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

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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Patient Involvement in Treatment Decision Making Can Help or Hinder Placebo Analgesia

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000179 ◽

2014 ◽

Vol 222 (3) ◽

pp. 165-170 ◽

Cited By ~ 2

Author(s):

Andrew L. Geers ◽

Jason P. Rose ◽

Stephanie L. Fowler ◽

Jill A. Brown

Keyword(s):

Patient Involvement ◽

Cold Water ◽

Prior Experience ◽

Water Immersion ◽

Treatment Decision ◽

Cold Water Immersion ◽

Not Given ◽

Placebo Analgesia ◽

Treatment Decision Making ◽

Immersion Experience

Experiments have found that choosing between placebo analgesics can reduce pain more than being assigned a placebo analgesic. Because earlier research has shown prior experience moderates choice effects in other contexts, we tested whether prior experience with a pain stimulus moderates this placebo-choice association. Before a cold water pain task, participants were either told that an inert cream would reduce their pain or they were not told this information. Additionally, participants chose between one of two inert creams for the task or they were not given choice. Importantly, we also measured prior experience with cold water immersion. Individuals with prior cold water immersion experience tended to display greater placebo analgesia when given choice, whereas participants without this experience tended to display greater placebo analgesia without choice. Prior stimulus experience appears to moderate the effect of choice on placebo analgesia.

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Thermoregulatory responses to cold water at different times of day

Journal of Applied Physiology ◽

10.1152/jappl.1999.87.1.243 ◽

1999 ◽

Vol 87 (1) ◽

pp. 243-246 ◽

Cited By ~ 7

Author(s):

John W. Castellani ◽

Andrew J. Young ◽

James E. Kain ◽

Michael N. Sawka

Keyword(s):

Cold Water ◽

Water Immersion ◽

Early Morning ◽

Cold Water Immersion ◽

Time Of Day ◽

Mean Skin Temperature ◽

Mean Body Temperature ◽

Metabolic Heat ◽

Body Temperature Change ◽

The Mean

This study examined how time of day affects thermoregulation during cold-water immersion (CWI). It was hypothesized that the shivering and vasoconstrictor responses to CWI would differ at 0700 vs. 1500 because of lower initial core temperatures (Tcore) at 0700. Nine men were immersed (20°C, 2 h) at 0700 and 1500 on 2 days. No differences ( P > 0.05) between times were observed for metabolic heat production (M˙, 150 W ⋅ m−2), heat flow (250 W ⋅ m−2), mean skin temperature (T sk, 21°C), and the mean body temperature-change in M˙(ΔM˙) relationship. Rectal temperature (Tre) was higher ( P < 0.05) before (Δ = 0.4°C) and throughout CWI during 1500. The change in Tre was greater ( P < 0.05) at 1500 (−1.4°C) vs. 0700 (−1.2°C), likely because of the higher Tre-T skgradient (0.3°C) at 1500. These data indicate that shivering and vasoconstriction are not affected by time of day. These observations raise the possibility that CWI may increase the risk of hypothermia in the early morning because of a lower initial Tcore.

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Changes in myocardial myosin heavy chain isoform composition with exercise and post-exercise cold-water immersion

Journal of Muscle Research and Cell Motility ◽

10.1007/s10974-021-09603-z ◽

2021 ◽

Author(s):

Ramzi A. Al-horani ◽

Mukhallad A. Mohammad ◽

Saja Haifawi ◽

Mohammed Ihsan

Keyword(s):

Myosin Heavy Chain ◽

Heavy Chain ◽

Cold Water ◽

Water Immersion ◽

Cold Water Immersion ◽

Post Exercise ◽

Myosin Heavy Chain Isoform

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Recovery strategies implemented by sport support staff of elite rugby players in South Africa

South African Journal of Physiotherapy ◽

10.4102/sajp.v65i1.78 ◽

2009 ◽

Vol 65 (1) ◽

Cited By ~ 6

Author(s):

