ArticleLiterature Review

Whole-body Cryotherapy as a Recovery Technique after Exercise: A Review of the Literature

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Abstract

This review aims to evaluate the current body of literature investigating the effect of whole body cryotherapy on recovery after exercise. A systematic search was conducted to investigate the effect of whole body cryotherapy (WBC, exposure to temperatures between −110 to −190°C) on markers of recovery after damaging exercise in healthy, physically active subjects. Of the 16 eligible articles extracted, ten induced muscle damage using controlled exercise in a laboratory setting, while six induced damage during sport-specific training. Results indicated that muscle pain was reduced in 80% of studies following WBC. Two applied studies found recovery of athletic capacity and performance with WBC improved, variables of this nature were also improved in 71% of studies using controlled exercise. Further benefits of WBC treatment included reduction of systemic inflammation and lower concentrations of markers for muscle cell damage. These results suggest that WBC may improve recovery from muscle damage, with multiple exposures more consistently exhibiting improvements in recovery from pain, loss of muscle function, and markers of inflammation and damage. The diversity in muscle damage protocols, exposure timing with regards to exercise, as well as temperatures, duration and frequencies of exposure, make specific recommendations preliminary at present.

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... Several studies have investigated post-exercise whole-body and partial cryotherapy in various sports [44][45][46]. Cryotherapy typically involves standing in a special chamber with temperatures ranging from − 110 to − 190 °C for 2-5 min [57][58][59]. This may involve one session or multiple sessions per day of cryotherapy over a period of consecutive days. ...
... This may involve one session or multiple sessions per day of cryotherapy over a period of consecutive days. A recent review by Rose et al. [58] assessing various laboratory and applied studies with athletes and physically active individuals reported that post-exercise muscle pain was reduced in 80% of studies following cryotherapy. Studies have also shown improvements with cryotherapy regarding muscle function (i.e., maximal voluntary contraction) and performance (i.e., counter movement jumps, running performance) following muscle-damaging exercise [60][61][62][63]. ...
... Although cryotherapy offers a quick solution to promote post-game recovery, the method is expensive and likely not available to basketball players at all levels of play. If players or teams have access and plan to implement cryotherapy at their facility, multiple exposures are recommended, at 3 min for each session, conducted immediately after and in the 2-3 days following competition, at temperatures ranging from − 110 to − 140 °C [58]. Implementing cryotherapy during travel is challenging for most teams. ...
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Basketball players face multiple challenges to in-season recovery. The purpose of this article is to review the literature on recovery modalities and nutritional strategies for basketball players and practical applications that can be incorporated throughout the season at various levels of competition. Sleep, protein, carbohydrate, and fluids should be the foundational components emphasized throughout the season for home and away games to promote recovery. Travel, whether by air or bus, poses nutritional and sleep challenges, therefore teams should be strategic about packing snacks and fluid options while on the road. Practitioners should also plan for meals at hotels and during air travel for their players. Basketball players should aim for a minimum of 8 h of sleep per night and be encouraged to get extra sleep during congested schedules since back-to back games, high workloads, and travel may negatively influence night-time sleep. Regular sleep monitoring, education, and feedback may aid in optimizing sleep in basketball players. In addition, incorporating consistent training times may be beneficial to reduce bed and wake time variability. Hydrotherapy, compression garments, and massage may also provide an effective recovery modality to incorporate post-competition. Future research, however, is warranted to understand the influence these modalities have on enhancing recovery in basketball players. Overall, a strategic well-rounded approach, encompassing both nutrition and recovery modality strategies, should be carefully considered and implemented with teams to support basketball players’ recovery for training and competition throughout the season.
... Equipment for whole-body cryotherapy (WBC) has been used in clinics around the world for over 40 years [1,2]. Despite this, until today there is no universally accepted concept describing the mechanism for achieving the healthcare effect of this physiotherapeutic procedure, and the physical conditions of safety and effectiveness of cryogenic cooling of the patient's skin surface have not been determined [3][4][5][6]. Temperature of the cooling gas and the duration of its contact with the patient's skin, being the most important technological parameters of WBC, vary over a wide range. The requirements for the power supply capacity of equipment for the implementation of WBC technology are not defined. ...
... In such conditions, manufacturers of devices for WBC procedures gradually increase the value of the minimum gas temperature in the WBC cab. Over 40 years of cryotherapeutic system production, the gas temperature declared by manufacturers of devices for WBC has doubled from 98 K in 1978 [1,2] to 192 K [4][5][6][7]. By increasing the operating temperature of the equipment, manufacturers significantly reduce the cost of its production. ...
... At the same time, the result obtained is significantly more than can be removed from a WBC device by using 2 kg of liquid nitrogen for one patient's cooling [6,11]. ...
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Whole-body cryotherapy (WBC) is a highly effective treatment method of a number of serious diseases. The therapeutic effect of WBC is achieved by stimulating cold receptors of the patient's skin, which provide supercooling of the skin surface to the level of À2°C. To achieve such a temperature of the skin surface, it is necessary to ensure heat removal with intensity not less than 3500 W/m 2. Such a heat flux can remove gas with the temperature not higher than À130°C. Procedures lasting less than 2 minutes do not form therapeutic effect. Procedures lasting more than 3 minutes are dangerous for the patient's health. WBC procedures are carried out in single-and multi-seat devices. Due to the compact placement of the patient in the WBC area, the share of useful heat load on the cryostatting system is up to 70%. In multi-seat installations, the useful heat load share is not more than 50%. During the WBC procedure, consumption of liquid nitrogen per patient is 3.77 kg. For the effective use of WBC technology, it is necessary to determine the general requirements for the power of cooling systems and the temperature of cryostatting of the WBC area.
... The use of post-exercise recovery strategies such as massage, compression garments, hydrotherapy, cryotherapy, stretching, foam rolling, sleep and nutritional approaches has been extensively investigated in various sports (Herbert et al., 2011;Poppendieck et al., 2016;Rose et al., 2017;Dupuy et al., 2018;Wiewelhove et al., 2019;Ortiz et al., 2019;Bongiovanni et al., 2020;Davis et al., 2020;Skinner et al., 2020;Afonso et al., 2021;Kwiecien and McHugh, 2021). However, only a relatively limited number of studies has specifically analyzed the efficacy of such interventions in basketball (Calleja-González et al., 2016;Huyghe et al., 2020;Davis et al., 2021). ...
... As such, considering the present findings, a dissociation between established evidence and perceived effectiveness was present for the participants in the present study. Accordingly, strategies which have shown potential beneficial effects, such as whole-body cryotherapy (Rose et al., 2017;Dupuy et al., 2018;Kwiecien and McHugh, 2021), have been perceived as less effective by the participants. As previously suggested (Fullagar et al., 2019), sport practitioners may favor one-on-one or group conversations over journal articles as a source of knowledge, which could partly explain the current findings. ...
... While it is true that some methods (e.g. CWI, whole-body cryotherapy, nutritional supplements) have been studied and appear promising (Rose et al., 2017;Dupuy et al., 2018;Bongiovanni et al., 2020;Kwiecien and McHugh, 2021), there is still a great number of tools which have not been sufficiently investigated or whose evidence is conflicting. Therefore, it is understandable that some practitioners would rather exploit the available time prioritizing other aspects of the training process. ...
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The purpose of this study was to assess the perceived usefulness, actual use and barriers to the implementation of recovery strategies among basketball practitioners. 107 participants (strength and conditioning coaches, sport scientists, performance specialists) from different countries and competitive levels completed an online survey. Most participants rated recovery strategies as either extremely (46%) or very important (49%). Active recovery, massage, foam rolling, and stretching were perceived as most useful (80, 73, 72 and 59% of participants, respectively) and were most frequently adopted (68, 61, 72 and 67%, respectively). Participants mentioned lack of devices and facilities (51%), excessive cost (51%), lack of time (27%), players' negative perception (25%) and lack of sufficient evidence (16%) as barriers to the implementation of recovery strategies. The present findings reveal that some dissociation between scientific evidence and perceived effectiveness was present among the study participants. A possible solution would be to ensure that scientific evidence-based guidelines are followed when considering the application of recovery strategies. Regarding actual use, participants favored easily implementable strategies (e.g. active recovery, stretching), rather than evidence-supported, but expensive and/or impractical strategies (e.g. whole-body cryotherapy). Possible solutions may include the use of practical tools that don't need specific facilities, the development and validation of new low-cost recovery devices, the promotion of players education regarding recovery strategies, and conducting further research to increase the scientific knowledge in the area.
... Cold water immersion therapy (CWI) One of the most common recovery strategies used to prevent DOMS in the context of EIMD is cold water immersion therapy (CWI) (▶ Fig. 2). Generally, most studies investigated the effects on muscle damage, based on the enzyme activity of muscular creatine kinase (CK), systemic inflammatory response via cortisol and cytokines (IL-6) and athletic performance [6]. The idea of using post-exercise CWI in particular after EIMD and cardiovascular strain is based on the assumption that recovery is enhanced by decreasing tissue temperature and blood flow [7 -9]. ...
... To date, whole body cryotherapy (WBC) by air exposure is another used recovery technique, especially in professional sport because of its supposed anti-inflammatory effects under chronic inflammatory conditions [6]. In the beginning WBC was used for patients as e. g. in rheumatism, rheumatoid arthritis, multiple sclerosis, and psoriasis [2]. ...
... Thus, WBC is suggested to be beneficial for both structural and functional aspects of muscles following EIMD and DOMS [19 -22]. However, there is limited information about the proper application of WBC protocols and only few evidence for its efficacy [6]. Similar to CWI, disagreement remains concerning different WBC modalities, frequencies, temperatures, timing in relation to exercises, etc. [23]. ...
Article
Delayed-onset muscle soreness (DOMS) describes an entity of ultrastructural muscle damage. The manifestation of DOMS is caused by eccentric muscle contractions or unaccustomed forms of exercise. Clinical signs include impaired muscular force capacities, painful restriction of movement, stiffness, swelling, and altered biomechanics in adjacent joints. Although DOMS is categorised as a mild type of muscle damage, it is one of the most common reasons for compromised sportive performance. In the last decade, many hypotheses have been developed to explain the aetiology of DOMS, and there are a wide range of different interventions aiming to prevent or alleviate the symptoms. Many studies have evaluated various types of cold or heat therapy, compression, massage, physical therapy or nutritional interventions. Treatment considerations focus on the primary prevention of ultrastructural lesions during exercise, the treatment of the inflammatory response that leads to DOMS, and recovery strategies for manifest DOMS. This narrative review aims to present an overview of the current treatment and preventive strategies in the field of DOMS. © Georg Thieme Verlag KG Stuttgart · New York.
... Over recent years, cold exposure in the form of cold-water immersion (CWI) or whole-body cryotherapy (WBC) have been introduced into sports medicine to relieve pain and inflammatory symptoms associated with chronic pathological conditions but also to improve exercise performance and recovery [9]. A typical session of WBC involves the participant standing in a chamber filled with extremely cold gas at the temperature between −110 and −190 • C for 2-5 min [10]. The physiological benefits of WBC in athletes have been attributed to cold-induced analgesia, reduction of muscle temperature, and suppression of inflammation-derived RONS and cytokines. ...
... Although repeated WBC may prove effective in reducing systemic markers of skeletal muscle damage, its effect on regenerative processes is mostly limited to cortisol and cytokines such as interleukin 6 (IL-6), serum interleukin 1β (IL-1β), tumor necrosis factor α (TNFα), and interleukin 10 (IL-10). Thus, it is difficult to confirm which aspects of the recovery process are affected by cryotherapy or cold-water immersion [10]. Available literature data according the combing exercise training and cold therapy do not present a clear position. ...
... WBC was not found to significantly affect the skeletal muscle damage in our athletes who were exposed to cryotherapy twice a day for seven consecutive days of sports training. According to Rose et al. [10], a reduction in circulating CK was proportional to the number of exposures to WBC during the recovery process. Both Hausswirth et al. [28] and Fonda et al. [29] found no significant changes in CK when protocols with either three or six exposures to WBC were applied. ...
Article
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The oxi-inflammatory response is part of the natural process mobilizing leukocytes and satellite cells that contribute to clearance and regeneration of damaged muscle tissue. In sports medicine, a number of post-injury recovery strategies, such as whole-body cryotherapy (WBC), are used to improve skeletal muscle regeneration often without scientific evidence of their benefits. The study was designed to assess the impact of WBC on circulating mediators of skeletal muscle regeneration. Twenty elite athletes were randomized to WBC group (3-min exposure to −120 °C, twice a day for 7 days) and control group. Blood samples were collected before the first WBC session and 1 day after the last cryotherapy exposure. WBC did not affect the indirect markers of muscle damage but significantly reduced the generation of reactive oxygen and nitrogen species (H2O2 and NO) as well as the concentrations of serum interleukin 1β (IL-1β) and C-reactive protein (CRP). The changes in circulating growth factors, hepatocyte growth factor (HGF), insulin-like growth factor (IGF-1), platelet-derived growth factor (PDGFBB), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF), were also reduced by WBC exposure. The study demonstrated that WBC attenuates the cascade of injury–repair–regeneration of skeletal muscles whereby it may delay skeletal muscle regeneration.
... Exposure of the damaged muscle to cold (cryotherapy) is believed to retard the secondary injury process (Merrick et al., 1999;. Cryotherapy, the reduction of tissue temperature by the withdrawal of heat from the body (Michlovitz, 1990), refers to a range of cooling modalities such as local ice application to the skin (Yackzan et al., 1984;Gulick et al., 1996;Oakley et al., 2013;Nogueira et al., 2019), cold water immersion (CWI) of a large part of the body (Lane and Wenger, 2004;Yeargin et al., 2006;Vaile et al., 2007Vaile et al., , 2010Peiffer et al., 2008;Rowsell et al., 2009Brophy-Williams et al., 2011;Leeder et al., , 2019Webb et al., 2013;Garcia et al., 2016;Wilson et al., 2018), whole body cryotherapy (Banfi et al., 2009Costello et al., 2011Ziemann et al., 2012;Fonda and Sarabon, 2013;Guilhem et al., 2013;Bleakley et al., 2014;Ferreira-Junior et al., 2015;Vieira et al., 2015;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019; WBC) and more recently phase change material (PCM) cooling (Clifford et al., 2018;Kwiecien et al., 2018Kwiecien et al., , 2020aBrownstein et al., 2019;Mullaney et al., 2020), that are employed in various contexts. The most popular cryotherapy modality used following exercise is CWI involving immersion of a large surface area of the body, typically immersion of at least the legs up to at least the umbilicus, in cold water. ...
