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Costello JT, Baker PRA, Minett GM, Bieuzen F, Stewart IB, Bleakley C. Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Cochrane Database Syst Rev 2015; 2015:CD010789. [PMID: 26383887 PMCID: PMC9579836 DOI: 10.1002/14651858.cd010789.pub2] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recovery strategies are often used with the intention of preventing or minimising muscle soreness after exercise. Whole-body cryotherapy, which involves a single or repeated exposure(s) to extremely cold dry air (below -100 °C) in a specialised chamber or cabin for two to four minutes per exposure, is currently being advocated as an effective intervention to reduce muscle soreness after exercise. OBJECTIVES To assess the effects (benefits and harms) of whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. SEARCH METHODS We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, the British Nursing Index and the Physiotherapy Evidence Database. We also searched the reference lists of articles, trial registers and conference proceedings, handsearched journals and contacted experts.The searches were run in August 2015. SELECTION CRITERIA We aimed to include randomised and quasi-randomised trials that compared the use of whole-body cryotherapy (WBC) versus a passive or control intervention (rest, no treatment or placebo treatment) or active interventions including cold or contrast water immersion, active recovery and infrared therapy for preventing or treating muscle soreness after exercise in adults. We also aimed to include randomised trials that compared different durations or dosages of WBC. Our prespecified primary outcomes were muscle soreness, subjective recovery (e.g. tiredness, well-being) and adverse effects. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results, selected studies, assessed risk of bias and extracted and cross-checked data. Where appropriate, we pooled results of comparable trials. The random-effects model was used for pooling where there was substantial heterogeneity. We assessed the quality of the evidence using GRADE. MAIN RESULTS Four laboratory-based randomised controlled trials were included. These reported results for 64 physically active predominantly young adults (mean age 23 years). All but four participants were male. Two trials were parallel group trials (44 participants) and two were cross-over trials (20 participants). The trials were heterogeneous, including the type, temperature, duration and frequency of WBC, and the type of preceding exercise. None of the trials reported active surveillance of predefined adverse events. All four trials had design features that carried a high risk of bias, potentially limiting the reliability of their findings. The evidence for all outcomes was classified as 'very low' quality based on the GRADE criteria.Two comparisons were tested: WBC versus control (rest or no WBC), tested in four studies; and WBC versus far-infrared therapy, also tested in one study. No studies compared WBC with other active interventions, such as cold water immersion, or different types and applications of WBC.All four trials compared WBC with rest or no WBC. There was very low quality evidence for lower self-reported muscle soreness (pain at rest) scores after WBC at 1 hour (standardised mean difference (SMD) -0.77, 95% confidence interval (CI) -1.42 to -0.12; 20 participants, 2 cross-over trials); 24 hours (SMD -0.57, 95% CI -1.48 to 0.33) and 48 hours (SMD -0.58, 95% CI -1.37 to 0.21), both with 38 participants, 2 cross-over studies, 1 parallel group study; and 72 hours (SMD -0.65, 95% CI -2.54 to 1.24; 29 participants, 1 cross-over study, 1 parallel group study). Of note is that the 95% CIs also included either no between-group differences or a benefit in favour of the control group. One small cross-over trial (9 participants) found no difference in tiredness but better well-being after WBC at 24 hours post exercise. There was no report of adverse events.One small cross-over trial involving nine well-trained runners provided very low quality evidence of lower levels of muscle soreness after WBC, when compared with infrared therapy, at 1 hour follow-up, but not at 24 or 48 hours. The same trial found no difference in well-being but less tiredness after WBC at 24 hours post exercise. There was no report of adverse events. AUTHORS' CONCLUSIONS There is insufficient evidence to determine whether whole-body cryotherapy (WBC) reduces self-reported muscle soreness, or improves subjective recovery, after exercise compared with passive rest or no WBC in physically active young adult males. There is no evidence on the use of this intervention in females or elite athletes. The lack of evidence on adverse events is important given that the exposure to extreme temperature presents a potential hazard. Further high-quality, well-reported research in this area is required and must provide detailed reporting of adverse events.
