Effect of whole-body cryotherapy on recovery after high-intensity training in elite rowers

The purpose of this study was to investigate the effect of whole-body cryotherapy (WBC) on acute recovery after a single high-intensity training day. Twelve elite professional male rowers from the national aquatic training base. They were randomly divided into a WBC group (n = 6) and a control group (CON group, n = 6). They performed a high-intensity training program, with a single session immediately followed by WBC (-110°C, 3 min) or recovered naturally for 3 min (CON group). Rowing performance, skin temperature, heart rate, blood pressure, and blood lactate concentrations were recorded before training, immediately, 5 min, and 15 min after the intervention. Blood samples were collected early in the morning of the day of intervention and that of the following day. The results indicated that 1) the blood lactate concentrations after WBC were significantly lower than pre-training (p < 0.05); 2) the maximum power significantly decreased immediately after WBC compared to pre-training (p < 0.05); 3) a significant main effect of time was observed for average speed, which significantly decreased after WBC (p < 0.05); 4) a significant main effect of time for blood parameters was observed. Specifically, hematocrit, cortisol, and hemoglobin were significantly lower after WBC than pre-intervention, whereas testosterone/cortisol was significantly higher than pre-intervention (p < 0.05). The results of this study showed that a single session of WBC had a positive effect on accelerating the elimination of blood lactate after HIT, but did not significantly change rowing performance and physiological parameters. A single session of WBC was not an effective strategy for elite rowers for acute recovery after HIT.

Chill Without Thrill: A Crossover Study on Whole-Body Cryotherapy and Postmatch Recovery in High-Level Youth Basketball Players

PURPOSE

To assess the effect of whole-body cryotherapy (WBC) on postmatch recovery in basketball.

METHODS

Using a crossover design, 17 youth male players (age 16.2 [1.2] y, stature 190.5 [9.4] cm, body mass 79.2 [9.6] kg, experience 9.9 [3.9] y) completed 2 simulated matches, followed by WBC (4 min, -75 to - 85 °C) or a placebo intervention (CON). Countermovement-jump height, change-of-direction performance, 10- and 20-m sprint times, heart-rate variability (log-transformed squared root of the mean sum of the squared differences between R-R intervals [Ln-rMSSD]), muscle soreness, and perceived recovery (Perceived Recovery Status Scale [PRS]) were recorded at prematch, postmatch, postrecovery, and 24 hours postmatch. Additionally, Ln-rMSSD was recorded upon awakening on match day and the following morning.

RESULTS

Compared with CON, higher PRS values were reported in WBC at prematch and postrecovery (P ≤ .026), while no significant between-interventions differences were found for any other measure (P > .05). Regarding the effect of time, our findings revealed that 20-m sprint times, Ln-rMSSD, and PRS deteriorated in both interventions from prematch to postmatch (ie, acute changes, P ≤ .045), while muscle soreness worsened in WBC only (P ≤ .003). Conversely, countermovement-jump height, change-of-direction, and 10-m sprint performance were unaffected by match play in the acute phase (P > .05), while none of the investigated measures showed impairments at 24 hours postmatch, compared with prematch (P > .05).

CONCLUSIONS

Overall, these findings suggest that WBC was mostly ineffective for improving postexercise recovery in the investigated sample, with benefits observed for perceived recovery being potentially influenced by the participants' status at baseline (ie, higher prematch PRS scores in WBC compared with CON).

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.

Cold-water immersion and whole-body cryotherapy attenuate muscle soreness during 3 days of match-like tennis protocol

PURPOSE

This study aimed to investigate the effect of whole-body cryotherapy (WBC), cold-water immersion (CWI) and passive recovery (PAS) on tennis recovery.

METHODS

Thirteen competitive male tennis players completed three consecutive match-like tennis protocols, followed by recovery (WBC, CWI, PAS) in a crossover design. Five tennis drills and serves were performed using a ball machine to standardize the fatiguing protocol. Maximal voluntary contraction (MVC) peak torque, creatine kinase activity (CK), muscle soreness, ball accuracy and velocity together with voluntary activation, low- and high-frequency torque and EMG activity were recorded before each protocol and 24 h following the third protocol.

