced vascular resistance.
The aim of the present review is to present techniques used for measuring blood flow in human subjects and advice as to when they may be applicable. Since blood flow is required to estimate substrate fluxes, energy turnover and metabolic rate of skeletal muscle, accurate measurements of blood flow are of extreme importance. Several techniques have therefore been developed to enable estimates to be made of the arterial inflow to, venous outflow from, or local blood flow within the muscle. Regional measurements have been performed using electromagnetic flow meters, plethysmography, indicator methods (e.g. thermodilution and indo-cyanine green dye infusion), ultrasound Doppler, and magnetic resonance velocity imaging. Local estimates have been made using 133Xe clearance, microdialysis, near i.r. spectroscopy, positron emission tomography and laser Doppler. In principle, the aim of the study, the type of interventions and the limitations of each technique determine which method may be most appropriate. Ultrasound Doppler and continuous indo-cyanine green dye infusion gives the most accurate limb blood flow measurements at rest. Moreover, the ultrasound Doppler is unique, as it does not demand a steady-state, and because its high temporal resolution allows detection of normal physiological variations as well as continuous measurements during transitional states such as at onset of and in recovery from exercise. During steady-state exercise thermodilution can be used in addition to indo-cyanine green dye infusion and ultrasound Doppler, where the latter is restricted to exercise modes with a fixed vessel position. Magnetic resonance velocity imaging may in addition be used to determine blood flow within deep single vessels. Positron emission tomography seems to be the most promising tool for local skeletal muscle blood-flow measurements in relation to metabolic activity, although the mode and intensity of exercise will be restricted by the apparatus design.
Near-infrared spectroscopy (NIRS) measures hemoglobin saturation in small vessels. A number of interesting studies have used this method. However, difficulties with signal quantification and studies in which NIRS oxygen saturation did not behave as expected raise concerns. NIRS remains promising for studies of skeletal muscle, but a better understanding of the method is needed.
This study assessed the effects of cooling on blood flow and intramuscular water content in human skeletal muscles after exercise using magnetic resonance imaging. In six male subjects, their legs were randomly assigned to be control or to be cooled. All subjects performed ankle dorsiflexion exercise inside an imaging magnet and after exercise, an ice bag was placed on the ankle dorsiflexors of the cooled leg. Flow-sensitive images, which reflect both perfusion and intramuscular water, were obtained before and up to 270 s post-exercise at 30-s intervals. The flow-sensitive alternating inversion recovery (FAIR) images, which extract only the perfusion change, were also obtained. Signal intensity (SI) in the ankle dorsiflexors was estimated before and after exercise in both flow-sensitive and FAIR images. On the flow-sensitive images, the control leg increased SI 30-270 s after exercise (P<0.05), but the cooled leg showed no significant change. On the FAIR images, the control leg increased SI 30-270 s post-exercise (P<0.05), while the cooled leg increased SI 30-150 s and 210 s after exercise (P<0.05). The findings suggest that cooling attenuates the perfusion elevation and prevents the oedema formation in skeletal muscle immediately after exercise.
The purpose of this study was to examine the effects of active recovery (AR), massage (MR), and cold water immersion (CR) on performance of repeated bouts of high-intensity cycling separated by 24 hours. For each recovery condition, subjects were asked to take part in 2 intermittent cycling sessions; 18 minutes of varying work intervals performed in succession at a resistance of 80 g/kg body weight separated by 24 hours. One of four 15-minute recovery conditions immediately followed the first session and included: (a) AR, cycling at 30% Vo(2)max; (b) CR, immersion of legs in a 15 degrees C water bath; (c) MR, massage of the legs; and (d) control, seated rest. Only the control condition showed a significant decline in the total work completed between the first and second exercise sessions (108.1 +/- 5.4 kJ vs. 106.0 +/- 5.0 kJ, p < 0.05). Thus, AR, MR, and CR appeared to facilitate the recovery process between 2 high-intensity, intermittent exercise sessions separated by 24 hours.