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Affiliation(s)
- Joseph T Costello
- University of PortsmouthDepartment of Sport and Exercise ScienceSpinnaker BuildingCambridge RoadPortsmouthUKP01 2ER
| | - Philip RA Baker
- Queensland University of TechnologySchool of Public Health and Social Work, Institute of Health and Biomedical InnovationVictoria Park RoadKelvin GroveQueenslandAustralia4059
| | - Geoffrey M Minett
- Queensland University of TechnologySchool of Exercise and Nutrition Sciences and Institute of Health and Biomedical InnovationVictoria Park RoadKelvin GroveBrisbaneQueenslandAustralia4059
| | - Francois Bieuzen
- French National Institute of Sport (INSEP)Laboratory of Sport, Expertise and Performance ‐ EA 737011 avenue du TremblayParisFrance75012
| | - Ian B Stewart
- Queensland University of TechnologySchool of Exercise and Nutrition Sciences and Institute of Health and Biomedical InnovationVictoria Park RoadKelvin GroveBrisbaneQueenslandAustralia4059
| | - Chris Bleakley
- University of UlsterUlster Sports AcademySchool of Health SciencesShore RoadNewtownabbeyCounty AntrimUKBT37 0QB
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SCHAAL KARINE, LE MEUR YANN, LOUIS JULIEN, FILLIARD JEANROBERT, HELLARD PHILIPPE, CASAZZA GRETCHEN, HAUSSWIRTH CHRISTOPHE. Whole-Body Cryostimulation Limits Overreaching in Elite Synchronized Swimmers. Med Sci Sports Exerc 2015; 47:1416-25. [PMID: 25314578 DOI: 10.1249/mss.0000000000000546] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Head Exposure to Cold during Whole-Body Cryostimulation: Influence on Thermal Response and Autonomic Modulation. PLoS One 2015; 10:e0124776. [PMID: 25915642 PMCID: PMC4411165 DOI: 10.1371/journal.pone.0124776] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/08/2015] [Indexed: 12/13/2022] Open
Abstract
Recent research on whole-body cryotherapy has hypothesized a major responsibility of head cooling in the physiological changes classically reported after a cryostimulation session. The aim of this experiment was to verify this hypothesis by studying the influence of exposing the head to cold during whole-body cryostimulation sessions, on the thermal response and the autonomic nervous system (ANS). Over five consecutive days, two groups of 10 participants performed one whole-body cryostimulation session daily, in one of two different systems; one exposing the whole-body to cold (whole-body cryostimulation, WBC), and the other exposing the whole-body except the head (partial-body cryostimulation, PBC).10 participants constituted a control group (CON) not receiving any cryostimulation. In order to isolate the head-cooling effect on recorded variables, it was ensured that the WBC and PBC systems induced the same decrease in skin temperature for all body regions (mean decrease over the 5 exposures: -8.6°C±1.3°C and -8.3±0.7°C for WBC and PBC, respectively), which persisted up to 20-min after the sessions (P20). The WBC sessions caused an almost certain decrease in tympanic temperature from Pre to P20 (-0.28 ±0.11°C), while it only decreased at P20 (-0.14±0.05°C) after PBC sessions. Heart rate almost certainly decreased after PBC (-8.6%) and WBC (-12.3%) sessions. Resting vagal-related heart rate variability indices (the root-mean square difference of successive normal R-R intervals, RMSSD, and high frequency band, HF) were very likely to almost certainly increased after PBC (RMSSD:+49.1%, HF: +123.3%) and WBC (RMSSD: +38.8%, HF:+70.3%). Plasma norepinephrine concentration was likely increased in similar proportions after PBC and WBC, but only after the first session. Both cryostimulation techniques stimulated the ANS with a predominance of parasympathetic tone activation from the first to the fifth session and in slightly greater proportion with WBC than PBC. The main result of this study indicates that the head exposure to cold during whole-body cryostimulation may not be the main factor responsible for the effects of cryostimulation on the ANS.