... However, evidence to support its use for accelerating recovery of strength loss following exercise remains equivocal Poppendieck et al., 2013;Hohenauer et al., 2015;Machado et al., 2015). Comparably, some studies suggest that WBC might be beneficial in accelerating subjective recovery of soreness Ziemann et al., 2012;Fonda and Sarabon, 2013;Bleakley et al., 2014;Rose et al., 2017), strength loss , and might mitigate the signs of functional overreaching (Schaal et al., 2015). However, more recently, there remains little evidence to support improvements in functional recovery (Bleakley et al., 2014;Lombardi et al., 2017;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019). ...
... Comparably, some studies suggest that WBC might be beneficial in accelerating subjective recovery of soreness Ziemann et al., 2012;Fonda and Sarabon, 2013;Bleakley et al., 2014;Rose et al., 2017), strength loss , and might mitigate the signs of functional overreaching (Schaal et al., 2015). However, more recently, there remains little evidence to support improvements in functional recovery (Bleakley et al., 2014;Lombardi et al., 2017;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019). On the contrary, local ice application does not improve the symptoms associated with soreness or strength loss (Nogueira et al., 2019). ...
... Exposure of the damaged muscle to cold (cryotherapy) is believed to retard the secondary injury process (Merrick et al., 1999;. Cryotherapy, the reduction of tissue temperature by the withdrawal of heat from the body (Michlovitz, 1990), refers to a range of cooling modalities such as local ice application to the skin (Yackzan et al., 1984;Gulick et al., 1996;Oakley et al., 2013;Nogueira et al., 2019), cold water immersion (CWI) of a large part of the body (Lane and Wenger, 2004;Yeargin et al., 2006;Vaile et al., 2007Vaile et al., , 2010Peiffer et al., 2008;Rowsell et al., 2009Brophy-Williams et al., 2011;Leeder et al., , 2019Webb et al., 2013;Garcia et al., 2016;Wilson et al., 2018), whole body cryotherapy (Banfi et al., 2009Costello et al., 2011Ziemann et al., 2012;Fonda and Sarabon, 2013;Guilhem et al., 2013;Bleakley et al., 2014;Ferreira-Junior et al., 2015;Vieira et al., 2015;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019; WBC) and more recently phase change material (PCM) cooling (Clifford et al., 2018;Kwiecien et al., 2018Kwiecien et al., , 2020aBrownstein et al., 2019;Mullaney et al., 2020), that are employed in various contexts. The most popular cryotherapy modality used following exercise is CWI involving immersion of a large surface area of the body, typically immersion of at least the legs up to at least the umbilicus, in cold water. ...
... However, evidence to support its use for accelerating recovery of strength loss following exercise remains equivocal Poppendieck et al., 2013;Hohenauer et al., 2015;Machado et al., 2015). Comparably, some studies suggest that WBC might be beneficial in accelerating subjective recovery of soreness Ziemann et al., 2012;Fonda and Sarabon, 2013;Bleakley et al., 2014;Rose et al., 2017), strength loss , and might mitigate the signs of functional overreaching (Schaal et al., 2015). However, more recently, there remains little evidence to support improvements in functional recovery (Bleakley et al., 2014;Lombardi et al., 2017;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019). ...
... Comparably, some studies suggest that WBC might be beneficial in accelerating subjective recovery of soreness Ziemann et al., 2012;Fonda and Sarabon, 2013;Bleakley et al., 2014;Rose et al., 2017), strength loss , and might mitigate the signs of functional overreaching (Schaal et al., 2015). However, more recently, there remains little evidence to support improvements in functional recovery (Bleakley et al., 2014;Lombardi et al., 2017;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019). On the contrary, local ice application does not improve the symptoms associated with soreness or strength loss (Nogueira et al., 2019). ...
... Exposure of the damaged muscle to cold (cryotherapy) is believed to retard the secondary injury process (Merrick et al., 1999;Merrick, 2002). Cryotherapy, the reduction of tissue temperature by the withdrawal of heat from the body (Michlovitz, 1990), refers to a range of cooling modalities such as local ice application to the skin (Yackzan et al., 1984;Gulick et al., 1996;Oakley et al., 2013;Nogueira et al., 2019), cold water immersion (CWI) of a large part of the body (Lane and Wenger, 2004;Yeargin et al., 2006;Vaile et al., 2007Vaile et al., , 2008Vaile et al., , 2010Halson et al., 2008;Montgomery et al., 2008;Peiffer et al., 2008;Rowsell et al., 2009Rowsell et al., , 2011Brophy-Williams et al., 2011;Bleakley et al., 2012;Leeder et al., 2012Leeder et al., , 2019Versey et al., 2013;Webb et al., 2013;Roberts et al., 2015;Garcia et al., 2016;Machado et al., 2016;Wilson et al., 2018), whole body cryotherapy (Banfi et al., 2009(Banfi et al., , 2010Costello et al., 2011Costello et al., , 2015Pournot et al., 2011;Ziemann et al., 2012;Fonda and Sarabon, 2013;Guilhem et al., 2013;Bleakley et al., 2014;Ferreira-Junior et al., 2015;Vieira et al., 2015;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019;WBC) and more recently phase change material (PCM) cooling (Clifford et al., 2018;Kwiecien et al., 2018Kwiecien et al., , 2020aBrownstein et al., 2019;Mullaney et al., 2020), that are employed in various contexts. The most popular cryotherapy modality used following exercise is CWI involving immersion of a large surface area of the body, typically immersion of at least the legs up to at least the umbilicus, in cold water. ...
... However, evidence to support its use for accelerating recovery of strength loss following exercise remains equivocal (Bleakley et al., 2012;Leeder et al., 2012;Poppendieck et al., 2013;Versey et al., 2013;Hohenauer et al., 2015;Machado et al., 2015). Comparably, some studies suggest that WBC might be beneficial in accelerating subjective recovery of soreness (Banfi et al., 2010;Pournot et al., 2011;Ziemann et al., 2012;Fonda and Sarabon, 2013;Bleakley et al., 2014;Costello et al., 2015;Rose et al., 2017), strength loss , and might mitigate the signs of functional overreaching (Schaal et al., 2015). However, more recently, there remains little evidence to support improvements in functional recovery (Bleakley et al., 2014;Lombardi et al., 2017;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019). ...
... Comparably, some studies suggest that WBC might be beneficial in accelerating subjective recovery of soreness (Banfi et al., 2010;Pournot et al., 2011;Ziemann et al., 2012;Fonda and Sarabon, 2013;Bleakley et al., 2014;Costello et al., 2015;Rose et al., 2017), strength loss , and might mitigate the signs of functional overreaching (Schaal et al., 2015). However, more recently, there remains little evidence to support improvements in functional recovery (Bleakley et al., 2014;Lombardi et al., 2017;Rose et al., 2017;Broatch et al., 2019;Krueger et al., 2019). On the contrary, local ice application does not improve the symptoms associated with soreness or strength loss (Nogueira et al., 2019). ...
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Strenuous exercise can result in muscle damage in both recreational and elite athletes, and is accompanied by strength loss, and increases in soreness, oxidative stress, and inflammation. If the aforementioned signs and symptoms associated with exercise-induced muscle damage are excessive or unabated, the recovery process becomes prolonged and can result in performance decrements; consequently, there has been a great deal of research focussing on accelerating recovery following exercise. A popular recovery modality is cryotherapy which results in a reduction of tissue temperature by the withdrawal of heat from the body. Cryotherapy is advantageous because of its ability to reduce tissue temperature at the site of muscle damage. However, there are logistical limitations to traditional cryotherapy modalities, such as cold-water immersion or whole-body cryotherapy, because they are limited by the duration for which they can be administered in a single dose. Phase change material (PCM) at a temperature of 15°C can deliver a single dose of cooling for a prolonged duration in a practical, efficacious, and safe way; hence overcoming the limitations of traditional cryotherapy modalities. Recently, 15°C PCM has been locally administered following isolated eccentric exercise, a soccer match, and baseball pitching, for durations of three to six hours with no adverse effects. These data showed that using 15°C PCM to prolong the duration of cooling successfully reduced strength loss and soreness following exercise. Extending the positive effects associated with cryotherapy by prolonging the duration of cooling can enhance recovery following exercise and give athletes a competitive advantage.
... From what can be deduct from testimonies of coaches and athletes, it seems that exposure to cryostimulation prior than ∼3 h to competition could have a performance enhancement effect (Partridge et al., 2019). The use of cryostimulation before training or competition may have a beneficial effect by a multi-factorial hypothesis, such as the positive effects of hormonal changes (Hornery et al., 2005;Rose et al., 2017), with an increase of circulating cortisol and testosterone, and by a peripheral vasoconstriction, which consequently leads to high muscle oxygenation afterward (Hornery et al., 2005), and by a psychological well-being. The scientific community will have to study the possible effects of cryostimulation on sport performance, since further studies are required to provide recommendations for the coaches and athletes based on evidence. ...
... Despite the increasing popularity of cryostimulation in sport medicine, very few studies have investigated the acute or longterm effects of very-low temperatures on the muscle strength performance, while, on the contrary, there are significantly more studies on the influence of cryostimulation as a recovery technique after strength exercises (Rose et al., 2017). ...
Article
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Recovery after exercise is a crucial key in preventing muscle injures and in speeding up processes to return at the homeostasis level. There are several ways of developing a recovery strategy with the use of different kinds of traditional and up-to date techniques. The use of cold has traditionally been used after physical exercise for recovery purposes. In the recent years, the use of whole-body cryotherapy/cryostimulation (an extreme cold stimulation lasting 1-4 min and given in a cold room at a temperature comprised from -60 to -195°C) has tremendously increased for such purposes. However, there are controversies about the benefits that the use of this technique may provide. Therefore, this paper describes what is whole body cryotherapy/cryostimulation, reviews and debates the benefits that its use may provide, presents practical considerations and applications, and emphasizes the need of customization depending on the context, the purpose, and the subject characteristics. This review is written by international experts from the working group on whole body cryotherapy/cryostimulation from the International Institute of Refrigeration.
... El entrenamiento y la puesta en forma de deportistas de elite también ha dado publicidad. La aplicación del frío después de la competición puede mejorar la recuperación de daño muscular, de dolor, de pérdida de la función muscular, y disminución de los marcadores de inflamación y daño (34). Los sujetos que experimentan crioterapia total se visten con ropa mínima y se exponen al aire muy frío (a -110 °C o menos) para 1-4 min. ...
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RESUMEN El frío, para una gran mayoría de gente, puede ser considerado como un factor negativo para la salud, pero cuando comenzamos a entender su función y la reacciones que produce sobre nuestro organismo puede cambiar nuestra perspectiva y comenzar a ver su parte positiva y la importancia que puede tener para conservar y recuperar nuestra salud. Revisamos sus formas de aplicación más sencillas, razonables y seguras. Con consejos prácticos para evitar efectos secundarios desagradables. ABSTRACT The cold for a great majority of people can be considered as a negative factor for health, but when we begin to understand its function and the reactions it produces on our organism it can change our perspective on it, and begin to see its positive part and the importance that can have to preserve and recover our health. We review your formal application more simple, reasonable and safe. With practical advice to avoid unpleasant side effects.
... During this intervention, patients are exposed to temperatures ranging from -110°C to -135°C for 2-3 minutes. WBC is currently used in rheumatological diseases because it decreases oxidative stress and general inflammatory response, but the exact mechanisms of action and, therefore, other applications remain unexamined (Bouzigon et al., 2016;Lubkowska et al., 2011;Pournot et al., 2011;Rose et al., 2017;Stanek et al. 2018aStanek et al. , 2018bStanek et al. , 2016Ziemann et al., 2014). The study conducted by Rymaszewska et al. (2018) showed that daily WBC caused a significant improvement in cognitive functioning in people with mild cognitive impairments (MCI) (Rymaszewska et al., 2018). ...
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There is a great deal of impetus for the comprehensive understanding of the complete pathological function, genetic information, and functional diversity of the gut microbiota that favors the development of dementia. It has been reported that patients with mild cognitive impairment and Alzheimer’s disease present with several metabolic and immune-inflammatory alterations. The recently highlighted aspects of human health linked to cognitive decline include insulin-resistance, obesity, and chronic low-grade inflammation. Gut microbiota is known to produce neurotransmitters, such as GABA, acetylcholine, dopamine or serotonin, vitamins, intestinal toxins, and modulate nerve signaling – with emphasis on the vagus nerve. Additionally, gut dysbiosis results in impaired synthesis of signaling proteins affecting metabolic processes relevant to the development of Alzheimer’s disease. Due to numerous links of gut microbiota to crucial metabolic and inflammatory pathways, attempts aimed at correcting the gut microflora composition may affect dementia pathology in a pleiotropic manner. Taking advantage of the metabolic effects of cold exposure on organisms by the introduction of whole-body cryostimulation in dementia patients could lead to alterations in gut microbiota and, therefore, decrease of an inflammatory response and insulin resistance, which remain one of the critical metabolic features of dementia. Further studies are needed in order to explore the potential application of recent findings and ways of achieving the desired goals.
... Initially, due to its analgesic and anti-inflammatory effects, it was empirically applied as a symptomatic adjunct therapy in rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis, and fibromyalgia) [1][2][3][4] . In recent years, there has been a growing interest in the possibility of administering systemic cryotherapy to athletes and physically active individuals to improve recovery of injured muscles following exercise [5][6][7] and enhance athletic performance 8 . ...
