Article

Cold Water Immersion as a Strategy for Muscle Recovery in Professional Basketball Players During the Competitive Season: A Retrospective Cohort Study

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Abstract

Context: Despite prior studies that have addressed the recovery effects of cold-water immersion (CWI) in different sports, there is a lack of knowledge about longitudinal studies across a full season of competition assessing these effects. Objective: To analyze the CWI effects, as a muscle recovery strategy, in professional basketball players throughout a competitive season. Design: A prospective cohort design. Setting: Elite basketball teams. Participants: A total of 28 professional male basketball players divided into 2 groups: CWI (n = 12) and control (n = 16) groups. Main Outcome Measures: Muscle metabolism serum markers were measured during the season in September-T1, November-T2, March-T3, and April-T4. Isokinetic peak torque strength and ratings of perceived exertion were measured at the beginning and at the end of the season. CWI was applied immediately after every match and after every training session before matches. Results: All serum muscular markers, except myoglobin, were higher in the CWI group than the control group (P < .05). The time course of changes in muscle markers over the season also differed between the groups (P < .05). In the CWI group, ratings of perceived exertion decreased significantly from the beginning (T1-T2) to the end (T3-T4). Isokinetic torque differed between groups at the end of the season (60°/s peak torque: P < .001 and η p 2 = .884 ; and 180°/s peak torque: P < .001 and η p 2 = .898 ) and had changed significantly over the season in the CWI group (P < .05). Conclusions: CWI may improve recovery from muscle damage in professional basketball players during a regular season.

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... Among these interventions are "contrast therapy", which alternates between hot and cold treatment; full-body "cryotherapy"; "cold water immersion" (CWI); and hydro-massage". These physiotherapy modalities can alleviate fatigue and increase performance during training and competition 6 . ...
... The effects of CWI are reflected in reduced pain, inflammation, blood flow, cell metabolism and muscle pain [11][12][13] . The efficiency of CWI appears to depend on the application length, the treatment area, the time it is applied, level of physical activity and the modality used 6,14 . Whatever the protocol used, the main beneficial effect of cold during recovery is vasoconstriction, which limits the permeability of the vessels and therefore inflammatory processes, reducing muscle pain 15 . ...
... In view of the above, the study of the effects of recovery practices for performance has become a priority issue for players, coaches and sports researchers alike, as improved recovery has the potential to increase sporting performance. Both CWI and compression stockings have been used routinely to speed up recovery after exercise on an individual level 6,8 . Therefore, applying compressive cryotherapy (CC) allows two recovery practices to be applied together, which could potentially yield better results in the athletes' recovery and performance. ...
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Resumen Introducción: Tanto la inmersión en agua fría como las prendas de compresión han sido usadas rutinariamente para acelerar la recuperación después del ejercicio, sin embargo, hay una falta de conocimiento del uso de ambas técnicas de forma simul-tánea. Pressurice Compressport, es una herramienta simple, no farmacológica y carente de efectos secundarios que permite aplicar la crioterapia compresiva (CC). Objetivo: Investigar el efecto crónico del Pressurice Compressport, tras cada partido, y sesión de entrenamiento, sobre los marcadores de daño muscular, la fuerza muscular y la fatiga. Métodos: Un diseño de cohorte prospectivo. En 24 jugadores de baloncesto masculinos divididos en dos grupos, recupe-ración (RP) (n=12) y control (GC) (n=12). Los marcadores séricos del metabolismo muscular, la fuerza de cuádriceps (FC) y los valores de esfuerzo percibido (RPE) por escala de Borg CR10, se midieron en 3 momentos del estudio: a) día 1, (T1); b) día 28 (T2) y c) día 56 (T3). La CC se aplicó inmediatamente después de cada partido y entrenamiento. Resultados: Se observó una disminución progresiva de todos los marcadores de daño muscular al final de la pre-temporada en el grupo RP. Por el contrario, en el GC aumentaron y fueron significativas para la creatina quinasa (CK) (T1 vs. T3 p<0,05). El curso temporal de la mioglobina (Mb) en el grupo RP (p>0,05), siguió un patrón diferente al GC (p<0,05). En RP los RPE disminuyeron significativamente (p<0,05) en todos los puntos del estudio. La FC fue mayor en el RP que en el GC, además se obtuvieron ganancias a lo largo de la pre-temporada en RP y una disminución en GC. Conclusión: La CC es potencialmente capaz de promover la recuperación del daño muscular asociada con la competición y el entrenamiento, con reducciones en los marcadores del daño muscular, mejoras de la fuerza muscular y disminución significativa RPE. Palabras clave: Recuperación. Daño muscular. Baloncesto. Crioterapia. Prendas de compresión. Medicina deportiva. Summary Introduction: Both cold water immersion and compression garments have been routinely used to speed recovery after exercise, however, there is a lack of knowledge of applying both techniques simultaneously. Pressurice Compressport, which is a simple tool, non-pharmacological and free of side effects that allows the application of compressive cryotherapy (CC). Objective: To investigate the chronic effect of Pressurice Compressport, after each match and training session, on the markers of muscle damage, muscle strength and fatigue. Methods: A prospective cohort design. In 24 male basketball players divided into two groups, recovery (RP) (n=12) and control (GC) (n=12). Serum markers of muscle metabolism, quadriceps strength (FC) and perceived effort values (RPE) by Borg CR10 scale were measured at 3 times in the study: a) day 1, (T1); b) day 28 (T2) and c) day 56 (T3). The CC was applied immediately after each match and training. Results: A progressive decrease in all markers of muscle damage was observed at the end of the pre-season in the RP group. On the contrary, in the GC they increased significantly for creatine kinase (CK) (T1 vs. T3 p<0.05). The time course of myoglobin (Mb) in the RP group (p>0.05) followed a pattern different from that of GC (p<0.05). In RP, the RPE significantly decreased (p<0.05) in all points of the study. The HR was higher in the RPE than in the GC, in addition gains were obtained throughout the pre-season in RPE and a decrease in GC. Conclusion: CC is potentially capable of promoting recovery from muscle damage associated with competition and training, with reductions in markers of muscle damage, improvements in muscle strength and significant decrease in RPE.
... Based on the scientific literature included in this systematic review, a couple of studies have investigated the effects of cold-water immersion (CWI) on physical performance parameters, muscle soreness, RPE, blood-related markers of muscle disruption, and blood lactate concentration in basketball players [52,[85][86][87][88]. Each of them implemented a slightly different CWI protocol, with the main difference being in the water temperature. ...
... The positive impact of CWI (i.e., 5 × 1 min at 11 • C) on a decrease in muscle soreness levels was also observed by Montgomery et al. [86], while Delextrat et al. [52] found that similar CWI treatment (i.e., 2 min at 11 • C with 2 min break at 20 • C) resulted in the improvement of vertical jump performance 24 h post-game. In addition, Seco-Calvo et al. [88] have observed the benefits of intermittent CWI recovery protocol on blood-related markers of muscle disruption such as lactate dehydrogenase, creatine kinase, and aldolase. Analogous findings pertaining to a decrease in blood lactate concentration following continuous CWI treatment (i.e., 16 • C for 7 min) have been observed by Pelana [87]. ...
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Although different strategies have been implemented to manage recovery-fatigue status in athletes, there is still a lack of consensus on which recovery protocols have the greatest impact and effectiveness when implemented with basketball players, including both physiological and psychological recovery methods. Thus, the purpose of this systematic review is to: (a) determine which recovery methods attain the greatest benefit in restoring the process of attenuating fatigue and (b) provide sports practitioners with guidelines on how some of the most effective recovery strategies can be used to optimize athletes’ recovery and ultimately enhance their performance. Using the PRISMA guidelines, a total of 3931 research reports were obtained through four database searches (i.e., PubMed, Scopus, Cochrane, and Web of Science), from which only 25 met the inclusion and exclusion criteria. The recovery protocols analyzed in this systematic review were: sleep, nutrition, hydration, ergogenic aids, cold-water immersion, compression garments, massage, acupuncture, tapering, mindfulness, and red-light irradiation. The results revealed that all recovery strategies are capable of attenuating fatigue and enhancing recovery in basketball players to a certain degree. However, an individualized approach should be promoted, where a combination of proactive recovery modalities appears to result in the most rapid rates of recovery and athletes’ ability to maintain high-level performance. Recovery should be programmed as an integral component of training regimens. Also, cooperation and communication between coaches, players, and the rest of the team staff members are essential in minimizing the risk of non-functional overreaching or injury and optimizing basketball players’ on-court performance.
... Finally, these processes may result in an increase of temperature, which might be an additional symptom of inflammation (Cheung et al., 2003). This leads to muscle stiffness and consequently causes pain that can alter the neuromuscular response during movement and impair the athlete's performance and training program (Hotfiel et al., 2018;Seco-Calvo et al., 2020). ...
... Recently, cryotherapy has emerged as a promising method for reducing DOMS and enhancing post-exercise recovery. There are several cold therapy methods used by athletes: cold water immersion (CWI), contrast water therapy (CWT), whole-body cryotherapy (WBC), and cryosauna (Jajtner et al., 2015;Argus et al., 2017;Lombardi et al., 2017;Seco-Calvo et al., 2020;Miranda et al., 2021). Cryotherapy involves exposing the body to cold temperatures to induce physiological responses that promote healing and regeneration by reducing inflammation, increasing blood flow, and, finally, enhancing muscle recovery (Banfi et al., 2009;Pournot et al., 2011;Siqueira et al., 2018). ...
Article
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The main goal was to investigate the effectiveness of cryosauna in preventing the development of delayed onset muscle soreness and to analyze the regenerative changes within muscles after acute fatigue-induced exercises. Thirty-one volunteers were assigned into two groups: 1) an intervention group that participated in cryostimulation after fatigue-induced exercise protocol (CRYO, n = 16) and a control group that performed fatigue-induced exercise protocol, but without any intervention (CONT, n = 15). Main outcome measures include at baseline: blood sample testing (leukocyte content, myoglobin concentration, and creatine kinase activity) and muscle stiffness of lower extremity; immediately after (stiffness), and 24-48-72-96 h post-exercise (blood samples and stiffness). Both groups performed an exercise-induced muscle damage protocol based on repeated countermovement jumps (10 sets, 10 repetitions). The CRYO group underwent a cryosauna (temperature: −110°C, time: 1.5 min per session) intervention during four sessions (i.e., immediately after, 24-48-72 h post-exercise). Leukocyte content was significantly greater 24-48-72 h after exercise in CONT, compared with the CRYO group (p ≤ 0.05 for all), while creatine kinase activity was greater 24-48-96 h in CONT, compared with the CRYO group (p ≤ 0.05 for all). Muscle stiffness increased significantly in rectus femoris, tibialis anterior, and fibula muscle after 48 h post-exercise (p ≤ 0.05 for all), as well as in tibialis anterior and fibula after 72 h post-exercise (p ≤ 0.05 for all) in the CRYO group. Multiple cryosauna was an effective recovery strategy that reduced blood biomarkers and muscle stiffness after exercise-induced muscle damage. Moreover, the development of delayed onset muscle soreness, expressed by a greater muscle stiffness post-exercise, was attenuated to the first 48 h.
... While there is now a reasonable amount of evidence to support the use of hydrotherapy for athletic recovery, there remains minimal research that is basketball specific. The majority of studies examining hydrotherapy recovery specifically with basketball athletes have focused on CWI [38][39][40][41]. ...
... Only one study has investigated the chronic use of CWI over a season. It was found that regular use of CWI (5 × 2 min at 10.5 °C) led to improvements in isokinetic strength and rating of perceived exertion at the end of the season compared to a control [38]. Based on the body of evidence examining the benefits of intermittent CWI on perceptual, performance, and biomarker recovery following basketball training, matches, and tournaments, it may be recommended that teams use intermittent protocols rather than continuous protocols. ...