RESULTS

MVC peak torque (- 7.7 ± 11.3%; p = 0.001) and the high- to low-frequency torque ratio (- 10.0 ± 25.8%; p < 0.05) decreased on Day 1 but returned to baseline on Day 2, Day 3 and Day 4 (p = 0.052, all p > 0.06). The CK activity slightly increased from 161.0 ± 100.2 to 226.0 ± 106.7 UA L-1 on Day 1 (p = 0.001) and stayed at this level (p = 0.016) across days with no differences between recovery interventions. Muscle soreness increased across days with PAS recovery (p = 0.005), while no main effect of time was neither observed with WBC nor CWI (all p > 0.292). The technical performance was maintained across protocols with WBC and PAS, while it increased for CWI on Day 3 vs Day 1 (p = 0.017).

CONCLUSION

Our 1.5-h tennis protocol led to mild muscle damage, though neither the neuromuscular function nor the tennis performance was altered due to accumulated workload induced by consecutive tennis protocols. The muscle soreness resulting from tennis protocols was similarly alleviated by both CWI and WBC.

TRIAL REGISTRATION

IRB No. 2017-A02255-48, 12/05/2017.

The Acute Demands of Repeated-Sprint Training on Physiological, Neuromuscular, Perceptual and Performance Outcomes in Team Sport Athletes: A Systematic Review and Meta-analysis

BACKGROUND

Repeated-sprint training (RST) involves maximal-effort, short-duration sprints (≤ 10 s) interspersed with brief recovery periods (≤ 60 s). Knowledge about the acute demands of RST and the influence of programming variables has implications for training prescription.

OBJECTIVES

To investigate the physiological, neuromuscular, perceptual and performance demands of RST, while also examining the moderating effects of programming variables (sprint modality, number of repetitions per set, sprint repetition distance, inter-repetition rest modality and inter-repetition rest duration) on these outcomes.

METHODS

The databases Pubmed, SPORTDiscus, MEDLINE and Scopus were searched for original research articles investigating overground running RST in team sport athletes ≥ 16 years. Eligible data were analysed using multi-level mixed effects meta-analysis, with meta-regression performed on outcomes with ~ 50 samples (10 per moderator) to examine the influence of programming factors. Effects were evaluated based on coverage of their confidence (compatibility) limits (CL) against elected thresholds of practical importance.

RESULTS

From 908 data samples nested within 176 studies eligible for meta-analysis, the pooled effects (± 90% CL) of RST were as follows: average heart rate (HRavg) of 163 ± 9 bpm, peak heart rate (HRpeak) of 182 ± 3 bpm, average oxygen consumption of 42.4 ± 10.1 mL·kg-1·min-1, end-set blood lactate concentration (B[La]) of 10.7 ± 0.6 mmol·L-1, deciMax session ratings of perceived exertion (sRPE) of 6.5 ± 0.5 au, average sprint time (Savg) of 5.57 ± 0.26 s, best sprint time (Sbest) of 5.52 ± 0.27 s and percentage sprint decrement (Sdec) of 5.0 ± 0.3%. When compared with a reference protocol of 6 × 30 m straight-line sprints with 20 s passive inter-repetition rest, shuttle-based sprints were associated with a substantial increase in repetition time (Savg: 1.42 ± 0.11 s, Sbest: 1.55 ± 0.13 s), whereas the effect on sRPE was trivial (0.6 ± 0.9 au). Performing two more repetitions per set had a trivial effect on HRpeak (0.8 ± 1.0 bpm), B[La] (0.3 ± 0.2 mmol·L-1), sRPE (0.2 ± 0.2 au), Savg (0.01 ± 0.03) and Sdec (0.4; ± 0.2%). Sprinting 10 m further per repetition was associated with a substantial increase in B[La] (2.7; ± 0.7 mmol·L-1) and Sdec (1.7 ± 0.4%), whereas the effect on sRPE was trivial (0.7 ± 0.6). Resting for 10 s longer between repetitions was associated with a substantial reduction in B[La] (-1.1 ± 0.5 mmol·L-1), Savg (-0.09 ± 0.06 s) and Sdec (-1.4 ± 0.4%), while the effects on HRpeak (-0.7 ± 1.8 bpm) and sRPE (-0.5 ± 0.5 au) were trivial. All other moderating effects were compatible with both trivial and substantial effects [i.e. equal coverage of the confidence interval (CI) across a trivial and a substantial region in only one direction], or inconclusive (i.e. the CI spanned across substantial and trivial regions in both positive and negative directions).