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Skeletal muscle and adipose tissue play an important role in maintaining metabolic homeostasis and thermogenesis. We aimed to investigate the effects of single and repeated exposure to whole-body cryotherapy in volunteers with different physical fitness levels on 25-hydroxyvitamin D (25(OH)D) and myokines. The study included 22 healthy male volunteers (mean age: 21 ± 1.17 years), who underwent 10 consecutive sessions in a cryogenic chamber once daily (3 minutes, −110 °C). Blood samples were collected before and 30 minutes and 24 hours after the first and last cryotherapy sessions. Prior to treatment, body composition and physical fitness levels were measured. After 10 cryotherapy treatments, significant changes were found in myostatin concentrations in the low physical fitness level (LPhL) group. The 25(OH)D levels were increased in the high physical fitness level (HPhL) group and decreased in the LPhL group. The HPhL group had significant changes in the level of high-sensitivity interleukin-6 after the first treatment. The LPhL group had significant changes in 25(OH)D, irisin, and myostatin levels after the tenth treatment. Our data demonstrated that in healthy young men, cryotherapy affects 25(OH)D levels, but they were small and transient. The body’s response to a series of 10 cryotherapy treatments is modified by physical fitness level.
... When the subject leaves the cryosauna, blood vessels dilate, nutrient-rich blood flow increases, favoring in the outlying areas the healing of tissue damage and removal of toxins, and giving a pleasant and comfortable feeling. Heat shock stimulates body hardening (increases the body defenses), reduces pain, enhances joint mobility and triggers a series of reactions that lead to the release of wellbeing hormones such as endorphins (Rose et al., 2017). ...
... This additional mechanical load could also increase muscular activity, with such articular strain contributing to injury risk [36,37]. Cyclists engaged in trail terrain cycling may benefit from the use of recovery strategies such as cryotherapy, stretching compression garments, nutrition, or massage therapy under medical supervision [38,39]. ...
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Although cycling has been associated with overuse/fatigue and acute injuries, there is lack of information regarding associated risk factors and prevention factors. The objective of the study was to determine the factors associated with injury, and perceptions of discomfort and pain in cyclists. A total of 739 cyclists completed an online questionnaire between February and October 2016. The questionnaire acquired information on participant demographics, characteristics related to cycling profile and fitness training, bike components and cycling posture, self-reported perceptions of comfort and pain, and injuries sustained in the last 12 months. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (95%CI) that examined factors associated with reporting overuse/fatigue injury, acute injury, body discomfort, saddle discomfort, and pain while cycling. Odds of reporting an overuse/fatigue injury increased when the cyclists complemented training with running (OR = 1.74; 95%CI = 1.03–2.91) or swimming (OR = 2.17; 95%CI = 1.19–3.88), and with reported pain while cycling (OR = 1.17; 95%CI = 1.05–3.69) and not cycling (OR = 1.76; 95%CI = 1.07–2.90). Odds of reporting an acute injury increased when biking to work (OR = 1.79; 95%CI = 1.07–2.86), and decreased with increased average cycling speed (1-km/h decrease OR = 0.93; 95%CI = 0.88–0.97), and compared to low-end bike, with the use of mid-range (OR = 0.25; 95%CI = 0.09–0.72) and high-end bike (OR = 0.34; 95%CI = 0.13–0.96). Although body discomfort was only associated with saddle discomfort and the presence of pain during cycling, saddle discomfort was also associated with biking to work (OR = 0.46; 95%CI = 0.22–0.88). Finally, pain perception was associated with a number of factors such as ride to work, core training, cycling experience, saddle discomfort, pain while not cycling. Numerous factors are associated with injury, and perceptions of discomfort and pain in cyclists. Such factors should be considered when developing training routines, bicycle maintenance best practices, and injury prevention programs.
... In particular, the dynamics of the temperature field on the surface of the skin and in the tissues as a whole is not known. This parameter is of great importance to ensure greater efficiency and safety of the procedure, since overcooling of the epidermis to a temperature below -2.5 °C [3,4] leads to irreversible destruction of tissue. The rate of change of the temperature field will allow us to calculate the appropriate temperature of nitrogen vapor and the exposure to cryotherapeutic effects. ...
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In this work, experimental data are presented that allows one to estimate the relative amount of heat release. It also provides the opportunity to state the general tendency of its change over time for patients with various individual characteristics of the organism. An important indicator of safety and effectiveness of cryotherapy is the temperature of the skin surface T k , which should not fall below -2 °C during exposure. It is also planned to propose a method for studying the dynamics of T k and heat flux from the human body using a thermoelectric module (TEM). The paper evaluates the experimental data on the TEM current changes during and after cryotherapy. Also, dynamics assessment of heat flow during cryotherapy is given and the possibility of evaluating T k will be shown. It is planned to get an overall picture of the process of heat exchange of the measuring device with the skin of the test object. The results allow us to make recommendations regarding the duration and intensity of cryotherapy.
... С. Rose и соавт. [14] оценили результаты применения ОВТ при мышечных болях, связанных с интенсивными тренировками, проведя систематический обзор 16 исследований. В 80% литературных источников было зафиксировано значимое уменьшение мышечной боли без какихлибо серьезных НР. ...
Article
Medical rehabilitation is a set of non-drug methods aimed at reducing pain and functional disorders, restoring working ability, social activity, and mental stability in patients. This is a necessary part of treatment in patients with rheumatic diseases, which is as important as pharmacotherapy in many cases (for example, osteoarthritis, chronic nonspecific back pain, and spondyloarthritis). Unfortunately, many Russian physicians underestimate the possibilities of nondrug approaches, referring to the fact that the effectiveness of medical rehabilitation and physiotherapy methods have not been evaluated during clinical trials and their therapeutic significance has passed no serious test in the context of evidence-based medicine. This is not entirely true. This review presents data from a large number of clinical trials and related meta-analyses of studies evaluating the efficiency of the most commonly used medical rehabilitation techniques: cryotherapy, laser therapy, magnetotherapy, ultrasound therapy, percutaneous electroneuromyostimulation, acupuncture, manual therapy, massage, and therapeutic exercises.
... The exposure to cold air induces vasoconstriction [16] and stimulation of dermal thermoreceptors, which leads to slower nerve conduction [17] ultimately resulting in an analgesic effect. So far, it has been used as a recovery technique after physical exercise [18] and has been successfully tested in inflammatory diseases such as rheumatoid arthritis [19,20] and ankylosing spondylitis [19,21]. In addition to its symptomatic and immediate effects, WBC has been shown to affect the immune system. ...
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Introduction Whole-body cryotherapy (WBC) has shown to be beneficial in the treatment of fibromyalgia (FM). There is cumulative evidence that cytokines play a crucial role in FM. It’s unknown whether clinical effects of WBC can be demonstrated at the molecular level and how long the effects last. Methods We compared effects of serial WBC (6 sessions (− 130 °C in 6 weeks) in FM patients and healthy controls (HC). Primary outcome was the change in pain level (visual analogue scale 0–100 mm) after 6 sessions. Secondary outcomes were a change in disease activity (revised Fibromyalgia Impact Questionnaire) and pain after 3 sessions and 3 months after discontinued therapy and in cytokine levels (interleukin (IL-)1, IL-6, tumor necrosis factor α (TNF-α) and IL-10). The patients’ opinions on the satisfaction, effectiveness and significance of WBC were evaluated. Results Twenty-three FM patients and 30 HC were enrolled. WBC resulted in a significant reduction in pain and disease activity after 3 and 6 sessions. No clinical benefit could be measured 3 months after discontinued treatment. Overall, probands were satisfied with WBC and considered WBC to be important and effective. FM patients had significantly different levels of IL-1, IL-6, TNF-α and IL-10 at each reading point compared to HC. Levels of IL-1, IL-6 and IL-10 were significantly altered over time in FM patients. Compared to HC FM patients showed a significantly different response of IL1, − 6 and − 10 to WBC. Conclusion Serial WBC is a fast acting and effective treatment for FM. Proven effects of WBC may be explained by changes in cytokines.
... Instructions were phrased carefully with repeated prompts to preclude endorsement of unintentional cold exposure or deliberate cold exposure not linked specifically to weight and/or shape control (e.g., injuries, muscle soreness) and to avoid wording which inadvertently captured general distress or negative affectivity (i.e., "I am troubled by, "). As traditional and whole-body cryotherapy are used extensively in medicine for anti-inflammatory and anti-analgesic purposes (Hohenauer et al., 2015;Costello et al., 2016;Rose et al., 2017), we carefully phrased instructions and used repeated prompts to ensure participants only rated cold exposure owing to shape and weight concerns and not incidental cold exposure (i.e., forgetting one's coat) or prescribed cold exposure. Specifically, participants were instructed as follows: "Below is a list of things that people might do to intentionally induce shivering or make themselves feel cold in an effort to burn calories or control weight/shape. ...
Article
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Very little is known about potentially dangerous forms of weight control or compensatory behaviors involving deliberately exposing oneself to cold temperature. We investigated frequency of intentional cold exposure behavior to influence shape/weight and its relation to eating disorder pathology. Participants (496; 94.0% females) were recruited via print advertisements and social media. Items were based on a review of scientific literature, popular media, pro-ED forums, and input from clinicians and persons with a lived experience. Lifetime cold exposure and frequency during the past 28 days (“never” to “very often”) were assessed. Participants completed a new self-report questionnaire (Intentional Cold Exposure-Questionnaire; ICE-Q) and measures of eating pathology. Approximately 1/2 of individuals with a current ED had engaged in at least one type of cold exposure behavior during the past 28 days versus 17% of individuals without an ED, although average frequency was low. Common cold exposure behaviours included underdressing, turning down the heat, ingesting ice-cold beverages, and ice baths. Significant moderate correlations existed between the ICE-Q and measures of ED pathology. This is the first study to assess intentional exposure to cold temperature as a means of controlling shape and/or weight. Cold exposure does not appear to be socially normative as a weight control method, but a markedly pathological behavior associated with ED symptomology. Findings indicate a propensity towards experimentation, but sporadic uptake, of cold exposure by individuals with a ED. Future research is needed to assess replicability and to investigate the clinical, theoretical, and prognostic significance of deliberate cold exposure behavior.
... Until now, WBC has been used mainly in sports medicine [16,17] and in the treatment of locomotor system diseases [18,19]. Currently, WBC is used more and more frequently as a wellness method in healthy subjects, to help maintain good health [2,20], but the mechanisms of WBC action are not fully known. ...
Article
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Objective: The aim of the study was to estimate the impact of whole-body cryotherapy (WBC) and subsequent kinesiotherapy on oxidative stress and lipid profile when performed in a closed cryochamber on healthy subjects. Material and methods: The effect of ten WBC procedures lasting 3 minutes a day followed by a 60-minute session kinesiotherapy on oxidative stress and lipid profile in healthy subjects (WBC group, n = 16) was investigated. The WBC group was compared to the kinesiotherapy only (KT; n = 16) group. The routine parameters of oxidative stress (antioxidant enzymatic and nonenzymatic antioxidant status, lipid peroxidation products, total oxidative status (TOS), and oxidative stress index (OSI)) and lipid profile were estimated one day before the beginning and one day after the completion of the research program. Results: After treatment, in the WBC group, a significant decrease of oxidative stress markers (TOS and OSI) and a significant increase of total antioxidant capacity were observed. The activity of plasma SOD-Mn and erythrocyte total SOD increased significantly in the WBC group. In the KT group, the erythrocyte activity of total SOD, CAT, and GR decreased significantly after the treatment. The levels of T-Chol and LDL-Chol decreased significantly after treatment in both groups, but the observed decrease of these lipid parameters in the WBC group was higher in comparison to the KT group. The level of TG decreased significantly after treatment in the WBC group only. Conclusion: WBC performed in a closed cryochamber followed by kinesiotherapy improves lipid profile and decreases oxidative stress in healthy subjects.
... Because CWI resulted in lower T values at the final timepoint compared to PRE, more research is needed to determine the duration of this suppression. In a study by Russell et al. (2017), T response was compared between whole-body cryotherapy, a form of cryotherapy in which super cold air (− 60 to − 120 °C) is delivered in a short period of time (30-120 s) via a cryochamber (Rose et al. 2017), to passive recovery after repeated 30 m sprints. In this study, the authors observed increased testosterone 2 and 24 h after exercise. ...
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Introduction Cold-water immersion (CWI) is often used to promote recovery by reducing exercise-induced muscle damage, soreness, and inflammation. However, recent reports have cautioned that CWI may attenuate the adaptive response to resistance training. Purpose To determine the effect of post resistance-exercise CWI on circulating free testosterone (T) and cytokine (IL-6 and TNF-α) response. Methods Using a randomized and counterbalanced repeated-measures design, 11 resistance-trained men completed two workouts (6 sets of 10 repetitions of back squats at 80% of maximum load) a week apart after which they took part in either 15 min of CWI (15 °C) or passive recovery. T, IL-6, and TNFα were measured in blood samples taken before (PRE) and 5 (5POST), 15 (15POST), 30 (30POST), and 60 (60POST) min post-exercise and compared between treatments and over time. Results For T, a significant interaction effect of condition over time (p = 0.030) as well as greater relative concentrations of T in CON (Δ9.2%) than CWI (Δ-0.5%, p = 0.049) at 30POST were observed. In addition, at 60POST, T dropped below PRE values in CWI (Δ-10.4%, p = 0.028) but not in CON (Δ-1.6%, p = 0.850). A suppressed cytokine response was observed after CWI in IL-6 at 30POST (CWI: Δ4.9%, CON: Δ47.5%, p = 0.041) and TNFα at 15POST (CWI: Δ5.3%, CON: Δ17.0%, p = 0.022). Conclusions CWI blunted the T and cytokine response after a bout of resistance exercise. These results indicate that CWI results in an altered anabolic response and may help to explain the previous observation of attenuated hypertrophy when CWI is used after resistance exercise.
... Although a few studies have reported improvements in performance recovery after cryotherapy, variation in how performance was assessed precludes any definitive conclusions [58]. It is unclear whether cryotherapy provides greater benefits for recovery compared with other strategies such as cold immersion [1,73,74]. ...
Article
Recovery after exercise is an essential element of the training–adaptation cycle. The overall goal of postexercise recovery is to restore homeostasis in many of the body's physiological systems. After exercise, fluids and fuels lost or consumed during exercise must be replaced, body temperature and regular cardiovascular function must be restored, and damaged tissue must be repaired. These events should all occur in a timely manner before the next training session or competitive event occurs. Our understanding of the physiological foundation of postexercise strategies is growing, and further research will help to refine how such strategies are used in practice. Other priorities for future research include (i) investigating methods to promote good sleep behavior in athletes, (ii) examining the effectiveness of combining different recovery interventions, and (iii) determining the optimum timing and frequency of when to adopt recovery strategies between training/competition and across the different phases of a season.