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Ferreira-Junior JB, Bottaro M, Vieira A, Siqueira AF, Vieira CA, Durigan JLQ, Cadore EL, Coelho LGM, Simões HG, Bemben MG. One session of partial-body cryotherapy (−110 °C) improves muscle damage recovery. Scand J Med Sci Sports 2014; 25:e524-30. [DOI: 10.1111/sms.12353] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2014] [Indexed: 11/29/2022]
Affiliation(s)
- J. B. Ferreira-Junior
- College of Physical Education; University of Brasília; Brasilia DF Brazil
- Federal Institute of Triangulo Mineiro; Paracatu MG Brazil
| | - M. Bottaro
- College of Physical Education; University of Brasília; Brasilia DF Brazil
| | - A. Vieira
- College of Physical Education; University of Brasília; Brasilia DF Brazil
| | - A. F. Siqueira
- College of Physical Education; University of Brasília; Brasilia DF Brazil
| | - C. A. Vieira
- College of Physical Education; University of Brasília; Brasilia DF Brazil
| | - J. L. Q. Durigan
- Physical Therapy Division; University of Brasília; Brasilia DF Brazil
| | - E. L. Cadore
- College of Physical Education; University of Brasília; Brasilia DF Brazil
| | - L. G. M. Coelho
- Federal Center for Technological Education of Minas Gerais; Divinopolis MG Brazil
| | - H. G. Simões
- Graduate Program on Physical Education; Catholic University of Brasilia; Brasilia DF Brazil
| | - M. G. Bemben
- Department of Health and Exercise Science; University of Oklahoma; Norman Oklahoma USA
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Cardiovascular and autonomic responses to whole-body cryostimulation in essential hypertension. Cryobiology 2014; 69:249-55. [DOI: 10.1016/j.cryobiol.2014.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 07/24/2014] [Accepted: 07/24/2014] [Indexed: 11/18/2022]
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Zalewski P, Bitner A, Słomko J, Szrajda J, Klawe JJ, Tafil-Klawe M, Newton JL. Whole-body cryostimulation increases parasympathetic outflow and decreases core body temperature. J Therm Biol 2014; 45:75-80. [PMID: 25436954 DOI: 10.1016/j.jtherbio.2014.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 11/28/2022]
Abstract
The cardiovascular, autonomic and thermal response to whole-body cryostimulation exposure are not completely known. Thus the aim of this study was to evaluate objectively and noninvasively autonomic and thermal reactions observed after short exposure to very low temperatures. We examined 25 healthy men with mean age 30.1 ± 3.7 years and comparable anthropomorphical characteristic. Each subject was exposed to cryotherapeutic temperatures in a cryogenic chamber for 3 min (approx. -120 °C). The cardiovascular and autonomic parameters were measured noninvasively with Task Force Monitor. The changes in core body temperature were determined with the Vital Sense telemetric measurement system. Results show that 3 min to cryotherapeutic temperatures causes significant changes in autonomic balance which are induced by peripheral and central blood volume changes. Cryostimulation also induced changes in core body temperature, maximum drop of core temperature was observed 50-60 min after the stimulation. Autonomic and thermal reactions to cryostimulation were observed up to 6 h after the exposure and were not harmful for examined subjects.
