Influence of recovery strategies upon performance and perceptions following fatiguing exercise: a randomized controlled trial

Correlation between postural stability and fall risk in trans-femoral amputees due to muscle fatigue

[Purpose] This study aimed to establish a connection between postural stability and falling in individuals with transfemoral amputation (TFA), particularly with muscle fatigue. [Participants and Methods] Fourteen participants were recruited. Muscle fatigue was induced using a sit-to-stand (STS) fatigue protocol. Pre-fatigue and post-fatigue assessments were conducted using the Biodex Balance System (BBS). [Result] The findings of the study revealed significant increases in the postural stability index between the pre-fatigue and post-fatigue conditions for the TFA group, particularly in the overall stability index (OSI) and anterior-posterior stability index (APSI) components. The mean postural stability index scores for the TFA group exhibited a percentage increase of 65.2% for OSI, 52.7% for APSI, and 50% for medial-lateral stability index (MLSI). Furthermore, the TFA fall risk index surged by 61.4%. Regarding the relationships observed, a significant correlation emerged between fall risk and both OSI and APSI. [Conclusion] These findings underscore the impact of muscle fatigue on postural stability and an increase in fall risk among TFA. By mitigating the effects of muscle fatigue, therapists can play an important role in reducing the risk of falls and promoting better postural stability in this population.

Optimizing sports performance in China: Investigating the influence of training, recovery, motivation, and environmental support within a moderation-mediation framework

The expansion of sports in China is astounding. Given the country's focus on athletic achievement, it is crucial to comprehend the different facets of sports. This research examines China's athletic success in training, recuperation, motivation, and environment. The moderation-mediation strategy is used to understand how these variables affect athletic performance. This study fills a gap in understanding Chinese players' on-field performance. The study examined 355 Chinese athletes from various regions and sports. The sample has a balanced gender distribution, diverse age distribution, and representation from various regions. Furthermore, training programs, recovery strategies, motivation, psychological well-being, support systems, and experience levels influence athletes' sports performance. The study reveals that the coefficients indicate that training, recuperation tactics, motivation, and support systems affect athletic performance. Psychological health emerges as a critical mediator in explaining the effects of these factors on performance outcomes. Additionally, athlete experience moderates the influence of these variables, highlighting nuanced differences. These findings offer crucial insights for enhancing the performance of Chinese athletes. By adopting a moderation-mediation approach, this research illuminates the interconnected dynamics among key components, enriching our understanding of avenues for athlete improvement. Specifically, the results underscore the interconnectedness of athletes' psychological well-being, on-field experience, and competitive performance, emphasizing the importance of tailored interventions. This study could help Chinese politicians, sports psychologists, and coaches enhance athletes' performance.

The effects of hydrotherapy and cryotherapy on recovery from acute post-exercise induced muscle damage-a network meta-analysis

BACKGROUND

This systematic review and network meta-analysis assessed via direct and indirect comparisons the recovery effects of hydrotherapy and cold therapy at different temperatures on exercise induced muscle damage.

METHODS

Five databases were searched in English and Chinese. The included studies included exercise interventions such as resistance training, high-intensity interval training, and ball games, which the authors were able to define as activities that induce the appearance of EIMD. The included RCTs were analyzed using the Cochrane Risk of Bias tool. Eligible studies were included and and two independent review authors extracted data. Frequentist network meta-analytical approaches were calculated based on standardized mean difference (SMD) using random effects models. The effectiveness of each intervention was ranked and the optimal intervention was determined using the surface under the cumulative ranking curve (SUCRA) indicator.

RESULTS

57 studies with 1220 healthy participants were included, and four interventions were examined: Cold Water Immersion (CWI), Contrast Water Therapy (CWT), Thermoneutral or Hot Water Immersion (TWI/HWI), and Cryotherapy(CRYO). According to network meta-analysis, Contrast Water Immersion (SUCRA: 79.9% )is most effective in recovering the biochemical marker Creatine Kinase. Cryotherapy (SUCRA: 88.3%) works best to relieve Delayed Onset Muscle Soreness. In the recovery of Jump Ability, cryotherapy (SUCRA: 83.7%) still ranks the highest.