CONCLUSIONS

The physiological, neuromuscular, perceptual and performance demands of RST are substantial, with some of these outcomes moderated by the manipulation of programming variables. To amplify physiological demands and performance decrement, longer sprint distances (> 30 m) and shorter, inter-repetition rest (≤ 20 s) are recommended. Alternatively, to mitigate fatigue and enhance acute sprint performance, shorter sprint distances (e.g. 15-25 m) with longer, passive inter-repetition rest (≥ 30 s) are recommended.

Salivary Markers Responses in the Post-Exercise and Recovery Period: A Systematic Review

The use of saliva to monitor immune and hormonal responses in training, competitions, and during recovery is an easy and non-invasive alternative means of collecting samples compared to serum collection. Saliva can provide insight into a number of interesting biomarkers such as cortisol, testosterone, immunoglobulins, alpha-amylase, and melatonin, among others. High-intensity and exhaustive exercises, such as training or competition, provide variations in immune, protein and hormonal markers. An adequate recovery period, calming down, and recovery methods can contribute to a fast normalization of these markers, decreasing illness, as well as the likelihood of overtraining and injuries, but their effectiveness is still inconclusive. The aim of this review was to investigate the evidence of salivary markers in post-exhaustive exercise during the recovery period. This study is a systematic review from three electronic databases with studies from 2011 to 2021 within healthy humans. The search found 213 studies, and after applying the inclusion and exclusion criteria, while excluding duplicated studies, 14 studies were included in this review. The most cited salivary markers were cortisol and testosterone, as well as their ratio, alpha-amylase and IgA. Half of the studies applied a variety of recovery methods that showed controversial results over salivary markers' impact. However, they showed an impact on the markers from the exercise, which was still dependent on exercise intensity, methodology, and duration.

Determining the capacity for effort and recovery of the elite soccer players specialized in different playing positions

Background

The capacity for effort and recovery in performance sports can be increased by means of modern methodological strategies. This capacity to recover after intense matches and training helps to determine the performance in soccer. Using the Yumeiho technique will accelerate the exercise capacity recovery of the soccer players specialized in central zone positions.

Methods

The research was conducted with the C.S. Internațional Bălești team, formed of 16 players, aged 19-37 years, divided into two groups: experimental group A, n = 8 with central area players and control group B, n = 8 with players from side zones. Measurement and assessment tests: determining lactic acid level (LAC) in blood; 60 m sprinting speed motor test (ST); anaerobic lactic exercise; Gacon Test for evaluating the aerobic power; VO2max test; Dorgo Test for determining the individual recovery capacity; Sleep Quality and Efficiency Index (PSQI) and sleep duration. Means used in the recovery strategy: easy running, static stretching, cryotherapy; Yumeiho therapy was applied only to group A to accelerate the recovery.

Results

The anaerobic lactic capacity was evaluated by 60 m sprint test at the beginning and the end of the research. The results highlight the increase of the sprinting speed by 0.08 s in group A (p < 0.001). The aerobic capacity evaluated by means of Gacon Test in both groups shows the value 23.7%, namely a well-prepared level (p < 0.001). VO2max value in the soccer players of group A shows 87.5% good aerobic power, while the players of group B have 50% good aerobic power (p < 0.001). The concentration of LAC after exercise has a higher value in group A (p > 0.05). The level of recovery after exercise is improved in both groups, with larger differences in group A (very good level, p < 0.001). The PSQI grew by 20.37% in group A and by 11% in group B. The sleep duration increased in both groups (p < 0.001). The results of the correlation analysis in the soccer players of group A highlight strong connections of 14.8% while in group B the value is 12.5%.

