Effects of post-exercise cold-water immersion on performance and perceptive outcomes of competitive adolescent swimmers.

PURPOSE: To evaluate the effects of repeated use of cold-water immersion (CWI) during a training week on performance and perceptive outcomes in competitive adolescent swimmers. METHODS: This randomized-crossover study included 20 athletes, who received each intervention [CWI (14 ± 1 °C), thermoneutral water immersion (TWI) (27 ± 1 °C) as placebo, and passive recovery (PAS)] three times a week between the land-based resistance training and swim training. The interventions were performed in a randomized order with a 1-week wash-out period. We tested athletes before and after each intervention week regarding swim (100 m freestyle sprints) and functional performance (flexibility, upper and lower body power, and shoulder proprioception). We monitored athlete's perceptions (well-being, heaviness, tiredness, discomfort and pain) during testing sessions using a 5-item questionnaire. Athlete preferences regarding the interventions were assessed at the end of the study. We used generalized linear mixed models and generalized estimating equations for continuous and categorical variables, respectively (intervention x time). RESULTS: We found a time effect for swim performance (p = .01) in which, regardless the intervention, all athletes improved sprint time at post-intervention compared to baseline. There was an intervention effect for pain (p = .04) and tiredness (p = .04), but with no significant post-hoc comparisons. We found no significant effects for other outcomes. All athletes reported a preference for CWI or TWI in relation to PAS. CONCLUSION: The repeated use of CWI throughout a training week did not impact functional or swim performance outcomes of competitive adolescent swimmers. Perceptive outcomes were also similar across interventions; however, athletes indicated a preference for both CWI and TWI.

Repeated Massage Improves Swimmers' Perceptions during Training Sessions but Not Sprint and Functional Performance: A Randomized Controlled Trial.

This study aimed to investigate the effects of repeated massage adjusted for swimmers' training on the perceptive, functional, and performance outcomes of a sprint. We also investigated the effects of a single short massage on swimmers' self-reported perceptions after resistance training. This cross-over randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis included 19 male and female competitive swimmers between 12 and 20 years old. Participants were subjected to three 12-min interventions over a week between resistance and swim training and monitored regarding training load and perceptions. After the intervention week we assessed: perceptive (well-being, heaviness, tiredness, discomfort, and pain), performance (sprint time, FINA points, and stroke characteristics), and functional outcomes (flexibility, squat jump, bench press, proprioception), in addition to athlete beliefs and preferences. A massage was defined as consisting of sliding movements on the arms, back, and anterior thigh, with metronomic rhythm control (1:1), and was divided into two protocols: superficial massage (SM) (light touch) and deep massage (DM) (light, moderate, intense effleurage) while the control (CON) rested. After repeated massage (SM and SM), participants had less chances to report tiredness, and they also maintained perceptions of well-being while CON got worse throughout the week. However, we found evidence of worsening of the perceptions of heaviness and pain at the main stages of the swim training for the massage groups. SM and DM had no effects over sprint and functional performance. Our results suggest that the swimmers were able to train harder with no harm to recovery.

What Parameters Influence the Effect of Cold-Water Immersion on Muscle Soreness? An Updated Systematic Review and Meta-Analysis.