... Initially, due to its analgesic and anti-inflammatory effects, it was empirically applied as a symptomatic adjunct therapy in rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis, and fibromyalgia) [1][2][3][4] . In recent years, there has been a growing interest in the possibility of administering systemic cryotherapy to athletes and physically active individuals to improve recovery of injured muscles following exercise [5][6][7] and enhance athletic performance 8 . ...
Article
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The study aimed to identify the effects of whole-body cryotherapy (WBC) on immunological, hormonal, and metabolic responses of non-professional male athletes. Ten cyclists and ten middle-distance runners received 3 once-a-day sessions of WBC. Before initiating and after the final WBC session, a full set of hematologic parameters, serum chemistry profile, hormones, circulating mitochondrial (mt) DNA levels, cytokines, and chemokines concentration were evaluated. The phenotype of monocyte, T cells, and B cells was analyzed. mRNA expression of 6 genes involved in inflammasome activation (NAIP, AIM2, NLRP3, PYCARD, IL-1β, and IL-18) was quantified. WBC reduced glucose and C and S protein and increased HDL, urea, insulin-like growth factor (IGF)-1, follicle-stimulating hormone, IL-18, IL-1RA, CCL2, and CXCL8. Intermediate and non-classical monocyte percentages decreased, and the CD14, CCR5, CCR2, and CXCR4 expressions changed in different subsets. Only IL-1β mRNA increased in monocytes. Finally, a redistribution of B and T cell subsets was observed, suggesting the migration of mature cells to tissue. WBC seems to induce changes in both innate and adaptive branches of the immune system, hormones, and metabolic status in non-professional male athletes, suggesting a beneficial involvement of WBC in tissue repair.
... Die Evidenzlage bezüglich des Einsatzes von Kältekammern/-kabinen ist im Vergleich zum Kaltwasserbad noch gering. Obwohl Schmerzreduktionen, Leistungssteigerungen und antiinflammatorische Effekte bereits nachgewiesen werden konnten, ist auch hier die Heterogenität das Hauptproblem, was eine generalisierte Empfehlung für diese Behandlungsmethode nicht zulässt [9][29].Neben den positiven Effekten gibt es auch Hinweise, dass die Kältebehandlung nach sportlicher Aktivität die Trainingsanpassungen negativ beeinflussen kann. So konnte festgestellt werden, dass Kältetherapie nach Krafttraining einen negativen Einfluss auf die Muskelproteinsynthese und somit Adaptation auf den Trainingsreiz haben kann[13][14]. ...
Article
Behandlungsparadigmen sollten in der Sportphysiotherapie regelmäßig aktualisiert werden, basierend auf dem aktuellen Stand der Forschungsergebnisse. Das gilt insbesondere auch für den Einsatz von Kälte im Sport.
... Interchangeably with CWI, whole body cryostimulation or partial exposure to extremely low temperature is also applied. Although the increasing accessibility of cryo-chambers is making the implementation of whole body cryostimulation in training more feasible and convenient, reports on the application of this treatment as part of a professional training program are limited (Rose et al., 2017). Therapies based on exposure to extremely low temperatures (−110 to −130 • C) are known to be well-tolerated by professional athletes (Bouzigon et al., 2018), to limit exerciseassociated inflammation and to enhance athletes' performance during demanding competition and training periods (Ziemann et al., 2012;Schaal et al., 2015;Bouzigon et al., 2020). ...
Article
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This study aimed to evaluate the effect of a specific training program, supported by 10 sessions of whole body cryostimulation, on growth factors concentrations, amino acids profile and motor abilities in professional judokas. Ultimately, twelve athletes took part in the study. They were randomly assigned to the cryostimulation group (CRY, n = 6) or the control group (CON, n = 6). During 2 weeks of the judo training program, the CRY group performed 10 cryo-sessions (3-min, at a temperature of −110°C) and the CON group rested passively. Anthropometric measurements, a strength test, the Special Judo Efficiency Test (SJET) were assessed 2 days before and after the judo training program. Blood samples were collected at rest, 1 h after the first and the second SJET and 1 h after the first and the last cryo-session to establish growth factors and amino acid concentrations. Lactate level was measured before, immediately after and 1 h after the first and the second SJET. The applied intervention resulted in a significant increase of resting concentrations of brain-derived neurotrophic factor (from 10.23 ± 1.61 to 15.13 ± 2.93 ng⋅ml –1 ; p = 0.01) and insulin-like growth factor 1 (IGF-1; from 174.29 ± 49.34 to 300.50 ± 43.80 pg⋅ml –1 ; p = 0.00) in the CRY group. A different response was registered 1 h directly post SJET in the CRY group (a significant increase of IGF-1, interleukin 15 and irisin: p = 0.01; p = 0.00; p = 0.03). Additionally, the significant drop of proline and leucine concentrations in the CRY group was obtained. Athletes’ performance remained unchanged in both groups. However, subjects perceived positive changes induced by the intervention – not directly after cryostimulation but in response to the specific training workload. The increase of growth factors concentrations and the improvement of amino acid profile (proline and leucine) contributed to maintaining a high level of muscle function.
... Stoffel et al. reported that central obesity in healthy women is linked with high serum levels of inflammatory cytokines and hepcidin (56), suggesting that central obesity may attribute to reduced beige thermogenesis as the high levels of hepcidin inhibit iron mobilization and redistribution required for beige conversion. Another insight comes from cryogenic therapy, Essential role of systemic iron mobilization and redistribution for adaptive thermogenesis through HIF2-α/hepcidin axis which involves exposure to extreme cold vapor for a short duration (57). Cryogenic therapy reduces fat mass due to augmented thermogenic energy loss from the subcutaneous fat, a coldinduced thermogenic process (58). ...
Article
Iron is an essential biometal, but is toxic if it exists in excess. Therefore, iron content is tightly regulated at cellular and systemic levels to meet metabolic demands but to avoid toxicity. We have recently reported that adaptive thermogenesis, a critical metabolic pathway to maintain whole-body energy homeostasis, is an iron-demanding process for rapid biogenesis of mitochondria. However, little information is available on iron mobilization from storage sites to thermogenic fat. This study aimed to determine the iron-regulatory network that underlies beige adipogenesis. We hypothesized that thermogenic stimulus initiates the signaling interplay between adipocyte iron demands and systemic iron liberation, resulting in iron redistribution into beige fat. To test this hypothesis, we induced reversible activation of beige adipogenesis in C57BL/6 mice by administering a β3-adrenoreceptor agonist CL 316,243 (CL). Our results revealed that CL stimulation induced the iron-regulatory protein–mediated iron import into adipocytes, suppressed hepcidin transcription, and mobilized iron from the spleen. Mechanistically, CL stimulation induced an acute activation of hypoxia-inducible factor 2-α (HIF2-α), erythropoietin production, and splenic erythroid maturation, leading to hepcidin suppression. Disruption of systemic iron homeostasis by pharmacological HIF2-α inhibitor PT2385 or exogenous administration of hepcidin-25 significantly impaired beige fat development. Our findings suggest that securing iron availability via coordinated interplay between renal hypoxia and hepcidin down-regulation is a fundamental mechanism to activate adaptive thermogenesis. It also provides an insight into the effects of adaptive thermogenesis on systemic iron mobilization and redistribution.
... Such stimulus induces pain and inflammatory status reduction in different conditions [15][16][17][18] and induces improvements in depression, anxiety [19], functional status and fatigue [20], and quality of sleep [21]. It is widely used as a recovery technique after physical exercise in elite athletes [22] and the positive effects of 10 serial WBC sessions on PCC patients have been reported 1 month after discontinued treatment [23]. The broader existing evidence of clinical and functional benefits following WBC in musculoskeletal and neurological conditions provides a rationale for prescribing WBC for post-COVID symptoms. ...
Article
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Given the severity and prevalence of post-COVID-19 symptoms in the general population, the identification of boosters for rehabilitation programs appears to be of paramount importance. The purpose of this case series is to provide some preliminary evidence about the role of whole-body cryostimulation (WBC) as an effective adjuvant for the recovery of patients with the post-COVID-19 condition (PCC). We recruited seven patients with previously confirmed SARS-CoV-2 infection and symptoms of PCC of different severities for a comprehensive rehabilitation program, including WBC. The main symptoms were dyspnea, chronic and muscular fatigue, chronic pain, and poor sleep quality. Moreover, some patients presented high levels of hematological markers of inflammation. Because we provided a range of interventions, including nutritional and psychological support along with physical exercise and physiotherapy, we could not determine to what extent WBC may per se have accounted for the clinical and functional improvements. However, for all reported cases, it was observed that the introduction of WBC sessions represented a turning point in the patient’s subjective and objective improvements related to health and functioning.
... The application of cryotherapy on an area of the skin causes a reflex activation, or depolarization, of several sympathetic adrenergic nerve fibers, such depolarization of the fibers causes a release of the neurotransmitter norepinephrine on the smooth muscle receptors that involve the blood vessels, with this, it occurs potent reflex vasoconstriction. After vasoconstriction, the body promotes dilation of the vascular system and increases blood flow in the affected regions to promote possible repairs caused by vasoconstriction, which enhances recovery in the region (Rose et al., 2017). ...
Article
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Background: Cryotherapy brings benefits for muscle recovery and reduction of lactate thresholds in fighters; however, the effect of cryotherapy on the autonomous cardiac recovery (ACR) of wrestlers is not yet defined in the scientific literature. Objective: To analyze the effect of cryotherapy on ACR after simulated combat exercise in mixed martial arts (MMA) fighters. Methods: Crossover randomized clinical trial with a sample of 17 MMA fighters (male, age >18 years). There was simulated combat of three rounds of MMA; each round lasted 5-min, there were the 60s between rounds. ACR was assessed by resting heart rate (RHR), which was monitored by a portable Polar-FT1® device. We measured RHR in the interval between the rounds at the 30s and 60s of rest in the conditions: without cryotherapy (Control), application of an ice pack in the thoracic region (TC); Immersion of feet in ice water (FC). Results: At 30-s of RHR, the control condition was better than FC to reduce RHR in rounds 1 and 2 (p<0.05; η2p:0.28). At the 60s of RHR, the control condition was better than FC and TC (p<0.05; η2p:0.32). The control condition had a better RHR recovery rate than the FC condition after rounds one (η2p: 0.23), two (η2p: 0.46), and three (η2p: 0.27) (p<0.05). The TC condition did not show differences concerning the control and FC conditions. Conclusion: Cryotherapy applications in the thoracic region and by complete immersion of the feet did not generate significant effects on the ACR of MMA fighters.
... Sports such as rugby and American football were early adopters of WBC chambers for recovery, mainly due to the proposed reduction in inflammation that is common in contact sports (Selfe et al. 2014). It is suggested that the extreme temperatures of WBC magnify the effect of cold therapies (such as in comparison to CWI), thus potentially shortening recovery time (Rose et al. 2017). Anecdotally, athletes have reported preferring the use of 'dry' therapies such as WBC rather than prolonged immersion in CWI; one reason for its increased popularisation. ...
Article
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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.
... Other methods to reduce blood lactate accumulation and DOMS that are frequent in athletes are compression garments, massage, or cryotherapy [1,22,23]. There is some evidence that cold water immersion or cryotherapy can reduce DOMS when compared to passive methods, however, there is insufficient evidence comparing it to other methods [24,25]. These methods can also be impractical, costly, and unpleasant for the participant. ...
Article
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Context Muscle damage and delayed onset muscle soreness (DOMS) can occur following intense exercise. Various modalities have been studied to improve blood lactate accumulation, which is a primary reason for DOMS. It has been well established that active recovery facilitates blood lactate removal more rapidly that passive recovery due to the pumping action of the muscle. The pedal pump is a manual lymphatic technique used in osteopathic manipulative medicine to increase lymphatic drainage throughout the body. Pedal pump has been shown to increase lymphatic flow and improve immunity. This may improve circulation and improve clearance of metabolites post-exercise. Objective This study compared the use of pedal pump lymphatic technique to passive supine recovery following maximal exercise. Methods 17 subjects (male n = 10, age 23 ± 3.01; female n = 7, age 24 ± 1.8), performed a maximal volume O2 test (VO2 max) using a Bruce protocol, followed by a recovery protocol using either pedal pump technique or supine passive rest for 10 min, followed by sitting for 10 min. Outcome measures included blood lactate concentration (BL), heart rate (HR), systolic blood pressure (SBP) and VO2. Subjects returned on another day to repeat the VO2 max test to perform the other recovery protocol. All outcomes were measured at rest, within 1- minute post-peak exercise, and at minutes 4, 7, 10 and 20 of the recovery protocols. A 2 × 6 repeated measures ANOVA was used to compare outcome measures (p ≤ 0.05). Results No significant differences were found in VO2, HR, or SBP between any of the recovery protocols. There was no significant difference in BL concentrations for recovery at minutes 4, 7, or 10 (p > 0.05). However, the pedal pump recovery displayed significantly lower BL concentrations at minute 20 of recovery (p = 0.04). Conclusion The pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20. The use of manual lymphatic techniques in exercise recovery should be investigated further.
... Likewise, since oxygen delivery and utilization are influenced by hypoxia, exercise performance and recovery can lead to negative developments such as overtraining syndrome, injuries, or illnesses (Kellmann et al., 2018). Therefore, different interventions have been developed to improve performance and recovery, including nutrition therapy (Lynch et al., 2018), oxygen therapy (Sperlich et al., 2017), and cryotherapy (Rose et al., 2017). Among these, oxygen therapy has been applied as an ergogenic aid to enhance performance and accelerate recovery after exercise due to the importance of oxygen in the aerobic energy system (Hodges et al., 2003), and the low tolerance of human tissues and organs to hypoxia (Millet et al., 2010). ...