Article
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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.
... An important caveat is that positive adaptations to resistance training are still observed with CWI; they are just smaller than those observed in active recovery controls. There is further evidence to show that functional changes in strength or power are not affected [17][18][19][20]. More recently, others have suggested that the magnitude of the effect that CWI has on strength adaptations is moderated by the timing and nature of the intervention; for example, avoiding the use of CWI in close proximity to a strength-based session seems to prevent any dampening effect [4]. ...
Article
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Whilst cold therapies such as cold-water immersion are regularly used in practice, the practical application does not always align with best practices. In this commentary, we highlight the key components of the British Association of Sport and Exercise Sciences (BASES) Expert Statement on the use of cooling therapies for post-exercise recovery and provide additional discussion on the empirical evidence and rationale that informed our perspective. We developed a series of specific questions to ensure that cold therapy recovery protocols are context-specific and tailored to the needs of the individual athletes. These questions, which cover the WHEN, WHAT, and HOW of cold therapy, were central to the development of the Expert Statement. This was presented as a decision tree to ensure that key messages could be concisely disseminated across a range of sporting environments and populations (e.g., gyms, locker rooms, and treatment rooms), supporting and informing decision-making for those wanting to use cold therapy to assist their recovery in line with previously published peer-reviewed work. Discussion points included the suitability of cooling therapies in some contexts, how athletes' choice of cooling mode should be largely driven by practicalities (e.g., budget and availability), and, lastly, future research directions.
... From the analysis of the data it can be deduced that all evaluations were carried out analytically (specifically in a plane of movement). Only the study by Seco Calvo et al. (2020) used the assessment of joint movements (multiple planes of movement). The most used muscle contraction evaluation modality in the selected articles was the concentric-concentric (CON-CON), present in 27 studies. ...
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Objective: A systematized review was carried out to identify the studies that during the last ten years have used isokinetic equipment in sports in which the upper extremity is the basis of its practice, to provide an updated and detailed view of its use, methodologies and the variables used to express their results. Methods: A systematized search of 10 years of information was carried out, according to the PRISMA process, in the databases: Scopus, Web of Science, Pubmed, CINAHL, using combined terms: «isokinetic» «upper extremity», «upper limb», «sport», «exercises», «upper extremity». Results: 9406 articles were identified in the databases for review, of which only 46 were selected based on inclusion criteria. Among the sports evaluated, 25 articles correspond to sports with overhead throws (basketball, volleyball, baseball, handball, among others), followed by Paralympic sports with six articles (basketball and volleyball). Sports such as swimming, judo, weightlifting, water polo, or combined sports complete the list. The shoulder rotator muscles were the most evaluated and the concentric-concentric modality was the most used. The variable moment is the most reported, but the evaluation methodologies and selected speeds differ significantly between studies. Conclusion: The methodologies used are varied (i.e., selection of speed, type of muscular contraction, positioning, and dominance), and their selection was not always oriented toward the functionality of sports practice. In addition, it was observed that some studies needed to specify the isokinetic modality used, leaving a gap in relevant information within the study methods and affecting their future replicability.
... While some of these strategies have shown potential for enhancing the recovery process, others are not well supported in literature or have produced mixed results. CWI has been reported to positively affect the recovery status of basketball players in terms of physical performance, muscle soreness, exercise-induced muscle damage and inflammatory markers (Montgomery et al., 2008;Delextrat et al., 2013;Sánchez-Ureña et al., 2017;Seco-Calvo et al., 2020), thus supporting its application in a real-world context. Similarly, a recent review suggested that athletes may benefit from the consumption of nutritional supplements such as vitamin D, Omega-3 fatty acids, tart cherries, beetroot and pomegranate juice to enhance the recovery process (Bongiovanni et al., 2020). ...
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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.
... Esto coincide con lo reportado en Futbol y Básquetbol profesional elite (Altarriba- . Si bien se han publicado varias revisiones sobre los métodos de recuperación en deportes de equipo (Calleja-González et al., 2016;Gill, Beaven, & Cook, 2006;Nedelec et al., 2013;Nédélec et al., 2012), la mayoría de los estudios realizados en Básquetbol hacen foco en aspectos fisiológicos y perceptivos de la fatiga (Macedo, Vicente, Cesário, & Guirro, 2016;Montgomery, Pyne, Cox, et al., 2008;Moreno, Ramos-Castro, Rodas, Tarragó, & Capdevila, 2015;Seco-Calvo, Mielgo-Ayuso, Calvo-Lobo, Cordova, & Córdova, 2019) , dejando de lado aspectos de rendimiento. Además, debemos mencionar que la mayoría de las investigaciones realizadas han estudiado el efecto de los métodos de recuperación por separado y no en combinación Martínez-Guardado et al., 2020), estableciendo la necesidad de investigar si diferentes protocolos de recuperación post esfuerzo producen resultados distintos. ...
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Introduction: The aim of this study was to compare different post-exercise recovery protocols and determine their influence on physical performance (CMJ, RSAT) and general wellness (BG) at 24 h.Materials and methods:Thirty-two trained adolescent basketball players (15.1 ± 1.3 years, 64.1 ± 17.4 kg, 170.05 ± 10.73 cm) were evaluated. The sample was randomly divided into three groups, Stretching (EST=11), Stretching + Foam Rolling (EST+FR=11) and Stretching + Foam Rolling + Immersion in cold water (EST+FR+INM=10). After inducing fatigue, each group was given a different recovery protocol. Countermovement jump (CMJ), ability to repeat sprints (RSAT) and general well-being (BG) were evaluated pre and post intervention. Results: Muscle pain showed a significant increase in the EST+FM+INM group 24h after the experimental intervention (t (2,29) = -3.820; p = 0.01; 95% CI (0.22 to 2.57 AU). No differences were found between groups (intervention) or moments (pre vs post) of any other study variable. Conclusions: In conclusion, when the replenishment of fluids and energy substrates after exercise is guaranteed, the combination of EST, FR and INM is not more effective in recovering the baseline values of performance and general Wellness in adolescent male basketball players. However, a trend towards improvement is observed when recovery methods are added to the protocols, but it does not reach statistical significance.
... Recent work ( Table 1) examining the longer-term effects of CWI on training performance and recovery amongst professional and semi-professional athletes provides invaluable insights regarding CWI programming and recovery-adaptation interaction throughout training/competition phases Tavares et al., , 2020Seco-Calvo et al., 2020). These studies collectively demonstrate no impairments in strength gains despite administering frequent post-exercise CWI over 2.5 weeks to 8 months. ...
... Recent work ( Table 1) examining the longer-term effects of CWI on training performance and recovery amongst professional and semi-professional athletes provides invaluable insights regarding CWI programming and recovery-adaptation interaction throughout training/competition phases Tavares et al., , 2020Seco-Calvo et al., 2020). These studies collectively demonstrate no impairments in strength gains despite administering frequent post-exercise CWI over 2.5 weeks to 8 months. ...
... Recent work (Table 1) examining the longer-term effects of CWI on training performance and recovery amongst professional and semi-professional athletes provides invaluable insights regarding CWI programming and recovery-adaptation interaction throughout training/competition phases (Lindsay et al., 2016;Tavares et al., 2019Tavares et al., , 2020Seco-Calvo et al., 2020). These studies collectively demonstrate no impairments in strength gains despite administering frequent post-exercise CWI over 2.5 weeks to 8 months. ...
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In the last decade, cold water immersion (CWI) has emerged as one of the most popular post-exercise recovery strategies utilized amongst athletes during training and competition. Following earlier research on the effects of CWI on the recovery of exercise performance and associated mechanisms, the recent focus has been on how CWI might influence adaptations to exercise. This line of enquiry stems from classical work demonstrating improved endurance and mitochondrial development in rodents exposed to repeated cold exposures. Moreover, there was strong rationale that CWI might enhance adaptations to exercise, given the discovery, and central role of peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) in both cold-and exercise-induced oxidative adaptations. Research on adaptations to post-exercise CWI have generally indicated a mode-dependant effect, where resistance training adaptations were diminished, whilst aerobic exercise performance seems unaffected but demonstrates premise for enhancement. However, the general suitability of CWI as a recovery modality has been the focus of considerable debate, primarily given the dampening effect on hypertrophy gains. In this mini-review, we highlight the key mechanisms surrounding CWI and endurance exercise adaptations, reiterating the potential for CWI to enhance endurance performance, with support from classical and contemporary works. This review also discusses the implications and insights (with regards to endurance and strength adaptations) gathered from recent studies examining the longer-term effects of CWI on training performance and recovery. Lastly, a periodized approach to recovery is proposed, where the use of CWI may be incorporated during competition or intensified training, whilst strategically avoiding periods following training focused on improving muscle strength or hypertrophy.
... Esto coincide con lo reportado en futbol profesional elite 11 . Si bien se han publicado varias revisiones sobre los métodos de recuperación en deportes de equipo 9,12-14 , la mayoría de los estudios realizados en Baloncesto hacen foco en aspectos fisiológicos y perceptivos de la fatiga [15][16][17][18] ,dejando de lado aspectos de rendimiento. Además, debemos mencionar que la mayoría de las investigaciones realizadas han estudiado el efecto de los métodos de recuperación por separado y no en combinación 19,20 , estableciendo la necesidad de investigar si diferentes protocolos de recuperación post esfuerzo producen resultados diferentes. ...
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Introduction: The aim of this study was to compare different post-excercise recovery protocols and determine their influence on physical performance, subjective perception of pain, and general wellness the day after. Materials and methods: 28 trained adolescent basketball players (15.1 ± 1.7 years, 65.8 ± 15.9 kg, 171.8 ± 11.4 cm) were evaluated. The sample was randomly divided into four groups, Control (CON = 4), Stretches (ST = 7), Stretches + Foam Rolling (ST + FR = 9) and Stretches + Foam Rolling + Cold water Immersion (EST + FR + CWI= 8). After inducing fatigue, each group was administered a different recovery post-exercise protocol. Counter movement jump (CMJ), delayed onset muscle soreness (DOMS), general wellness (W) and ability to repeat sprints (RSAT) were evaluated pre and post intervention. Results: In RSAT, differences were found between pre and post for TT (total time) in ST + FR + CWI group (p = 0.028). DOMS in ST group was lower than CON group (p = 0.012) and ST + FR + CWI group (p = 0.001), ES + FR group showed lower values than ST + FR group + INM (p = 0.041). Conclusions: The combination of ST, FR and CWI was more effective in the recovery and improvement of Sprint TT performance in adolescent male basketball players. The percentage improvements and the "medium" effect size in the CMJ variable would indicate an intervention to take into account in the recovery processes. The use of ST in isolation or in combination with FR produced significant reductions in DOMS
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Rationale Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast water therapy), and WBC (whole-body cryostimulation). Previous systematic reviews focused on the effect of cryostimulation on muscle fatigue and sports performance. However, studies on the selection of different cryostimulation methods and their intervention effects present inconsistent results. Introduction To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that the effects of various cryostimulation methods, including CWI, CWT, and WBC, on exercise performance and fatigue recovery. Methods Following PRISMA guidelines, we conducted searches in PubMed, Embase, The Cochrane Library, Web of Science, and EBSCO databases to gather randomized controlled trials or self-controlled trials involving CWI/CWT/WBC and their effects on exercise performance or fatigue recovery. The search period ranged from November 2013 to November 2, 2023. Literature screening was performed using EndNote X9.1, and the quality of included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis was conducted using RevMan 5.3 software. Results This study included a total of 18 articles, included a total of 499 healthy participants, comprising 479 males and 20 females. Among them, participants underwent cryostimulation, including 102 using CWT, using CWI, and 58 using WBC. Compared to the control group, cryostimulation can significantly alleviate muscle pain intensity (SMD -0.45, 95% CL -0.82 to 0.09, P = 0.01). Specifically, CWI significantly reduced muscle pain intensity (SMD = −0.45, 95% CI: 0.820.09, P = 0.01), WBC significantly decreased C-reactive protein levels (SMD = −1.36, 95% CI: 2.350.36, P = 0.008). While, CWT showed no significant differences from the control group in exercise performance and fatigue recovery indicators (P > 0.05). Conclusion Cryostimulation can significantly reduce muscle pain intensity and perceived fatigue. Specifically, CWI significantly alleviates muscle pain intensity, WBC significantly lowers markers of inflammation caused by fatigue after exercise, in contrast, CWT does not significantly improve exercise performance and fatigue recovery. After exercise, compared with rest, using cryostimulation may have more noticeable benefits for muscle fatigue and muscle pain, with recommendations prioritizing WBC and CWI particularly for addressing inflammation and muscle pain. However, all cryostimulation may have no significant influence on exercise performance.
