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.

Do final rehabilitation volumes influence function after anterior cross ligament reconstruction? A pilot study / Volumes finais de reabilitação influenciam função após reconstrução de ligamento cruzado anterior? Um estudo piloto

Abstract Introduction Rupture of the anterior cruciate ligament (ACL) is one of the frequent traumatic injuries of the knee joint complex, and the isokinetic dynamometer is essential to assess and measure its joint function. Objective To analyze the volume of physical therapy treatment using the same protocol with different duration in patients undergoing ACL reconstruction. Methods This is a prospective observational cohort study. The sample consisted of 13 adult male individuals who underwent ACL reconstruction surgery. Participants were divided into two groups: accelerated treatment (AC) and non-accelerated treatment (NAC). Participants underwent a standardized protocol of post-reconstruction physio-therapy, starting in the immediate postoperative period. The AC group performed the treatment three times a week, with a duration of 4 hours each session for 6 months, while the NAC performed twice a week with duration of two hours each session for eight months. Results The groups showed the same behavior during the post-reconstruction treatment periods, showing that regardless of time, the results were beneficial at the end of the treatment. However, in the accelerated protocol, the injured limb showed a significant difference for extender peak torque (PTEXT) in the preoperative and 4-month postoperative period (230.5 vs 182.6), 4-month postoperative period and final (182.6 vs 242.1) in the AC group, while in the NAC group there was no significant difference between times in this same limb. Conclusion Greater volumes of weekly training characterized better results, showing that rehabilitation time is not a predictor of discharge, but rehabilitation time obtains good results for the variables.

Resumo Introdução A ruptura do ligamento cruzado anterior (LCA) é uma das lesões traumáticas frequentes do complexo articular do joelho, sendo o dinamômetro isocinético fundamental para avaliar e mensurar sua função articular. Objetivo Analisar o volume de tratamento fisioterapêutico utilizando o mesmo protocolo com diferentes durações em pacientes submetidos à reconstrução do LCA. Métodos Trata-se de um estudo de coorte observacional prospectivo. A amostra foi composta por 13 indivíduos adultos do sexo masculino submetidos à cirurgia de reconstrução do LCA. Os participantes foram divididos em dois grupos: tratamento acelerado (AC) e tratamento não acelerado (NAC). Os participantes foram submetidos a um protocolo padronizado de fisioterapia pós-reconstrução, com início no pós-operatório imediato. O grupo AC realizou o trata-mento três vezes por semana, com duração de 4 horas cada sessão, durante 6 meses, enquanto o grupo NAC realizou duas vezes por semana, com duração de duas horas cada sessão, durante oito meses. Resultados Os grupos apresentaram o mesmo comportamento durante os períodos de tratamento pós-reconstrução, mostrando que independente do tempo, os resultados foram benéficos ao final do tratamento. No protocolo acelerado, porém, o membro lesionado apresentou diferença significativa para pico de torque extensor (PTEXT) no pré-operatório e pós-operatório de 4 meses (230,5 vs 182,6), pós-operatório de 4 meses e final (182,6 vs 242,1) no grupo AC, enquanto no NAC não houve diferença significativa entre os tempos neste mesmo membro. Conclusão Maiores volumes de treinamento semanal caracterizaram melhores resultados, mostrando que o tempo de reabilitação não é preditor de alta, mas o tempo de reabilitação obtém bons resultados para as variáveis.

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.

Submaximal Elastic Resistance Band Tests to Estimate Upper and Lower Extremity Maximal Muscle Strength.