Article
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Background: As a World Anti-doping Agency (WADA)-approved treatment, hyperbaric oxygen (HBO 2 ) therapy has been used to improve exercise performance in sports practice. Objective: We aimed to investigate the effect of pre-, post-, and intra-exercise HBO 2 therapy on performance and recovery. Methods: A literature search was conducted using EMBASE, CENTRAL, PubMed, Web of Science, and SPORTDiscus to obtain literature published until May 2021. A total of 1,712 studies that met the following criteria were identified: (1) enrolled healthy adults who were considered physically active; (2) evaluated HBO 2 therapy; (3) included a control group exposed to normobaric normoxic (NN) conditions; (4) involved physical testing (isokinetic or dynamic strength exercise, maximal incremental treadmill/cycle exercise, etc.); and (5) included at least one exercise performance/recovery index as an outcome measure. The Cochrane risk of bias assessment tool was used to evaluate the included studies, and the heterogeneity of therapy effects was assessed using the I ² statistic by Review Manager 5.3. Results: Ten studies (166 participants) were included in the qualitative analysis, and six studies (69 participants) were included in the quantitative synthesis (meta-analysis). In comparisons between participants who underwent HBO 2 therapy and NN conditions, the effects of pre-exercise HBO 2 therapy on exercise performance were not statistically significant ( P > 0.05), and the effects of post-exercise HBO 2 therapy on recovery were not statistically significant either ( P > 0.05). Although individual studies showed positive effects of intra-exercise HBO 2 therapy on exercise performance, a meta-analysis could not be performed. Conclusion: Hyperbaric oxygen therapy before or after exercise had no significant effect on performance and recovery. However, hyperbaric oxygen therapy during exercise could improve muscle endurance performance, which needs to be confirmed by further empirical studies. At present, the practical relevance of these findings should be treated with caution.
... Currently, there is growing interest in new methods of biological regeneration, aimed to accelerate the pace of recovery and reduce post-exercise skeletal muscle damage [5]. Scientific reports have mostly evaluated the use of systemic cryotherapy [6] and massage [7]. However, there are also studies evaluating various forms of vibration. ...
Article
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Prolonged exercise can lead to muscle damage, with soreness, swelling, and ultimately reduced strength as a consequence. It has been shown that whole-body vibration (WBV) improves recovery by reducing the levels of stress hormones and the activities of creatine kinase (CK) and lactate dehydrogenase (LDH). The aim of the study was to demonstrate the effect of local vibration treatment applied after exercise on the level of selected markers of muscle fiber damage. The study involved 12 untrained men, aged 21.7 ± 1.05 years, with a VO2peak of 46.12 ± 3.67 mL. kg −1. min −1. A maximal intensity test to volitional exhaustion was performed to determine VO2peak and individual exercise loads for prolonged exercise. The subjects were to perform 180 min of physical effort with an intensity of 50 ± 2% VO2peak. After exercise, they underwent a 60 min vibration treatment or placebo therapy using a mattress. Blood samples were taken before, immediately after the recovery procedure, and 24 h after the end of the exercise test. Myoglobin (Mb) levels as well as the activities of CK and LDH were recorded. Immediately after the hour-long recovery procedure (vibra-tion or placebo), the mean concentrations of the determined indices were significantly different from baseline values. In the vibration group, significantly lower values of Mb (p = 0.005), CK (p = 0.030), and LDH (p = 0.005) were seen. Differences were also present 24 h after the end of the exercise test. The results of the vibration group compared to the control group differed in respect to Mb (p = 0.002), CK (p = 0.029), and LDH (p = 0.014). After prolonged physical effort, topical vibration improved post-workout recovery manifested by lower CK and LDH activity and lower Mb concentration compared to a control group.
... В настоящее время применяется большое количество низкотемпературных технологий (НТ), которые могут быть разделены на две группы: технологии, в которых используются умеренно низкие температурные воздействия (от -30°С до +20°С), и технологии применения экстремально низких температур (от -30°С до -180°С). Наиболее ярким представителем НТ в медицинской реабилитации является экстремальная аэрокриотерапия (ЭАКТ) [6][7][8]. ...
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The mechanisms of increasing the resistance of cells to significant temperature and damaging effects are typical, and cellular tolerance, ensuring the effectiveness of systemic regulation, is an important part of increasing the adaptive and rehabilitative potential of the entire organism. The expression of early genes encoding a wide range of stress-protective proteins increases the resistance of cells not only to significant temperature stimuli, but also to ischemia, hypoxia, and other damaging factors, forming the effects of cross-adaptation. Even a small change in temperature is significant enough to trigger the processes of genomic reprogramming. It seems to us important to consider the mechanisms of low-temperature therapeutic and rehabilitation technologies from the standpoint of cellular response to temperature stimuli. Currently, a large number of low temperature technologies (HT) are used in medical rehabilitation, which can be divided into two groups: moderately low temperature effects (from 30C to +20C) and extremely low temperature effects (from 30C to 180C), which includes the technology of extreme aerocriotherapy (EACT). The purpose of the review is to analyze the systemic and local mechanisms of EACT implemented with the participation of the main known stress-protective proteins.
... Rose et al. (52) published a literature review of 16 articles on WBC and found an overall beneficial trend in recovery. Muscle pain was reduced by an average of 31% in 144 subjects, and 71% of the studies found evidence of recovery (reduced IL-6, CK, CRP, TNF-α, and increased IL-10) in patients who used WBC (−110°C to −190°C). ...
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Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy.
... Similarly, an increased duration with which cold water immersion and cryotherapy practices are employed were highlighted among ~20% of practitioners. Although, little evidence is available to support a doseresponse relationship, recovery benefits after exercise are better established following cryotherapy [30]. Nevertheless, practitioners individualised player recovery protocols, which is advised given that high inter-individual variations exist with recovery [5]. ...
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Research has demonstrated that the extra-time (ET) period of soccer negatively impacts recovery. However, it is not known to what extent recovery practices are being adapted by practitioners following ET and where gaps exist between research and practice. Therefore, this study explored soccer practitioner perceptions of recovery practices following ET matches. A total of 72 practitioners from across different levels of soccer and several countries completed a bespoke online survey. Inductive content analysis of the responses identified five higher-order themes: ‘conditioning’, ‘player monitoring’, ‘recovery practices’, ‘training’, ‘and ‘future research directions’. Mixed responses were received in relation to whether practitioners condition players in preparation for ET, though 72% allowed players to return to training based on fatigue markers following this additional 30-min period. Sixty-three (88%) practitioners believed that ET delays the time-course of recovery, with 82% highlighting that practices should be adapted following ET compared with a typical 90-min match. Forty-nine practitioners (68%) reduce training loads and intensities for up to 48 hr post ET matches, though training mostly recommences as ‘normal’ at 72 hr. Sixty-three (88%) practitioners believed that more research should be conducted on recovery following ET, with ‘tracking players physiological and physical responses’, ‘nutritional interventions to accelerate recovery’ and ‘changes in acute injury-risk’ being the three areas of research that practitioners ranked as most important. These data suggest practitioners and coaches adjust recovery practices following ET matches compared to 90 min. Further research on the efficacy of recovery strategies following ET matches is required to inform applied practice.
... The physiological, neuromuscular, and perceptual effects of WBC for accelerating recovery following exercise have been well reviewed (Bleakley et al. 2014). Studies indicate that WBC may successfully accelerate subjective recovery of soreness following exercise Pournot et al. 2011;Ziemann et al. 2012;Fonda and Sarabon 2013;Bleakley et al. 2014;Costello et al. 2015;Rose et al. 2017). Evidence further suggests that WBC might effectively suppress the acute inflammatory response following exercise (Banfi et al. 2009(Banfi et al. , 2010Hervé Pournot et al. 2011;Ziemann et al. 2012;Guilhem et al. 2013;. ...
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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.
... Several studies already explained how to reduce DOMS, such as whole body cryotherapy (Rose et al., 2017) cold water immersion (Ihsan et al., 2016), heat therapy (Malanga et al., 2015), pneumatic compression device (PCD) (Winke & Williamson, 2018), massage (Visconti et al., 2015;Holub & Smith, 2017), acupuncture (Fleckenstein et al., 2016), non-steroidal anti-inflammatory drugs (NSAIDs) (Bryant et al., 2017), branched-chain amino acids (BCAAs) (Vandusseldorp et al., 2018), stretching (Xie et al., 2018) and foam rolling (Heiss et al., 2019;Cheatham, 2015). ...
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Long distance running (LDR) is an exercise that has a relatively heavy load which can cause Delayed Onset Muscle Soreness (DOMS) and increase Reactive Oxygen Species (ROS) levels. Xanthine, one derivate of ROS will increase 10 times during aerobic activity which is metabolized to Uric Acid (mg/dL) (UA). Foam rolling (FR) is used for the recovery process. This study aims to determine the effect of long distance running on changes in UA levels and the effect of FR as an active recovery against changes in UA levels. This was a quasi-experiment study using a purposive sampling design, one-group repeated measure design of a sample population of young healthy males (17-25 years). The sample consisted of 10 trained young males in Semarang. The average value of UA before intervention was 4.43 mg/dL ± 0.51. In 90 minutes, it was 5.90 mg/dL ± 0.52, in 120 minutes was 5.71 mg/dL ± 0.72 and at 24 hours after intervention was 6.1 mg/dL ± 0.57. LDR has been shown to increase UA levels. FR which is done only once has not been able to reduce UA levels. The percentage of occurrence of post-LDR DOMS occurred at 24 hours.
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Low-temperature Technologies. Edited by: Tatiana Morosuk and Muhammad Sultan. ISBN: 978-1-83880-667-5. Print ISBN 978-1-83880-666-8. eBook (PDF) ISBN: 978-1-83880-668-2. Published: June 10th 2020.
Article
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The aim of this study was to investigate the effects of regular post-exercise whole-body cryotherapy (WBC) on physiological and performance adaptations to high-intensity interval training (HIT). In a two-group parallel design, twenty-two well-trained males performed four weeks of cycling HIT, with each session immediately followed by 3 min of WBC (−110 °C) or a passive control (CON). To assess the effects of WBC on the adaptive response to HIT, participants performed the following cycling tests before and after the training period; a graded exercise test (GXT), a time-to-exhaustion test (Tmax), a 20-km time trial (20TT), and a 120-min submaximal test (SM120). Blood samples were taken before and after training to measure changes in basal adrenal hormones (adrenaline, noradrenaline, and cortisol). Sleep patterns were also assessed during training via wrist actigraphy. As compared with CON, the administration of WBC after each training session during four weeks of HIT had no effect on peak oxygen uptake (\(\dot{{\rm{V}}}\)O2peak) and peak aerobic power (Ppeak) achieved during the GXT, Tmax duration and work performed (WTmax), 20TT performance, substrate oxidation during the SM120, basal adrenaline/noradrenaline/cortisol concentrations, or sleep patterns (P > 0.05). These findings suggest that regular post-exercise WBC is not an effective strategy to augment training-induced aerobic adaptations to four weeks of HIT.
Article
Background: Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown. Objective: To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions. Methods: 2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis. Results: The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low. Conclusion: This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.
Article
The steady growth in the number of obese patients consequently leads to an increase in bariatric surgeries, while the issues of rehabilitation of these patients remain not fully resolved. Aim of the research: to evaluate the effectiveness of using the whole-body cryotherapy (WBC) in complex medical rehabilitation of patients after laparoscopic gastric bypass in the treatment of obesity. Materials and methods. An interventional, single-center, prospective, controlled, single-blinded, experimental, randomized study. The study included 2 stages. Stage 1: 40 patients underwent laparoscopic mini-gastric bypass with band-separated gastric pouch. Stage 2: the patients were divided into 2 groups: with the use of WBC as part of complex medical rehabilitation (Group A, n = 20) and without additional physiotherapy methods (Group B, n = 20). The course of WBC was 15 sessions of 1–3 minutes. The CryoSpace 2K device consists of a cryochamber (temperature –110 °С) and a pre-chamber (–60 °С). The procedures were carried out every other day; the exposure duration increased in parallel with the growth of cryoresistance. The patients were followed up for a total of 2 years. Results. Surgical results: the average duration of surgery was 85 ± 26 minutes; the length of stay in the hospital was 3.7 ± 1.5 days. One complication was registered. Initially, the patients in groups A and B did not differ in terms of sex, age, anthropometric data, and comorbidities composition. After 2 years of follow-up, BMI was significantly lower in group A with the use of WBC compared with group B (26.7 vs 29.4 kg/m2). The percentage of total weight loss, percentage of BMI loss and percentage of excess weight loss were significantly higher in group A. Conclusion. Taking into account the ongoing rehabilitation measures, the group with the use of WBC showed significantly better indicators for achieving ideal body weight and losing excess weight, which is an argument for recommending the use of this type of physiotherapy in the rehabilitation complex after bariatric procedures.
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La cryothérapie du corps entier se pratique principalement soit par immersion en eau froide, soit en chambre de cryothérapie. Pratiquée depuis l’Antiquité et considérée comme une méthode « naturelle », la cryothérapie tend à attirer de plus en plus d’adeptes. Des effets bénéfiques pour la santé ont été décrits dans la littérature. Néanmoins, l’interprétation de ses effets est difficile en raison de la faible qualité des études actuelles. La cryothérapie pourrait toutefois être utile en complément des thérapies classiques dans diverses pathologies et situations, à condition de connaître les risques, les contre-indications et les règles de bonnes pratiques.
Conference Paper
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Whole-body cryotherapy (WBC) and partial-body cryotherapy (PBC) are two methods that expose a patient to extreme cold for a short time, and both require a specialised cold chamber or cabin. Little known a few years ago, these therapies have recently been the subject of tremendous interest. According to PubMed, there were approximatively 30 scientific studies concerning this topic before 2010 and there have been over 120 since then. The two most investigated domains are improvements in mental and physical health and improvements in recovery after physical exercise (Bouzigon et al., 2016). The populations studied include patients suffering from traumatologic, inflammatory or mental diseases, healthy individuals, and athletes (all levels) as well as active participants (moderate level of sport activity). Several technologies of PBC and WBC have emerged and, there are approximately fifteen producers worldwide. The differences between the two methods involve the exclusion of the head in PBC treatment, different ways to create cold, and different device sizes and mobility possibilities, which can attract different populations of users. PBC uses a moderate-sized mobile device, whereas WBC employs a larger fixed device. Thus, PBC is used more in the field with sport teams, and WBC is used more often in rehabilitation or athletic sport centres. WBC and PBC were first used to relieve rheumatic and inflammatory diseases such as rheumatoid arthritis (Hirvonen et al., 2006), fibromyalgia (Bettoni et al., 2013) or ankylosing spondylitis (Stanek et al., 2015). Currently, these methods are also being used to provides benefits for fatigue and functional status in multiple sclerosis patients (Miller et al., 2016), in psychiatry to improve mental well-being (Szczepanska-Gieracha et al., 2013) and to relieve depression and anxiety syndromes (Rymaszewska and Ramsey, 2008). WBC and PBC were later used in the sports domain to enhance physical exercise recovery (Rose et al., 2017).
