Effect of cold or thermoneutral water immersion on post-exercise heart rate recovery and heart rate variability indices

Effects of different extreme cold exposure on heart rate variability

Frequent extreme cold events in recent years have brought serious threats to outdoor workers and rescuers. Changes in ambient temperature are associated with altered cardiac autonomic function. The study aims to investigate heart rate variability (HRV) and its relationship to other physiological parameters under extreme cold exposures. Twelve males underwent a 30-min preconditioning phase in a neutral environment followed by a 30-min cold exposure (-5, -10, -15, and -20 °C). Time-domain indexes(meanRR, SDNN, RMSSD, and pNN50), frequency domain indexes [Log(HF), Log(LF), and low frequency/high frequency (LF/HF)], parasympathetic nervous system (PNS), and sympathetic nervous system (SNS) were analysed. Results showed all HRV indexes of four cold exposures were significant. The decrease in temperature was accompanied by progressive PNS activation with SNS retraction. SDNN was the most sensitive HRV index and had good linear relationships with blood pressure, pulse, and hand temperature. The results are significant for formulating safety protection strategies for workers in extremely cold environments.Practitioner Summary: This study investigated heart rate variability (HRV) in 12 males during a 30-min cold exposure (-5, -10, -15, and -20 °C). Results showed all HRV indexes of four cold exposures were significant. The decrease in temperature was accompanied by progressive PNS activation with SNS retraction. SDNN was the most sensitive HRV index and had good linear relationships with blood pressure, pulse, and hand temperature.

Heart Rate Variability to Automatically Identify Hyperbaric States Considering Respiratory Component

This study's primary objective was to identify individuals whose physiological responses deviated from the rest of the study population by automatically monitoring atmospheric pressure levels to which they are exposed and using parameters derived from their heart rate variability (HRV). To achieve this, 28 volunteers were placed in a dry hyperbaric chamber, where they experienced varying pressures from 1 to 5 atmospheres, with five sequential stops lasting five minutes each at different atmospheric pressures. The HRV was dissected into two components: the respiratory component, which is linked to respiration; and the residual component, which is influenced by factors beyond respiration. Nine parameters were assessed, including the respiratory rate, four classic HRV temporal parameters, and four frequency parameters. A k-nearest neighbors classifier based on cosine distance successfully identified the atmospheric pressures to which the subjects were exposed to. The classifier achieved an 88.5% accuracy rate in distinguishing between the 5 atm and 3 atm stages using only four features: respiratory rate, heart rate, and two frequency parameters associated with the subjects' sympathetic responses. Furthermore, the study identified 6 out of 28 subjects as having atypical responses across all pressure levels when compared to the majority. Interestingly, two of these subjects stood out in terms of gender and having less prior diving experience, but they still exhibited normal responses to immersion. This suggests the potential for establishing distinct safety protocols for divers based on their previous experience and gender.

Influence of physical post-exercise recovery techniques on vagally-mediated heart rate variability: A systematic review and meta-analysis

In sports, physical recovery following exercise-induced fatigue is mediated via the reactivation of the parasympathetic nervous system (PNS). A noninvasive way to quantify the reactivation of the PNS is to assess vagally-mediated heart rate variability (vmHRV), which can then be used as an index of physical recovery. This systematic review and meta-analysis investigated the effects of physical recovery techniques following exercise-induced fatigue on vmHRV, specifically via the root mean square of successive differences (RMSSD). Randomized controlled trials from the databases PubMed, WebOfScience, and SportDiscus were included. Twenty-four studies were part of the systematic review and 17 were included in the meta-analysis. Using physical post-exercise recovery techniques displayed a small to moderate positive effect on RMSSD (k = 22, Hedges' g = 0.40, 95% confidence interval [CI] = 0.20-0.61, p = 0.04) with moderate heterogeneity. In the subgroup analyses, cold water immersion displayed a moderate to large positive effect (g = 0.75, 95% CI: 0.42-1.07) compared with none for other techniques. For exercise type, physical recovery techniques performed after resistance exercise (g = 0.69, 95% CI: 0.48-0.89) demonstrated a larger positive effect than after cardiovascular intermittent (g = 0.52, 95% CI: 0.06-0.97), while physical recovery techniques performed after cardiovascular continuous exercise had no effect. No significant subgroup differences for training status and exercise intensity were observed. Overall, physical post-exercise recovery techniques can accelerate PNS reactivation as indexed by vmHRV, but the effectiveness varies with the technique and exercise type.

Energetic responses of head-out water immersion at different temperatures during post-exercise recovery and its consequence on anaerobic mechanical power

PURPOSE

While exercise recovery may be beneficial from a physiological point of view, it may be detrimental to subsequent anaerobic performance. To investigate the energetic responses of water immersion at different temperatures during post-exercise recovery and its consequences on subsequent anaerobic performance, a randomized and controlled crossover experimental design was performed with 21 trained cyclists.

METHOD

Participants were assigned to receive three passive recovery strategies during 10 min after a Wingate Anaerobic Test (WAnT): control (CON: non-immersed condition), cold water immersion (CWI: 20 ℃), and hot water immersion (HWI: 40 ℃). Blood lactate, cardiorespiratory, and mechanical outcomes were measured during the WAnT and its recovery. Time constant (τ), asymptotic value, and area under the curve (AUC) were quantified for each physiologic parameter during recovery. After that, a second WAnT test and 10-min recovery were realized in the same session.

RESULTS

Regardless the water immersion temperature, water immersion increased [Formula: see text] (+ 18%), asymptote ([Formula: see text]+ 16%, [Formula: see text] + 13%, [Formula: see text] + 17%, HR + 16%) and AUC ([Formula: see text]+ 27%, [Formula: see text] + 18%, [Formula: see text] + 20%, HR + 25%), while decreased [Formula: see text] (- 33%). There was no influence of water immersion on blood lactate parameters. HWI improved the mean power output during the second WAnT (2.2%), while the CWI decreased 2.4% (P < 0.01).

CONCLUSION

Independent of temperature, water immersion enhanced aerobic energy recovery without modifying blood lactate recovery. However, subsequent anaerobic performance was increased only during HWI and decreased during CWI. Despite higher than in other studies, 20 °C effectively triggered physiological and performance responses. Water immersion-induced physiological changes did not predict subsequent anaerobic performance.

Practical internal and external cooling methods do not influence rapid recovery from simulated taekwondo performance

Background/Objectives

The influence of post-exercise cooling on recovery has gained much attention in the empirical literature, however, data is limited in regards to optimizing recovery from taekwondo performance when combat is repeated in quick succession within the same day. The aim of this study was therefore to compare the effects of external and internal cooling after simulated taekwondo combat upon intestinal temperature (T_int), psychomotor skills (reaction time, response time, movement time), and neuromuscular function (peak torque, average power, time to reach peak torque).

Methods

Using a randomized counterbalanced crossover design, 10 well-trained male taekwondo athletes completed four recovery methods on separate occasions: passive recovery (CON), a 5-minute thermoneutral water immersion (35°C) (TWI), a 5-min cold water immersion (15°C) (CWI), and ice slurry ingestion (-1°C) (ICE; consumed every 5 min for 30 min). Heart rate (HR), blood lactate (Blac) concentrations, and T_int were determined at rest, immediately after combat, and at selected intervals during a 90-min recovery period. Neuromuscular functional (measured with isokinetic dynamometer) and psychomotor indices were assessed at baseline and after the recovery period.