OBJECTIVE: Our objective was to determine the efficacy of cold-water immersion (CWI) on the management of muscle soreness to identify the impact of immersion time, water temperature, CWI protocol, and type of exercise on this outcome. DESIGN: Intervention systematic review and meta-analysis. SETTING: MEDLINE/PubMed, Embase, Central, and SPORTDiscus databases were searched from their earliest record to July 30, 2020. Only randomized controlled trials that assessed muscle soreness comparing CWI and control were included. Studies were pooled in different subgroups regarding the used protocol: water temperature (severe or moderate cold), immersion time (short, medium, or longer time), CWI protocol (intermittent or continuous application), and type of exercise (endurance or resistance exercise). Data were pooled in a meta-analysis and described as weighted mean difference (95% confidence interval, P < 0.05). PARTICIPANTS: Athletes and nonathletes. INTERVENTIONS: Cold-water immersion and control condition. MAIN OUTCOME MEASURES: Muscle soreness. RESULTS: Forty-four studies were included. For immediate effects, CWI was superior to control regardless of water temperature and protocol, and for short and medium immersion times and endurance exercises. For delayed effects, CWI was superior to control in all subgroups except longer immersions time. CONCLUSIONS: This study suggests that CWI is better than control for the management of muscle soreness and water temperature and CWI protocol do not influence this result, but only short and medium immersions times presented positive effects. Aiming immediate effects, the best results suggest CWI application only after endurance exercises, while delayed effect CWI was superior both after endurance and resistance exercises.

Photobiomodulation therapy applied during an exercise-training program does not promote additional effects in trained individuals: A randomized placebo-controlled trial.

BACKGROUND: Previous studies have shown positive results of photobiomodulation (PBM) for improving performance and accelerating post-exercise recovery. However, the effects of PBM in healthy individuals who underwent a neuromuscular adaptation training remain unclear. OBJECTIVE: To investigate the effects of PBM during a training program combining sprints and explosive squats exercises on clinical, functional, and systemic outcomes in trained healthy individuals compared to a placebo intervention and a control. METHODS: We conducted a randomized placebo-controlled trial. Healthy males were randomly assigned to three groups: active PBM (30 J per site), placebo, or control (passive recovery). The participants performed a six-week (12 sessions) of a training program consisting of a combination of sprints and squats with recovery applied between sprints and squats. To prevent the influence of the primary neuromuscular adaptation to exercise on the results, all participants had to participate in a period of six weeks of exercise training program. Functional, clinical, and psychological outcomes and vascular endothelial growth factor (VEGF) were assessed at baseline and after six weeks. Results are expressed as mean difference (MD) and 95% confidence intervals (CI). RESULTS: Thirty-nine healthy male volunteers (aged 18-30 years; body mass index 23.9 ±â€¯3 kg/m²) were recruited. There was no significant time by group interaction, and no significant effect of group, but there was a significant effect of time for maximal voluntary isometric contraction (primary outcome) (MD=22 Nm/kg; 95%CI: 3.9, 40) and for squat jump (MD=1.6 cm; 95CI%: 0.7, 2.5). There was no significant interaction (time*group), time, or group effect for the other outcomes. CONCLUSION: The addition of PBM to a combined training performed for six weeks in previously trained individuals did not result in additional benefits compared to placebo or no additional intervention.

A New Mathematical Approach to Explore the Post-exercise Recovery Process and Its Applicability in a Cold Water Immersion Protocol.

Micheletti, JK, Vanderlei, FM, Machado, AF, de Almeida, AC, Nakamura, FY, Netto Junior, J, and Pastre, CM. A new mathematical approach to explore the post-exercise recovery process and its applicability in a cold water immersion protocol. J Strength Cond Res 33(5): 1266-1275, 2019-The objective of this study was to propose a mathematical model to analyze the post-training recovery of perceptive, functional, metabolic, and autonomic parameters from the use of cold water immersion (CWI) through isolated and combined analysis. Following simulated training, 64 male soccer players were randomized into an experimental group (EG: CWI, 13 ± 1° C; 15 minutes) and a control group (CG: passive recovery; 15 minutes). Perceptive (soreness and perception of recovery), autonomic (heart rate variability [HRV]), metabolic (lactate concentration), and functional parameters (squat jump, T agility test, sprint test, 40-second test, and maximal voluntary isometric contraction) were analyzed before and at specific moments after training (without exceeding 2 hours after training). The variables were analyzed using the raw data, dichotomization of each variable (isolated analysis), and through a mathematical model using the combination of all parameters analyzed (combined analysis). The combined analysis did not demonstrate better efficacy of the EG compared with the CG (69.17 and 63.4%, p = 0.09). In the isolated analysis, a chance of the technique being better was observed in the metabolic parameter at 1 and 2 hours after training (odds ratio, 95% confidence interval = 3.75 [1.01-13.88] and 11.11 [1.25-98.49]), respectively, and in the autonomic parameter at 40-45 minutes after training (4.4 [1.09-17.67]). For the raw data, all parameters analyzed presented recovery by 2 hours after training for both groups. Based on the proposed mathematical model, it is concluded that CWI is not better than the control condition. However, considering the analysis of variables in isolation, the technique presents a better chance of recovery for blood lactate concentration and HRV.