CONCLUSION

We found that CWT was the best for recovering biochemical markers CK, and CRYO was best for muscle soreness and neuromuscular recovery. In clinical practice, we recommend the use of CWI and CRYO for reducing EIMD.

SYSTEMATIC REVIEW REGISTRATION

[PROSPERO], identifier [CRD42023396067].

A evidence-based approach to selecting post-exercise cryostimulation techniques for improving exercise performance and fatigue recovery: A systematic review and meta-analysis

Rationale

Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast water therapy), and WBC (whole-body cryostimulation). Previous systematic reviews focused on the effect of cryostimulation on muscle fatigue and sports performance. However, studies on the selection of different cryostimulation methods and their intervention effects present inconsistent results.

Introduction

To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that the effects of various cryostimulation methods, including CWI, CWT, and WBC, on exercise performance and fatigue recovery.

Methods

Following PRISMA guidelines, we conducted searches in PubMed, Embase, The Cochrane Library, Web of Science, and EBSCO databases to gather randomized controlled trials or self-controlled trials involving CWI/CWT/WBC and their effects on exercise performance or fatigue recovery. The search period ranged from November 2013 to November 2, 2023. Literature screening was performed using EndNote X9.1, and the quality of included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis was conducted using RevMan 5.3 software.

Results

This study included a total of 18 articles, included a total of 499 healthy participants, comprising 479 males and 20 females. Among them, participants underwent cryostimulation, including 102 using CWT, using CWI, and 58 using WBC. Compared to the control group, cryostimulation can significantly alleviate muscle pain intensity (SMD -0.45, 95% CL -0.82 to 0.09, P = 0.01). Specifically, CWI significantly reduced muscle pain intensity (SMD = -0.45, 95% CI: 0.820.09, P = 0.01), WBC significantly decreased C-reactive protein levels (SMD = -1.36, 95% CI: 2.350.36, P = 0.008). While, CWT showed no significant differences from the control group in exercise performance and fatigue recovery indicators (P > 0.05).

Conclusion

Cryostimulation can significantly reduce muscle pain intensity and perceived fatigue. Specifically, CWI significantly alleviates muscle pain intensity, WBC significantly lowers markers of inflammation caused by fatigue after exercise, in contrast, CWT does not significantly improve exercise performance and fatigue recovery. After exercise, compared with rest, using cryostimulation may have more noticeable benefits for muscle fatigue and muscle pain, with recommendations prioritizing WBC and CWI particularly for addressing inflammation and muscle pain. However, all cryostimulation may have no significant influence on exercise performance.

Evaluation of a preemptive intervention regimen with hesperidin methyl chalcone in delayed-onset muscle soreness in young adults: a randomized, double-blinded, and placebo-controlled trial study

PURPOSE

Delayed-onset muscle soreness (DOMS) describes an entity characterized by ultrastructural muscle damage. Hesperidin methyl chalcone (HMC) is a synthetic flavonoid presenting analgesic, anti-inflammatory, and antioxidant properties. We evaluated the effects of HMC upon DOMS.

METHOD

In a preventive paradigm, 31 sedentary young men were submitted to a randomized, double-blinded parallel trial and received HMC 500 mg or one placebo capsule × 3 days before an intense dynamic exercise protocol (concentric/eccentric actions) applied for lower limbs for inducing muscle damage. Assessments were conducted at baseline, and 24 and 48 h after, comprising physical performance, and post-muscle soreness and damage, inflammation, recovery of muscle strength, and postural balance associated with DOMS. HMC safety was also evaluated. Thirty participants completed the study.

RESULTS

HMC improved the performance of participants during exercise (40.3 vs 51.3 repetitions to failure, p = 0.0187) and inhibited CPK levels (90.5 vs 57.9 U/L, p = 0.0391) and muscle soreness during passive quadriceps palpation (2.6 vs 1.4 VAS cm, p = 0.0439), but not during active actions, nor did it inhibit IL-1β or IL-10 levels. HMC improved muscle strength recovery, and satisfactorily refined postural balance, without inducing injury to kidneys or liver.