Muscle strength assessment is fundamental to track the progress of performance and prescribe correct exercise intensity. In field settings, simple tests are preferred. This study develops equations to estimate maximal muscle strength in upper- and lower-extremity muscles based on submaximal elastic resistance tests. Healthy adults (n = 26) performed a maximal test (1 RM) to validate the ability of the subsequent submaximal tests to determine maximal muscle strength, with elastic bands. Using a within-group repeated measures design, three submaximal tests of 40%, 60%, and 80% during (1) shoulder abduction, (2) shoulder external rotation, (3) hip adduction, and (4) prone knee flexion were performed. The association between number of repetitions and relative intensity was modeled with both 1st and 2nd order polynomials to determine the best predictive validity. For both upper-extremity tests, a strong linear association between repetitions and relative intensity was found (R2 = 0.97-1.00). By contrast, for the lower-extremity tests, the associations were fitted better with a 2nd order polynomial (R2 = 1.00). The results from the present study provide formulas for predicting maximal muscles strength based on submaximal resistance in four different muscles groups and show a muscle-group-specific association between repetitions and intensity.

Phototherapy on Management of Creatine Kinase Activity in General Versus Localized Exercise: A Systematic Review and Meta-Analysis.

OBJECTIVE: The main focus of this systematic review was to determine the efficacy of phototherapy in the management of creatine kinase (CK) activity after exercise and furthermore to identify for which exercise model protocol phototherapy provides the best results. DESIGN: Meta-analysis comparing phototherapy with a control condition. SETTING: The MEDLINE, EMBASE, SPORTDiscus, PEDro, and CENTRAL databases were searched from their earliest records to October 03, 2016. Data were pooled in a meta-analysis and described as standardized mean difference (SMD) with 95% confidence intervals (CIs) using a random effects model. PARTICIPANTS: Healthy subjects (no restrictions were applied, eg, age, sex, and exercise level). INTERVENTION: Phototherapy (low-level laser therapy and/or light-emitting diode therapy) before or after exercise and a placebo or control condition. MAIN OUTCOME MEASURES: Creatine kinase activity (no restriction to any analysis, eg, serum, plasma, or capillary blood). RESULTS: Fourteen studies were included for review. The results revealed that phototherapy has a more positive effect than control condition in management of CK activity [SMD = 0.77, 95% CI (0.32 to 1.22); P = 0.0007; I = 72%]. In exploratory analysis, the results showed that phototherapy was effective only in the exercise protocol with localized exercise with large effect size [localized exercise: SMD = 0.89, 95% CI (0.26 to 1.51); P = 0.0002; I = 76%; general exercise: SMD = 0.61, 95% CI (-0.05 to 1.26); P = 0.07; I = 67%]. CONCLUSIONS: The available evidence suggest that phototherapy has beneficial effects on the management of CK activity and demonstrate a possible relationship based on damage caused by exercise, providing a greater effect in studies that used localized exercise.

Association between lifestyle and musculoskeletal pain: cross-sectional study among 10,000 adults from the general working population.

BACKGROUND: Work-related musculoskeletal pain is a major cause of work disability and sickness absence. While pain is a multifactorial phenomenon being influenced by work as well as lifestyle, less is known about the association between specific lifestyle factors and the type of musculoskeletal pain. The aim of the study was to investigate if a dose-response association existed between lifestyle factors and musculoskeletal pain intensity in the low back and neck-shoulder. METHODS: Currently employed wage earners (N = 10,427) replied in 2010 to questions about work environment, lifestyle and health. Logistic regression analyses adjusted for various confounders tested the association of alcohol intake, physical activity, fruit and vegetable intake, and smoking (explanatory variables) with low back pain and neck-shoulder pain intensity (outcomes variables, scale 0-9, where ≥4 is high pain). RESULTS: The minimally adjusted model found that physical activity and fruit and vegetable intake were associated with lower risk of musculoskeletal pain, while smoking was associated with higher risk of musculoskeletal pain. In the fully adjusted model, physical activity ≥5 h per week was associated with lower risk of low back pain and neck-shoulder pain with risk ratios (RR) of 0.95 (95% CI 0.90-1.00) and 0.90 (95% CI 0.82-0.99), respectively. No association was found between alcohol intake and pain. CONCLUSION: Being physically active associated with lower risk of having musculoskeletal pain, while smoking habits and healthy eating were associated with higher pain when adjusting for age and gender. Considering the continuously increasing retirement age in many societies, initiatives to promote healthy habits should still be a political priority to help the workers to stay healthy and cope to their work.