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Background and Objectives The aim of this study was to Acute changes in aldolase activity and some hematologic parameters compared to different recoveries. Subjects and Methods The research is of applied type and quasi-experimental research method which was conducted in field-laboratory form with pre-test-post-test design with control group on female semiprofessional athletes in athletics (runners) in Tehran. Sampling was done by simple random sampling, so that after informing and inviting interested people and passing the preliminary stages, 30 runners were selected as the research sample and randomly in 3 groups of 10 people (active recycling group (running), inactivated recycling group (sports massage) and inactive sitting). The main activity included a sports competition. Blood samples were taken from the samples in 3 stages (pre-test (fasting), post-race and post-recovery). In this study, one-way analysis of variance and SPSS statistical software v. 22 were used to examine the data at a significance level of P<0.05. Results The results of this study showed that there is no significant difference between the three types of recycling methods in changing the amount of aldolase and erythrocyte factors (P>0.05), but recycling by massage has an effect on reducing aldolase levels after strenuous exercise. There is a significant difference between the three types of recycling methods (passive, jogging, massage) in reducing the number of white blood cells and hemoglobin in favor of recovery by the massage group. Conclusion According to the results, it can be said that among the recovery methods, the use of massage was more effective in reducing the aldolase activity of female athletes after the run competition.
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Recuperar rapidamente os atletas das cargas de treinamento e jogos constantes denota vantagem competitiva. O objetivo desta pesquisa é investigar os efeitos da crioterapia na recuperação física dos jogadores de basquetebol através de uma revisão de literatura. Foram consultadas cinco bases de dados eletrônicas (PubMed, Google Scholar, Scielo, LILACS and MEDLINE) onde foram selecionados um total de 35 artigos publicados acerca do uso da crioterapia como método recuperativo, 03 livros texto sobre teoria do treinamento esportivo, 01 livro texto sobre fisiologia do exercício, 01 monografia de conclusão de curso. A crioterapia é um método recuperativo que consiste no resfriamento tecidual para gerar benefícios fisiológicos positivos na capacidade psicobiológica de trabalho dos atletas. Os estudos que investigaram os efeitos da crioestimulação no basquetebol costumam empregar protocolos com formatos distintos, utilizando jogadores de diferentes categorias. Neste sentido, as principais variáveis manipuladas são o tipo de abordagem, duração total, temperatura da água e, área corporal submersa. Nos basquetebolistas, a crioterapia foi mais efetiva em restaurar a agilidade, velocidade, força explosiva de membros inferiores, flexibilidade, força de membros inferiores e superiores, dor muscular tardia, sistema imunológico e hematológico. O efeito agudo da crioterapia sobre o equilibrio e a propriocepção é negativo. Os marcadores de dano muscular e a resistência cardiovascular apresentaram respostas restaurativas contraditórias nas pesquisas. A eletromiografia dos membros inferiores sofreu interferências sendo mais acentuado nos indivíduos não-atletas quando comparados aos jogadores de basquetebol. Por fim, devido a inexistência de diretrizes para aplicação da crioterapia em basquetebolistas, foram feitas recomendações práticas específicas.
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Purpose: It is well-documented that severe cold stress impairs exercise performance. Repeated immersion in cold water induces an insulative type of cold acclimation, wherein enhanced vasoconstriction leads to greater body heat retention, which may attenuate cold-induced exercise impairments. The purpose of this study, therefore, was to investigate changes in exercise performance during a 7-day insulative type of cold acclimation. Methods: Twelve healthy participants consisting of eight males and four females (mean ± SD age: 25.6 ± 5.2 years, height: 174.0 ± 8.9 cm, weight: 75.6 ± 13.1 kg) performed a 20 min self-paced cycling test in 23 °C, 40% humidity without prior cold exposure. Twenty-four hours later they began a 7-day cold acclimation protocol (daily 90 min immersion in 10 °C water). On days one, four, and seven of cold acclimation, participants completed the same cycling test. Measurements of work completed, core and skin temperatures, heart rate, skin blood flow, perceived exertion, and thermal sensation were measured during each cycling test. Results: Successful insulative cold acclimation was observed. Work produced during the baseline cycling test (220 ± 70 kJ) was greater (p < 0.001) than all three tests that were performed following immersions (195 ± 58, 197 ± 60, and 194 ± 62 kJ) despite similar ratings of perceived exertion during each test, suggesting that cold exposure impaired cycling performance. This impairment, however, was not attenuated over the cold acclimation period. Conclusions: Results suggest that insulative cold acclimation does not attenuate impairments in exercise performance that were observed following acute cold water immersion.
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Purpose: To explore the influence of body composition on thermal responses to cold water immersion (CWI) and the recovery of exercise performance. Methods: Male subjects were stratified into two groups; low fat (LF; n=10); or high fat (HF; n=10). Subjects completed a high intensity interval test (HIIT) on a cycle ergometer followed by 15 min recovery intervention (control (CON) or CWI). Core temperature (Tc), skin temperature (Tsk) and heart rate were recorded continuously. Performance was assessed at baseline, immediately post-HIIT and 40 min post-recovery using a 4 min cycling time trial (TT), countermovement jump (CMJ), and isometric mid-thigh pull (IMTP) tests. Perceptual measures (thermal sensation (TS), total quality of recovery (TQR), soreness and fatigue) were also assessed. Results: Tc and TS were significantly lower in LF compared to HF from 10 min (Tc: LF 36.5±0.5, HF 37.2±0.6°C; TS: LF 2.3±0.5, HF 3.0±0.7 arbitrary units (a.u.)) to 40 min (Tc: LF 36.1±0.6, HF 36.8±0.7°C; TS: LF 2.3±0.6, HF 3.2±0.7 a.u.) following CWI (P<0.05). Recovery of TT performance was significantly enhanced following CWI in HF (10.3±6.1%) compared to LF (3.1±5.6%, P=0.01) however, no differences were observed between HF (6.9±5.7%) and LF (5.4±5.2%) with CON. No significant differences were observed between groups for CMJ, IMTP, TQR, soreness or fatigue in both conditions. Conclusion: Body composition influences the magnitude of Tc change during and following CWI. Additionally, CWI enhanced performance recovery in the HF group only. Therefore, body composition should be considered when planning CWI protocols to avoid overcooling and maximise performance recovery. https://goo.gl/hPRnFa
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Objectives: Biochemical (e.g. creatine kinase (CK)) and neuromuscular (e.g. peak power output (PPO)) markers of recovery are expensive and require specialist equipment. Perceptual measures are an effective alternative, yet most validated scales are too long for daily use. Design: This study utilises a longitudinal multi-level design to test an adapted Brief Assessment of Mood (BAM+), with four extra items and a 100mm visual analogue scale to measure recovery. Methods: Elite under-21 academy soccer players (N=11) were monitored across five games with data (BAM+, CK and PPO) collected for each game at 24h pre, 24h and 48h post-match. Match activity data for each participant was also collected using GPS monitors on players. Results: BAM+, CK and PPO had significant (p<.05) linear and quadratic growth curves across time and games that matched the known time reports of fatigue and recovery. Multi-level linear modelling (MLM) with random intercepts for 'participant' and 'game' indicated only CK significantly contributed to the variance of BAM+ scores (p<.05). Significant correlations (p<.01) were found between changes in BAM+ scores from baseline at 24 and 48h post-match for total distance covered per minute, high intensity distance covered per minute, and total number of sprints per minute. Conclusions: Visual and inferential results indicate that the BAM+ appears effective for monitoring longitudinal recovery cycles in elite level athletes. Future research is needed to confirm both the scales reliability and validity.
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PurposeWe tested the hypothesis that both post-exercise and passive cold water immersion (CWI) increases PGC-1α and VEGF mRNA expression in human skeletal muscle. Method Study 1 Nine males completed an intermittent running protocol (8 × 3-min bouts at 90 % V˙O2max\dot{V}{\text{O}}_{2} \hbox{max}, interspersed with 3-min active recovery (1.5-min at 25 % and 1.5-min at 50 % V˙O2max\dot{V}{\text{O}}_{2} \hbox{max}) before undergoing CWI (10 min at 8 °C) or seated rest (CONT) in a counterbalanced, randomised manner. Study 2 Ten males underwent an identical CWI protocol under passive conditions. ResultsStudy 1 PGC-1α mRNA increased in CONT (~3.4-fold; P < 0.001) and CWI (~5.9-fold; P < 0.001) at 3 h post-exercise with a greater increase observed in CWI (P < 0.001). VEGFtotal mRNA increased after CWI only (~2.4-fold) compared with CONT (~1.1-fold) at 3 h post-exercise (P < 0.01). Study 2 Following CWI, PGC-1α mRNA expression was significantly increased ~1.3-fold (P = 0.001) and 1.4-fold (P = 0.0004) at 3 and 6 h, respectively. Similarly, VEGF165 mRNA was significantly increased in CWI ~1.9-fold (P = 0.03) and 2.2-fold (P = 0.009) at 3 and 6 h post-immersion. Conclusions Data confirm post-exercise CWI augments the acute exercise-induced expression of PGC-1α mRNA in human skeletal muscle compared to exercise per se. Additionally CWI per se mediates the activation of PGC-1α and VEGF mRNA expression in human skeletal muscle. Cold water may therefore enhance the adaptive response to acute exercise.
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Intense training results in numerous physiological perturbations such as muscle damage, hyperthermia, dehydration and glycogen depletion. Insufficient/untimely restoration of these physiological alterations might result in sub-optimal performance during subsequent training sessions, while chronic imbalance between training stress and recovery might lead to overreaching or overtraining syndrome. The use of post-exercise cold water immersion (CWI) is gaining considerable popularity among athletes to minimize fatigue and accelerate post-exercise recovery. CWI, through its primary ability to decrease tissue temperature and blood flow, is purported to facilitate recovery by ameliorating hyperthermia and subsequent alterations to the central nervous system (CNS), reducing cardiovascular strain, removing accumulated muscle metabolic by-products, attenuating exercise-induced muscle damage (EIMD) and improving autonomic nervous system function. The current review aims to provide a comprehensive and detailed examination of the mechanisms underpinning acute and longer term recovery of exercise performance following post-exercise CWI. Understanding the mechanisms will aid practitioners in the application and optimisation of CWI strategies to suit specific recovery needs and consequently improve athletic performance. Much of the literature indicates that the dominant mechanism by which CWI facilitates short term recovery is via ameliorating hyperthermia and consequently CNS mediated fatigue and by reducing cardiovascular strain. In contrast, there is limited evidence to support that CWI might improve acute recovery by facilitating the removal of muscle metabolites. CWI has been shown to augment parasympathetic reactivation following exercise. While CWI-mediated parasympathetic reactivation seems detrimental to high-intensity exercise performance when performed shortly after, it has been shown to be associated with improved longer term physiological recovery and day to day training performances. The efficacy of CWI for attenuating the secondary effects of EIMD seems dependent on the mode of exercise utilised. For instance, CWI application seems to demonstrate limited recovery benefits when EIMD was induced by single-joint eccentrically biased contractions. In contrast, CWI seems more effective in ameliorating effects of EIMD induced by whole body prolonged endurance/intermittent based exercise modalities.