Results

ICE led to a significantly lower T_int at 30 min (P<0.01) and 45 min (P<0.01) after simulated combat; 15-30 min after cessation of ingesting ice slurry, compared with the CON and TWI conditions, respectively. However, there were no differences in T_int across time points between the other conditions (P>0.05). Psychomotor skills and neuromuscular function indices returned to baseline values after the 90 min recovery period (P>0.05) with no differences observed between conditions (P>0.05).

Conclusion

The present findings suggest that internal (ICE) and external (CWI) recovery methods appear to have little impact on physiological and functional indices over the time course required to influence repeated taekwondo combat performance.

Effects of aquatic exercises on physical fitness and quality of life in postmenopausal women: an updated systematic review and meta-analysis

Objective

In the present systematic review and meta-analysis, we aimed to evaluate and update the effects of aquatic exercise on physical fitness and quality of life (QoL) in postmenopausal women.

Methods

The databases Cochrane Library, PubMed, Web of Science, and MEDLINE were searched for randomized controlled trials (RCTs) on the topic from inception to July 2022. The GetData software was used to extract data from the published images. RevMan5.4 software was used for statistical analysis. Data are expressed as standardized mean difference (SMD) with 95% confidence intervals (CI). I² index was employed for heterogeneity. Egger's test was used to assess publication bias. We evaluated the methodological quality of included studies using the Physiotherapy Evidence Database scale.

Results

We included 594 participants in 16 RCTs (19 comparison groups). The results indicated that aquatic exercise can significantly improve lower limb strength (LLS), upper limb strength (ULS), agility, flexibility, and overall QoL. No significant effects were found on aerobic capacity. Subgroup-analysis results indicated that aquatic exercise only significantly improved LLS, ULS, agility, and flexibility in postmenopausal women < 65 years of age. However, aquatic exercise improves the overall QoL both in postmenopausal women < 65 years and ≥ 65 years. Aquatic resistance exercise significantly improves LLS, ULS, agility and flexibility. In addition, aquatic aerobic exercise can effectively increase LLS, and combined aquatic aerobic and resistance exercise can enhance the overall QoL.

Conclusions

Aquatic exercise can effectively improve physical fitness and overall QoL in postmenopausal women, but has limited effects on aerobic capacity; thus, it is highly recommended in postmenopausal women.

Does Exercise Training Improve Cardiac-Parasympathetic Nervous System Activity in Sedentary People? A Systematic Review with Meta-Analysis

The aim of this study was to investigate the training-induced effect on cardiac parasympathetic nervous system (PNS) activity, assessed by resting heart rate variability (HRV) and post-exercise heart rate recovery (HRR), in sedentary healthy people. Electronic searches were carried out in PubMed, Embase, and Web of Science. Random-effects models of between-group standardised mean difference (SMD) were estimated. Heterogeneity analyses were performed by means of the chi-square test and I² index. Subgroup analyses and meta-regressions were performed to investigate the influence of potential moderator variables on the training-induced effect. The results showed a small increase in RMSSD (SMD₊ = 0.57 [95% confidence interval (CI) = 0.23, 0.91]) and high frequency (HF) (SMD₊ = 0.21 [95% CI = 0.01, 0.42]) in favour of the intervention group. Heterogeneity tests reached statistical significance for RMSSD and HF (p ≤ 0.001), and the inconsistency was moderate (I² = 68% and 60%, respectively). We found higher training-induced effects on HF in studies that performed a shorter intervention or lower number of exercise sessions (p ≤ 0.001). Data were insufficient to investigate the effect of exercise training on HRR. Exercise training increases cardiac PNS modulation in sedentary people, while its effect on PNS tone requires future study.

Effects of Acute Aquatic High-Intensity Intermittent Exercise on Blood Pressure and Arterial Stiffness in Postmenopausal Women with Different ACE Genotypes

The present study investigated the effects of acute aquatic high-intensity intermittent jumping (HIIJ) on blood pressure (BP) and arterial stiffness in postmenopausal women with different angiotensin-converting enzyme genotypes (ACE). We recruited 12 postmenopausal women carrying the ACE deletion/deletion (DD) genotype and 61 carrying the insertion/insertion or insertion/deletion (II/ID) genotype. The participants performed 12 trials of 30 s, 75% heart rate reserve (HRR) jumping, and 60 s, 50% HRR recovery, and 3 trials of 40 s upper limb resistance exercises were performed as fast as possible. The heart rate (HR) and BP were measured before exercise, immediately, 10 min, and 45 min after exercise. The brachial-ankle pulse wave velocity (baPWV) was measured before and after exercise. The systolic blood pressure (SBP) of the DD genotype increased more significantly than those with the II/ID genotype post-exercise (30.8 ± 4.48 vs. 20.4 ± 2.00 mmHg, p = 0.038). The left and right sides of baPWV increased significantly after exercise (1444.8 ± 29.54 vs. 1473.4 ± 32.36 cm/s, p = 0.020; 1442.1 ± 30.34 vs. 1472.0 ± 33.09, p = 0.011), and there was no significant difference between the two groups. The HIIJ increased baPWV. The postmenopausal women with the DD genotype have a higher SBP increased post-exercise than those with II/ID genotype. These findings suggest that the aquatic exercise program has better effects in decreasing blood pressure in postmenopausal women with the II/ID genotype. Those with the DD genotype should pay attention to the risk of increasing blood pressure after aquatic HIIJ exercise.

Post‐Exercise Cold‐ and Contrasting‐Water Immersion Effects on Heart Rate Variability Recovery in International Handball Female Players

This study aimed to investigate the effect of water immersion (WI) on cardiac parasympathetic reactivation during recovery from handball training sessions in elite female players during a two-week training camp. On the first three days of both weeks, players completed a crossover design with one of three 60-min delayed post-exercise WI protocols or passive rest (PAS). Recovery interventions consisted of a period of 6-min cold-WI (10°C; CWI₆) and two contrasting periods cold- and hot-WI (36°C): one session included 3 min cold + 2 min hot + 3 min cold and the other session 5 × 2 min with cold at the very end. Short-term measures of heart rate variability (HRV) were collected before and after handball training sessions, and after WI. Derived parasympathetic HRV indices collected daily showed lower values post-training compared to pre-training values (p < 0.0001, large ES). Individual handball training sessions revealed similar clear depression of the vagal tone throughout the training camp. The comparison between each WI protocol and PAS revealed significant time × condition interaction particularly for CWI₆. All parasympathetic indices revealed higher post-recovery values in CWI₆ than PAS (p < 0.001 –p < 0.0001, with large ES ranging from 0.86 to 0.94). Surprisingly, 60-min delayed post-training WI revealed for most of parasympathetic HRV indices higher values than pre-training. This study highlighted that post-exercise parasympathetic disruption was exacerbated in response to handball training, and the 60-min delayed WI recovery interventions improved parasympathetic reactivity. Cardiac vagal tone can be highly improved with CWI₆ compared to PAS. For the purpose of HRV modulations, CWI₆ is recommended for short-term recovery.

Autonomic Nervous System characterization in hyperbaric environments considering respiratory component and non-linear analysis of Heart Rate Variability

OBJECTIVES

an evaluation of Principal Dynamic Mode (PDM) and Orthogonal Subspace Projection (OSP) methods to characterize the Autonomic Nervous System (ANS) response in three different hyperbaric environments was performed.

METHODS

ECG signals were recorded in two different stages (baseline and immersion) in three different hyperbaric environments: (a) inside a hyperbaric chamber, (b) in a controlled sea immersion, (c) in a real reservoir immersion. Time-domain parameters were extracted from the RR series of the ECG. From the Heart Rate Variability signal (HRV), classic Power Spectral Density (PSD), PDM (a non-linear analysis of HRV which is able to separate sympathetic and parasympathetic activities) and OSP (an analysis of HRV which is able to extract the respiratory component) methods were used to assess the ANS response.