Conclusion

The assessment of effort capacity in soccer players specialized in different playing positions at the beginning and the end of the research highlights the increase of the anaerobic lactic effort and aerobic effort. This assessment also shows the improvement of the individual recovery capacity. A higher PSQI and the increase of sleep duration in both groups, with greater differences of group A were found, which determined their level of capacity for effort and recovery. The use of the Yumeiho technique in the program of post-exercise recovery accelerates the aerobic and anaerobic lactic effort capacity of the soccer players specialized in the central zone positions. It positively influences exercise capacity recovery in general.

Effects of treatment dosage of whole-body cryotherapy upon post-match recovery of endocrine and biochemical markers in elite rugby league players: An experimental study

Background and Aims

The use of whole-body cryotherapy (WBC) for athletic recovery is becoming increasingly popular despite the lack of evidence supporting the dosage parameters in its implementation. The aim of the current study was to investigate the dose-response effects of WBC following match-play in elite rugby league players.

Methods

We observed endocrine (salivary cortisol and testosterone) and biochemical (creatine kinase) responses following three separate post-match recovery periods in elite rugby league players. Comparisons were made between a single exposure (3 min at -120°C to --135°C) of WBC to two consecutive exposures (2 × 3 min), to a control (no exposure) during the recovery trials. Recovery characteristics were measured 36 h prematch, immediately postmatch, and 60 h postmatch.

Results

Cortisol concentrations remained unchanged in its pattern of response during the postmatch recovery periods across all WBC doses. Testosterone concentrations increased significantly (p < 0.0005) at 60 h, in the WBC2 trial. The Testosterone:Cortisol ratio increased significantly (p < 0.0005) at 60 h in the WBC2 trial, while during the WBC0 trial it did not recover to baseline levels. No significant effect on creatine kinase concentration was observed, although a statistical trend was shown in WBC2 for improved reduction of this marker at 60 h.

Conclusions

These findings suggest that two, consecutive exposures to WBC immediately following fatiguing rugby league competition appear to stimulate an increase to the anabolic endocrine profile of participants by 60 h post-match, and may reduce the CK concentration. Coaches and athletes should consider the treatment dosage of WBC when used to optimize the desired response following a high-stress environment.

Timing of Preexercise Partial-Body Cryotherapy Exposure to Promote Jump Performance

PURPOSE

This study evaluated the effect of partial-body cryotherapy (PBC) exposure 1, 2, or 3 hours before maximal-effort jump performance, salivary enzyme concentration, perceived readiness, and well-being.

METHODS

Male team-sport players (N = 27; 24.2 [3.6] y; 91.5 [13.2] kg) were exposed to a blinded bout of PBC (-135°C [6°C]) and control (-59°C [17°C]) either 1, 2, or 3 hours prior to countermovement jumps. Passive saliva samples were collected to determine α-amylase concentration. Self-reported performance readiness and well-being questionnaires were completed using a 1-5 Likert scale.

RESULTS

Differences in the change in mean countermovement jump velocity and absolute power between PBC and control were unclear at 1 hour (+1.9% [5.3%], P = .149; +0.7% [10.6%], P = .919; mean difference [90% confidence limits]), 2 hours (+3.3% [2.7%], P = .196; +7.8% [7.4%], P = .169), and 3 hours postexposure (+3.1% [3.3%], P = .467; +0.7% [4.8%], P = .327). Salivary α-amylase concentration was elevated 15 minutes postexposure in the 1-hour (+61% [14%], P = .008) and 2-hour groups (+55% [12%], P = .013). The increase in self-reported performance readiness was higher after PBC (+2.4 [1.2] units, P = .046) in the 2-hour group and by 1.4 (1.1) units (P = .023) after 3 hours. Mental fatigue was favorably decreased 2 hours after PBC exposure (+0.5 [0.1], P = .041).

CONCLUSIONS

An acute exposure of PBC elicits potentially favorable but unclear changes in countermovement jump performance. The PBC enhances salivary α-amylase concentration and perceived performance readiness, reduces mental fatigue, and could be useful in sport-specific training or competitions.