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We investigated the effect of cold water immersion (CWI) on the recovery of muscle function and physiological responses following high-intensity resistance exercise. Using a randomized, cross-over design, 10 physically active men performed high-intensity resistance exercise, followed by one of two recovery interventions: 10 min of cold water immersion at 10 degrees C, or 10 min active recovery (low-intensity cycling). After the recovery interventions, maximal muscle function was assessed after 2 h and 4 h by measuring jump height and isometric squat strength. Submaximal muscle function was assessed after 6 h by measuring the average load lifted during six sets of 10 squats at 80% 1RM. Intramuscular temperature (1 cm) was also recorded, and venous blood samples were analyzed for markers of metabolism, vasoconstriction and muscle damage. CWI did not enhance recovery of maximal muscle function. However, during the final three sets of the submaximal muscle function test, the participants lifted a greater load (p<0.05; 38%; Cohen's d 1.3) following CWI compared with active recovery. During CWI, muscle temperature decreased ~6 degrees C below post-exercise values, and remained below pre-exercise values for another 35 min. Venous blood O2 saturation decreased below pre-exercise values for 1.5 h after CWI. Serum endothelin-1 concentration did not change after CWI, whereas it decreased after active recovery. Plasma myoglobin concentration was lower, whereas plasma interleukin-6 concentration was higher after CWI compared with active recovery. These results suggest that cold water immersion after resistance exercise allow athletes to complete more work during subsequent training sessions, which could enhance long-term training adaptations.
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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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The aim of this study was to assess the nutrient intakes of elite junior basketball players in comparison to non-athletes. A previously designed food frequency questionnaire was undertaken by 57 male elite junior basketball players 15-16 years of age and 53 non-athlete peers. Mean estimated energy intake was more than 700 kcal higher in basketball players than in the non-athletes (p=0.002). In both groups estimated energy intake was ~14% from protein, 38% from fat, and ~48% from carbohydrates. For the basketball players, estimated protein intake was below 1.4 g/kg in 32% of the group and above 1.7 g/kg in 51%, while carbohydrate intake was below 6 g/kg in 56%. Percentages of participants who apparently failed to meet the Estimated Average Requirement for micronutrients were higher in the non-athlete group. The nutrients most likely to fail to meet the recommendations for nutrient density were vitamin A (~70%), zinc (49% in basketball players and 30% in non-athletes), niacin and calcium (~30% for both micronutrients in both groups). Within the limitations of the survey methodology, elite junior basketball players appear to consume higher absolute energy, macronutrient and micronutrient intakes than non-athletes, but the contribution of macronutrients to daily energy intake and the nutrient density of food choices was similar for both groups. Elite junior basketball players might benefit from nutrition education targeting carbohydrate and protein intake. Dietary modifications that increase intakes of vitamin A, zinc, calcium and niacin in the diets of both groups might also be of value.
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Several studies analysed the effectiveness of cold water immersion (CWI) to support recovery after strenuous exercise but the overall results seem to be conflicting. Most of these studies analysed only short-term recovery effects, whereas the adaptational aspect has been widely neglected. Therefore, we analysed the effects of repeated cooling following training sessions (CWI) on adaptations to strength training. 17 trained male students volunteered. After a two week familiarization period, a pre-test (T1) of 1-RM and 12-RM was conducted followed by the 5-week strength training period (withinsubject design). After the post-test (T2) and a 2-week detraining period a retention-test (T3) was carried out. Directly after each training session, CWI was applied for one randomly assigned leg. Cooling consisted of three 4-minute intervals with a 30-s rest period. The other leg was not cooled. A significant increase in 1-RM and 12-RM from baseline to T2 and T3 (p < 0.001), respectively, as well as a further significant increase in 12-RM from T2 to T3 (p < 0.05) was observed. In addition, a tendency for a large leg effect with higher values for the "control leg" in both parameters (p = 0.08 each) as well as a moderate time * leg interaction in favor of the control leg was found (1-RM: p = 0.11; 12-RM: p = 0.09). The percentage change differences between both conditions were 1.6% for the increase in 1-RM from T1 to T2 and 2.0% from T1 to T3 in favor of the control leg. Long-term strength training adaptations in trained subjects can be negatively affected by CWI. However, effects were small and the practical relevance relative to possible recovery effects needs to be considered in a sports practical setting.
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Background: Training recovery is vital for adaptation and performance, and to avoid cumulative fatigue and symptoms associated with overtraining. The use of cold-water immersion (CWI) as a recovery strategy is common; however, the physiological and biochemical rationale behind its use remains unclear. This study aimed to assess the relationship between body temperature responses to water immersion and individual perception of recovery, with subsequent exercise performance. Methods: Twelve male rugby players participated in a 3-week cross-over trial where an intense 60 min conditioning session was followed immediately by 15 min of either 14°C CWI, 30°C warm-water immersion (WWI) or passive control (CON) recovery intervention. Postexercise body temperatures and subjective ratings of the recovery intervention were recorded and subsequently related to performance in a 5×40 m repeated sprint protocol undertaken 24 h later. Results: CWI induced large reductions in core body temperature postimmersion (effect size (ES) range 1.05-3.21) and improved subsequent sprint performance compared to WWI (ES 1.04±0.84) and CON (ES 1.44±0.84). Both the degree of temperature decrease at 60 min postimmersion (r=0.6948; p=0.0121) and the subjective rating of the recovery intervention (r=0.5886; p=0.0441) were related to subsequent sprint performance. A very strong linear correlation was observed when these two factors were integrated (r=0.7743; p=0.0031). Conclusion: A combination of physiological and psychological indices provides an improved indication of subsequent performance and suggests an important role of individual perception in enhancing training recovery.
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The authors investigated the efficacy of a single exposure to 14 min of cold-water immersion (COLD) and contrast water therapy (CWT) on posttraining recovery in Australian football (AF). Fourteen AF players participated in 3 wk of standardized training. After week 1 training, all players completed a passive recovery (PAS). During week 2, COLD or CWT was randomly assigned. Players undertook the opposing intervention in week 3. Repeat-sprint ability (6 × 20 m), countermovement and squat jumps, perceived muscle soreness, and fatigue were measured pretraining and over 48 h posttraining. Immediately posttraining, groups exhibited similar performance and psychometric declines. At 24 h, repeat-sprint time had deteriorated by 4.1% for PAS and 1.0% for CWT but was fully restored by COLD (0.0%). At 24 and 48 h, both COLD and CWT attenuated changes in mean muscle soreness, with COLD (0.6 ± 0.6 and 0.0 ± 0.4) more effective than CWT (1.9 ± 0.7 and 1.0 ± 0.7) and PAS having minimal effect (5.5 ± 0.6 and 4.0 ± 0.5). Similarly, after 24 and 48 h, COLD and CWT both effectively reduced changes in perceived fatigue, with COLD (0.6 ± 0.6 and 0.0 ± 0.6) being more successful than CWT (0.8 ± 0.6 and 0.7 ± 0.6) and PAS having the smallest effect (2.2 ± 0.8 and 2.4 ± 0.6). AF training can result in prolonged physical and psychometric deficits persisting for up to 48 h. For restoring physical-performance and psychometric measures, COLD was more effective than CWT, with PAS being the least effective. Based on these results the authors recommend that 14 min of COLD be used after AF training.
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Increasing emphasis has been placed on the use of effect size reporting in the analysis of social science data. Nonetheless, the use of effect size reporting remains inconsistent, and interpretation of effect size estimates continues to be confused. Researchers are presented with numerous effect sizes estimate options, not all of which are appropriate for every research question. Clinicians also may have little guidance in the interpretation of effect sizes relevant for clinical practice. The current article provides a primer of effect size estimates for the social sciences. Common effect sizes estimates, their use, and interpretations are presented as a guide for researchers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Abstract The aim of this study was to compare the effects of intermittent cold-water immersion and massage on perceptual and performance markers of recovery by basketball players after competitive matches. Eight men (age 23 ± 3 years; stature 190.5 ± 8.9 cm; body mass 90.3 ± 9.6 kg; body fat 12.8 ± 4.8%) and eight women (age 22 ± 2 years; stature 179.0 ± 8.5 cm; body mass 77.6 ± 9.2 kg; body fat 22.5 ± 6.6%) basketball players participated. Massage, cold-water immersion or control were applied immediately after competitive matches, followed by assessments of perceptual measures of recovery and physical performance, countermovement jump and repeated-sprint ability 24 h after intervention. There was lower perception of fatigue overall and in the legs immediately after the massage and cold-water immersion condition (P < 0.001; [Formula: see text] = 0.91). Furthermore, women had a lower perception of fatigue in cold-water immersion than massage at any testing time (P < 0.001; [Formula: see text] = 0.37). Jump performance was greater after cold-water immersion than the control condition (P = 0.037, [Formula: see text] = 0.37). There was no effect of any of the recovery interventions on repeated-sprint measures (P at best 0.067, [Formula: see text] at best 0.68). The results suggest that both massage and cold-water immersion improve perceptual measures of recovery. Furthermore, cold-water immersion improves jump performance although neither such immersion nor massage had an effect on repeated-sprint ability. This suggests that, overall, cold-water immersion is more useful than massage in the recovery from basketball matches, especially in women.
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The aim of this investigation was to elucidate the effects of cold water immersions (CWIs) following damaging exercise on the repeated bout effect (RBE). Sixteen males performed two bouts of drop jump exercise separated by 14-21 days. Participants were equally, but randomly assigned to either a CWI (12-min CWI at 15 degrees C) or control group (12-min seated rest). Treatments were given immediately after the first exercise bout, 24, 48 and 72 h post-exercise. No interventions were given following the second bout. Maximum voluntary contraction (MIVC), soreness (DOMS), creatine kinase (CK), thigh girth and range of motion (ROM) were recorded before and for 96 h following the initial and repeated bouts of damaging exercise. All variables, except ROM, showed a significant time effect (P < 0.01) indicating the presence of muscle damage following the initial bout; there were no differences between the CWI and control groups after the initial bout. Following the repeated bout of exercise there was a significant attenuation in the reduction of MIVC (P = 0.002) and a reduction in DOMS (P < 0.001), which is indicative of the RBE. There were no significant differences between groups following the repeated bout of damaging exercise. These data show that CWI had no effect following damaging exercise and did not inhibit the RBE. Despite CWI being used routinely, its efficacy remains unclear and there is a need to elucidate the benefits of this intervention on recovery and adaptation to provide practitioners with evidence based practice.
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To describe a case of exertional rhabdomyolysis in a collegiate American football player after preventive coldwater immersion. A healthy man (19 years old) participated in full-contact football practice followed by conditioning (2.5 hours). After practice, he entered a coach-mandated postpractice cold-water immersion and had no signs of heat illness before developing leg cramps, for which he presented to the athletic training staff. After 10 minutes of repeated stretching, massage, and replacement of electrolyte-filled fluids, he was transported to the emergency room. Laboratory tests indicated a creatine kinase (CK) level of 2545 IU/L (normal range, 45-260 IU/L), CK-myoglobin fraction of 8.5 ng/mL (normal < 6.7 ng/mL), and CK-myoglobin relative index of 30% (normal range, 25%-30%). Myoglobin was measured at 499 ng/mL (normal = 80 ng/mL). The attending physician treated the athlete with intravenous fluids. Exercise-associated muscle cramps, dehydration, exertional rhabdomyolysis. The patient was treated with rest and rehydration. One week after the incident, he began biking and swimming. Eighteen days later, the patient continued to demonstrate elevated CK levels (527 IU/L) but described no other symptoms and was allowed to return to football practice as tolerated. Two months after the incident, his CK level remained high (1900 IU/L). The athlete demonstrated no signs of heat illness upon entering the cold-water immersion but experienced severe leg cramping after immersion, resulting in a diagnosis of exertional rhabdomyolysis. Previously described cases have not linked cold-water immersion with the pathogenesis of rhabdomyolysis. In this football player, CK levels appeared to be a poor indicator of rhabdomyolysis. Our patient demonstrated no other signs of the illness weeks after the incident, yet his elevated CK levels persisted. Cold-water immersion immediately after exercise should be monitored by the athletic training staff and may not be appropriate to prevent muscle damage, given the lack of supporting evidence.