RESULTS

PDM and OSP parameters follows the same trend when compared to the PSD ones for the hyperbaric chamber dataset. Comparing the three hyperbaric scenarios, significant differences were found: i) heart rate decreased and RMSSD increased in the hyperbaric chamber and the controlled dive, but they had the opposite behavior during the uncontrolled dive; ii) power in the OSP respiratory component was lower than power in the OSP residual component in cases a and c; iii) PDM and OSP methods showed a significant increase in sympathetic activity during both dives, but parasympathetic activity increased only during the uncontrolled dive.

CONCLUSIONS

PDM and OSP methods could be used as an alternative measurement of ANS response instead of the PSD method. OSP results indicate that most of the variation in the heart rate variability cannot be described by changes in the respiration, so changes in ANS response can be assigned to other factors. Time-domain parameters reflect vagal activation in the hyperbaric chamber and in the controlled dive because of the effect of pressure. In the uncontrolled dive, sympathetic activity seems to be dominant, due to the effects of other factors such as physical activity, the challenging environment, and the influence of breathing through the scuba mask during immersion. In sum, a careful description of the changes in all the possible factors that could affect the ANS response between baseline and immersion stages in hyperbaric environments is needed for better interpretation of the results.

The role of the vagus nerve in fibromyalgia syndrome

Fibromyalgia (FM) syndrome is a common illness characterized by chronic widespread pain, sleep problems, fatigue, and cognitive difficulties. Dysfunctional neurotransmitter systems that influence the body's endogenous stress response systems are thought to underlie many of the major FM-related symptoms. A model of FM pathogenesis suggests biological and psychosocial variables interact to influence the genetic predisposition, but the precise mechanisms remain unclear. The Polyvagal Theory provides a theoretical framework from which to investigate potential biological mechanisms. The vagus nerve (VN) has anti-inflammatory properties via its afferent and efferent fibers. A low vagal tone (as assessed by low heart rate variability), has been observed in painful and inflammatory diseases, including FM, while the ventral branch of the VN is linked to emotional expression and social engagement. These anti-inflammatory and psychological (limbic system) properties of the VN may possess therapeutic potential in treating FM. This review paper summarizes the scientific literature regarding the potential role of the VN in transducing and/or therapeutically managing FM signs and symptoms.

Post-exercise Body Cooling: Skin Blood Flow, Venous Pooling, and Orthostatic Intolerance

Athletes and certain occupations (e.g., military, firefighters) must navigate unique heat challenges as they perform physical tasks during prolonged heat stress, at times while wearing protective clothing that hinders heat dissipation. Such environments and activities elicit physiological adjustments that prioritize thermoregulatory skin perfusion at the expense of arterial blood pressure and may result in decreases in cerebral blood flow. High levels of skin blood flow combined with an upright body position augment venous pooling and transcapillary fluid shifts in the lower extremities. Combined with sweat-driven reductions in plasma volume, these cardiovascular alterations result in levels of cardiac output that do not meet requirements for brain blood flow, which can lead to orthostatic intolerance and occasionally syncope. Skin surface cooling countermeasures appear to be a promising means of improving orthostatic tolerance via autonomic mechanisms. Increases in transduction of sympathetic activity into vascular resistance, and an increased baroreflex set-point have been shown to be induced by surface cooling implemented after passive heating and other arterial pressure challenges. Considering the further contribution of exercise thermogenesis to orthostatic intolerance risk, our goal in this review is to provide an overview of post-exercise cooling strategies as they are capable of improving autonomic control of the circulation to optimize orthostatic tolerance. We aim to synthesize both basic and applied physiology knowledge available regarding real-world application of cooling strategies to reduce the likelihood of experiencing symptomatic orthostatic intolerance after exercise in the heat.

Multivariable relationships between autonomic nervous system related indices in hyperbaric environments

The main aim of this work is to model the relationships between parameters extracted from the heart rate variability (HRV) signal, which is derived from the electrocardiogram (ECG), at different stages of a simulated immersion in a hyperbaric chamber. The response of the Autonomic Nervous System is known to be affected by changes in atmospheric pressure, reflected in changes in the HRV signal. A dataset consisting of ECG signals from 17 subjects exposed to a controlled hyperbaric environment, simulating depths from 0 m to 40 m, was used. Both linear and nonlinear dependences of HRV parameters were analysed using linear regression and Mutual Information (entropy-based) techniques. Furthermore, relationships between parameters of the HRV signals, biophysical variables of the subjects, and atmospheric pressure changes were characterized by artificial neural networks. In particular, self-organizing maps (SOM) were trained for modelling and clustering all the data. In the mid-term, these models could be the basis to create predictive models of HRV parameters at high depths in order to increase the safety for divers by warning them if some abnormal body response could be expected just by processing the ECG signal at sea level before immersion.

Effects of postexercise cooling on heart rate recovery in normotensive and hypertensive men

BACKGROUND

Postexercise heart rate recovery (HRR) is determined by cardiac autonomic restoration after exercise and is reduced in hypertension. Postexercise cooling accelerates HRR in healthy subjects, but its effects in a population with cardiac autonomic dysfunction, such as hypertensives (HT), may be blunted. This study assessed and compared the effects of postexercise cooling on HRR and cardiac autonomic regulation in HT and normotensive (NT) subjects.

METHODS

Twenty-three never-treated HT (43 ± 8 years) and 25 NT (45 ± 8 years) men randomly underwent two exercise sessions (30 min of cycling at 70% VO_2peak ) followed by 15 min of recovery. In one randomly allocated session, a fan was turned on in front of the subject during the recovery (cooling), while in the other session, no cooling was performed (control). HRR was assessed by heart rate reductions after 60 s (HRR60s) and 300 s (HRR300s) of recovery, short-term time constant of HRR (T30) and the time constant of the HRR after exponential fitting (HRRτ). HRV was assessed using time- and frequency-domain indices.

RESULTS

HRR and HRV responses in the cooling and control sessions were similar between the HT and NT. Thus, in both groups, postexercise cooling equally accelerated HRR (HRR300s = 39±12 versus 36 ± 10 bpm, P≤0·05) and increased postexercise HRV (lnRMSSD = 1·8 ± 0·7 versus 1·6 ± 0·7 ms, P≤0·05).

CONCLUSION

Differently from the hypothesis, postexercise cooling produced similar improvements in HRR in HT and NT men, likely by an acceleration of cardiac parasympathetic reactivation and sympathetic withdrawal. These results suggest that postexercise cooling equally accelerates HRR in hypertensive and normotensive subjects.

Photic sneeze reflex: another variant of the trigeminocardiac reflex?

The photic sneeze reflex (PSR) is a condition of uncontrollable sneezing episodes in response to bright light. This reflex often manifests as a mild phenomenon but may cause devastating consequences in some situations (aeroplane pilots, car drivers, etc.). Its exact mechanism is poorly understood. Interestingly, the roles of the fifth and tenth cranial nerves, brainstem nuclei and inciting patterns closely mimic a well-known brainstem reflex, known as the trigeminocardiac reflex (TCR). In this critical review, we hypothesize that the PSR can be a variant of the TCR. This concept will lead to a better understanding of the PSR and sharpens the TCR characteristics and open the doors for new research possibilities.

Exploring the Efficacy of a Safe Cryotherapy Alternative: Physiological Temperature Changes From Cold-Water Immersion Versus Prolonged Cooling of Phase-Change Material

PURPOSE

To evaluate the effectiveness between cold-water immersion (CWI) and phase-change-material (PCM) cooling on intramuscular, core, and skin-temperature and cardiovascular responses.