The Physiological Profile Following Two Popular Cold Interventions After Activity in Hot and Humid Environment

This research aims to describe and compare the effects of partial-body cryotherapy (PBC) and cold-water immersion (CWI) on the physiological responses of soccer players after cycling in a hot and humid environment. Sixteen elite soccer players participated in three experiments, and received CWI (13°C for 15 min), PBC (110°C−140°C for 3 min), and CON (room temperature: 21°C ± 2°C), respectively, after aerobic and anaerobic cycling in a hot and humid environment (temperature: 35°C–38°C; humidity: 60%–70%). Heart rate (HR), blood lactate (BLa-), perfusion index (PI), oxygen saturation (SaO₂), core temperature (Tc), skin temperature (Ts), and rating of perceived exertion (RPE) were assessed at baseline and through 20 min (5-min intervals). HR was lower in CWI than CON after 20 min (p < .05). SaO₂ was higher in CWI than PBC and CON between 10 and 20 min (p < .05). Tc was lower from CWI and PBC than CON between 10 and 20 min (p < .05). Ts was lower in PBC than CWI between 15 and 20 min (p < .05). RPE was lower in PBC than CON 20 min after the exercise (p < .05). No main group differences for BLa- and PI were observed. The physiological effects of PBC are generally similar to CWI. Compared with CON, both CWI and PBC could promote the recovery of physiological indexes within 20 min of exercise in a hot and humid environment. However, PBC can lead to a decrease in SaO₂ due to excessive nitrogen inhalation.

Cryostimulation for Post-exercise Recovery in Athletes: A Consensus and Position Paper

Recovery after exercise is a crucial key in preventing muscle injuries and in speeding up the processes to return to homeostasis level. There are several ways of developing a recovery strategy with the use of different kinds of traditional and up-to-date techniques. The use of cold has traditionally been used after physical exercise for recovery purposes. In recent years, the use of whole-body cryotherapy/cryostimulation (WBC; an extreme cold stimulation lasting 1-4 min and given in a cold room at a temperature comprised from -60 to -195°C) has been tremendously increased for such purposes. However, there are controversies about the benefits that the use of this technique may provide. Therefore, the main objectives of this paper are to describe what is whole body cryotherapy/cryostimulation, review and debate the benefits that its use may provide, present practical considerations and applications, and emphasize the need of customization depending on the context, the purpose, and the subject's characteristics. This review is written by international experts from the working group on WBC from the International Institute of Refrigeration.

Pre-Exercise Whole- or Partial-Body Cryotherapy Exposure to Improve Physical Performance: A Systematic Review

Whole- (WBC) and partial-body cryotherapy (PBC) are commonly used sports medicine modalities for the treatment of injury and exercise recovery. Physiological and perceptual effects have the potential to be utilised in a novel application that involves pre-exercise WBC and PBC exposure to improve physical performance. A systematic literature search of multiple databases was conducted in July 2021 to identify and evaluate the effects of pre-exercise exposure of WBC or PBC on physical performance measures, and any potential translational effects. The following inclusion criteria were applied: (1) use of WBC or PBC exposure pre-exercise, (2) use of WBC or PBC in healthy and/or athletic populations, (3) control group was used in the data collection, and (4) investigated physiological, psychosocial or direct physical performance impacts of pre-exercise cryotherapy exposure. A total of 759 titles were identified, with twelve relevant studies satisfying the inclusion criteria after full-text screening. The twelve studies were categorised into three key areas: performance testing (n = 6), oxidative stress response (n = 4) and lysosomal enzyme activity (n = 2). The potential for eliciting favourable physical and physiological responses from pre-exercise WBC or PBC is currently unclear with a paucity of good quality research available. Furthermore, a lack of standardisation of cryotherapy protocols is a current challenge.

Acute effect of HIIT on testosterone and cortisol levels in healthy individuals: A systematic review and meta-analysis