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Elite-level athletic training and competition is accompanied by the recovery of a series of physiological stressors. The physiological stress will vary considerably depending upon the specific exercise type, duration and intensity and also on the athletes' familiarisation to the exercise insult. It is well documented that when the exercise stress incorporates a novel eccentric component or the exercise is of considerable intensity or duration,1 athletes will likely experience numerous signs and symptoms of fatigue and cellular disturbance that have the potential to reduce performance. Physiological stress induced by intense exercise is associated with energy substrate depletion, hyperthermia, mechanical muscle damage, oxidative stress, inflammation and nervous system fatigue. The resulting symptoms manifest as reduced performance potential, likely due to increased muscle soreness and decreased muscle function,2 disturbed muscle position sense and reaction time3 as well as increased stiffness and swelling that can last for several days.4 The aetiology of reduced performance potential will vary depending upon the exact physiological stress being recovered from. For example, eccentric exercise is associated with a large mechanical stress and relatively low metabolic cost,5 whereas intermittent sprint exercise may involve both a large mechanical stress and a heightened metabolic cost.6 It is possible that the underlying time course of recovery between different exercise stressors is different, and this consequently may influence how recovery strategies could be implemented. For the purpose of this review, exercise will be subdivided into two categories: ‘eccentric exercise’ that refers to the stress caused from exercise incorporating high mechanical stress (eg, eccentric contractions) and ‘high-intensity exercise’ that refers to stress caused from exercise with a high metabolic cost as well as some elements of eccentric muscle contractions (eg, repeat sprint sports). Given the potential for physiological stress to compromise training and/or competition performance, there has been …
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A single bout of high-force exercise has been shown to increase the muscle levels of heat shock proteins (HSPs). Here, changes in the levels of HSPs after 2 and 11 weeks of strength training with either one or three sets per exercise were examined. Fifteen young men (27 ± 6 years, 182 ± 8 cm and 82 ± 13 kg) were randomized to train either one set in lower-body exercises and three sets in upper-body exercises (1L-3UB), or three sets in lower-body exercises and one set in upper-body exercises (3L-1UB). Biopsies from vastus lateralis and trapezius were obtained before, during (2 weeks) and after 11 weeks of strength training (3 bouts per week). The biopsies were analysed for HSP27 (cytosolic and cytoskeletal fractions) and HSP70 and αB-crystallin (cytosolic fraction). No evidence for an effect of training volume (1 vs. 3 sets) on the HSP response was found. For all subjects combined, HSP27 [186 ± 69% (mean ± SD)], HSP70 (146 ± 51%) and αB-crystallin (184 ± 82%) increased in the cytosolic fraction of vastus lateralis after 11 weeks of training. In the trapezius, the only observed increase was for HSP27 in the cytosolic fraction after 2 weeks of training (149 ± 59%). However, the trapezius contained somewhat higher levels of HSP70 and αB-crystallin than vastus lateralis at baseline. The HSP27 levels in the cytoskeletal compartment did not increase significantly in either muscle. In conclusion, strength training resulted-independent of training volume-in elevated levels of HSP27, HSP70 and αB-crystallin in the cytosolic compartment of the vastus lateralis. In the trapezius, only the cytosolic HSP27 levels were increased with training.
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This study examined the effects of cold therapy (COLD) on recovery of voluntary and evoked contractile properties following high-intensity, muscle-damaging and fatiguing exercise. Ten resistance-trained males performed 6 × 25 maximal concentric/eccentric muscle contractions of the dominant knee extensors (KE) followed by a 20-min recovery (COLD v control) in a randomized cross-over design. Voluntary and evoked neuromuscular properties of the right KE, ratings of perceived muscle soreness (MS) and pain, and blood markers for muscle damage were measured pre- and post-exercise, and immediately post-recovery, 2, 24 and 48-h post-recovery. Exercise resulted in decrements in voluntary and evoked torque, increased MS and elevated muscle damage markers (p < 0.05). Measures of maximal voluntary contraction (MVC) or voluntary activation (VA) were not significantly enhanced by COLD (p > 0.05). Activation of right KE decreased post-exercise with increased activation of biceps femoris (BF) (p < 0.05). However, no significant differences were evident between conditions of activation of KE and hamstrings at any time point (p > 0.05). No significant differences were observed between conditions for creatine kinase or asparate aminotransferase (p > 0.05). However, perceptual ratings of pain were significantly (p < 0.05) lower following COLD compared to control. In conclusion, following damage to the contractile apparatus, COLD did not significantly hasten the recovery of peripheral contractile trauma. Despite no beneficial effect of COLD on recovery of MVC, perceptions of pain were reduced following COLD.
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In order to investigate the effectiveness of different techniques of water immersion recovery on maximal strength, power and the post-exercise inflammatory response in elite athletes, 41 highly trained (Football, Rugby, Volleyball) male subjects (age = 21.5 ± 4.6 years, mass = 73.1 ± 9.7 kg and height = 176.7 ± 9.7 cm) performed 20 min of exhaustive, intermittent exercise followed by a 15 min recovery intervention. The recovery intervention consisted of different water immersion techniques, including: temperate water immersion (36°C; TWI), cold water immersion (10°C; CWI), contrast water temperature (10-42°C; CWT) and a passive recovery (PAS). Performances during a maximal 30-s rowing test (P(30 s)), a maximal vertical counter-movement jump (CMJ) and a maximal isometric voluntary contraction (MVC) of the knee extensor muscles were measured at rest (Pre-exercise), immediately after the exercise (Post-exercise), 1 h after (Post 1 h) and 24 h later (Post 24 h). Leukocyte profile and venous blood markers of muscle damage (creatine kinase (CK) and lactate dehydrogenase (LDH)) were also measured Pre-exercise, Post 1 h and Post 24 h. A significant time effect was observed to indicate a reduction in performance (Pre-exercise vs. Post-exercise) following the exercise bout in all conditions (P < 0.05). Indeed, at 1 h post exercise, a significant improvement in MVC and P(30 s) was respectively observed in the CWI and CWT groups compared to pre-exercise. Further, for the CWI group, this result was associated with a comparative blunting of the rise in total number of leucocytes at 1 h post and of plasma concentration of CK at 24 h post. The results indicate that the practice of cold water immersion and contrast water therapy are more effective immersion modalities to promote a faster acute recovery of maximal anaerobic performances (MVC and 30″ all-out respectively) after an intermittent exhaustive exercise. These results may be explained by the suppression of plasma concentrations of markers of inflammation and damage, suggesting reduced passive leakage from disrupted skeletal muscle, which may result in the increase in force production during ensuing bouts of exercise.
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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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Muscle tissue may be damaged following intense prolonged training as a consequence of both metabolic and mechanical factors. Serum levels of skeletal muscle enzymes or proteins are markers of the functional status of muscle tissue, and vary widely in both pathological and physiological conditions. Creatine kinase, lactate dehydrogenase, aldolase, myoglobin, troponin, aspartate aminotransferase, and carbonic anhydrase CAIII are the most useful serum markers of muscle injury, but apoptosis in muscle tissues subsequent to strenuous exercise may be also triggered by increased oxidative stress. Therefore, total antioxidant status can be used to evaluate the level of stress in muscle by other markers, such as thiobarbituric acid-reactive substances, malondialdehyde, sulfhydril groups, reduced glutathione, oxidized glutathione, superoxide dismutase, catalase and others. As the various markers provide a composite picture of muscle status, we recommend using more than one to provide a better estimation of muscle stress. Clin Chem Lab Med 2010;48:757–67.
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It is well known that reducing tissue temperature changes sensory and motor nerve conduction. However, few studies have compared the effect of different cold modalities on nerve conduction parameters. The purpose of this study was to compare the effects of ice pack, ice massage, and cold water immersion on the conduction parameters of the sural (sensorial) and tibial motor nerves. An experimental study was conducted in which the participants were randomly assigned to 1 of 3 intervention groups (n=12 per group). Independent variables were cold modality and pre- and post-cooling measurement time. Dependent variables were skin temperature and nerve conduction parameters. Thirty-six people who were healthy, with a mean (SD) age of 20.5 (1.9) years, participated in the study. Each group received 1 of the 3 cold modalities, applied to the right calf region for 15 minutes. Skin temperature and nerve conduction parameters were measured before and immediately after cooling. All 3 modalities reduced skin temperature (mean=18.2 degrees C). There also was a reduction in amplitude and an increase in latency and duration of the compound action potential. Ice massage, ice pack, and cold water immersion reduced sensory nerve conduction velocity (NCV) by 20.4, 16.7, and 22.6 m/s and motor NCV by 2.5, 2.1, and 8.3 m/s, respectively. Cold water immersion was the most effective modality in changing nerve conduction parameters. The cooling area of the ice massage and ice pack was smaller than that of the cold water immersion. The examiner was not blinded to the treatment group. The population included only participants who were healthy and young. All 3 modalities were effective in reducing skin temperature and changing sensory conduction at a physiological level that is sufficient to induce a hypoalgesic effect. The results suggest that cold water immersion, as applied in this study, is the most indicated modality for inducing therapeutic effects associated with the reduction of motor nerve conduction.
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The purpose of this study was to examine the effectiveness of a single bout of cold-water immersion on recovery from exercise-induced muscle damage. Eighteen physically active female volunteers (age 19.9 (+/-0.97 years), height 1.66 (+/-0.05 m), mass 63.7 (+/-10 kg), completed 10 sets of 10 counter-movement jumps to induce muscle damage and were randomly allocated to a control or treatment group. The treatment group was given a single 10-min bout of lower limb cold-water immersion therapy at 10 degrees C immediately following damage-inducing exercise. Indicators of muscle damage (plasma creatine kinase activity, perceived soreness and maximal voluntary contraction of the quadriceps) were assessed immediately prior to counter-movement jumps, and at 1, 24, 48, 72 and 96 h, following the damaging exercise. Significant (p = 0.05) time effects were recorded on all indicators of muscle damage, but there were no significant group or group x time interaction effects found on any of the measured variables. The results indicate that a single bout of cold-water immersion after a damaging bout of exercise has no beneficial effects on the recovery from exercise-induced muscle damage.
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Cryotherapy is an effective treatment for acute sports injury to soft tissue, although the effect of cryotherapy on exercise-induced muscle damage is unclear. The aim of this study was to assess the effects of cold water immersion on the symptoms of exercise-induced muscle damage following strenuous eccentric exercise. After performing a bout of damage-inducing eccentric exercise (eight sets of five maximal reciprocal contractions at 0.58 rad x s(-1)) of the elbow flexors on an isokinetic dynamometer, 15 females aged 22.0+/-2.0 years (mean +/- s) were allocated to a control group (no treatment, n = 7) or a cryotherapy group (n = 8). Subjects in the cryotherapy group immersed their exercised arm in cold water (15 degrees C) for 15 min immediately after eccentric exercise and then every 12 h for 15 min for a total of seven sessions. Muscle tenderness, plasma creatine kinase activity, relaxed elbow angle, isometric strength and swelling (upper arm circumference) were measured immediately before and for 3 days after eccentric exercise. Analysis of variance revealed significant (P < 0.05) main effects for time for all variables, with increases in muscle tenderness, creatine kinase activity and upper arm circumference, and decreases in isometric strength and relaxed elbow angle. There were significant interactions (P<0.05) of group x time for relaxed elbow angle and creatine kinase activity. Relaxed elbow angle was greater and creatine kinase activity lower for the cryotherapy group than the controls on days 2 and 3 following the eccentric exercise. We conclude that although cold water immersion may reduce muscle stiffness and the amount of post-exercise damage after strenuous eccentric activity, there appears to be no effect on the perception of tenderness and strength loss, which is characteristic after this form of activity.
