Optimizing Cold Water Immersion for Exercise-Induced Hyperthermia

2015 ◽  
Vol 47 (11) ◽  
pp. 2464-2472 ◽  
Author(s):  
YANG ZHANG ◽  
JON-KYLE DAVIS ◽  
DOUGLAS J. CASA ◽  
PHILLIP A. BISHOP
2009 ◽  
Vol 44 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Brendon P. McDermott ◽  
Douglas J. Casa ◽  
Matthew S. Ganio ◽  
Rebecca M. Lopez ◽  
Susan W. Yeargin ◽  
...  

Abstract Objective: To assess existing original research addressing the efficiency of whole-body cooling modalities in the treatment of exertional hyperthermia. Data Sources: During April 2007, we searched MEDLINE, EMBASE, Scopus, SportDiscus, CINAHL, and Cochrane Reviews databases as well as ProQuest for theses and dissertations to identify research studies evaluating whole-body cooling treatments without limits. Key words were cooling, cryotherapy, water immersion, cold-water immersion, ice-water immersion, icing, fanning, bath, baths, cooling modality, heat illness, heat illnesses, exertional heatstroke, exertional heat stroke, heat exhaustion, hyperthermia, hyperthermic, hyperpyrexia, exercise, exertion, running, football, military, runners, marathoner, physical activity, marathoning, soccer, and tennis. Data Synthesis: Two independent reviewers graded each study on the Physiotherapy Evidence Database (PEDro) scale. Seven of 89 research articles met all inclusion criteria and a minimum score of 4 out of 10 on the PEDro scale. Conclusions: After an extensive and critical review of the available research on whole-body cooling for the treatment of exertional hyperthermia, we concluded that ice-water immersion provides the most efficient cooling. Further research comparing whole-body cooling modalities is needed to identify other acceptable means. When ice-water immersion is not possible, continual dousing with water combined with fanning the patient is an alternative method until more advanced cooling means can be used. Until future investigators identify other acceptable whole-body cooling modalities for exercise-induced hyperthermia, ice-water immersion and cold-water immersion are the methods proven to have the fastest cooling rates.


2016 ◽  
Vol 51 (6) ◽  
pp. 500-501 ◽  
Author(s):  
Emma A. Nye ◽  
Jessica R. Edler ◽  
Lindsey E. Eberman ◽  
Kenneth E. Games

Reference: Zhang Y, Davis JK, Casa DJ, Bishop PA. Optimizing cold water immersion for exercise-induced hyperthermia: a meta-analysis. Med Sci Sports Exerc. 2015;47(11):2464−2472. Clinical Questions: Do optimal procedures exist for implementing cold-water immersion (CWI) that yields high cooling rates for hyperthermic individuals? Data Sources: One reviewer performed a literature search using PubMed and Web of Science. Search phrases were cold water immersion, forearm immersion, ice bath, ice water immersion, immersion, AND cooling. Study Selection: Studies were included based on the following criteria: (1) English language, (2) full-length articles published in peer-reviewed journals, (3) healthy adults subjected to exercise-induced hyperthermia, and (4) reporting of core temperature as 1 outcome measure. A total of 19 studies were analyzed. Data Extraction: Pre-immersion core temperature, immersion water temperature, ambient temperature, immersion duration, and immersion level were coded a priori for extraction. Data originally reported in graphical form were digitally converted to numeric values. Mean differences comparing the cooling rates of CWI with passive recovery, standard deviation of change from baseline core temperature, and within-subjects r were extracted. Two independent reviewers used the Physiotherapy Evidence Database (PEDro) scale to assess the risk of bias. Main Results: Cold-water immersion increased the cooling rate by 0.03°C/min (95% confidence interval [CI] = 0.03, 0.04°C/min) compared with passive recovery. Cooling rates were more effective when the pre-immersion core temperature was ≥38.6°C (P = .023), immersion water temperature was ≤10°C (P = .036), ambient temperature was ≥20°C (P = .013), or immersion duration was ≤10 minutes (P < .001). Cooling rates for torso and limb immersion (mean difference = 0.04°C/min, 95% CI = 0.03, 0.06°C/min) were higher (P = .028) than those for forearm and hand immersion (mean difference = 0.01°C/min, 95% CI = −0.01, 0.04°C/min). Conclusions: Hyperthermic individuals were cooled twice as fast by CWI as by passive recovery. Therefore, the former method is the preferred choice when treating patients with exertional heat stroke. Water temperature should be <10°C, with the torso and limbs immersed. Insufficient published evidence supports CWI of the forearms and hands.


2015 ◽  
Vol 47 ◽  
pp. 459
Author(s):  
Cory L. Butts ◽  
Katherine E. Luhring ◽  
Cody R. Smith ◽  
Jenna M. Burchfield ◽  
Nicole E. Moyen ◽  
...  

2016 ◽  
Vol 51 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Cory L. Butts ◽  
Brendon P. McDermott ◽  
Brian J. Buening ◽  
Jeffrey A. Bonacci ◽  
Matthew S. Ganio ◽  
...  