METHODS

In a randomized, crossover design, 11 men completed 15 min of 15°C CWI to the umbilicus and 2-h recovery or 3 h of 15°C PCM covering the quadriceps and 1 h of recovery, separated by 24 h. Vastus lateralis intramuscular temperature at 1 and 3 cm, core and skin temperature, heart-rate variability, and thermal comfort were recorded at baseline and 15-min intervals throughout treatment and recovery.

RESULTS

Intramuscular temperature decreased (P < .001) during and after both treatments. A faster initial effect was observed from 15 min of CWI (Δ: 4.3°C [1.7°C] 1 cm; 5.5°C [2.1°C] 3 cm; P = .01). However, over time (2 h 15 min), greater effects were observed from prolonged PCM treatment (Δ: 4.2°C [1.9°C] 1 cm; 2.2°C [2.2°C] 3 cm; treatment × time, P = .0001). During the first hour of recovery from both treatments, intramuscular temperature was higher from CWI at 1 cm (P = .013) but not 3 cm. Core temperature deceased 0.25° (0.32°) from CWI (P = .001) and 0.28°C (0.27°C) from PCM (P = .0001), whereas heart-rate variability increased during both treatments (P = .001), with no differences between treatments.

CONCLUSIONS

The magnitude of temperature reduction from CWI was comparable with PCM, but intramuscular temperature was decreased for longer during PCM. PCM cooling packs offer an alternative for delivering prolonged cooling whenever application of CWI is impractical while also exerting a central effect on core temperature and heart rate.

Cold water immersion recovery strategy increases blood pressure levels after high-intensity intermittent exercise

BACKGROUND

This study aimed to investigate the effects of cold water immersion (CWI) recovery strategies on the blood pressure levels and related physiological parameters after high-intensity intermittent exercise (HIIE).

METHODS

This randomized crossover study included 20 men (21.5±1.6 years). Each participant performed a maximum-exertion exercise performance test on a bicycle, and heart rate was measured. Subsequently, six cycles of HIIE (1 minute at 120% heart rate reserve [HRR] and 4 minutes at 40% HRR) were performed in a random sequence, and the recovery period involved either CWI or static rest (SR).

RESULTS

Systolic and diastolic blood pressure levels at the 6th and 20th minute of CWI recovery were significantly higher than those during SR and significantly higher than those during a quiet state at the 6th minute. The heart rates at the 20th minute and 35th minute of CWI recovery were significantly lower than that during SR, and the ratings of perceived exertion (RPE) at the 6th and 20th minute of CWI recovery were significantly lower than that during SR. No significant difference in lactate production was evident between the two recovery strategies. Ear temperature was not significantly different when it was quiet, at the end of exercise, and at the 6th and 35th minute of recovery; however, at the 20th minute of recovery, ear temperature during CWI was significantly higher than that during SR.

CONCLUSIONS

CWI after HIIE reduced the extent to which blood pressure decreased. For the fatigue-related heart rate and RPE indicators, CWI was superior to SR.

Short-Term Cardiac Autonomic Recovery after a Repeated Sprint Test in Young Soccer Players

The aim of this study was to describe the time course (within 2 h post-exercise) of heart rate variability (HRV) recovery following a traditional repeated sprint ability (RSA) test applied to youth soccer players. Twenty-four young soccer players (18.4 ± 0.5 years) undertook the following assessments: (1) 10 min rest in the seated position for HRV assessment; (2) a repeated sprint ability (RSA) test; (3) passive recovery in the seated position for 10 min, immediately after finishing the RSA test and 1 h and 2 h post-RSA test. During the HRV measurements (using the natural log of root mean square difference of successive normal RR intervals—lnRMSSD) the participants were instructed to assume a comfortable sitting position, remaining awake and breathing spontaneously for 10 min. Magnitude-based inference was used in the analyses. After the RSA test, the post-1 h measure was almost certainly lower than the resting measure, but almost certainly higher than the lnRMSSD measured post-RSA test. The lnRMSSD post-2 h was likely lower than the resting lnRMSSD and very likely higher than post-1 h. In conclusion, lnRMSSD is severely depressed after performing an RSA test, and reactivation is incomplete after 2 h of passive recovery. This result should be considered by practitioners when applying successive training sessions within intervals shorter than 2 h.

Delayed parasympathetic reactivation and sympathetic withdrawal following maximal cardiopulmonary exercise testing (CPET) in hypoxia

PURPOSE

This study investigated the effects of acute hypoxic exposure on post-exercise cardiac autonomic modulation following maximal cardiopulmonary exercise testing (CPET).

METHODS

Thirteen healthy men performed CPET and recovery in normoxia (N) and normobaric hypoxia (H) (FiO₂ = 13.4%, ≈ 3500 m). Post-exercise cardiac autonomic modulation was assessed during recovery (300 s) through the analysis of fast-phase and slow-phase heart rate recovery (HRR) and heart rate variability (HRV) indices.

RESULTS

Both short-term, T30 (mean difference (MD) 60.0 s, 95% CI 18.2-101.8, p = 0.009, ES 1.01), and long-term, HRRt (MD 21.7 s, 95% CI 4.1-39.3, p = 0.020, ES 0.64), time constants of HRR were higher in H. Fast-phase (30 and 60 s) and slow-phase (300 s) HRR indices were reduced in H either when expressed in bpm or in percentage of HR_peak (p < 0.05). Chronotropic reserve recovery was lower in H than in N at 30 s (MD - 3.77%, 95% CI - 7.06 to - 0.49, p = 0.028, ES - 0.80) and at 60 s (MD - 7.23%, 95% CI - 11.45 to - 3.01, p = 0.003, ES - 0.81), but not at 300 s (p = 0.436). Concurrently, Ln-RMSSD was reduced in H at 60 and 90 s (p < 0.01) but not at other time points during recovery (p > 0.05).

CONCLUSIONS

Affected fast-phase, slow-phase HRR and HRV indices suggested delayed parasympathetic reactivation and sympathetic withdrawal after maximal exercise in hypoxia. However, a similar cardiac autonomic recovery was re-established within 5 min after exercise cessation. These findings have several implications in cardiac autonomic recovery interpretation and in HR assessment in response to high-intensity hypoxic exercise.

Autonomic Nervous System Measurement in Hyperbaric Environments Using ECG and PPG Signals

The main aim of this paper was to characterize the Autonomic Nervous System response in hyperbaric environments using electrocardiogram (ECG) and pulse-photoplethysmogram (PPG) signals. To that end, 26 subjects were introduced into a hyperbaric chamber and five stages with different atmospheric pressures (1 atm; descent to 3 and 5 atm; ascent to 3 and 1 atm) were recorded. Respiratory information was extracted from the ECG and PPG signals and a combined respiratory rate was studied. This information was also used to analyze Heart Rate Variability (HRV) and Pulse Rate Variability (PRV). The database was cleaned by eliminating those cases where the respiratory rate dropped into the low frequency band (LF: 0.04-0.15 Hz) and those in which there was a discrepancy between the respiratory rates estimated using the ECG and PPG signals. Classical temporal and frequency indices were calculated in such cases. The ECG results showed a time-related dependency, with the heart rate and sympathetic markers (normalized power in LF and LF/HF ratio) decreasing as more time was spent inside the hyperbaric environment. A dependence between the atmospheric pressure and the parasympathetic response, as reflected in the high-frequency band power (HF: 0.15-0.40 Hz), was also found, with power increasing with atmospheric pressure. The combined respiratory rate also reached a maximum in the deepest stage; thus, highlighting a significant difference between this stage and the first one. The PPG data gave similar findings and also allowed the oxygen saturation to be computed; therefore, we propose the use of this signal for future studies in hyperbaric environments.