Post-exercise recovery of biological, clinical and metabolic variables after different temperatures and durations of cold water immersion: a randomized clinical trial.

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 it is 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: One hundred and five 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±1 °C; 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 14 °C 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 14 °C. Regarding the perception of recovery, CWI for 5 minutes at 14 °C 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.

The effects of cold water immersion with different dosages (duration and temperature variations) on heart rate variability post-exercise recovery: A randomized controlled trial.

OBJECTIVES: The aim of the present study was to investigate the effects of cold water immersion during post-exercise recovery, with different durations and temperatures, on heart rate variability indices. DESIGN: Hundred participants performed a protocol of jumps and a Wingate test, and immediately afterwards were immersed in cold water, according to the characteristics of each group (CG: control; G1: 5' at 9±1°C; G2: 5' at 14±1°C; G3: 15' at 9±1°C; G4: 15' at 14±1°C). METHODS: Analyses were performed at baseline, during the CWI recuperative technique (TRec) and 20, 30, 40, 50 and 60min post-exercise. The average HRV indices of all RR-intervals in each analysis period (MeanRR), standard deviation of normal RR-intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent RR-intervals (RMSSD), spectral components of very low frequency (VLF), low frequency (LF) and high frequency (HF), scatter of points perpendicular to the line of identity of the Poincaré Plot (SD1) and scatter points along the line of identity (SD2) were assessed. RESULTS: Mean RR, VLF and LF presented an anticipated return to baseline values at all the intervention groups, but the same was observed for SDNN and SD2 only in the immersion for 15min at 14°C group (G4). In addition, G4 presented higher values when compared to CG. CONCLUSIONS: These findings demonstrate that if the purpose of the recovery process is restoration of cardiac autonomic modulation, the technique is recommended, specifically for 15min at 14°C.

Advice to Stay Active or Structured Exercise in the Management of Sciatica: A Systematic Review and Meta-analysis.

STUDY DESIGN: A systematic review and meta-analysis. OBJECTIVE: To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. SUMMARY OF BACKGROUND DATA: Conservative management of sciatica usually includes interventions to promote physical activity in the form of advice to stay active or exercise, but there has been no systematic review directly comparing the effectiveness of these 2 approaches. METHODS: Data Sources included MEDLINE, CINAHL, EMBASE, and PEDro databases. Studies were randomized controlled trials comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short, intermediate, and long-term follow-ups. The GRADE approach was used to summarize the strength of evidence. RESULTS: Five trials were included in the meta-analysis, which showed a significant, although small effect favoring exercise over advice for reducing leg pain intensity in the short term (weighted mean difference: 11.43 [95% confidence interval, 0.71-22.16]) but no difference for disability (weighted mean difference: 1.45 [95% confidence interval, -2.86 to 5.76]). Furthermore, there was no difference at intermediate and long-term follow-ups between advice and exercise for patient-relevant outcomes. CONCLUSION: There is low-quality evidence (GRADE) that exercise provides small, superior effects compared with advice to stay active on leg pain in the short term for patients experiencing sciatica. However, there is moderate-quality evidence showing no difference between advice to stay active and exercise on leg pain and disability status in people with sciatica in the long term. LEVEL OF EVIDENCE: 1.