Exercise conducted in hot, humid environments increases the risk for exertional heat stroke (EHS). The current recommended treatment of EHS is cold-water immersion; however, limitations may require the use of alternative resources such as a cold shower (CS) or dousing with a hose to cool EHS patients.Context: To investigate the cooling effectiveness of a CS after exercise-induced hyperthermia.Objective: Randomized, crossover controlled study.Design: Environmental chamber (temperature = 33.4°C ± 2.1°C; relative humidity = 27.1% ± 1.4%).Setting: Seventeen participants (10 male, 7 female; height = 1.75 ± 0.07 m, body mass = 70.4 ± 8.7 kg, body surface area = 1.85 ± 0.13 m2, age range = 19–35 years) volunteered.Patients or Other Participants: On 2 occasions, participants completed matched-intensity volitional exercise on an ergometer or treadmill to elevate rectal temperature to ≥39°C or until participant fatigue prevented continuation (reaching at least 38.5°C). They were then either treated with a CS (20.8°C ± 0.80°C) or seated in the chamber (control [CON] condition) for 15 minutes.Intervention(s): Rectal temperature, calculated cooling rate, heart rate, and perceptual measures (thermal sensation and perceived muscle pain).Main Outcome Measure(s): The rectal temperature (P = .98), heart rate (P = .85), thermal sensation (P = .69), and muscle pain (P = .31) were not different during exercise for the CS and CON trials (P > .05). Overall, the cooling rate was faster during CS (0.07°C/min ± 0.03°C/min) than during CON (0.04°C/min ± 0.03°C/min; t16 = 2.77, P = .01). Heart-rate changes were greater during CS (45 ± 20 beats per minute) compared with CON (27 ± 10 beats per minute; t16 = 3.32, P = .004). Thermal sensation was reduced to a greater extent with CS than with CON (F3,45 = 41.12, P < .001).Results: Although the CS facilitated cooling rates faster than no treatment, clinicians should continue to advocate for accepted cooling modalities and use CS only if no other validated means of cooling are available.Conclusions:


2017 ◽  
Author(s):  
Danny Christiansen ◽  
Robyn M. Murphy ◽  
James R. Broatch ◽  
Jens Bangsbo ◽  
Michael J. McKenna ◽  
...  

AbstractWe investigated the effect of a session of sprint-interval exercise on the mRNA content of NKA isoforms (α1-3, β1-3) and FXYD1 in human skeletal muscle. To explore some of the cellular stressors involved in this regulation, we evaluated the association between these mRNA responses and those of the transcription factors Sp1, Sp3 and HIF-1α. Given cold exposure perturbs muscle redox homeostasis, which may be one mechanism important for increases in NKA-isoform mRNA, we also explored the effect of post-exercise cold-water immersion (CWI) on the mRNA responses. Muscle was sampled from nineteen men before (Pre) and after (+0h, +3h) exercise plus passive rest (CON, n=10) or CWI (10°C; COLD, n=9). In COLD, exercise increased NKAα2 and Sp1 mRNA (+0h, p<0.05). These genes remained unchanged in CON (p>0.05). In both conditions, exercise increased NKAα1, NKAβ3 and HIF-1α mRNA (+3h; p <0.05), decreased NKAβ2 mRNA (+3h; p<0.05), whereas NKAα3, NKAβ1, FXYD1 and Sp3 mRNA remained unchanged (p>0.05). These human findings highlight 1) sprint-interval exercise increases the mRNA content of NKA α1 and β3, and decreases that of NKA β2, which may relate, in part, to exercise-induced muscle hypoxia, and 2) post-exercise CWI augments NKAα2 mRNA, which may be associated with promoted Sp1 activation.


2021 ◽  
Vol 3 ◽  
Author(s):  
Mohammed Ihsan ◽  
Chris R. Abbiss ◽  
Robert Allan

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.


Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 539
Author(s):  
Yuri Hosokawa ◽  
Luke N. Belval ◽  
William M. Adams ◽  
Lesley W. Vandermark ◽  
Douglas J. Casa

Background and objectives: Exertional heat stroke (EHS) is a potentially lethal, hyperthermic condition that warrants immediate cooling to optimize the patient outcome. The study aimed to examine if a portable cooling vest meets the established cooling criteria (0.15 °C·min−1 or greater) for EHS treatment. It was hypothesized that a cooling vest will not meet the established cooling criteria for EHS treatment. Materials and Methods: Fourteen recreationally active participants (mean ± SD; male, n = 8; age, 25 ± 4 years; body mass, 86.7 ± 10.5 kg; body fat, 16.5 ± 5.2%; body surface area, 2.06 ± 0.15 m2. female, n = 6; 22 ± 2 years; 61.3 ± 6.7 kg; 22.8 ± 4.4%; 1.66 ± 0.11 m2) exercised on a motorized treadmill in a hot climatic chamber (ambient temperature 39.8 ± 1.9 °C, relative humidity 37.4 ± 6.9%) until they reached rectal temperature (TRE) >39 °C (mean TRE, 39.59 ± 0.38 °C). Following exercise, participants were cooled using either a cooling vest (VEST) or passive rest (PASS) in the climatic chamber until TRE reached 38.25 °C. Trials were assigned using randomized, counter-balanced crossover design. Results: There was a main effect of cooling modality type on cooling rates (F[1, 24] = 10.46, p < 0.01, η2p = 0.30), with a greater cooling rate observed in VEST (0.06 ± 0.02 °C·min−1) than PASS (0.04 ± 0.01 °C·min−1) (MD = 0.02, 95% CI = [0.01, 0.03]). There were also main effects of sex (F[1, 24] = 5.97, p = 0.02, η2p = 0.20) and cooling modality type (F[1, 24] = 4.38, p = 0.047, η2p = 0.15) on cooling duration, with a faster cooling time in female (26.9 min) than male participants (42.2 min) (MD = 15.3 min, 95% CI = [2.4, 28.2]) and faster cooling duration in VEST than PASS (MD = 13.1 min, 95% CI = [0.2, 26.0]). An increased body mass was associated with a decreased cooling rate in PASS (r = −0.580, p = 0.03); however, this association was not significant in vest (r = −0.252, p = 0.39). Conclusions: Although VEST exhibited a greater cooling capacity than PASS, VEST was far below an acceptable cooling rate for EHS treatment. VEST should not replace immediate whole-body cold-water immersion when EHS is suspected.


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