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Affiliation(s)
- Pawel Zalewski
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
| | - Anna Bitner
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Joanna Słomko
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Justyna Szrajda
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Jacek J Klawe
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Malgorzata Tafil-Klawe
- Department of Human Physiology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Karlowicza 24, 85-092 Bydgoszcz, Poland
| | - Julia L Newton
- Institute for Ageing and Health,The Medical School, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4HH, United Kingdom
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Ferreira-Junior JB, Bottaro M, Loenneke JP, Vieira A, Vieira CA, Bemben MG. Could whole-body cryotherapy (below -100°C) improve muscle recovery from muscle damage? Front Physiol 2014; 5:247. [PMID: 25071592 PMCID: PMC4078193 DOI: 10.3389/fphys.2014.00247] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/13/2014] [Indexed: 01/10/2023] Open
Affiliation(s)
- Joao B Ferreira-Junior
- College of Physical Education, University of Brasília Brasília, Brazil ; Federal Institute of Triângulo Mineiro Paracatu, Brazil
| | - Martim Bottaro
- College of Physical Education, University of Brasília Brasília, Brazil
| | - Jeremy P Loenneke
- Neuromuscular Research Laboratory, Department of Health and Exercise Science, The University of Oklahoma Norman, OK, USA
| | - Amilton Vieira
- College of Physical Education, University of Brasília Brasília, Brazil
| | - Carlos A Vieira
- College of Physical Education, University of Brasília Brasília, Brazil
| | - Michael G Bemben
- Neuromuscular Research Laboratory, Department of Health and Exercise Science, The University of Oklahoma Norman, OK, USA
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Fonda B, De Nardi M, Sarabon N. Effects of whole-body cryotherapy duration on thermal and cardio-vascular response. J Therm Biol 2014; 42:52-5. [PMID: 24802149 DOI: 10.1016/j.jtherbio.2014.04.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/01/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
Abstract
Whole-body cryotherapy (WBC) is the exposure of minimally dressed participants to very cold air, either in a specially designed chamber (cryo-chamber) or cabin (cryo-cabin), for a short period of time. Practitioners are vague when it comes to recommendations on the duration of a single session. Recommended exposure for cryo-chamber is 150s, but no empirically based recommendations are available for a cryo-cabin. Therefore the aim of this study was to examine thermal and cardio-vascular responses after 90, 120, 150 and 180s of WBC in a cryo-cabin. Our hypothesis was that skin temperature would be significantly lower after longer exposers. Twelve male participants (age 23.9±4.2 years) completed four WBC of different durations (90, 120, 150 and 180s) in a cryo-cabin. Thermal response, heart rate and blood pressure were measured prior, immediately after, 5min after and 30min after the session. Skin temperature differed significantly among different durations, except between 150 and 180s. There was no significant difference in heart rate and blood pressure. Thermal discomfort during a single session displayed a linear increase throughout the whole session. Our results indicate that practitioners and clinicians using cryo-cabin for WBC do not need to perform sessions longer than 150s. We have shown that longer sessions do not substantially affect thermal and cardio-vascular response, but do increase thermal discomfort.
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Affiliation(s)
- Borut Fonda
- S2P, Science to Practice Ltd., Laboratory for Motor Control and Motor Behaviour, Tehnološki Park 19, 1000 Ljubljana, Slovenia; University of Birmingham, School of Sport, Exercise and Rehabilitation Sciences, Birmingham, United Kingdom.