Thesis
L’entrainement aérobie (EA) montre des bénéfices sur la santé des personnes âgées présentant la maladie d’Alzheimer (MA) mais les mécanismes physiologiques expliquant ceux-ci restent à analyser. Les objectifs de ce travail étaient d’étudier la faisabilité d’un EA de type continu (EATC) ou intermittent (EATI) durant 9 semaines et de comparer leur effet sur : la synthèse plasmatique du facteur neurotrophique dérivé du cerveau (BDNFp), l’endurance cardiorespiratoire (EC), les capacités cognitives et la qualité de vie (QdV), chez des personnes âgées présentant la MA. Après EATC et EATI, aucun effet n’a été observé sur le taux de BDNFp et les performances cognitives. Une amélioration des paramètres d’endurance a été trouvée. La QdV était améliorée après EATC. Ce travail a montré que l’EATC et l’EATI sont faisables et efficaces indifféremment pour améliorer l’EC. L’EATC a eu un impact positif sur la QdV, mais les 2 types d’EA n’ont pas eu d’effet sur la synthèse de BDNFp et les capacités cognitives.
Article
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The study aimed to determine whether combining cryostimulation with resistance training would effectively increase muscle strength, and if so, whether this adaptation would be related to changes in circulating levels of exerkines (i.e., mediators of systemic adaptation to exercise). Twenty-five students completed 12 sessions of resistance training, each followed by either cryostimulation (n = 15, 3 min exposure at −110 °C) or passive recovery (n = 10). Prior to and post this intervention, participants performed two eccentric cycling bouts (before and after training). At these points, serum concentrations of muscle damage marker (myoglobin), exerkines (interleukin 6 (IL-6), interleukin 15 (IL-15), irisin, brain-derived neurotrophic factor), hypertrophy-related factors (myostatin, insulin-like growth factor 1), and muscle strength were measured. The applied procedure reduced the physiological burden of the second eccentric cycling bout and myoglobin concentrations only in the group subject to cryostimulation. The same group also exhibited decreased levels of myostatin (from 4.7 ± 1.7 to 3.8 ± 1.8 ng·mL−1, p < 0.05). A significant and large interaction between the group × time was noted in IL-15 concentration (p = 0.01, ηp2= 0.27). Training and cryostimulation induced a positive and likely significant improvement of isokinetic muscle strength. Altogether, obtained results support the claim that resistance training combined with cold exposure modified muscle strength through modulation of myostatin and IL-15 concentrations.
Article
Cold therapy is commonly used to relieve pain and inflammation and to aid in muscle recovery after exercise in human medicine. A number of applications have also been observed in veterinary practice. In this article, a critical evaluation of equine protocol applied with a new commercial concept of equine whole-body cryostimulation (WBC) was made. With this new concept of WBC, the protocol usually utilized for relieving pain and discomfort in humans has been extended to horses. The investigations described herein focus on the reduction of horse skin temperature when applying human WBC protocols. Based on infrared thermography measurements, results show that exposing a horse for 3 minutes to a temperature of −140°C, which are conventional parameters used for humans, does not induce sufficient skin thermal gradients in horses. Consequently, beneficial cold reflexes such as vasomotor, neuroconduction, and biochemical reactions cannot be triggered. Further investigations should therefore be carried out to design an adequate protocol specifically aimed at horses.
Article
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Background: The purpose of this study was to estimate the effect of whole-body cryostimulation (WBC) and subsequent kinesiotherapy on inflammatory endothelium and oxidative stress parameters in healthy subjects. Methods: The effects of ten WBC procedures lasting 3 min per day and followed by a 60-min session of kinesiotherapy on oxidative stress and inflammatory endothelium parameters in healthy subjects (WBC group n = 32) were analyzed. The WBC group was compared to a kinesiotherapy only (KT; n = 16) group. The following parameters were estimated one day before the start, and one day after the completion of the studies: oxidative stress parameters (the total antioxidant capacity of plasma (FRAP), paraoxonase-1 activity (PON-1), and total oxidative status (TOS)) and inflammatory endothelium parameters (myeloperoxidase activity (MPO), serum amyloid A (SAA), and sCD40L levels). Results: A significant decrease of PON-1 and MPO activities and TOS, SAA, and sCD40L levels as well as a significant FRAP increase were observed in the WBC group after the treatment. In addition, the SAA levels and PON-1 activity decreased significantly after the treatment in both groups, but the observed decrease of these parameters in the WBC group was higher in comparison to the KT group. Conclusion: WBC procedures have a beneficial impact on inflammatory endothelium and oxidative stress parameters in healthy subjects, therefore they may be used as a wellness method.
Chapter
Dez anos se passaram desde daquele 5 de novembro de 2009 - o sonho de criar um laboratório que pudesse estudar afundo as interações do exercício em contexto de aumento de rendimento humano e recuperação deste pudesse proporcionar aos estudantes de graduação em educação física e fisioterapia - não só da Universidade Federal do Amazonas - mas de toda uma região, um aprofundamento nas áreas do esporte, atividade física e saúde, e reabilitação do movimento. O Laboratório de Estudo do Desempenho Humano carinhosamente chamando de LEDEHU, surgiu da experiência positiva que muitos de seus membros fundadores tiveram dentro de laboratórios pelo país a fora. Mas um laboratório de pesquisa na sua essência desenvolve trabalho com preceitos no método científico, todavia no caso do LEDEHU este caminho foi arraigado pela conexão com a comunidade acadêmica e por aquela que usufrui dos serviços da universidade, eis o motivo de termos tantos projetos de extensão e ações dentro das disciplinas de formação dos cursos da Faculdade de Educação Física e Fisioterapia. E hoje, não obstante, é notório o peso que este laboratório teve no processo de aprovação do recém iniciado programa de pósgraduação Stricto Sensu em Ciência do Movimento Humano, uma conquista de muitos, mas com amparo deste laboratório, que no seu cerne tem missão, visão e valores bem definidos. Visão: Estar entre os laboratórios científicos de maior referência no Brasil. Missão: Contribuir para a realização de descobertas científicas no contexto da atividade física, esporte e reabilitação favorecendo a compreensão e aplicação deste conhecimento pela sociedade. Valores: * Compromisso com a sociedade - Oferecer para a sociedade profissionais capacitados com a interface da ciência aplicada; * Pensamento inovador - Compreender que mudanças na área da atividade física, esporte e reabilitação podem agregar importantes mudanças na vida das pessoas; * Ética nas ações - Seguir com rigor aspectos éticos norteadores. Na análoga história entre Davi e Golias, embora Golias um guerreiro Filisteu fosse mais bem preparado, ele foi derrotado pelo jovem israelita Davi, não um super guerreiro com armadura, escudo, lança e espada, como Golias, apenas um pastor com seu cajado e sua funda. O LEDEHU, em 10 anos, apresentou grandes vitórias, mostrando que a coesão de objetivos pode tornar algo inicialmente pequeno em grande, não fisicamente, mas em conquistas. Neste período foram mais de 180 artigos em revistas indexadas, seis ex-alunos tornaramse doutores e 19 mestres, mais de 50 fizeram iniciação cientifica e mais de 80 seu trabalho de conclusão de curso. Um impacto digno de Davi na estrutura gigantesca e desigual do sistema científico brasileiro. E tudo sempre com uma certeza, o LEDEHU seria eternizado pela vontade coletiva de progredir em prol de um avanço científico respaldado pelos valores expostos acima.
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Whole-body cryotherapy (WBC) has been used as a recovery strategy following different sports activities. Thus, the aim of the study reported here was to examine the effect of WBC on vertical jump recovery following a high-intensity exercise (HIE) bout. Twelve trained men (mean ± standard deviation age = 23.9±5.9 years) were randomly exposed to two different conditions separated by 7 days: 1) WBC (3 minutes of WBC at -110°C immediately after the HIE) and 2) control (CON; no WBC after the HIE). The HIE consisted of six sets of ten repetitions of knee extensions at 60° · s(-1) concentric and 180° · s(-1) eccentric on an isokinetic dynamometer. The vertical jump test was used to evaluate the influence of HIE on lower extremity muscular performance. The vertical jump was performed on a force platform before HIE (T1) and 30 minutes after (T2) the WBC and CON conditions. As a result of HIE, jump height, muscle power, and maximal velocity (Vmax) had significant decreases between T1 and T2, however no significance was found between the WBC and CON conditions. The results indicate that one session of WBC had no effect on vertical jump following an HIE compared with a CON condition. WBC may not improve muscle-function (dependent on stretch-shortening cycle) recovery in very short periods (ie, 30 minutes) following HIE.
Article
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To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at −110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage.
Article
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Introduction: Elite athletes frequently undergo periods of intensified training (IT) within their normal training program. These periods can lead athletes into functional overreaching, characterized by high perceived fatigue, impaired sleep and performance. As whole body cryostimulation (WBC) has been proven an effective recovery method in the short term (<76 hours), we investigated whether daily WBC sessions during IT could prevent exercise and sleep-related signs of overreaching. Methods: After a normal training week (BASE), 10 elite synchronized swimmers performed two 2-week IT periods in randomized crossover fashion, using WBC daily (ITWBC), or not (ITCON), separated by 9 days of light training. 400m swim time trials were performed at BASE and after each IT, to quantify blood lactate ([La-]B), heart rate (HR400), salivary alpha amylase ([[alpha]-amylase]s400) and cortisol ([cortisol]s400) responses. Swimmers wore a wrist actigraph nightly to monitor sleep patterns. Results: 400m swim speed, [La-]B400 and [[alpha]-amylase]s400 decreased from BASE to ITCON, while no significant changes were found after ITWBC. Decreased swim speed was correlated to decreased HR400 and [cortisol]s400. During ITCON, significant decreases in actual sleep duration (-21+/-7 min) and sleep efficiency (-1.9+/-0.8%) were observed, with increased sleep latency (+11+/-5 min)and fatigue compared to BASE, while these variables did not change during ITWBC. Using a qualitative statistical analysis, we observed that daily WBC use resulted in a 98%, 59%, 66% and 78% chance of preserving these respective variables compared to ITCON. Conclusion: WBC use during IT helped mitigate the signs of F-OR observed during ITCON, such as reduced sleep quantity, increased fatigue, impaired exercise capacity. These results support the daily use of WBC by athletes seeking to avoid F-OR during key periods of competition preparation.
Article
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The aim of this study was to evaluate the effects of a single partial-body cryotherapy bout between training sessions on strength recovery. 12 young men (23.9±5.9 years) were randomly exposed to 2 different conditions separated by 7 days: 1) Partial-body cryotherapy (subjects were exposed to 3 min of partial-body cryotherapy at - 110 °C between 2 high-intensity training sessions); 2) Control (subjects were not exposed to partial-body cryotherapy between 2 high-intensity training sessions). Subjects were exposed to partial-body cryotherapy after the first training session. The 2 knee extension high-intensity training sessions were separated by a 40-min rest interval. Knee extension training consisted of 6 sets of 10 repetitions at 60°.s(-1) for concentric actions and 6 sets of 10 at 180.s(-1) for eccentric actions. The decrease in eccentric peak torque and total work was significantly (p<0.05) less after partial-body cryotherapy (5.6 and 2%, respectively) when compared to control (16 and 11.6%, respectively). However, the decrease in concentric peak torque and total work was not different (p>0.05) between partial-body cryotherapy (9.4 and 6.5%, respectively) and control (7.5 and 5.2%, respectively). These results indicate that the use of partial-body cryotherapy between-training sessions can enhance eccentric muscle performance recovery.
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Muscle performance might be temporarily impaired by high-intensity exercise performed during a competition or training session. The attenuation in muscular strength may be transitory, lasting minutes, hours, or several days following training or competition (Barnett, 2006). Longer-lasting impairment in muscle strength accompanied by a reduction in range of motion, an increase in muscle proteins in the blood, an inflammatory response, muscle swelling, and delayed onset muscle soreness is referred to as exercise induced muscle damage (EIMD) (Clarkson and Hubal, 2002; Barnett, 2006; Paulsen et al., 2012). Different modalities have been used to improve recovery from a damaging bout of exercise (Barnett, 2006). Among the most common treatment approaches used to reestablish muscular function are active recovery, compression garments, massage, stretching, anti-inflammatory drugs, and cryotherapy (Cheung et al., 2003; Barnett, 2006; Bishop et al., 2008). A relatively novel modality of cryotherapy is whole-body cryotherapy (WBC), which consists of brief exposure (2–3 min) to extremely cold air (−100 to −195°C) in a temperature-controlled chamber or cryocabin (Banfi et al., 2010; Hausswirth et al., 2011; Fonda and Sarabon, 2013). Sessions of partial-body cryotherapy (PBC), in which the head is not exposed to cold, has also been used as a similar modality of WBC (Hausswirth et al., 2013). According to Hausswirth et al. (2013), WBC and PBC session decreased skin temperature, however, WBC induced a greater decrease compared to PBC. In addition, the tympanic temperature was reduced only after the WBC session. Moreover, parasympathetic tone stimulation was greater following the WBC session. Although WBC has been used since the end of the 1970s in the treatment of rheumatic diseases (Ksiezopolska-Pietrzak, 2000; Metzger et al., 2000; Rymaszewska et al., 2003), it has only recently been used with the purpose of hastening recovery from muscle damage by decreasing the inflammatory process linked to EIMD (Banfi et al., 2010). A logic model proposed by Costello et al. (2013) consisted of the physiological, neuromuscular, and perceptual effects following exposure to WBC which may interact to increase performance. However, a mechanistic model for how WBC may improve symptoms related to EIMD has to this point not been provided (Costello et al., 2013). Thus, the purpose of this manuscript was to briefly address a possible mechanism related to improved recovery from muscle damage by WBC.