CONCLUSIONS

Preemptive HMC supplementation may be beneficial for boosting physical performance and for the amelioration of clinical parameters related to DOMS, including pain on muscle palpation, increased blood CPK levels, and muscle strength and proprioceptive deficits, without causing adverse effects. These data advance the understanding of the benefits provided by HMC for DOMS treatment, which supports its usefulness for such purpose.

Effects of a Graphene Heating Device on Fatigue Recovery of Biceps Brachii

Far-infrared (FIR) is considered to be an ideal method to promote fatigue recovery due to its high permeability and strong radiation. In this paper, we report a flexible and wearable graphene heating device to help fatigue recovery of human exercise by using its high FIR divergence property. This study compares two different fatigue recovery methods, graphene far-infrared heating device hot application and natural recovery, over a 20 min recovery time among the male colleges' exhaustion exercise. Experimental results show that the achieved graphene device holds excellent electro-thermal radiation conversion efficiency of 70% and normal total emissivity of 89%. Moreover, the graphene FIR therapy in our work is more energy-efficient, easy to use, and wearable than traditional fatigue recovery methods. Such an anti-fatigue strategy offers new opportunities for enlarging potential applications of graphene film in body science, athletic training recovery, and wearable devices.

Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression

BACKGROUND

Studies investigating the effects of common recovery modalities following acute strenuous exercise have reported mixed results.

OBJECTIVES

This systematic review with meta-analysis and meta-regression compared the effects of cold-water immersion (CWI) against other common recovery modalities on recovery of athletic performance, perceptual outcomes, and creatine kinase (CK) following acute strenuous exercise in physically active populations.

STUDY DESIGN

Systematic review, meta-analysis, and meta-regression.

METHODS

The MEDLINE, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare, and Embase databases were searched up until September 2022. Studies were included if they were peer reviewed, published in English, included participants who were involved in sport or deemed physically active, compared CWI with other recovery modalities following an acute bout of strenuous exercise, and included measures of performance, perceptual measures of recovery, or CK.

RESULTS

Twenty-eight studies were meta-analysed. CWI was superior to other recovery methods for recovering from muscle soreness, and similar to other methods for recovery of muscular power and flexibility. CWI was more effective than active recovery, contrast water therapy and warm-water immersion for most recovery outcomes. Air cryotherapy was significantly more effective than CWI for the promotion of recovery of muscular strength and the immediate recovery of muscular power (1-h post-exercise). Meta-regression revealed that water temperature and exposure duration were rarely exposure moderators.

CONCLUSION

CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods.

PROTOCOL REGISTRATION

Open Science Framework: https://doi.org/10.17605/OSF.IO/NGP7C.

Relationship between postural stability and fall risk in young adult after lower limb muscle fatigue

Introduction: Muscle fatigue can reduce body balance and activity of daily living tasks. Therefore, this study aims to identify the correlation between postural stability and fall risk due to muscle fatigue. The components in postural stability include Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI), and Mediolateral Stability Index (MLSI). Design and Methods: A total of seven healthy adults aged 31.1±7.4 years were recruited in this study. The sit-to-stand (STS) protocol was used to induce lower limb muscle fatigue, while postural stability and fall risk were assessed using the Biodex Balance System (BBS) before and after muscle fatigue. Result: The result showed a significant increase in postural stability index after fatigue only for OSI with p<0.05, while no significant difference was found on APSI and MLSI with p=0.157 and p=0.109 respectively. However, the mean score for the postural stability index showed an increase in percentage with 47.8% in OSI, 26.3% in APSI and 46.8% in MLSI.  Furthermore,fall risk showed no significant differences with p=0.149, but the mean score data increased by 16.7% after fatigue. The correlation between fall risk and OSI was significant with p<0.05, while MLSI had a significant negative correlation with APSI (p<0.05). Conclusions: Based on the results, the young adults had reduced overall postural stability but were less affected by fall risk after muscle fatigue. The positive correlation between OSI and fall risk indicated that their overall postural stability can induce the fall risk after muscle fatigue. Therefore, young adults need to be aware of their fatigue symptoms during prolonged exercise that can increase fall risk potential.

