Impact of cold-water immersion compared with passive recovery following a single bout of strenuous exercise on athletic performance in physically active participants: a systematic review with meta-analysis and meta-regression
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Date
2022
Authors
Moore, E.
Fuller, J.T.
Buckley, J.D.
Saunders, S.
Halson, S.L.
Broatch, J.R.
Bellenger, C.R.
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Journal article
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Sports Medicine, 2022; 52(7):1667-1688
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Abstract
Background: Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations. Objectives: The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations. Study Design: Systematic review with meta-analysis and meta-regression.
Methods: A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables.
Results: Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise.
Conclusion: CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise.
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Data source: Supplementary information, https://doi.org/10.1007/s40279-022-01644-9
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Copyright 2022 the authors. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder (http://creativecommons.org/licenses/by/4.0/)