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Inflammation may accompany obesity and a variety of diseases, or result from excessive exercise. The aim of this study was to investigate the anti-inflammatory effect of whole-body cryostimulation on the inflammatory response induced by eccentric exercise under laboratory conditions. The study also sought to establish if cold treatment changes the lipid profile and modifies energy expenditure in young people. Eighteen healthy and physically active, college-aged men volunteered to participate in the experiment. They were divided into two subgroups: CRY- submitted to whole-body cryostimulation, and CONT- a control group. Both groups performed eccentric work to induce muscle damage. Blood samples were collected before and 24 h after the exercise. Over the five days that followed, the CRY group was exposed to a series of 10 sessions in a cryogenic chamber (twice a day, for 3 min, at a temperature of -110̊C). After this period of rest, both groups repeated a similar eccentric work session, following the same schedule of blood collection. The perceived pain was noted 24h after each session of eccentric workout. A 30-minute step up/down work-out induced delayed-onset muscle soreness in both groups. The five-day recovery period accompanied by exposure to cold significantly enhanced the concentration of the anti-inflammatory cytokine IL-10. It also led to a pronounced reduction in levels of the pro-inflammatory cytokine IL-1β, and reduced muscle damage. The values for IL-10 before the second bout of eccentric exercise in the CRY group were 2.0-fold higher in comparison to baseline, whereas in the CONT group, the concentration remained unchanged. Furthermore, blood concentrations of the pro-inflammatory cytokine IL-1β fell significantly in the CRY group. The main finding of this study was that a series of 10 sessions of whole body cryostimulation significantly reduced the inflammatory response induced by eccentric exercise. The lipid profile was also improved, but there was no effect on energy expenditure during the exercise.
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The aim of the study was to determine the effect of single whole-body cryotherapy (WBC) session applied prior to submaximal exercise on the activity of antioxidant enzymes, the concentration of lipid peroxidation products, total oxidative status, and the level of cytokines in blood of volleyball players. The study group consisted of 18 male professional volleyball players, who were subjected to extremely cold air (-130°C) prior to exercise performed on cycloergometer. Blood samples were taken five times: before WBC, after WBC procedure, after exercise preceded by cryotherapy (WBC exercise), and before and after exercise without WBC (control exercise). The activity of catalase statistically significantly increased after control exercise. Moreover, the activity of catalase and superoxide dismutase was lower after WBC exercise than after control exercise (P < 0.001). After WBC exercise, the level of IL-6 and IL-1β was also lower (P < 0.001) than after control exercise. The obtained results may suggest that cryotherapy prior to exercise may have some antioxidant and anti-inflammatory properties. The relations between the level of studied oxidative stress and inflammatory markers may testify to the contribution of reactive oxygen species in cytokines release into the blood system in response to exercise and WBC.
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The effect of whole-body cryostimulation (WBC) on the biomarkers of oxidative stress, lysosomal enzymes, creatine kinase and cortisol was studied. The rowers underwent two 6-day training cycles: with pre-training daily WBC (temperature: from -125°C to -150°C) and without cryostimulation (control). Blood samples were taken before and after the third and sixth day of training. The activity of superoxide dismutase and glutathione peroxidase was lower (by 44% and 42%, respectively) after the third day of training with WBC than without WBC. The concentration of lipid peroxidation products was also lower after the training preceded by WBC. Moreover, the acid phosphatase activity was 50% lower after the third day of training with WBC than training without WBC. Considering the antioxidant enzymes activity during training without WBC, the increase of superoxide dismutase and glutathione peroxidase activity was observed after the third day of training (by about 74% and 100%, respectively). The level of lipid peroxidation products also increased after the training without WBC. No statistically significant changes were observed in creatine kinase activity after the training preceded with WBC, while after the training without WBC activity of this enzyme was two-fold higher than before the training. The use of WBC prior to training may reduce the risk of oxidative stress and the extent of muscle fibre injuries provoked by intense exercise. The WBC seems to be an effective and safe method for limiting exercise-induced damage; thus it may be used in biological regeneration of sportsmen.
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Tournament season can provoke overreaching syndrome in professional tennis players, which may lead to deteriorated performance. Thus, appropriate recovery methods are crucial for athletes in order to sustain high-level performance and avoid injuries. We hypothesized that whole-body cryostimulation could be applied to support the recovery process. To assess the effects of 5 days of whole-body cryostimulation combined with moderate-intensity training on immunologic, hormonal, and hematologic responses; resting metabolic rate; and tennis performance in a posttournament season. Controlled laboratory study. National Olympic Sport Centre. Patients or Other Participants: Twelve high-ranking professional tennis players. Intervention(s): Participants followed a moderate-intensity training program. A subgroup was treated with the 5-day whole-body cryostimulation (-120°C) applied twice a day. The control subgroup participated in the training only. Main Outcome Measure(s): Pretreatment and posttreatment blood samples were collected and analyzed for tumor necrosis factor α, interleukin 6, testosterone, cortisol, and creatine kinase. Resting metabolic rate and performance of a tennis drill were also assessed. Proinflammatory cytokine (tumor necrosis factor α) decreased and pleiotropic cytokine (interleukin 6) and cortisol increased in the group exposed to cryostimulation. In the same group, greater stroke effectiveness during the tennis drill and faster recovery were observed. Neither the training program nor cryostimulation affected resting metabolic rate. Professional tennis players experienced an intensified inflammatory response after the completed tournament season, which may lead to overreaching. Applying whole-body cryostimulation in conjunction with moderate-intensity training was more effective for the recovery process than the training itself. The 5-day exposure to cryostimulation twice a day ameliorated the cytokine profile, resulting in a decrease in tumor necrosis factor α and an increase in interleukin 6.
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Exercise-induced muscle damage is an important topic in exercise physiology. However several aspects of our understanding of how muscles respond to highly stressful exercise remain unclear In the first section of this review we address the evidence that exercise can cause muscle damage and inflammation in otherwise healthy human skeletal muscles. We approach this concept by comparing changes in muscle function (i.e., the force-generating capacity) with the degree of leucocyte accumulation in muscle following exercise. In the second section, we explore the cytokine response to 'muscle-damaging exercise', primarily eccentric exercise. We review the evidence for the notion that the degree of muscle damage is related to the magnitude of the cytokine response. In the third and final section, we look at the satellite cell response to a single bout of eccentric exercise, as well as the role of the cyclooxygenase enzymes (COX1 and 2). In summary, we propose that muscle damage as evaluated by changes in muscle function is related to leucocyte accumulation in the exercised muscles. 'Extreme' exercise protocols, encompassing unaccustomed maximal eccentric exercise across a large range of motion, generally inflict severe muscle damage, inflammation and prolonged recovery (> 1 week). By contrast, exercise resembling regular athletic training (resistance exercise and downhill running) typically causes mild muscle damage (myofibrillar disruptions) and full recovery normally occurs within a few days. Large variation in individual responses to a given exercise should, however be expected. The link between cytokine and satellite cell responses and exercise-induced muscle damage is not so clear The systemic cytokine response may be linked more closely to the metabolic demands of exercise rather than muscle damage. With the exception of IL-6, the sources of systemic cytokines following exercise remain unclear The satellite cell response to severe muscle damage is related to regeneration, whereas the biological significance of satellite cell proliferation after mild damage or non-damaging exercise remains uncertain. The COX enzymes regulate satellite cell activity, as demonstrated in animal models; however the roles of the COX enzymes in human skeletal muscle need further investigation. We suggest using the term 'muscle damage' with care. Comparisons between studies and individuals must consider changes in and recovery of muscle force-generating capacity.
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Whole-body cryotherapy (WBC) covers a wide range of therapeutic applications and consists of briefly exposing the body to extremely cold air. In sports medicine, WBC is used to improve recovery from muscle injury; however, empirical studies on its application to this area are lacking. To fill this gap, we compared changes in immunological parameters (C3, IgA, IgM, IgG, C-reactive protein, PGE2), cytokines (IL-2, IL-8, IL-10), adhesion molecules (sICAM-1), and muscle enzymes (creatine kinase [CK], lactate dehydrogenase [LAD]) before and after WBC in 10 top-level Italian National team rugby players. The subjects underwent five sessions on alternate days once daily for 1 week. During the study period, the training workload was the same as that of the previous weeks. Compared to baseline values, immunological parameters remained unchanged, while CK and LAD levels significantly decreased after treatment. No alterations in immunological function were observed but there is a decrease in pro-inflammatory cytokine/chemokine and an increase in anti-inflammatory cytokine.As measured by changes in serum CK and LAD concentrations, and cytokines pathway, short-term cold air exposure was found to improve recovery from exercise-induced muscle injury and/or damage associated with intense physical training.
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Enhanced recovery following physical activity and exercise-induced muscle damage (EIMD) has become a priority for athletes. Consequently, a number of post-exercise recovery strategies are used, often without scientific evidence of their benefits. Within this framework, the purpose of this study was to test the efficacy of whole body cryotherapy (WBC), far infrared (FIR) or passive (PAS) modalities in hastening muscular recovery within the 48 hours after a simulated trail running race. In 3 non-adjoining weeks, 9 well-trained runners performed 3 repetitions of a simulated trail run on a motorized treadmill, designed to induce muscle damage. Immediately (post), post 24 h, and post 48 h after exercise, all participants tested three different recovery modalities (WBC, FIR, PAS) in a random order over the three separate weeks. Markers of muscle damage (maximal isometric muscle strength, plasma creatine kinase [CK] activity and perceived sensations [i.e. pain, tiredness, well-being]) were recorded before, immediately after (post), post 1 h, post 24 h, and post 48 h after exercise. In all testing sessions, the simulated 48 min trail run induced a similar, significant amount of muscle damage. Maximal muscle strength and perceived sensations were recovered after the first WBC session (post 1 h), while recovery took 24 h with FIR, and was not attained through the PAS recovery modality. No differences in plasma CK activity were recorded between conditions. Three WBC sessions performed within the 48 hours after a damaging running exercise accelerate recovery from EIMD to a greater extent than FIR or PAS modalities.
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The objectives of the present investigation was to analyze the effect of two different recovery modalities on classical markers of exercise-induced muscle damage (EIMD) and inflammation obtained after a simulated trail running race. Endurance trained males (n = 11) completed two experimental trials separated by 1 month in a randomized crossover design; one trial involved passive recovery (PAS), the other a specific whole body cryotherapy (WBC) for 96 h post-exercise (repeated each day). For each trial, subjects performed a 48 min running treadmill exercise followed by PAS or WBC. The Interleukin (IL) -1 (IL-1), IL-6, IL-10, tumor necrosis factor alpha (TNF-α), protein C-reactive (CRP) and white blood cells count were measured at rest, immediately post-exercise, and at 24, 48, 72, 96 h in post-exercise recovery. A significant time effect was observed to characterize an inflammatory state (Pre vs. Post) following the exercise bout in all conditions (p<0.05). Indeed, IL-1β (Post 1 h) and CRP (Post 24 h) levels decreased and IL-1ra (Post 1 h) increased following WBC when compared to PAS. In WBC condition (p<0.05), TNF-α, IL-10 and IL-6 remain unchanged compared to PAS condition. Overall, the results indicated that the WBC was effective in reducing the inflammatory process. These results may be explained by vasoconstriction at muscular level, and both the decrease in cytokines activity pro-inflammatory, and increase in cytokines anti-inflammatory.
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Cold therapy is commonly used as a procedure to relieve pain symptoms, particularly in inflammatory diseases, injuries and overuse symptoms. A peculiar form of cold therapy (or stimulation) was proposed 30 years ago for the treatment of rheumatic diseases. The therapy, called whole-body cryotherapy (WBC), consists of exposure to very cold air that is maintained at −110°C to −140°C in special temperature-controlled cryochambers, generally for 2 minutes. WBC is used to relieve pain and inflammatory symptoms caused by numerous disorders, particularly those associated with rheumatic conditions, and is recommended for the treatment of arthritis, fibromyalgia and ankylosing spondylitis. In sports medicine, WBC has gained wider acceptance as a method to improve recovery from muscle injury. Unfortunately, there are few papers concerning the application of the treatment on athletes. The study of possible enhancement of recovery from injuries and possible modification of physiological parameters, taking into consideration the limits imposed by antidoping rules, is crucial for athletes and sports physicians for judging the real benefits and/or limits of WBC. According to the available literature, WBC is not harmful or detrimental in healthy subjects. The treatment does not enhance bone marrow production and could reduce the sport-induced haemolysis. WBC induces oxidative stress, but at a low level. Repeated treatments are apparently not able to induce cumulative effects; on the contrary, adaptive changes on antioxidant status are elicited — the adaptation is evident where WBC precedes or accompanies intense training. WBC is not characterized by modifications of immunological markers and leukocytes, and it seems to not be harmful to the immunological system. The WBC effect is probably linked to the modifications of immunological molecules having paracrine effects, and not to systemic immunological functions. In fact, there is an increase in antiinflammatory cytokine interleukin (IL)-10, and a decrease in proinflammatory cytokine IL-2 and chemokine IL-8. Moreover, the decrease in intercellular adhesion molecule-1 supported the anti-inflammatory response. Lysosomal membranes are stabilized by WBC, reducing potential negative effects on proteins of lysosomal enzymes. The cold stimulation shows positive effects on the muscular enzymes creatine kinase and lactate dehydrogenase, and it should be considered a procedure that facilitates athletes’ recovery. Cardiac markers troponin I and high-sensitivity C-reactive protein, parameters linked to damage and necrosis of cardiac muscular tissue, but also to tissue repair, were unchanged, demonstrating that there was no damage, even minimal, in the heart during the treatment. N-Terminal pro B-type natriuretic peptide (NT-proBNP), a parameter linked to heart failure and ventricular power decrease, showed an increase, due to cold stress. However, the NT-proBNP concentrations observed after WBC were lower than those measured after a heavy training session, suggesting that the treatment limits the increase of the parameter that is typical of physical exercise. WBC did not stimulate the pituitary-adrenal cortex axis: the hormonal modifications are linked mainly to the body’s adaptation to the stress, shown by an increase of noradrenaline (norepinephrine). We conclude that WBC is not harmful and does not induce general or specific negative effects in athletes. The treatment does not induce modifications of biochemical and haematological parameters, which could be suspected in athletes who may be cheating. The published data are generally not controversial, but further studies are necessary to confirm the present observations.