D.V. Van Wyk ◽

M.I. Lambert

Keyword(s):

Cold Water ◽

Water Immersion ◽

Total Duration ◽

Cold Water Immersion ◽

Support Staff ◽

Medical Support ◽

Cross Sectional ◽

Study Results ◽

Recovery Strategies ◽

Rugby Players

Objective: The main aim of this study was to determine strategies used toaccelerate recovery of elite rugby players after training and matches, asused by medical support staff of rugby teams in South A frica. A secondaryaim was to focus on specifics of implementing ice/cold water immersion asrecovery strategy. Design: A Questionnaire-based cross sectional descriptive survey was used.Setting and Participants: Most (n=58) of the medical support staff ofrugby teams (doctors, physiotherapists, biokineticists and fitness trainers)who attended the inaugural Rugby Medical A ssociation conference linked to the South A frican Sports MedicineA ssociation Conference in Pretoria (14-16th November, 2007) participated in the study. Results: Recovery strategies were utilized mostly after matches. Stretching and ice/cold water immersion were utilized the most (83%). More biokineticists and fitness trainers advocated the usage of stretching than their counter-parts (medical doctors and physiotherapists). Ice/Cold water immersion and A ctive Recovery were the top two ratedstrategies. A summary of the details around implementation of ice/cold water therapy is shown (mean) as utilized bythe subjects: (i) The time to immersion after matches was 12±9 min; (ii) The total duration of one immersion sessionwas 6±6 min; (iii) 3 immersion sessions per average training week was utilized by subjects; (iv) The average water temperature was 10±3 ºC.; (v) Ice cubes were used most frequently to cool water for immersion sessions, and(vi) plastic drums were mostly used as the container for water. Conclusion: In this survey the representative group of support staff provided insight to which strategies are utilizedin South A frican elite rugby teams to accelerate recovery of players after training and/or matches.

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Cold-water immersion following sprint interval training does not alter endurance signaling pathways or training adaptations in human skeletal muscle

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00434.2016 ◽

2017 ◽

Vol 313 (4) ◽

pp. R372-R384 ◽

Cited By ~ 13

Author(s):

James R. Broatch ◽

Aaron Petersen ◽

David J. Bishop

Keyword(s):

Mitochondrial Biogenesis ◽

Molecular Mechanisms ◽

Cold Water ◽

P53 Protein ◽

Water Immersion ◽

Interval Training ◽

Cold Water Immersion ◽

Peroxisome Proliferator ◽

Sprint Interval Training ◽

Single Session

We investigated the underlying molecular mechanisms by which postexercise cold-water immersion (CWI) may alter key markers of mitochondrial biogenesis following both a single session and 6 wk of sprint interval training (SIT). Nineteen men performed a single SIT session, followed by one of two 15-min recovery conditions: cold-water immersion (10°C) or a passive room temperature control (23°C). Sixteen of these participants also completed 6 wk of SIT, each session followed immediately by their designated recovery condition. Four muscle biopsies were obtained in total, three during the single SIT session (preexercise, postrecovery, and 3 h postrecovery) and one 48 h after the last SIT session. After a single SIT session, phosphorylated (p-)AMPK, p-p38 MAPK, p-p53, and peroxisome proliferator-activated receptor-γ coactivator-1α ( PGC-1α) mRNA were all increased ( P < 0.05). Postexercise CWI had no effect on these responses. Consistent with the lack of a response after a single session, regular postexercise CWI had no effect on PGC-1α or p53 protein content. Six weeks of SIT increased peak aerobic power, maximal oxygen consumption, maximal uncoupled respiration (complexes I and II), and 2-km time trial performance ( P < 0.05). However, regular CWI had no effect on changes in these markers, consistent with the lack of response in the markers of mitochondrial biogenesis. Although these observations suggest that CWI is not detrimental to endurance adaptations following 6 wk of SIT, they question whether postexercise CWI is an effective strategy to promote mitochondrial biogenesis and improvements in endurance performance.

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