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

OBJECTIVE

Our objective was to determine the efficacy of cold-water immersion (CWI) on the management of muscle soreness to identify the impact of immersion time, water temperature, CWI protocol, and type of exercise on this outcome.

DESIGN

Intervention systematic review and meta-analysis.

SETTING

MEDLINE/PubMed, Embase, Central, and SPORTDiscus databases were searched from their earliest record to July 30, 2020. Only randomized controlled trials that assessed muscle soreness comparing CWI and control were included. Studies were pooled in different subgroups regarding the used protocol: water temperature (severe or moderate cold), immersion time (short, medium, or longer time), CWI protocol (intermittent or continuous application), and type of exercise (endurance or resistance exercise). Data were pooled in a meta-analysis and described as weighted mean difference (95% confidence interval, P < 0.05).

PARTICIPANTS

Athletes and nonathletes.

INTERVENTIONS

Cold-water immersion and control condition.

MAIN OUTCOME MEASURES

Muscle soreness.

RESULTS

Forty-four studies were included. For immediate effects, CWI was superior to control regardless of water temperature and protocol, and for short and medium immersion times and endurance exercises. For delayed effects, CWI was superior to control in all subgroups except longer immersions time.

CONCLUSIONS

This study suggests that CWI is better than control for the management of muscle soreness and water temperature and CWI protocol do not influence this result, but only short and medium immersions times presented positive effects. Aiming immediate effects, the best results suggest CWI application only after endurance exercises, while delayed effect CWI was superior both after endurance and resistance exercises.

Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression

Background

Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations.

Objectives

The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations.

Study Design

Systematic review with meta-analysis and meta-regression.

Methods

A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables.

Results

Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise.

Conclusion

CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise.

Funding

Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training.

Protocol registration

Open Science Framework: 10.17605/OSF.IO/SRB9D.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01644-9.

Effect of cold and heat therapies on pain relief in patients with delayed onset muscle soreness: A network meta-analysis

OBJECTIVE

To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis.

METHODS

Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers.

RESULTS

A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first.

CONCLUSION

Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness.

Effects of Light Pedaling Added to Contrast Water Immersion for Recovery after Exhaustive Exercise

For years, athletes and coaches have been looking for new strategies to optimize post-exercise recovery; it has recently been suggested that combining several methods might be a great option. This study therefore aimed to investigate the efficacy of contrast water therapy (CWT) used alone or associated with pedaling to recover from exhaustive exercise. After high-intensity intermittent exercise, 33 participants underwent 30 min of either (i) passive rest (PASSIVE), (ii) CWT with pedaling while in water (COMB) or (iii) classic CWT (CWT). Blood lactate concentration, countermovement jump height and perceived exhaustion were recorded before exercise, immediately after, after recovery interventions and after an additional 30 min of passive rest. Blood lactate concentration returned to initial values after 30 min of COMB (5.9 mmol/L), whereas in the other conditions even 60 min was not enough (10.2 and 9.6 mmol/L for PASSIVE and CWT, respectively, p < 0.05). Jump height was close to initial values after 30 min of CWT (37.3 cm), whereas values were still depressed after 60 min in the PASSIVE (36.0 cm) and COMB (35.7 cm) conditions (p < 0.05). Perceived exertion was still high for all conditions after 60 min. The present results are in favor of the utilization of CWT after exhaustive exercise, but the modality has to be chosen depending on what comes next (subsequent exercise scheduled in the following hours or further away).

The use of recovery strategies by Spanish first division soccer teams: a cross-sectional survey

OBJECTIVES

different active and passive post-exercise recovery techniques such as massage, foam rolling, stretching or ice baths among others, are used by elite athletes to promote effective physiological, physical, and mental restoration. However, limited research is available investigating the use of recovery strategies in professional soccer. As such, we aimed to explore and describe the use of strategies by professional teams throughout the season, describing competitive and preparatory phases.

METHODS

the present study collected data from all professional Spanish soccer teams who played in 'LaLiga' (The Spanish first division), during the season 2018-2019 (n = 20) and the ones promoted for the season 2019-2020 (n = 3). A six-section online survey was responded once.