Effectiveness of Two Cold Water Immersion Protocols on Neuromuscular Function Recovery: A Tensiomyography Study

Cold water immersion (CWI) has become a highly used recovery method in sports sciences, which seeks to minimize fatigue and accelerate recovery processes; however, tensiomyography (TMG) is a new method to analyze the muscle mechanical response as a recovery indicator after CWI protocols, this relative new tool of muscle function assessment, can lead to new information of understand fatigue recovery trough CWI. The objective of the study was to compare the effect of two CWI protocols, on neuromuscular function recovery. Thirty-nine healthy males (21.8 ± 2.8 years, 73.2 ± 8.2 kg, 176.6 ± 5.3 cm and body fat 13.5 ± 3.4%) were included in the study. Participants were grouped into a continuous immersion (12 min at 12 ± 0.4°C) group, intermittent immersion (2 min immersion at 12 ± 0.4°C + 1 min out of water 23 ± 0.5°C) group, and a control group (CG) (12 min sitting in a room at 23 ± 0.5°C). Afterward, the participants performed eight sets of 30 s counter movement jumps (CMJs) repetitions, with a 90 s standing recovery between sets. Muscle contraction time (Tc), delay time (Td), muscle radial displacement (Dm), muscle contraction velocity at 10% of DM (V10), and muscle contraction velocity at 90% of DM (V90) in rectus, biceps femoris, and CMJ were measured. Neither CWI protocol was effective in showing improved recovery at 24 and 48 h after training compared with the CG (p > 0.05), in any TMG indicator of recovery in either muscle biceps or rectus femoris, nor was the CMJ performance (F_(6,111) = 0.43, p = 0.85, ωp2 = 0). Neither CWI protocol contributed to recovery of the neuromuscular function indicator.

Water Immersion Affects Episodic Memory and Postural Control in Healthy Older Adults

BACKGROUND AND PURPOSE

Previous research has reported that younger adults make fewer cognitive errors on an auditory vigilance task while in chest-deep water compared with on land. The purpose of this study was to extend this previous work to include older adults and to examine the effect of environment (water vs land) on linear and nonlinear measures of postural control under single- and dual-task conditions.

METHODS

Twenty-one older adult participants (age = 71.6 ± 8.34 years) performed a cognitive (auditory vigilance) and motor (standing balance) task separately and simultaneously on land and in chest-deep water. Listening errors (n = count) from the auditory vigilance test and sample entropy (SampEn), center of pressure area, and velocity for the balance test served as dependent measures. Environment (land vs water) and task (single vs dual) comparisons were made with a Wilcoxon matched-pair test.

RESULTS

Listening errors were 111% greater during land than during water environments (single-task = 4.0 ± 3.5 vs 1.9 ± 1.7; P = .03). Conversely, SampEn values were 100% greater during water than during land environments (single-task = 0.04 ± 0.01 vs 0.02 ± 0.01; P < .001). Center of pressure area and velocity followed a similar trend to SampEn with respect to environment differences, and none of the measures were different between single- and dual-task conditions (P > .05).

CONCLUSIONS

The findings of this study expand current support for the potential use of partial aquatic immersion as a viable method for challenging both cognitive and motor abilities in older adults.

A customised cold-water immersion protocol favours one-size-fits-all protocols in improving acute performance recovery

The purpose of the present study was to investigate whether a customised cold-water immersion (CWIc) protocol was more effective in enhancing acute performance recovery than a one-size-fits-all CWI (CWIs) or active recovery (AR) protocol. On three separate testing days, 10 healthy, physically active, non-smoking males completed the same fatiguing protocol (60 squat jumps and a 2'30″ all-out cycling time-trial) followed by CWIc (12°C, 10-17 min), CWIs (15°C, 10 min) or AR (60 W, 10 min). Outcome measures to assess acute recovery were heart rate variability (HRV) as HRVrecovery, muscle power (MP) as absolute and relative decline, and muscle soreness (MS) at 0 and 24 h. HRVrecovery for CWIc was significantly higher compared to CWIs (p = .026, r = 0.74) and AR (p = .000, r = 0.95). The relative decline in MP after CWIc was significantly lower than after CWIs (p = .017, r = 0.73). MS 0 h and MS 24 h post-intervention were not different after CWIc compared to CWIs and AR (p > .05). The findings of the present study demonstrated that CWIc outperforms CWIs and AR in the acute recovery of cardiovascular (HRV) and CWIs in neuromuscular (MP) performance with no differences in MS. To optimise the effects of CWI, contributions of the protocol duration and water temperature should be considered to guarantee an optimal customised dose.

Heart rate recovery improves after exercise in water when compared with on land

BACKGROUND

Water immersion has demonstrated its effectiveness in the recovery process after exercise. This study presents for the first time the impact of water immersion on heart rate recovery after low-intensity cycle exercise.

METHODS

Sixteen male volunteers were involved in the study. The experiment consisted of two cycling exercises: 1 h in ambient air and 1 h in water (temperature: 32 ± 0·2°C). The exercise intensity was individually prescribed to elicit around 35%-40% of VO₂ peak for both conditions. Heart rate recovery was analysed according to recognized methods, such as the differences between heart rate at exercise completion and within the 2 min recovery period.

RESULTS

Although the two exercises were performed both at same energy expenditure and heart rate, the indexes used to assess the fast and slow decay of the heart rate recovery were significantly shortened after exercise in water.

CONCLUSION

The results of the present study suggest that cycling in thermoneutral water decreases the cardiac work after exercise when compared with cycling on land.

Can natural ways to stimulate the vagus nerve improve seizure control?

The vagus nerve (VN) is the longest cranial nerve, innervating the neck, thorax and abdomen, with afferent fibers transmitting a range of interoceptive stimuli and efferent fibres to somatic structures and autonomic preganglions. Over the last few decades, electrical stimulation of the VN using implanted devices (VNS) has been developed leading to its approval for the treatment of epilepsy and depression. More recently, non-invasive devices to stimulation the VN have been developed. The VN has many functions and the activity that is most amenable to assessment is its effect in controlling the cardiac rhythm. This can be easily assessed by measuring heart rate variability (HRV). Decreased HRV is a result of poorer vagal parasympathetic tone and is associated with a wide range of ill health conditions including a higher risk of early mortality. People with epilepsy, particularly those with poorly controlled seizures, have been shown to have impaired parasympathetic tone. So, might natural ways to stimulate the VN, shown to improve parasympathetic tone as indicated by increased HRV, improve seizure control? There are numerous natural ways that have been shown to stimulate the VN, improving HRV and hence parasympathetic tone. These natural ways fall mainly into 3 categories - stress reduction, exercise, and nutrition. Though the natural ways to stimulate the VN have been shown to increase HRV, they have not been shown to reduce seizures. The exception is listening to Mozart's music, which has been shown to increase parasympathetic tone and decrease seizures. Clearly much more work is required to examine the effect of the various ways to increase HRV on seizure occurrence.