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.

Effects of training with elastic resistance versus conventional resistance on muscular strength: A systematic review and meta-analysis.

Given the practicality and low cost of using elastic resistance in training for different populations and its effectiveness in a range of outcomes, a comparison with conventional devices could clarify and quantify the benefits provided by both mode. To compare the effects of resistance training with elastic devices (tubes and Thera-Bands) and conventional devices (weight machines and dumbbells) on the outcome muscular strength. A search was performed in the databases PubMed/MEDLINE, EMBASE, PEDro (Physiotherapy Evidence Database), and CENTRAL (Cochrane Central Register of Controlled Trials) from the earliest records up to 20 December 2017. Data were pooled into a meta-analysis and described as standardized mean difference with a 95% confidence interval (registration number: CRD42016042152). Eight studies were included. The results of the meta-analysis demonstrated no superiority between the methods analyzed for lower limb (SMD = -0.11, 95% CI -0.40, 0.19, p = 0.48) or upper limb muscular strength (SMD=0.09; 95% CI -0.18, 0.35; p = 0.52) [corrected]. Elastic resistance training is able to promote similar strength gains to conventional resistance training, in different population profiles and using diverse protocols.

Is fatigue after work a barrier for leisure-time physical activity? Cross-sectional study among 10,000 adults from the general working population.

AIM: In spite of the many health-related benefits of regular physical activity, fatiguing work may be a barrier to performing leisure-time physical activity. This study investigates the association between work-related fatigue and the duration of low- and high-intensity leisure-time physical activity in workers with sedentary and physically demanding jobs. METHODS: From the 2010 round of the Danish Work Environment Cohort Study, currently employed wage earners from the general working population ( N=10,427) replied to questions about work-related fatigue (predictor) and duration of low- and high-intensity leisure-time physical activity (outcome). Associations were modelled using general linear models controlling for various confounders. RESULTS: Among workers with physically demanding jobs, higher levels of work-related fatigue were associated with gradually lower levels of leisure-time physical activity - for low, moderate and high levels of work-related fatigue the duration of high-intensity leisure-time physical activity was 133 (95% confidence interval (CI) 127-178), 134 (95% CI 109-160) and 113 (95% CI 86-140) min per week, respectively (trend test p<0.001). The duration of high-intensity leisure-time physical activity was lower among older workers (≥50 years) compared to younger workers (<50 years) (132 ± 126 vs 168 ± 150 min per week) ( p<0.0001). CONCLUSIONS: The duration of high-intensity leisure-time physical activity gradually decreases with increased work-related fatigue in workers with physically demanding jobs. Older workers perform less high-intensity physical activity than younger workers. Workplaces should consider initiatives to allow workers with physically demanding jobs and older workers to perform physical exercise during working hours and thereby increase physical capacity to meet the job demands.

Test-retest reliability of knee extensors endurance test with elastic resistance.

BACKGROUND: Reliable clinical tests capable of measuring resistance are important tools for rehabilitation. One alternative that has recently increased in popularity is the use of elastic tubes, which stand out for being easy to handle, low cost, practical, and feasible. OBJECTIVE: Analyze the test-retest reliability of the knee extensors muscle fatigue resistance test (FRT) with elastic tubes. METHODS: A total of 116 healthy young males, aged between 18 and 30 years old, participated in the study. Participants performed three pre-test stages: orientation, load presentation, and familiarization with equipment, lasting two weeks. Subsequently, they performed the FRT on two occasions (test and retest), with an interval of seven days. The reliability analyzes were performed using the intraclass correlation coefficient (ICC) with 95% confidence interval and typical measurement error (TME), also expressed as coefficient of variation (CV%). RESULTS: The findings regarding the reliability of the test demonstrated satisfactory values (time: ICC = 0.66; 95%CI [0.50; 0.76]; CV(%) = 9.34; repetition: ICC = 0.61; 95%CI [0.46; 0.73], CV(%) = 13.66; rhythm: ICC = 0.52; 95%CI [0.35; 0.67], CV(%) = 10.29. CONCLUSION: From the findings presented, it is concluded that the proposed clinical test with elastic tubes demonstrates evidence of acceptable values.