| | | | - Nejc Sarabon
- S2P, Science to Practice Ltd., Laboratory for Motor Control and Motor Behaviour, Tehnološki Park 19, 1000 Ljubljana, Slovenia; University of Primorska, Faculty of Mathematics, Natural Sciences and Information Technologies, Koper, Slovenia
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Szygula Z, Lubkowska A, Giemza C, Skrzek A, Bryczkowska I, Dołęgowska B. Hematological parameters, and hematopoietic growth factors: EPO and IL-3 in response to whole-body cryostimulation (WBC) in military academy students. PLoS One 2014; 9:e93096. [PMID: 24695100 PMCID: PMC3973677 DOI: 10.1371/journal.pone.0093096] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 02/28/2014] [Indexed: 12/04/2022] Open
Abstract
The effects of extreme cold on the human body are not fully understood, there are also no reports on the effect of cryogenic temperatures on the levels of erythropoietin (EPO) and interleukin 3 (IL-3), two important factors that regulate hematopoiesis. Aim: determination of changes in peripheral blood cell counts and EPO and IL-3 levels induced by a series of 10, 20 and 30 standard whole-body cryostimulation (WBC) treatments. The study involved 45 men, experimental group (EXP, n = 30) subjected to 30 WBC treatments (−130°C, treatment duration: 3 minutes) and a control group (CON, n = 15). Blood samples were collected before the series of treatments and after 10, 20 and 30 treatments. After 10 and 20 treatments we observed lower red blood cell counts and hematocrit and hemoglobin levels compared to baseline (p<0.05) and the control group (p<0.05). Additionally we observed an increase in hemoglobin concentration in plasma (p<0.05), and bilirubin after 10 and 20 treatments, and a decrease in plasma concentration of haptoglobin after 10, 20 and 30 treatments (p<0.05). The number of leukocytes was higher after 10 and 20 WBC treatments compared to baseline and the CON group. EPO concentration in plasma was elevated and the concentration of IL-3 was lower after 10, 20 and 30 WBC treatments. The decrease in indices of the erythrocytic system, plasma hemoglobin and bilirubin, with a simultaneous decrease in haptoglobin concentrations after 10 and 20 WBC treatments, may be due to increased intravascular hemolysis. At the same time there was a small, but statistically significant increase in the concentration of EPO stimulated erythropoiesis which could facilitate a return of erythrocytic system indices to initial levels after 30 WBC treatments. Changes in the white blood cell system showed transient mobilization of this system under the influence of WBC.
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Affiliation(s)
- Zbigniew Szygula
- Institute of Human Physiology, University School of Physical Education, Krakow, Poland
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
- Department of Physiology, Faculty of Natural Sciences, Szczecin University, Szczecin, Poland
- * E-mail:
| | - Czesław Giemza
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Anna Skrzek
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Iwona Bryczkowska
- Department of Functional Diagnostics and Physical Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Laboratory Diagnostics and Molecular Medicine, Pomeranian Medical University, Szczecin, Poland
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Bleakley CM, Bieuzen F, Davison GW, Costello JT. Whole-body cryotherapy: empirical evidence and theoretical perspectives. Open Access J Sports Med 2014; 5:25-36. [PMID: 24648779 PMCID: PMC3956737 DOI: 10.2147/oajsm.s41655] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Whole-body cryotherapy (WBC) involves short exposures to air temperatures below −100°C. WBC is increasingly accessible to athletes, and is purported to enhance recovery after exercise and facilitate rehabilitation postinjury. Our objective was to review the efficacy and effectiveness of WBC using empirical evidence from controlled trials. We found ten relevant reports; the majority were based on small numbers of active athletes aged less than 35 years. Although WBC produces a large temperature gradient for tissue cooling, the relatively poor thermal conductivity of air prevents significant subcutaneous and core body cooling. There is weak evidence from controlled studies that WBC enhances antioxidant capacity and parasympathetic reactivation, and alters inflammatory pathways relevant to sports recovery. A series of small randomized studies found WBC offers improvements in subjective recovery and muscle soreness following metabolic or mechanical overload, but little benefit towards functional recovery. There is evidence from one study only that WBC may assist rehabilitation for adhesive capsulitis of the shoulder. There were no adverse events associated with WBC; however, studies did not seem to undertake active surveillance of predefined adverse events. Until further research is available, athletes should remain cognizant that less expensive modes of cryotherapy, such as local ice-pack application or cold-water immersion, offer comparable physiological and clinical effects to WBC.
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Affiliation(s)
- Chris M Bleakley
- Sport and Exercise Science Research Institute, Faculty of Life and Health Sciences, University of Ulster, Newtownabbey, Northern Ireland
| | - François Bieuzen
- Research Department, Laboratory of Sport, Expertise and Performance, French National Institute of Sport (INSEP), Paris, France
| | - Gareth W Davison
- Sport and Exercise Science Research Institute, Faculty of Life and Health Sciences, University of Ulster, Newtownabbey, Northern Ireland
| | - Joseph T Costello
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Costello JT, Baker PRA, Minett GM, Bieuzen F, Stewart IB, Bleakley C. Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010789] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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