Thermoneutral immersion exercise accelerates heart rate recovery: A potential novel training modality

This study compared heart rate recovery (HRR) after incremental maximal exercise performed at the same external power output (P_ext) on dry land ergocycle (DE) vs. immersible ergocycle (IE). Fifteen young healthy participants (30 ± 7 years, 13 men and 2 women) performed incremental maximal exercise tests on DE and on IE. The initial P_ext on DE was 25 W and was increased by 25 W/min at a pedalling cadence between 60 and 80 rpm, while during IE immersion at chest level in thermoneutral water (30°C), the initial P_ext deployment was at a cadence of 40 rpm which was increased by 10 rpm until 70 rpm and thereafter by 5 rpm until exhaustion. Gas exchange and heart rate (HR) were measured continuously during exercise and recovery for 5 min. Maximal HR (DE: 176 ± 15 vs. IE 169 ± 12 bpm) reached by the subjects in the two conditions did not differ (P > .05). Parasympathetic reactivation parameters (ΔHR from 10 to 300 s) were compared during the DE and IE HR recovery recordings. During the IE recovery, parasympathetic reactivation in the early phase was more predominant (HRR at Δ10-Δ60 s, P < .05), but similar in the late phase (HRR at Δ120-Δ300 s, P > .05) when compared to the DE condition. In conclusion, incremental maximal IE exercise at chest level immersion in thermoneutral water accelerates the early phase parasympathetic reactivation compared to DE in healthy young participants.

Heart rate variability in the standing position reflects training adaptation in professional soccer players

PURPOSE

To show that heart rate variability (HRV) in the standing position better reflects the way in which athletes adapt to training in so-called intermittent sports than the indicator of resting parasympathetic tone usually employed in endurance sports.

METHODS

Twenty professional soccer players (intermittent sport) took part in a 5-week training session divided into three successive periods: "Warm-up", "Intensive training" and "Tapering". At the beginning and end of each of the three periods, a stand test was carried out and the heart rate was recorded, beat by beat (Polar Team 2). We analysed HRV to determine the indicator mostly used to demonstrate training adaptation in endurance sports (lnRMSSD supine, natural logarithm of root mean square of the successive differences) as well as indicators obtained by means of spectral analysis in both supine and standing position.

RESULTS

A decrease in heart rate was observed in the supine position at rest during training (-5.2 ± 1.3 bpm) while lnRMSSD and spectral analysis indicators remained unchanged. The "Warm-up" caused an increase in spectral analysis total power in standing position which was further highlighted by "Tapering" (3.39 ± 0.09, 3.61 ± 0.08 and 3.65 ± 0.09 log ms(2), respectively). However, the autonomic changes are probably more complex than a change in autonomic activity or balance since spectral analysis autonomic indicators remained unchanged.

CONCLUSIONS

HRV in the standing position could monitor training adaptation in intermittent sports contrary to the indicator usually employed in endurance sports. However, the significance of the HRV change in the standing position during training remains unclear.

Effects of Cold Water Immersion on Muscle Oxygenation During Repeated Bouts of Fatiguing Exercise: A Randomized Controlled Study

Postexercise cold water immersion has been advocated to athletes as a means of accelerating recovery and improving performance. Given the effects of cold water immersion on blood flow, evaluating in vivo changes in tissue oxygenation during cold water immersion may help further our understanding of this recovery modality. This study aimed to investigate the effects of cold water immersion on muscle oxygenation and performance during repeated bouts of fatiguing exercise in a group of healthy young adults. Twenty healthy subjects performed 2 fatiguing bouts of maximal dynamic knee extension and flexion contractions both concentrically on an isokinetic dynamometer with a 10-min recovery period in between. Subjects were randomly assigned to either a cold water immersion (treatment) or passive recovery (control) group. Changes in muscle oxygenation were monitored continuously using near-infrared spectroscopy. Muscle performance was measured with isokinetic dynamometry during each fatiguing bout. Skin temperature, heart rate, blood pressure, and muscle soreness ratings were also assessed. Repeated measures ANOVA analysis was used to evaluate treatment effects. The treatment group had a significantly lower mean heart rate and lower skin temperature compared to the control group (P < 0.05). Cold water immersion attenuated a reduction in tissue oxygenation in the second fatiguing bout by 4% when compared with control. Muscle soreness was rated lower 1 day post-testing (P < 0.05). However, cold water immersion had no significant effect on muscle performance in subsequent exercise. As the results show that cold water immersion attenuated decreased tissue oxygenation in subsequent exercise performance, the metabolic response to exercise after cold water immersion is worthy of further exploration.

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.

Cold applications for recovery in adolescent athletes: a systematic review and meta analysis

Recovery and regeneration modalities have been developed empirically over the years to help and support training programmes aimed at maximizing athletic performance. Professional athletes undergo numerous training sessions, characterized by differing modalities of varying volumes and intensities, with the aim of physiological adaptation leading to improved performance. Scientific support to athletes focuses on improving the chances of a training programme producing the largest adaptive response. In competition it is mainly targeted at maximizing the chances of optimal performance and recovery when high performance levels are required repeatedly in quick succession (e.g. heats/finals). In recent years, a lot of emphasis has been put on recovery modalities. In particular, emphasis has been placed on the need to reduce the delayed onset of muscle soreness (DOMS) typically evident following training and competitive activities inducing a certain degree of muscle damage. One of the most used recovery modalities consists of cold-water immersion and/or ice/cold applications to muscles affected by DOMS. While the scientific literature has provided a rationale for such modalities to reduce pain in athletes and recreationally active adults, it is doubtful if this rationale is appropriate to aid training with adolescent athletes. In particular, since these methods have been suggested to potentially impair the muscle remodeling process leading to muscle hypertrophy. While this debate is still active in the literature, many coaches adopt such practices in youth populations, simply transferring what they see in elite sportspeople directly; without questioning the rationale, safety or effectiveness as well as the potential for such activity to reduce the adaptive potential of skeletal muscle remodeling in adolescent athletes. The aim of this review was to assess the current knowledge base on the use of ice/cold applications for recovery purposes in adolescent athletes in order to provide useful guidelines for sports scientists, medical practitioners, physiotherapists and coaches working with such populations as well as developing research questions for further research activities in this area. Based on the current evidence, it seems clear that evidence for acute benefits of such interventions are scarce and more work is needed to ascertain the physiological implications on a pre or peri-pubertal population.

Cardiorespiratory responses and reduced apneic time to cold-water face immersion after high intensity exercise

Apnea after exercise may evoke a neurally mediated conflict that may affect apneic time and create a cardiovascular strain. The physiological responses, induced by apnea with face immersion in cold water (10 °C), after a 3-min exercise bout, at 85% of VO2max,were examined in 10 swimmers. A pre-selected 40-s apnea, completed after rest (AAR), could not be met after exercise (AAE), and was terminated with an agonal gasp reflex, and a reduction of apneic time, by 75%. Bradycardia was evident with immersion after both, 40-s of AAR and after AAE (P<0.05). The dramatic elevation of, systolic pressure and pulse pressure, after AAE, were indicative of cardiovascular stress. Blood pressure after exercise without apnea was not equally elevated. The activation of neurally opposing functions as those elicited by the diving reflex after high intensity exercise may create an autonomic conflict possibly related to oxygen-conserving reflexes stimulated by the trigeminal nerve, and those elicited by exercise.

The Properties of Water and their Applications for Training

The biological effects of immersion in water, which are related to the fundamental principles of hydrodynamics, may be beneficial in certain training contexts. The effects and physical properties of water, such as density, hydrostatic pressure and buoyancy are highly useful resources for training, when used as a counterbalance to gravity, resistance, a compressor and a thermal conductor. Not only does the aquatic medium enable a wider range of activities to be used in a context of low joint impact, but it also constitutes a useful tool in relation to sports rehabilitation, since it allows the athlete to return to training earlier or to continue with high-intensity exercise while ensuring both low joint impact and greater comfort for the individual concerned. Moreover, this medium enables the stimulation of metabolic and neuromuscular systems, followed by their corresponding physiological adaptations allowing both to maintain and improve athletic performance. Hydrotherapy can also play a beneficial role in an athlete’s recovery, helping to prevent as well as treat muscle damage and soreness following exercise.