RESULTS

teams used different recovery protocols and combinations, although natural and physical strategies such as sleep/nap, food/fluid replacement, cold/ice bath/shower/immersion, and massage were always present. However, there is no agreement in the protocols and timings employed. Three physical strategies showed a higher presence in the recovery protocols after competition: cold/ice bath/shower/immersion, massage and foam rolling; always used by seventeen teams (74%), sixteen (70%) and thirteen (57%) respectively. The design and supervision of recovery are multidisciplinary tasks in 87% of the teams. Our findings also demonstrate that although there is a body of scientific evidence on recovery, a gap between theory and practice exists with 13% of the teams acknowledging that insufficient logistics and economic resources limit the use of some strategies, and two teams (9%) not periodizing or individualizing recovery.

CONCLUSION

the investigation provided insight into the current use of recovery strategies by 'LaLiga' teams, highlighting that all clubs used them to one extent or another, but also that significant variability responding to individualized perceptions exists. Moreover, this study provides relevant contextual information that may be useful for professional soccer staff concerning the use of recovery strategies.

Effect of the Cooldown Type on Session Rating of Perceived Exertion

PURPOSE

This study investigated the effect of cooldown modality (active vs passive) and duration (5, 10, and 15 min) on session rating of perceived exertion (sRPE). Secondarily, the possible influence of training sessions' demand on this effect was studied.

METHODS

A total of 16 youth male soccer players (15.7 [0.4] y) completed 2 standardized training sessions per week across 6 weeks. During weeks 1 to 2, 3 to 4, and 5 to 6, cooldown lengths of 15, 10, and 5 minutes were studied, respectively. Using a crossover design, players were randomly assigned to 2 groups and each group performed 1 of 2 different cooldown interventions. Passive and active cooldown interventions based on static stretching and running exercises were studied. Heart rate and sRPE were recorded during all training sessions.

RESULTS

The lowest sRPE was observed when passive cooldown was performed. When the hardest training sessions were considered, a significant main effect of cooldown modality (P < .01) and duration (P < .05) and an interaction effect between these variables (P < .05) on sRPE were obtained. The lowest (P < .01) sRPE was observed during the longest cooldown (15 min).

CONCLUSION

The findings suggest that sRPE may be sensitive to the selected cooldown modality and duration, especially following the most demanding training sessions.

Post-competition recovery strategies in elite male soccer players. Effects on performance: A systematic review and meta-analysis

Aims

The main aim of the present review was to update the available evidence on the value interest of post-competition recovery strategies in male professional or semi-professional soccer players to determine its effect on post-game performance outcomes, physiological markers, and wellness indicators.

Methods

A structured search was carried out following the PRISMA guidelines using six online databases: Pubmed, Scopus, SPORTDiscus, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials. The risk of bias was completed following the Cochrane Collaboration Guidelines. Meta-analyses of randomized controlled trials were conducted to determine the between and within-group effects of different recovery strategies on performance, physiological markers and wellness data. Final meta-analyses were performed using the random-effects model and pooled standardized mean differences (SMD).

Results

Five randomized controlled trials that used Compression Garments (n = 3), Cold Water Immersion (n = 1), and acute Sleep Hygiene Strategy (n = 1) were included. Greater CMJ values at 48h for the intervention group (SMD = 0.70; 95% CI 0.14 to 1.25; p = 0.001; I² = 10.4%) were found. For the 20-m sprint and MVC, the results showed no difference either at 24h or 48h. For physiological markers (CK and CRP) and wellness data (DOMS), small to large SMD were present in favor of the intervention group both at 24h (-0.12 to -1.86) and 48h (-0.21 to -0.85). No heterogeneity was present, except for MVC at 24h (I² = 90.4%; p = 0.0012) and CALF DOMS at 48h (I² = 93.7%; p = 0.013).

Conclusion

The use of recovery strategies offers significant positive effects only in jumping performance (CMJ), with no effects on the 20-m sprint or MVC. Also, the use of recovery strategies offers greater positive effects on muscle damage (physiological markers and wellness data), highlighting the importance of post-match recovery strategies in soccer.