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The purpose of the present study was to test the hypothesis that a transient increase in plasma IL-6 induces an anti-inflammatory environment in humans. Therefore, young healthy volunteers received a low dose of recombinant human (rh)IL-6 or saline for 3 h. Plasma IL-6 levels during rhIL-6 infusion were approximately 140 pg/ml, corresponding to the levels obtained during strenuous exercise. The infusion of rhIL-6 did not induce enhanced levels of the proinflammatory cytokine TNF-alpha but enhanced the plasma levels of the two anti-inflammatory cytokines IL-1 receptor agonist (IL-1ra) and IL-10 compared with saline infusion. In addition, C-reactive protein increased 3 h post-rhIL-6 infusion and was further elevated 16 h later compared with saline infusion. rhIL-6 induced increased levels of plasma cortisol and, consequently, an increase in circulating neutrophils and a decrease in the lymphocyte number without effects on plasma epinephrine, body temperature, mean arterial pressure, or heart rate. In conclusion, this study demonstrates that physiological concentrations of IL-6 induce an anti-inflammatory rather than an inflammatory response in humans and that IL-6, independently of TNF-alpha, enhances the levels not only of IL-1ra but also of IL-10. Furthermore, IL-6 induces an increase in cortisol and, consequently, in neutrocytosis and late lymphopenia to the same magnitude and with the same kinetics as during exercise, suggesting that muscle-derived IL-6 has a central role in exercise-induced leukocyte trafficking.
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Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of muscle soreness or other DOMS symptoms. Exercise is the most effective means of alleviating pain during DOMS, however the analgesic effect is also temporary. Athletes who must train on a daily basis should be encouraged to reduce the intensity and duration of exercise for 1-2 days following intense DOMS-inducing exercise. Alternatively, exercises targeting less affected body parts should be encouraged in order to allow the most affected muscle groups to recover. Eccentric exercises or novel activities should be introduced progressively over a period of 1 or 2 weeks at the beginning of, or during, the sporting season in order to reduce the level of physical impairment and/or training disruption. There are still many unanswered questions relating to DOMS, and many potential areas for future research.
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This study tested the hypothesis that the magnitude of maximal isometric strength (MVC) loss immediately following eccentric exercise (MVC-post) would relate to changes in other indirect markers of muscle damage following exercise. Eighty-nine men were recruited from the same student population and performed 24 maximal eccentric actions of the elbow flexors. Commonly used markers of muscle damage such as relaxed and flexed elbow joint angles, range of motion (ROM), upper-arm circumference, muscle soreness, and plasma creatine kinase (CK) activity were measured before, immediately after, and 1-4 d after exercise. Pearson's product-moment correlation coefficients (r) between change in MVC-post and other markers of muscle damage, as well as MVC during recovery days, were calculated. Changes in MVC-post ranged from -72.8% to -17.6%, and correlated significantly (p < 0.01) with MVC at 1 (r = 0.59), 2 (0.63), 3 (0.61), and 4 (0.62) d after exercise. Reduction in MVC-post also correlated significantly (p < 0.05) with changes in relaxed (r = 0.50) and flexed elbow joint angles (-0.40), ROM (0.55), arm circumference (-0.45), peak palpation (-0.34) and extension muscle soreness (-0.48), and peak CK activity (-0.59). However, the r values were not necessarily high, and MVC-post poorly reflected the distribution of some measures, such as peak CK activity (124 - 50 440 IU x L(-1). These results suggest that MVC-post is not a strong correlate of the changes in markers of muscle damage following eccentric exercise of the elbow flexors.
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Delayed-onset muscle soreness, or 'DOMS', affects many people after exercise and can impair future performance. It usually peaks one to four days after exercise and several strategies are used to overcome it. The effectiveness and safety of many of these strategies applied and promoted is unknown. This article is protected by copyright. All rights reserved.
Article
To examine the effects of a whole-body cryotherapy protocol (3 min at -110°C) on acute recovery and key variables of endurance performance during high-intensity intermittent exercise in a thermoneutral environment. Eleven endurance athletes were tested twice in a randomized crossover design. 5 x 5 min of high-intensity running (HIR) were followed by one hour of passive rest at ~22°C, that either included 3 min of whole-body exposure to -110°C (WBC) or a placebo intervention of 3 min walking (PBO). A ramp test protocol was performed before HIR (R1) and after the one hour recovery period (R2). Time to exhaustion (tlim) was measured along with alterations in oxygen content of the m. vastus lateralis (TSI), oxygen consumption (VO2), capillary blood lactate (Lac), heart rate (HR) and rating of perceived exertion (RPE) during submaximal and maximal running. The difference in tlim between R1 and R2 was lower in the WBC condition compared to PBO (p < 0.05; effect size d = 1.13). During R2 TSI was higher in WBC during submaximal and maximal running (p < 0.01; d = 0.68 - 1.01). In addition VO2, HR and RPE were lower at submaximal level of R2 following WBC compared to PBO condition (p = 0.04 - <0.01; d = 0.23-0.83). WBC improves acute recovery during high-intensity intermittent exercise in thermoneutral conditions. The improvements might be induced by enhanced oxygenation of the working muscles as well as a reduction in cardiovascular strain and increased work economy at submaximal intensities.
Article
Objectives To determine the hypothalamic-pituitary-adrenal (HPA) axis and sympathoadrenal (SA) system response to repeated bouts of downhill running.Methods Eleven active but untrained males (age: 19.7 ± 0.4 y; VO2peak 47.8 ± 3.6 ml/kg/min) performed two 60 min bouts of downhill running (−13.5% gradient), separated by 14 days, at a speed eliciting 75% of their VO2peak on a level grade. Saliva samples were collected before (baseline), after, and every hour for 12 h and every 24 h for 6 days after each run. Salivary cortisol and α-amylase levels were measured as markers of the HPA axis and SA response, respectively. Results were analyzed using repeated measures ANOVA (12 h period: 2 × 14; 24 h intervals 2 × 7, P ≤ 0.05) with Tukey post-hoc tests where appropriate. Paired samples t-tests were used to compare collapsed data vs. baseline measurements.ResultsThere were no significant group × time interactions for cortisol or α-amylase for the hourly samples up to 12 h after each run, nor for the 24 h samples up to 6 days later. The 24 h samples for α-amylase showed a significant group effect between runs (Run 1: 69.77 ± 7.68 vs. Run 2: 92.19 ± 7.67 U/ml; P = 0.04). Significant time effects were measured for both cortisol (decreased 2 h to 12 h post-run) and α-amylase (elevated immediately after, 1 h and 2 h post-run) (P < 0.001).Conclusion The 24 h period group effect for salivary α-amylase suggested an adaptation in the sympathoadrenal system that may alter the systemic inflammatory response to exercise-induced muscle damage but may also reflect enhanced mucosal immunity. Am. J. Hum. Biol., 2014. © 2014 Wiley Periodicals, Inc.
Article
The purpose of this study was to determine the relationships among delayed-onset muscle soreness (DOMS), muscle damage and inflammatory responses to eccentric exercise and investigate the underlying mechanisms. Nine healthy males performed one-leg calf-raise exercise with their right leg on a force plate. They performed 10 sets of 40 repetitions of exercise at 0.5 Hz by the load corresponding to the half of their body weight, with a rest for 3 min between sets. DOMS was evaluated by a visual analogue scale (VAS). Blood and urine samples were collected before and 2, 4, 24, 48, 72 and 96 h post-exercise. Blood samples were analyzed for leucocyte differential counts and neutrophil functions (migratory activity and oxidative burst activity). We also determined a serum marker of muscle damage, myoglobin (Mb), and plasma and urinary prostaglandin E2 as an algesic substance. As for the inflammatory mediators, plasma and urine were analyzed for cytokines (interleukin (IL)-1beta, IL-1 receptor antagonist, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p40, IL-12p70, tumour necrosis factor-alpha, interferon-gamma, monocyte chemotactic protein-1, granulocyte colony-stimulating factor, macrophage colony-stimulating factor, and granulocyte macrophage colony-stimulating factor), leucocyte activation markers (calprotectin and myeloperoxidase), and neutrophil chemotactic factor complement 5a. All subjects reported muscle soreness on subsequent days and VAS peaked at 72 h after exercise. Serum Mb concentration significantly increased (p < 0.05) at 72 h after exercise as compared with the pre-exercise values which was correlated with the increases in VAS at 72 h (r = 0.73, p < 0.05). Circulating neutrophil count and migratory activity increased significantly (p < 0.01, and p < 0.05, respectively) at 4 h after exercise, whereas there were no significant changes in the other plasma and urinary inflammatory mediators. These results suggest that neutrophils can be mobilized into the circulation and migrate to the muscle tissue several hours after the eccentric exercise. There were also positive correlations between the exercise-induced increases in neutrophil migratory activity at 4 h and the increases in Mb at 48 h (r = 0.67, p < 0.05). These findings suggest that neutrophil mobilization and migration after exercise may be involved in the muscle damage and inflammatory processes.
Article
The purpose of this study was to examine the effects of whole-body cryotherapy (WBC) on biochemical, pain, and performance parameters during the 5-day recovery period after damaging exercise for hamstrings. Participants completed a bout of damaging exercise for the hamstring muscles on two separate occasions (control and experimental condition) separated by 10 weeks. During the control condition, subjects received no treatment after the damaging exercise. The experimental condition consisted of WBC everyday during the recovery period. WBC included single 3-min daily exposures to low temperatures (-140 to -195 °C) in the cryo-cabin. During the recovery period, subjects were tested for biochemical markers, perceived pain sensation, and physical performance (squat jump, counter movement jump, maximal isometric torque production, and maximally explosive isometric torque production). Majority of the observed variables showed statistically significant time effects (P < 0.05) in control group, which indicates the presence of muscle damage. Significant interaction between the control and WBC condition was evident for the rate of torque development (P < 0.05). Pain measures substantially differed between the WBC and the control condition after the exercise. Results of this study are not completely supportive of the use of WBC for recovery enhancement after strenuous training.
Article
Immediate and delayed-onset muscle soreness differ mainly in chronology of presentation. Both conditions share the same quality of pain, eliciting and relieving activities and a varying degree of functional deficits. There is no single mechanism for muscle soreness; instead, it is a culmination of 6 different mechanisms. The developing pathway of DOMS begins with microtrauma to muscles and then surrounding connective tissues. Microtrauma is then followed by an inflammatory process and subsequent shifts of fluid and electrolytes. Throughout the progression of these events, muscle spasms may be present, exacerbating the overall condition. There are a multitude of modalities to manage the associated symptoms of immediate soreness and DOMS. Outcomes of each modality seem to be as diverse as the modalities themselves. The judicious use of NSAIDs and continued exercise are suggested to be the most reliable methods and recommended. This review article and each study cited, however, represent just one part of the clinician's decisionmaking process. Careful affirmation of temporary deficits from muscle soreness is not to be taken lightly, nor is the advisement and medical management of muscle soreness prescribed by the clinician.
Article
Background: Many strategies are in use with the intention of preventing or minimising delayed onset muscle soreness and fatigue after exercise. Cold-water immersion, in water temperatures of less than 15°C, is currently one of the most popular interventional strategies used after exercise. Objectives: To determine the effects of cold-water immersion in the management of muscle soreness after exercise. Search methods: In February 2010, we searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library (2010, Issue 1), MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health (CINAHL), British Nursing Index and archive (BNI), and the Physiotherapy Evidence Database (PEDro). We also searched the reference lists of articles, handsearched journals and conference proceedings and contacted experts.In November 2011, we updated the searches of CENTRAL (2011, Issue 4), MEDLINE (up to November Week 3 2011), EMBASE (to 2011 Week 46) and CINAHL (to 28 November 2011) to check for more recent publications. Selection criteria: Randomised and quasi-randomised trials comparing the effect of using cold-water immersion after exercise with: passive intervention (rest/no intervention), contrast immersion, warm-water immersion, active recovery, compression, or a different duration/dosage of cold-water immersion. Primary outcomes were pain (muscle soreness) or tenderness (pain on palpation), and subjective recovery (return to previous activities without signs or symptoms). Data collection and analysis: Three authors independently evaluated study quality and extracted data. Some of the data were obtained following author correspondence or extracted from graphs in the trial reports. Where possible, data were pooled using the fixed-effect model. Main results: Seventeen small trials were included, involving a total of 366 participants. Study quality was low. The temperature, duration and frequency of cold-water immersion varied between the different trials as did the exercises and settings. The majority of studies failed to report active surveillance of pre-defined adverse events.Fourteen studies compared cold-water immersion with passive intervention. Pooled results for muscle soreness showed statistically significant effects in favour of cold-water immersion after exercise at 24 hour (standardised mean difference (SMD) -0.55, 95% CI -0.84 to -0.27; 10 trials), 48 hour (SMD -0.66, 95% CI -0.97 to -0.35; 8 trials), 72 hour (SMD -0.93; 95% CI -1.36 to -0.51; 4 trials) and 96 hour (SMD -0.58; 95% CI -1.00 to -0.16; 5 trials) follow-ups. These results were heterogeneous. Exploratory subgroup analyses showed that studies using cross-over designs or running based exercises showed significantly larger effects in favour of cold-water immersion. Pooled results from two studies found cold-water immersion groups had significantly lower ratings of fatigue (MD -1.70; 95% CI -2.49 to -0.90; 10 units scale, best to worst), and potentially improved ratings of physical recovery (MD 0.97; 95% CI -0.10 to 2.05; 10 units scale, worst to best) immediately after the end of cold-water immersion.Five studies compared cold-water with contrast immersion. Pooled data for pain showed no evidence of differences between the two groups at four follow-up times (immediately, 24, 48 and 72 hours after treatment). Similar findings for pooled analyses at 24, 48 and 72 hour follow-ups applied to the four studies comparing cold-water with warm-water immersion. Single trials only compared cold-water immersion with respectively active recovery, compression and a second dose of cold-water immersion at 24 hours. Authors' conclusions: There was some evidence that cold-water immersion reduces delayed onset muscle soreness after exercise compared with passive interventions involving rest or no intervention. There was insufficient evidence to conclude on other outcomes or for other comparisons. The majority of trials did not undertake active surveillance of pre-defined adverse events. High quality, well reported research in this area is required.