The effect of different water immersion temperatures on post-exercise parasympathetic reactivation

Purpose

We evaluated the effect of different water immersion (WI) temperatures on post-exercise cardiac parasympathetic reactivation.

Methods

Eight young, physically active men participated in four experimental conditions composed of resting (REST), exercise session (resistance and endurance exercises), post-exercise recovery strategies, including 15 min of WI at 15°C (CWI), 28°C (TWI), 38°C (HWI) or control (CTRL, seated at room temperature), followed by passive resting. The following indices were assessed before and during WI, 30 min post-WI and 4 hours post-exercise: mean R-R (mR-R), the natural logarithm (ln) of the square root of the mean of the sum of the squares of differences between adjacent normal R–R (ln rMSSD) and the ln of instantaneous beat-to-beat variability (ln SD1).

Results

The results showed that during WI mRR was reduced for CTRL, TWI and HWI versus REST, and ln rMSSD and ln SD1 were reduced for TWI and HWI versus REST. During post-WI, mRR, ln rMSSD and ln SD1 were reduced for HWI versus REST, and mRR values for CWI were higher versus CTRL. Four hours post exercise, mRR was reduced for HWI versus REST, although no difference was observed among conditions.

Conclusions

We conclude that CWI accelerates, while HWI blunts post-exercise parasympathetic reactivation, but these recovery strategies are short-lasting and not evident 4 hours after the exercise session.

Cardiac parasympathetic reactivation following exercise: implications for training prescription

The objective of exercise training is to initiate desirable physiological adaptations that ultimately enhance physical work capacity. Optimal training prescription requires an individualized approach, with an appropriate balance of training stimulus and recovery and optimal periodization. Recovery from exercise involves integrated physiological responses. The cardiovascular system plays a fundamental role in facilitating many of these responses, including thermoregulation and delivery/removal of nutrients and waste products. As a marker of cardiovascular recovery, cardiac parasympathetic reactivation following a training session is highly individualized. It appears to parallel the acute/intermediate recovery of the thermoregulatory and vascular systems, as described by the supercompensation theory. The physiological mechanisms underlying cardiac parasympathetic reactivation are not completely understood. However, changes in cardiac autonomic activity may provide a proxy measure of the changes in autonomic input into organs and (by default) the blood flow requirements to restore homeostasis. Metaboreflex stimulation (e.g. muscle and blood acidosis) is likely a key determinant of parasympathetic reactivation in the short term (0-90 min post-exercise), whereas baroreflex stimulation (e.g. exercise-induced changes in plasma volume) probably mediates parasympathetic reactivation in the intermediate term (1-48 h post-exercise). Cardiac parasympathetic reactivation does not appear to coincide with the recovery of all physiological systems (e.g. energy stores or the neuromuscular system). However, this may reflect the limited data currently available on parasympathetic reactivation following strength/resistance-based exercise of variable intensity. In this review, we quantitatively analyse post-exercise cardiac parasympathetic reactivation in athletes and healthy individuals following aerobic exercise, with respect to exercise intensity and duration, and fitness/training status. Our results demonstrate that the time required for complete cardiac autonomic recovery after a single aerobic-based training session is up to 24 h following low-intensity exercise, 24-48 h following threshold-intensity exercise and at least 48 h following high-intensity exercise. Based on limited data, exercise duration is unlikely to be the greatest determinant of cardiac parasympathetic reactivation. Cardiac autonomic recovery occurs more rapidly in individuals with greater aerobic fitness. Our data lend support to the concept that in conjunction with daily training logs, data on cardiac parasympathetic activity are useful for individualizing training programmes. In the final sections of this review, we provide recommendations for structuring training microcycles with reference to cardiac parasympathetic recovery kinetics. Ultimately, coaches should structure training programmes tailored to the unique recovery kinetics of each individual.

Effect of evening postexercise cold water immersion on subsequent sleep

PURPOSE

This study investigated the effect of cold water immersion after evening exercise on subsequent sleep quality and quantity in trained cyclists.

METHODS

In the evenings (~1900 h) on three separate occasions, male cyclists (n = 11) underwent either no exercise (control, CON), exercise only (EX), or exercise followed by cold water immersion (CWI). EX comprised cycling for 15 min at 75% peak power, then a 15-min maximal time trial. After each condition, a full laboratory-based sleep study (polysomnography) was performed. Core and skin temperature, heart rate, salivary melatonin, ratings of perceived fatigue, and recovery were measured in each trial.

RESULTS

No differences were observed between conditions for any whole night sleep measures, including total sleep time, sleep efficiency, sleep onset latency, rapid eye movement onset latency, wake after sleep onset, or proportion of the night spent in different sleep stages. Core temperature in EX and CWI trials was higher than CON, until it decreased below that of EX and CON until bedtime in CWI. After bedtime, core temperature was similar for all conditions throughout the night, except for a 90-min period where it was lower for CWI than EX and CON (3.5-4.5 h postexercise). Heart rates for EX and CWI were both significantly higher than CON postexercise until bedtime, whereas skin temperature after CWI was significantly lower than EX and CON, remaining lower than EX until 3 h postexercise. Melatonin levels and recovery ratings were similar between conditions. Fatigue ratings were significantly elevated after exercise in both CWI and EX conditions, with EX still being elevated compared with CON at bedtime.

CONCLUSION

Whole night sleep architecture is not affected by evening exercise alone or when followed by CWI.

Cold-water immersion and other forms of cryotherapy: physiological changes potentially affecting recovery from high-intensity exercise

High-intensity exercise is associated with mechanical and/or metabolic stresses that lead to reduced performance capacity of skeletal muscle, soreness and inflammation. Cold-water immersion and other forms of cryotherapy are commonly used following a high-intensity bout of exercise to speed recovery. Cryotherapy in its various forms has been used in this capacity for a number of years; however, the mechanisms underlying its recovery effects post-exercise remain elusive. The fundamental change induced by cold therapy is a reduction in tissue temperature, which subsequently exerts local effects on blood flow, cell swelling and metabolism and neural conductance velocity. Systemically, cold therapy causes core temperature reduction and cardiovascular and endocrine changes. A major hindrance to defining guidelines for best practice for the use of the various forms of cryotherapy is an incongruity between mechanistic studies investigating these physiological changes induced by cold and applied studies investigating the functional effects of cold for recovery from high-intensity exercise. When possible, studies investigating the functional recovery effects of cold therapy for recovery from exercise should concomitantly measure intramuscular temperature and relevant temperature-dependent physiological changes induced by this type of recovery strategy. This review will discuss the acute physiological changes induced by various cryotherapy modalities that may affect recovery in the hours to days (<5 days) that follow high-intensity exercise.

Effect of post-exercise hydrotherapy water temperature on subsequent exhaustive running performance in normothermic conditions

OBJECTIVE

Despite the widespread use of cold water immersion (CWI) in normothermic conditions, little data is available on its effect on subsequent endurance performance. This study examined the effect of CWI as a recovery strategy on subsequent running performance in normothermic ambient conditions (∼22°C).

DESIGN

Nine endurance-trained men completed two submaximal exhaustive running bouts on three separate occasions. The running bouts (Ex1 and Ex2) were separated by 15min of un-immersed seated rest (CON), hip-level CWI at 8°C (CWI-8) or hip-level CWI at 15°C (CWI-15).

METHODS

Intestinal temperature, blood lactate and heart rate were recorded throughout and V˙O2, running economy and exercise times were recorded during the running sessions.

