The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis

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.

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What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review

British Journal of Sports Medicine ◽

10.1136/bjsm.2009.065565 ◽

2009 ◽

Vol 44 (3) ◽

pp. 179-187 ◽

Cited By ~ 81

Author(s):

C. M Bleakley ◽

G. W Davison

Keyword(s):

Systematic Review ◽

Cold Water ◽

Water Immersion ◽

Cold Water Immersion

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Efficacy of acupuncture and acupressure for the treatment of Raynaud’s syndrome: Protocol for a meta-analysis of randomized controlled trials

10.1101/2020.06.03.20121699 ◽

2020 ◽

Author(s):

Jiawen Deng

Keyword(s):

Cold Water ◽

Meta Analysis ◽

Water Immersion ◽

Capillary Density ◽

Immersion Test ◽

Cold Water Immersion ◽

Positive Temperature ◽

Raynaud’S Syndrome ◽

Raynaud's Syndrome ◽

Emotional Events

ABSTRACTRaynaud’s syndrome is a rare vascular disorder that causes the contraction of blood vessels, usually in the fingers and toes, when there is a decrease in temperature or during emotional events. As a result, blood cannot reach the tissue in these areas, causing them to appear blue or white. It had long been speculated that acupuncture and acupressure may help mediate symptoms of Raynaud’s syndrome, however no knowledge synthesis project regarding this topic had ever been conducted (to our best knowledge). We propose a meta-analysis that investigates whether the use of acupuncture or acupressure can improve symptoms of Raynaud’s syndrome. Our proposed outcomes are incidences of positive cold water immersion test, incidences of positive temperature recovery after cold water immersion tests, incidences of remission/short-term remission, number and duration of attacks per day, and outcomes relating to nailfold microcirculation examinations (including capillary blood flow velocity, capillary deformity and capillary density).

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Cold water immersion and recovery from strenuous exercise: a meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2011-090061 ◽

2011 ◽

Vol 46 (4) ◽

pp. 233-240 ◽

Cited By ~ 140

Author(s):

Jonathan Leeder ◽

Conor Gissane ◽

Ken van Someren ◽

Warren Gregson ◽

Glyn Howatson

Keyword(s):

Cold Water ◽

Meta Analysis ◽

Water Immersion ◽

Cold Water Immersion ◽

Strenuous Exercise

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Efficacy of Cold Water Immersion Prior to Endurance Cycling or Running to Increase Performance: A Critically Appraised Topic

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2016-0087 ◽

2018 ◽

Vol 23 (1) ◽

pp. 3-9

Author(s):

Connor A. Burton ◽

Christine A. Lauber

Keyword(s):

Perceived Exertion ◽

Cold Water ◽

Water Immersion ◽

Endurance Performance ◽

Cold Water Immersion ◽

Rating Of Perceived Exertion ◽

Control Group ◽

Time To Exhaustion ◽

Bottom Line ◽

Endurance Cycling

Clinical Question: Is there evidence to support precooling with cold water immersion prior to endurance cycling and running in hot, humid environments to enhance performance? Clinical Bottom Line: There is moderate evidence suggesting cold water immersion (CWI) as a precooling intervention improves endurance performance in cyclists and runners in a hot, humid environment. All five included studies reported significant improvements in endurance performance regarding time to exhaustion or distance traveled. In all included studies, core temperature was significantly decreased in the CWI group versus the control group during the fifth and twentieth minutes of exercise. No significant differences were reported for the rating of perceived exertion (RPE) between the CWI and control groups.

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The Effect Of Cold Water Immersion On Recovery From Exercise-induced Fatigue: A Meta-analysis

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000402428.42817.19 ◽

2011 ◽

Vol 43 (Suppl 1) ◽

pp. 870

Author(s):

Jonathan Leeder ◽

Ken van Someren ◽

Conor Gisane ◽

Warren Gregson ◽

Glyn Howatson

Keyword(s):

Cold Water ◽

Meta Analysis ◽

Water Immersion ◽

Cold Water Immersion ◽

Exercise Induced

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A Matter of Degrees: A Systematic Review of the Ergogenic Effect of Pre-Cooling in Highly Trained Athletes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082952 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2952

Author(s):

Miguel Ángel Rodríguez ◽

José Víctor Piedra ◽

Mario Sánchez-Fernández ◽

Miguel del Valle ◽

Irene Crespo ◽

...

Keyword(s):

Systematic Review ◽

Cold Water ◽

Water Immersion ◽

Maximal Oxygen Consumption ◽

Peak Torque ◽

Cold Water Immersion ◽

The Body ◽

Time To Exhaustion ◽

Sports Performance ◽

Mean Power

The current systematic review evaluated the effects of different pre-cooling techniques on sports performance in highly-trained athletes under high temperature conditions. PubMed/MEDLINE, EMBASE, Web of Science, CENTRAL, Scopus, and SPORTDiscus databases were searched from inception to December 2019. Studies performing pre-cooling interventions in non-acclimatized highly-trained athletes (>55 mL/kg/min of maximal oxygen consumption) under heat conditions (≥30 °C) were included. The searched reported 26 articles. Pre-cooling techniques can be external (exposure to ice water, cold packs, or cooling clothes), internal (intake of cold water or ice), or mixed. Cooling prior to exercise concluded increases in distance covered (1.5–13.1%), mean power output (0.9–6.9%), time to exhaustion (19–31.9%), work (0.1–8.5%), and mean peak torque (10.4–22.6%), as well as reductions in completion time (0.6–6.5%). Mixed strategies followed by cold water immersion seem to be the most effective techniques, being directly related with the duration of cooling and showing the major effects in prolonged exercise protocols. The present review showed that pre-cooling methods are an effective strategy to increase sports performance in hot environments. This improvement is associated with the body surface exposed and its sensibility, as well as the time of application, obtaining the best results in prolonged physical exercise protocols.

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The Effect of Cold Exposure on Cognitive Performance in Healthy Adults: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189725 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9725

Author(s):

Marika Falla ◽

Alessandro Micarelli ◽

Katharina Hüfner ◽

Giacomo Strapazzon

Keyword(s):

Systematic Review ◽

Cognitive Performance ◽

Cold Exposure ◽

Healthy Subjects ◽

Cold Water ◽

Water Immersion ◽

Cold Water Immersion ◽

Cognitive Test ◽

Air Exposure ◽

Cognitive Domains

Several aspects of cognition can be affected after cold exposure, but contradictory results have been reported regarding affected cognitive domains. The aim of the current systematic review was to evaluate the effects of specific cold exposure on cognitive performance in healthy subjects. A systematic search was performed using MEDLINE (through PubMed), EMBASE (Scopus) and PsycINFO databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were healthy subjects exposed to a cold environment (either simulated or not) and cognitive performance related to cold exposure with an experimental design. The literature search identified 18 studies, eight studies investigated the effect of cold air exposure and ten the effect of cold water immersion on cognitive performance of healthy subjects. There were several differences among the studies (environmental temperature reached, time of exposure, timing, and type of cognitive test administration). Cold exposure induced in most of the experimental settings (15 of 18) an impairment of CP even before accidental hypothermia was established. The most investigated and affected cognitive domains were attention and processing speed, executive function, and memory. Gender differences and effects of repeated exposure and possible acclimation on cognitive performance need further studies to be confirmed.

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