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In eccentric exercise the contracting muscle is forcibly lengthened; in concentric exercise it shortens. While concentric contractions initiate movements, eccentric contractions slow or stop them. A unique feature of eccentric exercise is that untrained subjects become stiff and sore the day afterwards because of damage to muscle fibres. This review considers two possible initial events as responsible for the subsequent damage, damage to the excitation-contraction coupling system and disruption at the level of the sarcomeres. Other changes seen after eccentric exercise, a fall in active tension, shift in optimum length for active tension, and rise in passive tension, are seen, on balance, to favour sarcomere disruption as the starting point for the damage. As well as damage to muscle fibres there is evidence of disturbance of muscle sense organs and of proprioception. A second period of exercise, a week after the first, produces much less damage. This is the result of an adaptation process. One proposed mechanism for the adaptation is an increase in sarcomere number in muscle fibres. This leads to a secondary shift in the muscle's optimum length for active tension. The ability of muscle to rapidly adapt following the damage from eccentric exercise raises the possibility of clinical applications of mild eccentric exercise, such as for protecting a muscle against more major injuries.
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The purpose of this study was to measure isokinetically glenohumeral joint movement peak torque and work in professional basketball, volleyball, handball and baseball players and determine whether significant differences exist between the dominant and non-dominant extremity in athletes and controls. Eighty healthy professional overhead athletes (basketball, volleyball, handball and baseball players) and 20 controls were tested bilaterally on a CYBEX 6000 isokinetic dynamometer at 60 degrees and 180 degrees s(-1) for diagonal pattern of the glenohumeral joint. A standardized protocol and testing guidelines were strictly followed. The range of motion of internal rotation (IR) on the dominant side of baseball players was significantly smaller than those on the dominant side of basketball, handball and volleyball players, and controls (P<0.01). Flexion/abduction/external rotation were consistently higher on the dominant arm (8.5%) for peak torque at 60 degrees s(-1) in baseball players, and bilateral ratios were lower on the dominant arm (14.8%) for peak torque at 180 degrees s(-1) in basketball players. The results of this study are important for the application and interpretation of isokinetic data and flexibility and mobility characteristics on unilaterally dominant overhead athletes. Functional weakness in external rotators, mobility impairments in IR and muscle imbalance have been shown in the dominant arm of these overhead athletes.
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Cryotherapy and thermotherapy are useful adjuncts for the treatment of musculoskeletal injuries. Clinicians treating these conditions should be aware of current research findings regarding these modalities, because their choice of modality may affect the ultimate outcome of the patient being treated. Through a better understanding of these modalities, clinicians can optimize their present treatment strategies. Although cold and hot treatment modalities both decrease pain and muscle spasm, they have opposite effects on tissue metabolism, blood flow, inflammation, edema, and connective tissue extensibility. Cryotherapy decreases these effects while thermotherapy increases them. Continuous low-level cryotherapy and thermotherapy are newer concepts in therapeutic modalities. Both modalities provide significant pain relief with a low side-effect profile. Contrast therapy, which alternates between hot and cold treatment modalities, provides no additional therapeutic benefits compared with cryotherapy or thermotherapy alone. Complications of cryotherapy include nerve damage, frostbite, Raynaud's phenomenon, cold-induced urticaria, and slowed wound healing. With thermotherapy, skin burns may occur, especially in patients with diabetes mellitus, multiple sclerosis, poor circulation, and spinal cord injuries. In individuals with rheumatoid arthritis, deep-heating modalities should be used with caution because increased inflammation may occur. Whirlpool and other types of hydrotherapy have caused infections of the skin, urogenital, and pulmonary systems. Additionally, ultrasound should not be used in patients with joint prostheses.
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Recovery from exercise can be an important factor in performance during repeated bouts of exercise. In a tournament situation, where athletes may compete numerous times over a few days, enhancing recovery may provide a competitive advantage. One method that is gaining popularity as a means to enhance post-game or post-training recovery is immersion in water. Much of the literature on the ability of water immersion as a means to improve athletic recovery appears to be based on anecdotal information, with limited research on actual performance change. Water immersion may cause physiological changes within the body that could improve recovery from exercise. These physiological changes include intracellular-intravascular fluid shifts, reduction of muscle oedema and increased cardiac output (without increasing energy expenditure), which increases blood flow and possible nutrient and waste transportation through the body. Also, there may be a psychological benefit to athletes with a reduced cessation of fatigue during immersion. Water temperature alters the physiological response to immersion and cool to thermoneutral temperatures may provide the best range for recovery. Further performance-orientated research is required to determine whether water immersion is beneficial to athletes.
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The aim of this study was to assess the effects of cold-water immersion (cryotherapy) on indices of muscle damage following a bout of prolonged intermittent exercise. Twenty males (mean age 22.3 years, s = 3.3; height 1.80 m, s = 0.05; body mass 83.7 kg, s = 11.9) completed a 90-min intermittent shuttle run previously shown to result in marked muscle damage and soreness. After exercise, participants were randomly assigned to either 10 min cold-water immersion (mean 10 degrees C, s = 0.5) or a non-immersion control group. Ratings of perceived soreness, changes in muscular function and efflux of intracellular proteins were monitored before exercise, during treatment, and at regular intervals up to 7 days post-exercise. Exercise resulted in severe muscle soreness, temporary muscular dysfunction, and elevated serum markers of muscle damage, all peaking within 48 h after exercise. Cryotherapy administered immediately after exercise reduced muscle soreness at 1, 24, and 48 h (P < 0.05). Decrements in isometric maximal voluntary contraction of the knee flexors were reduced after cryotherapy treatment at 24 (mean 12%, s(x) = 4) and 48 h (mean 3%, s(x) = 3) compared with the control group (mean 21%, s(x) = 5 and mean 14%, s(x) = 5 respectively; P < 0.05). Exercise-induced increases in serum myoglobin concentration and creatine kinase activity peaked at 1 and 24 h, respectively (P < 0.05). Cryotherapy had no effect on the creatine kinase response, but reduced myoglobin 1 h after exercise (P < 0.05). The results suggest that cold-water immersion immediately after prolonged intermittent shuttle running reduces some indices of exercise-induced muscle damage.
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Cold water immersion (CWI) is used by endurance athletes to speed recovery between exercise bouts, but little evidence is available on the effects of CWI on subsequent endurance performance. The purpose of this study was to investigate the effects of CWI following an acute bout of interval training on 5000 m run performance 24 hrs after interval training, perceived muscle soreness (PMS), range of motion (ROM), thigh circumference (TC), and perceived exertion (RPE). Nine endurance-trained males completed 2 trials, each consisting of an interval training session of 8 repetitions of 1200 m at a running pace equal to 75% of VO2peak, either a control or CWI treatment, and a timed 5000 m run 24 hrs post interval training session. CWI was performed for 12 min at 12 degrees Celsius on the legs. Recovery treatments were performed in a counterbalanced design. Run time for 5000 m was not different between the CWI and control trials (CWI = 1317.33 ± 128.33 sec, control = 1303.44 ± 105.53 sec; p = 0.48). PMS increased significantly from baseline to immediately post exercise (BL = 1.17 ± 0.22, POST = 2.81 ± 0.52; p = 0.02) and remained elevated from baseline to 24 hrs post exercise (POST24 = 2.19 ± 0.32; p = 0.02), but no difference was observed between the treatments. No differences were observed for the interaction between time and treatment for TC (λ = 0.73, p = 0.15) and ROM (λ = 0.49; p = 0.10). CWI performed immediately following an interval training exercise bout did not enhance subsequent 5000 m run performance or reduce PMS. CWI may not provide a recovery or performance advantage when athletes are accustomed to the demands of the prior exercise bout.
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Background: Cold water immersion (CWI) is a commonly used recuperative strategy. However there is a lack of standardization of protocols considering the duration and temperature of application of the technique and the stress model. Therefore is it important to study the issue of dose response in a specific stress model. Thus the objective was to analyze and compare the effects of CWI during intense post-exercise recovery using different durations and temperatures of immersion. Methods: 105 male individuals were divided into five groups: one control group (CG) and four recovery groups (G1: 5' at 9±1°C; G2: 5' at 14±1oC; G3: 15' at 9±1°C; G4: 15' at 14±1°C). The volunteers were submitted to an exhaustion protocol that consisted of a jump program and the Wingate test. Immediately after the exhaustion protocol, the volunteers were directed to a tank with water and ice, where they were immersed for the recovery procedure, during which blood samples were collected for later lactate and creatine kinase (CK) analysis. Variables were collected prior to the exercise and 24, 48, 72, and 96 hours after its completion. Results: For the CK concentration, 15 minutes at 14oC was the best intervention option, considering the values at 72 hours after exercise, while for the moment of peak lactate an advantage was observed for immersion for 5 minutes at 14oC. Regarding the perception of recovery, CWI for 5 minutes at 14oC performed better long-term, from the time of the intervention to 96 hours post-exercise. For pain, no form of immersion responded better than the CG at the immediately post-intervention moment. Conclusions: There were no differences in behavior between the CWI intervention groups for the outcomes studied.
Article
This study determined the influence of cold (8°C) and cool (22°C) water immersion on lower limb and cutaneous blood flow following resistance exercise. Twelve males completed 4 sets of 10-repetition maximum squat exercise and were then immersed, semi-reclined, into 8°C or 22°C water for 10-min, or rested in a seated position (control) in a randomized order on different days. Rectal and thigh skin temperature, muscle temperature, thigh and calf skin blood flow and superficial femoral artery blood flow were measured before and after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure). The colder water reduced thigh skin temperature and deep muscle temperature to the greatest extent (P < .001). Reductions in rectal temperature were similar (0.2–0.4°C) in all three trials (P = .69). Femoral artery conductance was similar after immersion in both cooling conditions, with both conditions significantly lower (55%) than the control post-immersion (P < .01). Similarly, there was greater thigh and calf cutaneous vasoconstriction (40–50%) after immersion in both cooling conditions, relative to the control (P < .01), with no difference between cooling conditions. These findings suggest that cold and cool water similarly reduce femoral artery and cutaneous blood flow responses but not muscle temperature following resistance exercise.
Article
Purpose: An athlete's ability to recover quickly is important when there is limited time between training and competition. As such, recovery strategies are commonly used to expedite the recovery process. The purpose of this study was to determine the effectiveness of both cold water immersion (CWI) and contrast water therapy (CWT) compared to control on short-term recovery (<4h) following a single full-body resistance training session. Methods: Thirteen males (age, 26 ± 5 years; weight, 79 ± 7 kg; height, 177 ± 5 cm) were assessed for perceptual (fatigue and soreness) and performance measures (maximal voluntary isometric contraction (MVC) of the knee extensors, weighted and unweighted countermovement jumps) prior to and immediately following the training session. Subjects then completed one of three 14 minute recovery strategies (CWI, CWT, or passive sitting, CON), with the perceptual and performance measures reassessed immediately following recovery, two hours post-recovery, and four hours post-recovery. Results: Peak torque during MVC and jump performance were significantly decreased (P < 0.05) following the resistance training session and remained depressed for at least four hours post recovery in all conditions. Neither CWI nor CWT had any effect on perceptual or performance measures over the four hour recovery period. Conclusions: CWI and CWT did not improve short-term (<4h) recovery following a conventional resistance training session.