RESULTS

Running time to failure (min) during Ex2 was significantly (p<0.05, ES=0.7) longer following CWI-8 (27.7±6.3) than CON (23.3±5) but not different between CWI-15 (26.3±3.4) and CON (p=0.06, ES=0.7) or CWI-8 and CWI-15 (p=0.4, ES=0.2). Qualitative analyses showed a 95% and 89% likely beneficial effect of CWI-8 and CWI-15 during Ex2 compared with CON, respectively. Time to failure during Ex2 was significantly shorter than Ex1 only during the CON condition. Intestinal temperature and HR were significantly lower for most of Ex2 during CWI-8 and CWI-15 compared with CON but they were similar at failure for the three conditions. Blood lactate, running economy and V˙O2 were not altered by CWI.

CONCLUSIONS

These data indicate that a 15min period of cold water immersion applied between repeated exhaustive exercise bouts significantly reduces intestinal temperature and enhances post-immersion running performance in normothermic conditions.

Effect of recovery mode on postexercise vagal reactivation in elite synchronized swimmers

This study investigated the effect of whole-body cryostimulation (WBC), contrast-water therapy (CWT), active recovery (ACT), and passive condition (PAS) protocols on the parasympathetic reactivation and metabolic parameters of recovery in elite synchronized swimmers who performed 2 simulated competition ballets (B1 and B2) separated by 70 min. After determining maximal oxygen consumption (V̇O(2max400)) and blood lactate concentrations ([La(-)](b400)) during a 400-m swim trial, 11 swimmers performed 1 protocol per week in randomized order. Heart rate variability (HRV) was measured at rest (PreB1), 5 min after B1 (PostB1), before B2 (PreB2), and 5 min after B2 (PostB2). V̇O(2peak) was measured at PostB1 and PostB2, and [La(-)](b) was measured at PostB1, PreB2, and PostB2. PostB1 V̇O(2peak) and V̇O(2max400) were similar, but PostB1 [La(-)](b) was higher than [La(-)](b400) (p = 0.004). Each ballet caused significant decreases in HRV indices. At PreB2, all HRV indices had returned to PreB1 levels in the CWT, PAS, and ACT protocols, whereas the WBC protocol yielded a 2- to 4-fold increase in vagal-related HRV indices, compared with PreB1. WBC and ACT both increased [La(-)](b) recovery, compared with PAS (p = 0.06 and p = 0.04, respectively), and yielded an increased V̇O(2peak) from B1 to B2; however, it decreased after PAS (+5.4%, +3.4%, and -3.6%; p < 0.01). This study describes the physiological response to repeated maximal work bouts that are highly specific to elite synchronized swimming. In the context of short-term recovery, WBC yields a strong parasympathetic reactivation, and shows similar effectiveness to ACT on the metabolic parameters of recovery and subsequent exercise capacity.

Post-exercise cold water immersion: effect on core temperature and melatonin responses

To study the effect of post-exercise cold water immersion (CWI) on core temperature and melatonin responses, 10 male cyclists completed two evening (~1800 hours) cycling trials followed by a 15-min CWI (14 °C) or warm water immersion (WWI; 34 °C), and were then monitored for 90 min post-immersion. The exercise trial involved 15 min at 75 % peak power, followed by a 15 min time trial. Core (rectal) temperature was not different between the two conditions pre-exercise (~37.4 °C), post-exercise (~39 °C) or immediately post-immersion (~37.7 °C), but was significantly (p < 0.05) below pre-exercise levels at 60 and 90 min post-immersion in both conditions. Core temperature was significantly lower after CWI than WWI at 30 min (36.84 ± 0.24 vs. 37.42 ± 0.40 °C, p < 0.05) and 90 min (36.64 ± 0.24 vs. 36.95 ± 0.43 °C, p < 0.05) post-immersion. Salivary melatonin levels significantly increased (p < 0.05) from post-exercise (~5 pM) to 90 min post-immersion (~8.3 pM), but were not different between conditions. At 30 and 90 min post-immersion heart rate was significantly lower (~5-10 bpm, p < 0.01) after CWI than WWI. These results show that undertaking either CWI or WWI post-exercise in the evening lowers core temperature below baseline for at least 90 min; however, the magnitude of decrease is significantly greater following CWI. The usual evening increase in melatonin is unaffected by exercise or post-exercise water immersion undertaken between ~1800 and ~2000 hours.

Effect of Daily Cold Water Immersion on Heart Rate Variability and Subjective Ratings of Well-Being in Highly Trained Swimmers

Purpose:

We investigated the effect of daily cold water immersion (CWI), during a typical training week, on parasympathetic activity and subjective ratings of well-being.

Methods:

Over two different weeks, eight highly trained swimmers (4 men; 19.6 ± 3.2 y) performed their usual training load (5 d/wk, approx. 21 h/wk). Last training session of each training day was immediately followed by 5 min of seated recovery, in randomized order, with CWI (15°C) or without (CON). Each morning before the first training session (6:30 AM) during the two experimental weeks, subjective ratings of well-being (eg, quality of sleep) were assessed and the R-R intervals were recorded for 5 min in supine position. A vagal-related index (ie, natural logarithm of the square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals; Ln rMSSD) was calculated from the last 3-min segment.

Results:

Compared with CON, CWI effect on Ln rMSSD was rated as possibly beneficial on day 2 [7.0% (–3; 19)], likely beneficial on day 3 [20.0% (1.5; 43.5)], very likely beneficial on day 4 [30.4% (12.2; 51.6)] and likely beneficial on day 5 [24.1% (–0.4; 54.8)]. Cold water immersion was associated with a likely greater quality of sleep on day 2 [30.0% (2.7; 64.6)], very likely on day 3 [31.0% (5.0; 63.1)] and likely on day 4 [38.6% (11.4; 72.4)] when compared with CON.

Conclusion:

Five minutes of CWI following training can reduce the usual exercise-induced decrease in parasympathetic activity and is associated with improved rating of perceived sleep quality.

The effect of post-exercise hydrotherapy on subsequent exercise performance and heart rate variability

We investigated the effect of hydrotherapy on time-trial performance and cardiac parasympathetic reactivation during recovery from intense training. On three occasions, 18 well-trained cyclists completed 60 min high-intensity cycling, followed 20 min later by one of three 10-min recovery interventions: passive rest (PAS), cold water immersion (CWI), or contrast water immersion (CWT). The cyclists then rested quietly for 160 min with R-R intervals and perceptions of recovery recorded every 30 min. Cardiac parasympathetic activity was evaluated using the natural logarithm of the square root of mean squared differences of successive R-R intervals (ln rMSSD). Finally, the cyclists completed a work-based cycling time trial. Effects were examined using magnitude-based inferences. Differences in time-trial performance between the three trials were trivial. Compared with PAS, general fatigue was very likely lower for CWI (difference [90% confidence limits; -12% (-18; -5)]) and CWT [-11% (-19; -2)]. Leg soreness was almost certainly lower following CWI [-22% (-30; -14)] and CWT [-27% (-37; -15)]. The change in mean ln rMSSD following the recovery interventions (ln rMSSD(Post-interv)) was almost certainly higher following CWI [16.0% (10.4; 23.2)] and very likely higher following CWT [12.5% (5.5; 20.0)] compared with PAS, and possibly higher following CWI [3.7% (-0.9; 8.4)] compared with CWT. The correlations between performance, ln rMSSD(Post-interv) and perceptions of recovery were unclear. A moderate correlation was observed between ln rMSSD(Post-interv) and leg soreness [r = -0.50 (-0.66; -0.29)]. Although the effects of CWI and CWT on performance were trivial, the beneficial effects on perceptions of recovery support the use of these recovery strategies.