Práticas alimentares de pacientes em pós operatório de cirurgia bariátrica: revisão integrativa / Food practices of patients in postoperative surgery of bariatric surgery: integration review

Objetivo: Verificar na literatura quais são os hábitos alimentares comuns no pós-operatório de pacientes que foram submetidos à cirurgia bariátrica. Método: Por meio da questão norteadora "Qual a abordagem da literatura quanto às práticas alimentares adotadas por pacientes após cirurgia bariátrica?", realizou-se uma síntese dos artigos relacionados ao tema, disponibilizados nas bases de dados PubMed, Science Direct, LILACS, Portal de Periódicos Capes e SciELO, considerando autores, ano de publicação, objetivos, instrumentos utilizados para a coleta de dados e principais achados. Resultados: Foram encontrados 86 artigos, dos quais apenas 13 eram de interesse para esta revisão. A adesão no tratamento nutricional no período pós-operatório é reduzida em função do elevado percentual de desistência, associado ao abandono do estilo de vida saudável devido aos transtornos psicológicos e compulsão alimentar. Observou-se um consumo elevado de açúcares simples e alimentos gordurosos, que costumam levar ao reganho de peso após a realização da cirurgia. Conclusões: Faz-se necessário aconselhamento psicológico e nutricional para que a perda de peso e o pós-operatório ocorram de forma saudável e eficaz. Evidenciou-se a importância de novos estudos sobre as práticas alimentares adotadas por pacientes após a cirurgia, a fim de preservar a saúde dos mesmos.

Objective: The aim was to verify on the literature the common postoperative eating habits of patients who were underwent to bariatric surgery. Methods: A guiding question was made for this study: "What is the approach of the literature regarding dietary practices for patients after bariatric surgery?". A synthesis of articles related to the topic was made, searching in available databases as PubMed, Science Direct, LILACS, Portal de Periódicos Capes and SciELO, considering authors, year of publication, objectives, instruments used for data collection and main findings. Results: Eighty-six articles were found but only 13 were considered of interest to this review. The accession to the nutritional treatment in the postoperative period is reduced due to the high percentage of waiver, associated with the abandonment of healthy lifestyle by psychological disorders and binge eating. There was a high intake of simple sugars and fatty foods, which often lead to weight regained some years after the surgery. Conclusions: Nutritional and psychological counseling are both necessary for a healthy and effectively weight loss in postoperative period. It was evidenced the importance of further studies on feeding practices adopted by patients after surgery, to preserve the human health.(AU)

Effect of low-level laser therapy (LLLT) and light-emitting diodes (LEDT) applied during combined training on performance and post-exercise recovery: protocol for a randomized placebo-controlled trial.

BACKGROUND: Previous studies have shown positive results of phototherapy for improving performance and accelerating recovery; however, the effects of phototherapy during training and after a primary adaptation remain unclear. The aim of this randomized controlled trial is to analyze the effects of phototherapy and combined training on clinical, functional, and psychological outcomes and on vascular endothelial growth factor. METHODS: This randomized placebo-controlled trial by stratified sample will involve 45 healthy male participants. In phase 1, the participants will undergo six weeks of combined training (sprints and squats). In phase 2, participants will be allocated through stratified randomization (based on adaptation capacity) into three groups: active phototherapy group (AG), placebo group (PG), and non-treatment control group (CG). A new six-week training program will then start and the participants will receive the recovery strategy between sprints and squats. The primary outcome will be maximal isometric contraction. The secondary outcomes include strength and power testing, maximal incremental test, squat jump, sprint test, muscle soreness, pain threshold, perceptions of exertion and recovery, psychological questionnaire, and vascular endothelial growth factor. CONCLUSIONS: This will be the first trial to include phototherapy during training. We believe that this strategy will combine the ergogenic and prophylactic effects in the same session. Furthermore, an application protocol performed after primary adaptation may reflect the real effect of the technique.

Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis.

BACKGROUND: Cold water immersion (CWI) is a technique commonly used in post-exercise recovery. However, the procedures involved in the technique may vary, particularly in terms of water temperature and immersion time, and the most effective approach remains unclear. OBJECTIVES: The objective of this systematic review was to determine the efficacy of CWI in muscle soreness management compared with passive recovery. We also aimed to identify which water temperature and immersion time provides the best results. METHODS: The MEDLINE, EMBASE, SPORTDiscus, PEDro [Physiotherapy Evidence Database], and CENTRAL (Cochrane Central Register of Controlled Trials) databases were searched up to January 2015. Only randomized controlled trials that compared CWI to passive recovery were included in this review. Data were pooled in a meta-analysis and described as weighted mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included for review and meta-analysis. The results of the meta-analysis revealed that CWI has a more positive effect than passive recovery in terms of immediate (MD = 0.290, 95% CI 0.037, 0.543; p = 0.025) and delayed effects (MD = 0.315, 95% CI 0.048, 0.581; p = 0.021). Water temperature of between 10 and 15 °C demonstrated the best results for immediate (MD = 0.273, 95% CI 0.107, 0.440; p = 0.001) and delayed effects (MD = 0.317, 95% CI 0.102, 0.532; p = 0.004). In terms of immersion time, immersion of between 10 and 15 min had the best results for immediate (MD = 0.227, 95% 0.139, 0.314; p < 0.001) and delayed effects (MD = 0.317, 95% 0.102, 0.532, p = 0.004). CONCLUSIONS: The available evidence suggests that CWI can be slightly better than passive recovery in the management of muscle soreness. The results also demonstrated the presence of a dose-response relationship, indicating that CWI with a water temperature of between 11 and 15 °C and an immersion time of 11-15 min can provide the best results.

Efeitos imediatos e tardios da mobilização neural sobre força de preensão palmar e complacência neural de membro superior: um ensaio clínico randomizado / Immediate and delayed effect of neural mobilization on hand grip strength and neural complacency of upper limb: a randomized controlled trial

Introdução: A mobilização neural tem sido utilizada clinicamente a fim de restaurar e otimizar a função dos tecidos. Objetivos: Analisar o efeito imediato e tardio de técnicas de mobilização neural sobre a força de preensão palmar e complacência neural. Métodos: Vinte e sete participantes foram randomizadas em três grupos (G1: mobilização do nervo mediano, G2: mobilização do nervo radial e G3: mobilização do nervo ulnar). Valores de preensão palmar e complacência neural foram registrados nos momentos basal, 24 e 48 horas após a técnica. Resultados: O G1 apresentou diferença com relação ao basal (p<0,05) no momento tardio para força, e G1 e G2 apresentaram melhora da complacência neural no momento imediato. Não houve diferença entre os grupos. Conclusões: A mobilização neural do nervo mediano apresenta os melhores resultados para força de preensão palmar. Porém, não se observaram evidências que sugerissem a otimização de diferentes variáveis a partir da mobilização de único nervo.

Introduction: The neural mobilization has been used clinically to restore and optimize tissue function. Objectives: To analyze the immediate and late effects of neural mobilization techniques on grip strength and neural complacency. Methods: Twenty- seven subjects were randomized into three groups (G1: mobilization of the median nerve, G2: mobilization of the radial nerve, and G3: mobilization of the ulnar nerve). Handgrip values and neural complacency were recorded at baseline, 24 and 48 hours after the technique. Results: G1 difference from baseline (p <0.05) in delayed effect for strength, and G1 and G2 showed improved neural compliance in the immediate effect. There was no difference between groups. Conclusions: Neural mobilization of the median nerve provides the best results for grip strength. However, there was no evidence to suggest the optimization of several variables from the single nerve mobilization.