Article
Key points: Cold water immersion and active recovery are common post-exercise recovery treatments. A key assumption about the benefits of cold water immersion is that it reduces inflammation in skeletal muscle. However, no data are available from humans to support this notion. We compared the effects of cold water immersion and active recovery on inflammatory and cellular stress responses in skeletal muscle from exercise-trained men 2, 24 and 48 h during recovery after acute resistance exercise. Exercise led to the infiltration of inflammatory cells, with increased mRNA expression of pro-inflammatory cytokines and neurotrophins, and the subcellular translocation of heat shock proteins in muscle. These responses did not differ significantly between cold water immersion and active recovery. Our results suggest that cold water immersion is no more effective than active recovery for minimizing the inflammatory and stress responses in muscle after resistance exercise. Abstract: Cold water immersion and active recovery are common post-exercise recovery treatments. However, little is known about whether these treatments influence inflammation and cellular stress in human skeletal muscle after exercise. We compared the effects of cold water immersion versus active recovery on inflammatory cells, pro-inflammatory cytokines, neurotrophins and heat shock proteins (HSPs) in skeletal muscle after intense resistance exercise. Nine active men performed unilateral lower-body resistance exercise on separate days, at least 1 week apart. On one day, they immersed their lower body in cold water (10°C) for 10 min after exercise. On the other day, they cycled at a low intensity for 10 min after exercise. Muscle biopsies were collected from the exercised leg before, 2, 24 and 48 h after exercise in both trials. Exercise increased intramuscular neutrophil and macrophage counts, MAC1 and CD163 mRNA expression (P < 0.05). Exercise also increased IL1β, TNF, IL6, CCL2, CCL4, CXCL2, IL8 and LIF mRNA expression (P < 0.05). As evidence of hyperalgesia, the expression of NGF and GDNF mRNA increased after exercise (P < 0.05). The cytosolic protein content of αB-crystallin and HSP70 decreased after exercise (P < 0.05). This response was accompanied by increases in the cytoskeletal protein content of αB-crystallin and the percentage of type II fibres stained for αB-crystallin. Changes in inflammatory cells, cytokines, neurotrophins and HSPs did not differ significantly between the recovery treatments. These findings indicate that cold water immersion is no more effective than active recovery for reducing inflammation or cellular stress in muscle after a bout of resistance exercise.
Article
New Findings What is the central question of this study? Acute and repetitive cryotherapy are routinely used to accelerate postexercise recovery, although the effect on resident immune cells and repetitive exposure has largely been unexplored and neglected. What is the main finding and its importance? Using blood‐derived mononuclear cells and semi‐professional mixed martial artists, we show that acute and repetitive cryotherapy reduces the in vitro and in vivo T‐cell and monocyte activation response whilst remaining independent of the physical performance of elite athletes. We investigated the effect of repetitive cryotherapy on the in vitro (cold exposure) and in vivo (cold water immersion) activation of blood‐derived mononuclear cells following high‐intensity exercise. Single and repeated cold exposure (5°C) of a mixed cell culture (T cells and monocytes) was investigated using in vitro tissue culture experimentation for total neopterin production (neopterin plus 7,8‐dihydroneopterin). Fourteen elite mixed martial art fighters were also randomly assigned to either a cold water immersion (15 min at 10°C) or passive recovery protocol, which they completed three times per week during a 6 week training camp. Urine was collected and analysed for neopterin and total neopterin three times per week, and perceived soreness, fatigue, physical performance (broad jump, push‐ups and pull‐ups) and training performance were also assessed. Single and repetitive cold exposure significantly ( P < 0.001) reduced total neopterin production from the mixed cell culture, whereas cold water immersion significantly ( P < 0.05) attenuated urinary neopterin and total neopterin during the training camp without having any effect on physical performance parameters. Soreness and fatigue showed little variation between the groups, whereas training session performance was significantly ( P < 0.05) elevated in the cold water immersion group. The data suggest that acute and repetitive cryotherapy attenuates in vitro T‐cell and monocyte activation. This may explain the disparity in in vivo neopterin and total neopterin between cold water immersion and passive recovery following repetitive exposure during a high‐intensity physical impact sport that remains independent of physical performance.
Article
Basketball can be described as a moderate-to-long duration exercise including repeated bouts of high-intensity activity interspersed with periods of low to moderate active recovery or passive rest. A match is characterized by repeated explosive activities, such as sprints, jumps, shuffles and rapid changes in direction. In top-level modern basketball, players are frequently required to play consecutive matches with limited time to recover. To ensure adequate recovery after any basketball activity (i.e., match or training), it is necessary to know the type of fatigue induced and, if possible, its underlying mechanisms. Despite limited scientific evidence to support their effectiveness in facilitating optimal recovery, certain recovery strategies are commonly utilized in basketball. It is particularly important to optimize recovery because players spend a much greater proportion of their time recovering than they do in training. Therefore, the main aim of this report is to facilitate useful information that may lead to practical application, based on the scientific evidence and applied knowledge specifically in basketball.
Article
Basketball can be described as a moderate-to-long duration exercise including repeated bouts of high-intensity activity interspersed with periods of low to moderate active recovery or passive rest. A match is characterized by repeated explosive activities, such as: sprints, jumps, shuffles and rapid changes in direction. In top-level modern basketball, players are frequently required to play consecutive matches with limited time to recover. To ensure adequate recovery after any basketball activity (i.e., match or training), it is necessary to know the type of fatigue induced and, if possible, its underlying mechanisms. Despite limited scientific evidence to support their effectiveness in facilitating optimal recovery, certain recovery strategies are commonly utilized in basketball. It is particularly important to optimize recovery because players spend a much greater proportion of their time recovering than they do in training. Therefore, the main aim of this report is to facilitate useful information that may lead to practical application, based on the scientific evidence and applied knowledge specifically in basketball.
Article
Aim: Changes in IL-6, TNF-α, and TNF-α receptors - sTNFRI and sTNFRII - were evaluated in a group of professional cyclists treated with immunomodulator AM3 (Inmunoferón®) for 6 months of training and competition. Methods: Sixteen male professional cyclists with a similar training program participated in the study which was designed as a randomized, placebo-controlled, double-blind clinical trial. Venous blood samples were collected in basal conditions, before beginning the supplementation program, and after 90 and 180 days of training and competition season. Results: No significant differences in biochemical parameters or in IL-6 were evidenced between placebo and AM3-treated groups throughout the study. Plasma TNF-α levels significantly decreased (P<0.05) after 90 days of training in the AM3 treated group. TNF-α receptors increased during training season in both placebo and AM3 treated groups, although the increase was significantly higher (P<0.05) in the AM3 group with respect to the placebo group. Conclusion: The changes produced by regular training and competition were modified throughout the season by AM3 treatment which could reduce the inflammatory response to excessive exercise.
Article
Objectives Many International Rugby Board (IRB) sevens competitions require that two tournament stages are played over consecutive weekends, but the impact this has on player physical performance and recovery is lacking. We examined the influence of two consecutive tournaments on neuromuscular function (NMF) and muscle damage in rugby sevens players. Design Ten elite international rugby sevens players completed this observational study over 2 tournaments, separated by 5 days, during the IRB sevens series. Methods On the morning of day 1 and 2, of both tournament 1 (T1) and 2 (T2), players performed countermovement jumps (CMJ; jump height [JH]) and capillary blood samples (creatine kinase [CK]) were collected. After the last match of each day, further capillary samples were collected. Additional, CMJ were performed 12 and 60hr post-T1. Results Player JH decreased from day 1 to day 2 during T1 (mean ± SD; -6.0 ± 5.4%; P = 0.016), was reduced at 12 (-26.1 ± 5.0%; p < 0.001) and 60hr post-T1 (-7.1 ± 4.8%; P = 0.003) and remained lower, at am day 1 of T2 (-8.0 ± 6.0%; P = 0.007), when compared with day 1 of T1. Player JH was lower on day 1 and 2 of T2, compared with T1 (p < 0.05). CK concentrations were greater than baseline at all time points during each tournament (p < 0.001); no between tournament differences in CK responses existed (P = 0.302). Conclusions A single sevens tournament reduces NMF such that players are not fully recovered by the start of the second competition stage, however CK returns to baseline in-between and shows the same pattern across two consecutive tournaments.
Article
Physical exercise induces adaptations in metabolism considered beneficial for health. Athletic performance is linked to adaptations, training, and correct nutrition in individuals with genetic traits that can facilitate such adaptations. Intense and continuous exercise, training, and competitions, however, can induce changes in the serum concentrations of numerous laboratory parameters. When these modifications, especially elevated laboratory levels, result outside the reference range, further examinations are ordered or participation in training and competition is discontinued or sports practice loses its appeal. In order to correctly interpret commonly used laboratory data, laboratory professionals and sport physicians need to know the behavior of laboratory parameters during and after practice and competition. We reviewed the literature on liver, kidney, muscle, heart, energy, and bone parameters in athletes with a view to increase the knowledge about clinical chemistry applied to sport and to stimulate studies in this field. In liver metabolism, the interpretation of serum aminotransferases concentration in athletes should consider the release of aspartate aminotransferase (AST) from muscle and of alanine aminotransferase (ALT) mainly from the liver, when bilirubin can be elevated because of continuous hemolysis, which is typical of exercise. Muscle metabolism parameters such as creatine kinase (CK) are typically increased after exercise. This parameter can be used to interpret the physiological release of CK from muscle, its altered release due to rhabdomyolysis, or incomplete recovery due to overreaching or trauma. Cardiac markers are released during exercise, and especially endurance training. Increases in these markers should not simply be interpreted as a signal of cardiac damage or wall stress but rather as a sign of regulation of myocardial adaptation. Renal function can be followed in athletes by measuring serum creatinine concentration, but it should be interpreted considering the athlete's body-mass index (BMI) and phase of the competitive season; use of cystatin C could be a reliable alternative to creatinine. Exercise and training induce adaptations in glucose metabolism which improve glucose utilization in athletes and are beneficial for reducing insulin insensitivity in nonathletes. Glucose metabolism differs slightly for different sports disciplines, as revealed in laboratory levels. Sport activities induce a blood lipid profile superior to that of sedentary subjects. There are few reports for a definitive conclusion, however. The differences between athletes and sedentary subjects are mainly due to high-density lipoprotein cholesterol (HDLC) concentrations in physically active individuals, although some differences among sport disciplines exist. The effect of sports on serum and urinary markers for bone metabolism is not univocal; further studies are needed to establish the real and effective influence of sport on bone turnover and especially to establish its beneficial effect.
Article
This investigation examined the effects of cold water immersion (CWI) recovery after simulated collision sport exercise. Ten male rugby athletes performed three sessions consisting of a 2 × 30-min intermittent-sprint exercise (ISE) protocol with either tackling (T) or no tackling (CONT), followed by a 20-min CWI intervention (TCWI) or passive recovery (TPASS and CONT) in a randomized order. The ISE consisted of a 15-m sprint every minute separated by self-paced bouts of hard running, jogging, and walking for the remainder of the minute. Every sixth rotation, participants performed 5 × 10-m runs, receiving a shoulder-led tackle to the lower body on each effort. Sprint time and distance covered during ISE were recorded, with voluntary (maximal voluntary contraction; MVC) and evoked neuromuscular function (voluntary activation; VA), electromyogram (root mean square (RMS)), ratings of perceived muscle soreness (MS), capillary and venous blood markers for metabolites and muscle damage, respectively measured before and after exercise, immediately after recovery, and 2 and 24 h after recovery. Total distance covered during exercise was significantly greater in CONT (P = 0.01), without differences between TPASS and TCWI (P > 0.05). TCWI resulted in increased MVC, VA, and RMS immediately after recovery (P < 0.05). M-wave amplitude and peak twitch were significantly increased after recovery and 2 h after recovery, respectively, in TCWI (P < 0.05). Although TCWI had no effect on the elevation in blood markers for muscle damage (P > 0.05), lactate was significantly reduced after recovery compared with TPASS (P = 0.04). CWI also resulted in reduced MS 2 h after recovery compared with TPASS (P < 0.05). The introduction of body contact reduces exercise performance, whereas the use of CWI results in a faster recovery of MVC, VA, and RMS and improves muscle contractile properties and perceptions of soreness after collision-based exercise.