The influence of regular post-exercise cold application to exercised muscles trained by ergometer cycling (leg muscles) or handgrip exercise using a weight-loaded handgrip ergometer (forearm flexor muscles) was studied in human volunteers. Muscle loads were applied during exercise programs three to four times a week for 4-6 weeks. Besides measuring parameters characterizing muscle performance, femoral and brachial artery diameters were determined ultrasonographically. Training effects were identified by comparing pre- and post-training parameters in matched groups separately for the trained limbs cooled after exercise by cold-water immersion and the corresponding trained limbs kept at room temperature. Significant training effects were three times more frequent in the control than in the cold group, including increases in artery diameters in the control but not in the cold group. It is concluded that training-induced molecular and humoral adjustments, including muscle hyperthermia, are physiological, transient and essential for training effects (myofiber regeneration, muscle hypertrophy and improved blood supply). Cooling generally attenuates these temperature-dependent processes and, in particular, hyperthermia-induced HSP formation. This seems disadvantageous for training, in contrast to the beneficial combination of rest, ice, compression and elevation in the treatment of macroscopic musculo-tendinous damage.
To investigate the effects of cooling on local temperature and circulation in the skin and skeletal muscle at different cooling temperatures. Ten male subjects (mean age 24.9 years) participated in this study. Intramuscular temperatures were measured by inserting two 22-gauge temperature probes (needle length; 8 and 18 mm) into the ankle dorsiflexors, while skin temperature was measured using a thermocouple attached to the leg skin anteriorly. Near-infrared spectroscopy was also used to evaluate the concentration changes in oxygenated, deoxygenated, and total hemoglobin/myoglobin in local skin and skeletal muscle. These measurements were simultaneously performed during the 10-min noncooling, 30-min cooling (cooling pad temperature; 0, 10, or 20 degrees C), and 60-min recovery periods. Under all cooling conditions, skin and intramuscular temperatures decreased during cooling (P < 0.01) and began to increase after the cooling pad was removed. However, these values did not return to baseline values during the recovery period (P < 0.01). Moreover, tissue temperatures tended to show lower values during cooling at lower cooling temperatures. All hemoglobin/myoglobin concentrations also showed a concomitant significant decrease during cooling under three cooling conditions (P < 0.01); the oxygenated and total hemoglobin/myoglobin concentrations did not return to the exact values before cooling during the recovery period. This study suggested that the rate of decrease in tissue temperature depends on the cooling temperature and the effects of cooling on tissue temperatures and circulation tend to be maintained during 60 min post-cooling period despite the cooling temperature.
Cold water immersion (CWI) is a popular recovery modality, but actual physiological responses to CWI after exercise in the heat have not been well documented. The purpose of this study was to examine effects of 20-min CWI (14 degrees C) on neuromuscular function, rectal (T(re)) and skin temperature (T(sk)), and femoral venous diameter after exercise in the heat. Ten well-trained male cyclists completed two bouts of exercise consisting of 90-min cycling at a constant power output (216+/-12W) followed by a 16.1km time trial (TT) in the heat (32 degrees C). Twenty-five minutes post-TT, participants were assigned to either CWI or control (CON) recovery conditions in a counterbalanced order. T(re) and T(sk) were recorded continuously, and maximal voluntary isometric contraction torque of the knee extensors (MVIC), MVIC with superimposed electrical stimulation (SMVIC), and femoral venous diameters were measured prior to exercise, 0, 45, and 90min post-TT. T(re) was significantly lower in CWI beginning 50min post-TT compared with CON, and T(sk) was significantly lower in CWI beginning 25min post-TT compared with CON. Decreases in MVIC, and SMVIC torque after the TT were significantly greater for CWI compared with CON; differences persisted 90min post-TT. Femoral vein diameter was approximately 9% smaller for CWI compared with CON at 45min post-TT. These results suggest that CWI decreases T(re), but has a negative effect on neuromuscular function.
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