Does the type of foam roller influence the recovery rate, thermal response and DOMS prevention?

PURPOSE

Supporting post-exercise recovery requires choosing not only the right treatment but also the equipment, in which the impact is not always clear. The study aimed to determine the effect of foam rolling on the rate of lactate removal and DOMS prevention and whether the type of foam roller is effective in the context of post-exercise recovery.

METHODS

This randomized trial enrolled 33 active healthy males divided into three groups of eleven individuals: foam rolling with a smooth (STH) or grid roller (GRID) or passive recovery (PAS). All the participants performed full squat jumps for one minute. Examination took place at rest (thermal imaging of skin temperature-[Tsk] and blood lactate-[LA]), immediately following exercise (Tsk & LA), immediately after recovery treatment (Tsk) and after 30 minutes of rest (Tsk & LA). Their pain levels were assessed using the Visual Analog Scale (VAS) 24, 48, 72, and 96 hours after exercise.

RESULTS

The magnitude of lactate decrease depended on the type of recovery used. In the PAS group, the decrease in lactate concentration by 2.65 mmol/L following a half-hour rest was significantly lower than that in the other groups (STH vs. PAS p = 0.042 / GRID vs. PAS p = 0.025). For thermal responses, significant differences between both experimental groups were noted only 30 minutes after exercise. A significant decrease in pain in the STH group occurred between 48 and 96 hours, while the GRID group showed a systematic significant decrease in VAS values in subsequent measurements. Changes in VAS values in subsequent measurements in the PAS group were not statistically significant (p>0.05).

CONCLUSIONS

Foam rolling seems to be effective for enhancing lactate clearance and counteracting DOMS, but the type of foam roller does not seem to influence the recovery rate.

Effectiveness of exercise on fatigue in hemodialysis patients: a randomized controlled trial

BACKGROUND

Hemodialysis is one of the common therapies in patients with end-stage renal disease. Even patients who receive regular treatment suffer from fatigue, which is one of the main factors leading to poor quality of life. This study aimed to determine the effectiveness of exercising on mini-bikes on fatigue in hemodialysis patients.

METHODS

This study is a randomized controlled clinical trial. Thirty-seven hemodialysis patients participated in the study. The patients were randomly allocated to either the intervention group (n = 20) or the control group (n = 17). The participants in the intervention group exercised on mini-bikes for 20 min twice a week for 3 months. The patients' fatigue was measured four times during and after the intervention. Multidimensional Fatigue Inventory was used to measure the fatigue level. The total score in the MFI is 4 to 20 for each domain, with the resulting total fatigue score ranging from 20 to 100; thus, the higher the score, the higher the level of fatigue. Data were analyzed by SPSS 18. The repeated measures ANOVA was used to compare the fatigue scores within each group and between the groups at different times.

RESULTS

The mean score of fatigue in the intervention group at the beginning was 58.80 ± 15.29, which steadily decreased to 58.78 ± 13.54, 58.75 ± 14.73, 54.20 ± 15.16, and 54.23 ± 13.60 for the 3 months of intervention and 1 month post-intervention, respectively. In contrast, in the control group, this score was 62.53 ± 16.32 in the beginning, increasing to 64.03 ± 13.91, 64.22 ± 13.07, 69.53 ± 9.22, for the 3 months of intervention and 70.34 ± 7.69 one-month post-intervention. There were significant differences between the intervention group and the control group in the third month (P = 0.001) and 1 month after the intervention (P < 0.001).

CONCLUSIONS

The results showed that rehabilitation through exercising using mini-bikes had a significant impact on preventing further fatigue build-up in hemodialysis patients, making the mini-bike an effective non-pharmaceutical intervention preventing the increase in fatigue experienced by patients undergoing hemodialysis.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials: IRCT20180314039100N1. Registered 10 June 2018.

Is active recovery during cold water immersion better than active or passive recovery in thermoneutral water for postrecovery high-intensity sprint interval performance?