Article
Strenuous physical exercise of the limb muscles commonly results in damage, especially when that exercise is intense, prolonged and includes eccentric contractions. Many factors contribute to exercise-induced muscle injury and the mechanism is likely to differ with the type of exercise. Competitive sports players are highly susceptible to this type of injury. AM3 is an orally administered immunomodulator that reduces the synthesis of proinflammatory cytokines and normalizes defective cellular immune fractions. The ability of AM3 to prevent chronic muscle injury following strenuous exercise characterized by eccentric muscle contraction was evaluated in a double-blind and randomized pilot study. Fourteen professional male volleyball players from the First Division of the Spanish Volleyball League volunteered to take part. The participants were randomized to receive either placebo (n=7) or AM3 (n=7). The physical characteristics (mean+/-s) of the placebo group were as follows: age 25.7+/-2.1 years, body mass 87.2+/-4.1 kg, height 1.89+/-0.07 m, maximal oxygen uptake 65.3+/-4.2 ml.kg(-1).min(-1). Those of the AM3 group were as follows: age 26.1+/-1.9 years, body mass 85.8+/-6.1 kg, height 1.91+/-0.07 m, maximal oxygen uptake 64.6+/-4.5 ml.kg(-1).min(-1). All participants were evaluated for biochemical indices of muscle damage, including concentrations of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, creatine kinase (CK) and its MB fraction (CK-MB), myoglobin, lactate dehydrogenase, urea, creatinine and gamma-glutamyltranspeptidase, both before and 30 days after treatment (over the peak of the competitive season). In the placebo group, competitive exercise (i.e. volleyball) was accompanied by significant increases in creatine kinase (494+/-51 to 560+/-53 IU.l(-1), P < 0.05) and myoglobin (76.8+/-2.9 to 83.9+/-3.1 microg.l(-1), P < 0.05); aspartate aminotransferase (30.8+/-3.0 to 31.1+/-2.9 IU.l(-1)) and lactate dehydrogenase (380+/-31 to 376+/-29 IU.l(-1)) were relatively unchanged after the 30 days maximum effort. AM3 not only inhibited these changes, it led to a decrease from baseline serum concentrations of creatine kinase (503+/-49 to 316+/-37 IU.l(-1), P < 0.05) and myoglobin (80.1+/-3.2 to 44.1+/-2.6 IU.l(-1), P < 0.05), as well as aspartate aminotransferase (31.1+/-3.3 to 26.1+/-2.7 IU.l(-1), P < 0.05) and lactate dehydrogenase (368+/-34 to 310+/-3 IU.l(-1), P < 0.05). The concentration of CK-MB was also significantly decreased from baseline with AM3 treatment (11.6+/-1.2 to 5.0+/-0.7 IU.l(-1), P < 0.05), but not with placebo (11.4+/-1.1 to 10.8+/-1.4 IU.l(-1)). In conclusion, the use of immunomodulators, such as AM3, by elite sportspersons during competition significantly reduces serum concentrations of proteins associated with muscle damage.
Article
The purpose of this study was to establish a data base of normal shoulder strength of young adults using the Cybex II dynamometer and specially designed fixation devices. Fifty healthy subjects aged 21 to 40 years old (26 men, 24 women) were tested. The mean peak torque values of their shoulders were measured at speeds of 0 degree, 60 degrees, 180 degrees, and 300 degrees per second. Mean peak torque values generally decreased as speed increased. Men were significantly stronger than women for all motions and speeds tested. Shoulder extension torque was greatest followed by adduction, flexion, internal rotation, abduction, and external rotation. Torque production tended to be greater on the dominant side.
Article
To examine the reliability and validity of the Borg and OMNI rating of perceived exertion (RPE) scales in adolescent girls during treadmill exercise. Adolescent girls (N = 57, age = 15.3+/-1.5 yr) were randomly assigned to use an RPE scale (Borg or OMNI) during one of three treadmill submaximal exercise conditions (walking, walking uphill, or jogging). After RPE assessment, exercise intensity was increased until participants achieved volitional exhaustion (O2max). Expired respiratory gases and heart rate (HR) were measured continuously during exercise. Reliability of the RPE scales was assessed using ANOVA (intraclass) and Spearman-Brown prophecy formula (single trial) measures. Validity estimates were calculated using Pearson Product Moment correlations, with % HRmax and % O2max as criterion measures. Intraclass and single-trial reliability estimates were higher for the OMNI (r(xx) = 0.95 and r(kk) = 0.91, respectively) compared with the Borg (r(xx) = 0.78 and r(kk) = 0.64, respectively) RPE scale. Validity estimates were also higher for the OMNI scale compared with the Borg scale. Validity coefficients (r(xy)) for %HRmax and %O2max comparisons were 0.86 and 0.89, respectively, for the OMNI, compared with 0.66 and 0.70, respectively, for the Borg. The OMNI cycle pictorial scale was found to be reliable and valid for use with adolescent girls. It also appears to be more reliable and valid than the Borg scale for use in this population during treadmill exercise.
Article
To examine the interpretation of the verbal anchors used in the Borg rating of perceived exertion (RPE) scales in different clinical groups and a healthy control group. Prospective experimental study. Rehabilitation center. Nineteen subjects with brain injury, 16 with chronic low back pain (CLBP), and 20 healthy controls. Not applicable. Subjects used a visual analog scale (VAS) to rate their interpretation of the verbal anchors from the Borg RPE 6-20 and the newer 10-point category ratio scale. All groups placed the verbal anchors in the order that they occur on the scales. There were significant within-group differences ( P >.05) between VAS scores for 4 verbal anchors in the control group, 8 in the CLBP group, and 2 in the brain injury group. There was no significant difference in rating of each verbal anchor between the groups ( P >.05). All subjects rated the verbal anchors in the order they occur on the scales, but there was less agreement in rating of each verbal anchor among subjects in the brain injury group. Clinicians should consider the possibility of small discrepancies in the meaning of the verbal anchors to subjects, particularly those recovering from brain injury, when they evaluate exercise perceptions.
Article
In the present article, three scales developed by Borg are compared on bicycle ergometer work. In the first study, comparing the Borg Ratings of Perceived Exertion (RPE) and Category scales with Ratio properties (CR10) scales, 40 healthy subjects (12 men and eight women for each scale) with a mean age of about 30 years (SD approximately 6) participated. A work-test protocol with step-wise increase of work loads every minute was used (20 W increase for men and 15 W for women). Ratings and heart rates (HRs) were recorded every minute and blood lactates every third minute. Data obtained with the RPE scale were described with linear regressions, with individual correlations of about 0.98. Data obtained with the CR10 scale could also be described by linear regressions, but when described by power functions gave exponents of about 1.2 (SD approximately 0.4) (with one additional constant included in the power function). This was significantly lower than the exponent of between 1.5 and 1.9 that has previously been observed. Mean individual correlations were 0.98. Blood lactate concentration grew with monotonously increasing functions that could be described by power functions with a mean exponent of about 2.6 (SD approximately 0.6) (with two additional constants included in the power functions). In the second study, where also the more recently developed Borg CR100 scale (centiMax) was included, 24 healthy subjects (12 men and 12 women) with a mean age of about 29 years (SD approximately 3) participated in a work test with a step-wise increase of work loads (25 W) every third minute. Ratings and HRs were recorded. RPE values were described by linear regressions with individual correlations of about 0.97. Data from the two CR scales were described by power functions with mean exponents of about 1.4 (SD approximately 0.5) (with a-values in the power functions). Mean individual correlations were about 0.98. In both studies, a tendency for a deviation from linearity between RPE values and HRs was observed. The obtained deviations from what has previously been obtained for work of longer duration (4-6 min) points to a need for standardization of work-test protocols and to the advantage of using CR scales.
Article
The aims of this study were to examine the changes in plasma concentrations of inflammatory cytokines induced by training and competition in professional cyclists. We report the serum concentrations of interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-a), tumour necrosis factor receptors I and II (TNFR-I and -II) in a prospective, randomized, double-blind trial involving the administration of AM3 (Inmunoferon), an oral booster immunomodulator, or placebo to 16 professional cyclists (n = 8 in each group) for 65 consecutive days. Serum was collected just before treatment began (baseline), at the end of pre-competition training, before the mountain stage of the competition (60 days), 4 h after finishing this stage (62 days), and 18 h after the fifth and last day of competition (65 days). To determine the normal levels of cytokines and soluble TNF receptors, individual samples from 14 moderately trained healthy controls were studied. After 60 days of training, the serum concentrations of IL-6 did not differ significantly from those at the beginning of the study for either group of cyclists (placebo and AM3). A significant rise was seen in IL-6 concentrations in both the AM3 and placebo groups at 62 days, 4 h after finishing the mountain stage. The increase was significantly greater in the placebo group than in the AM3 group. At 65 days of treatment, 18 h after the fifth and last day of competition, IL-6 concentrations were similar to those recorded at the end of the training, but were significantly higher in the placebo group than in the AM3 group. At the end of training, serum TNFR-I concentrations in both groups of cyclists were significantly lower than at baseline. The concentrations of serum TNFR-I and -II both 4 h after finishing the mountain stage and 18 h after the fifth and last day of competition were significantly higher than those recorded after training in both groups. Professional cycling competition is associated with increases in serum IL-6 and TNFR-I and -II concentrations. Inmunoferon treatment reduced significantly the concentrations of IL-6 but not those of TNFR-I and -II.
Article
This study examined the effect of contrast water therapy (CWT) on the physiological and functional symptoms of delayed onset muscle soreness (DOMS) following DOMS-inducing leg press exercise. Thirteen recreational athletes performed 2 experimental trials separated by 6 weeks in a randomized crossover design. On each occasion, subjects performed a DOMS-inducing leg press protocol consisting of 5 x 10 eccentric contractions (180 seconds recovery between sets) at 140% of 1 repetition maximum (1RM). This was followed by a 15-minute recovery period incorporating either CWT or no intervention, passive recovery (PAS). Creatine kinase concentration (CK), perceived pain, thigh volume, isometric squat strength, and weighted jump squat performance were measured prior to the eccentric exercise, immediately post recovery, and 24, 48, and 72 hours post recovery. Isometric force production was not reduced below baseline measures throughout the 72-hour data collection period following CWT ( approximately 4-10%). However, following PAS, isometric force production (mean +/- SD) was 14.8 +/- 11.4% below baseline immediately post recovery (p < 0.05), 20.8 +/- 15.6% 24 hours post recovery (p < 0.05), and 22.5 +/- 12.3% 48 hours post recovery (p < 0.05). Peak power produced during the jump squat was significantly reduced (p < 0.05) following both PAS (20.9 +/- 13.4%) and CWT (12.8 +/- 8.0%), with the mean reduction in power for PAS being marginally (not significantly) greater than for CWT (effect size = 0.76). Thigh volume measured immediately following CWT was significantly less than PAS. No significant differences in the changes in CK were found; in addition, there were no significant (p > 0.01) differences in perceived pain between treatments. Contrast water therapy was associated with a smaller reduction, and faster restoration, of strength and power measured by isometric force and jump squat production following DOMS-inducing leg press exercise when compared to PAS. Therefore, CWT seems to be effective in reducing and improving the recovery of functional deficiencies that result from DOMS, as opposed to passive recovery.