High-intensity exercise is impaired by increased esophageal temperature (T_es) above 38 °C and/or decreased muscle temperature. We compared the effects of three 30-min recovery strategies following a first set of three 30-s Wingate tests (set 1), on a similar postrecovery set of Wingate tests (set 2). Recovery conditions were passive recovery in thermoneutral (34 °C) water (Passive-TN) and active recovery (underwater cycling; ∼33% maximum power) in thermoneutral (Active-TN) or cold (15 °C) water (Active-C). T_es rose for all conditions by the end of set 1 (∼1.0 °C). After recovery, T_es returned to baseline in both Active-C and Passive-TN but remained elevated in Active-TN (p < 0.05). At the end of set 2, T_es was lower in Active-C (37.2 °C) than both Passive-TN (38.1 °C) and Active-TN (38.8 °C) (p < 0.05). From set 1 to 2 mean power did not change with Passive-TN (+0.2%), increased with Active-TN (+2.4%; p < 0.05), and decreased with Active-C (-3.2%; p < 0.05). Heart rate was similar between conditions throughout, except at end-recovery; it was lower in Passive-TN (92 beats·min^-1) than both exercise conditions (Active-TN, 126 beats·min^-1; Active-C, 116 beats·min^-1) (p < 0.05). Although Active-C significantly reduced T_es, the best postrecovery performance occurred with Active-TN. Novelty An initial set of 3 Wingates increased T_es to ∼38 °C. Thirty minutes of Active-C was well tolerated, and decreased T_es and blood lactate to baseline values, but decreased subsequent Wingate performance.

Accelerating Recovery from Exercise-Induced Muscle Injuries in Triathletes: Considerations for Olympic Distance Races

The triathlon is one of the fastest developing sports in the world due to expanding participation and media attention. The fundamental change in Olympic triathlon races from a single to a multistart event is highly demanding in terms of recovery from and prevention of exercise-induced muscle injures. In elite and competitive sports, ultrastructural muscle injuries, including delayed onset muscle soreness (DOMS), are responsible for impaired muscle performance capacities. Prevention and treatment of these conditions have become key in regaining muscular performance levels and to guarantee performance and economy of motion in swimming, cycling and running. The aim of this review is to provide an overview of the current findings on the pathophysiology, as well as treatment and prevention of, these conditions in compliance with clinical implications for elite triathletes. In the context of DOMS, the majority of recovery interventions have focused on different protocols of compression, cold or heat therapy, active regeneration, nutritional interventions, or sleep. The authors agree that there is a compelling need for further studies, including high-quality randomized trials, to completely evaluate the effectiveness of existing therapeutic approaches, particularly in triathletes. The given recommendations must be updated and adjusted, as further evidence emerges.

Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response

It is widely believed that an active cool-down is more effective for promoting post-exercise recovery than a passive cool-down involving no activity. However, research on this topic has never been synthesized and it therefore remains largely unknown whether this belief is correct. This review compares the effects of various types of active cool-downs with passive cool-downs on sports performance, injuries, long-term adaptive responses, and psychophysiological markers of post-exercise recovery. An active cool-down is largely ineffective with respect to enhancing same-day and next-day(s) sports performance, but some beneficial effects on next-day(s) performance have been reported. Active cool-downs do not appear to prevent injuries, and preliminary evidence suggests that performing an active cool-down on a regular basis does not attenuate the long-term adaptive response. Active cool-downs accelerate recovery of lactate in blood, but not necessarily in muscle tissue. Performing active cool-downs may partially prevent immune system depression and promote faster recovery of the cardiovascular and respiratory systems. However, it is unknown whether this reduces the likelihood of post-exercise illnesses, syncope, and cardiovascular complications. Most evidence indicates that active cool-downs do not significantly reduce muscle soreness, or improve the recovery of indirect markers of muscle damage, neuromuscular contractile properties, musculotendinous stiffness, range of motion, systemic hormonal concentrations, or measures of psychological recovery. It can also interfere with muscle glycogen resynthesis. In summary, based on the empirical evidence currently available, active cool-downs are largely ineffective for improving most psychophysiological markers of post-exercise recovery, but may nevertheless offer some benefits compared with a passive cool-down.