To determine the acute effect of a single high-intensity interval training (HIIT) session on testosterone and cortisol levels in healthy individuals, a systematic search of studies was conducted in MEDLINE and Web of Science databases from inception to February 2020. Meta-analyses were performed to establish the acute effect of HIIT on testosterone and cortisol levels immediately after a single HIIT session; after 30 min and 60 min (primary outcomes); and after 120 min, 180 min, and 24 h (secondary outcomes, only for pre-post intervention groups). Potential effect-size modifiers were assessed by meta-regression analyses and analyses of variance. Study quality was assessed using the Cochrane's risk of bias tool and the Physiotherapy Evidence Database scale. The meta-analyses of 10 controlled studies (213 participants) and 50 pre-post intervention groups (677 participants) revealed a significant increase in testosterone immediately after a single HIIT session (d = 0.92 and 0.52, respectively), which disappeared after 30 min (d = 0.18 and -0.04), and returned to baseline values after 60 min (d = -0.37 and -0.16). Significant increases of cortisol were found immediately after (d = 2.17 and 0.64), after 30 min (d = 1.62 and 0.67) and 60 min (d = 1.32 and 0.27). Testosterone and cortisol levels decreased significantly after 120 min (d = -0.48 and -0.95, respectively) and 180 min (d = -0.29 and -1.08), and returned to baseline values after 24 h (d = 0.14 and -0.02). HIIT components and participant's characteristics seem to moderate the effect sizes. In conclusion, testosterone and cortisol increase immediately after a single HIIT session, then drop below baseline levels, and finally return to baseline values after 24 h. This meta-analysis provides a better understanding of the acute endocrine response to a single HIIT session, which would certainly be valuable for both clinicians and coaches in the prescription of exercise programs to improve health and performance. Testosterone and cortisol may be used as sensitive biomarkers to monitor the anabolic and catabolic response to HIIT.

Multiple Cryotherapy Attenuates Oxi-Inflammatory Response Following Skeletal Muscle Injury

The oxi-inflammatory response is part of the natural process mobilizing leukocytes and satellite cells that contribute to clearance and regeneration of damaged muscle tissue. In sports medicine, a number of post-injury recovery strategies, such as whole-body cryotherapy (WBC), are used to improve skeletal muscle regeneration often without scientific evidence of their benefits. The study was designed to assess the impact of WBC on circulating mediators of skeletal muscle regeneration. Twenty elite athletes were randomized to WBC group (3-min exposure to −120 °C, twice a day for 7 days) and control group. Blood samples were collected before the first WBC session and 1 day after the last cryotherapy exposure. WBC did not affect the indirect markers of muscle damage but significantly reduced the generation of reactive oxygen and nitrogen species (H₂O₂ and NO) as well as the concentrations of serum interleukin 1β (IL-1β) and C-reactive protein (CRP). The changes in circulating growth factors, hepatocyte growth factor (HGF), insulin-like growth factor (IGF-1), platelet-derived growth factor (PDGF^BB), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF), were also reduced by WBC exposure. The study demonstrated that WBC attenuates the cascade of injury–repair–regeneration of skeletal muscles whereby it may delay skeletal muscle regeneration.

No Effect of Partial-Body Cryotherapy on Restoration of Countermovement Jump or Well-Being Performance in Elite Rugby Union Players During the Competitive Phase of the Season

PURPOSE

Partial body cryotherapy (PBC) has been shown to be beneficial for postexercise recovery; however, no study has demonstrated the effectiveness of PBC for recovery following elite rugby union training. Rugby union is a unique sport that involves high-velocity collisions and may induce greater performance decrements than other sports; thus, PBC could be beneficial. The application of PBC in "real world" has rarely been investigated during the competitive phase of a playing season and warranted investigation.

METHODS

In a counterbalanced sequential research design, professional rugby athletes (n = 18; age 25.4 [4.0] y; training age 7.2 [4.0] y; mass 99.8 [10.6] kg; height 188.3 [6.0] cm) were assigned to a 12-week PBC intervention, washout period (4 wk), and reassessed as their own controls. Self-reported well-being, muscle soreness, sleep quality, and countermovement jump height were assessed before and 40 hours after "real-world" training. Wilcoxon signed-rank tests and Cohen d were used for statistical analysis.

RESULTS

No differences were observed between PBC and control conditions (P > .05; d = 0.00-0.14) for well-being (-0.02% [0.08%] vs 0.01% [0.06%]), muscle soreness (-0.01% [0.11%] vs 0.01% [0.16%]), sleep quality (-0.03% [0.14%] vs 0.10% [0.29%]), or countermovement jump height (36.48-36.59 vs 38.13-37.52 cm; P = .54).

CONCLUSIONS

These results suggest PBC is ineffective for the restoration of selected performance parameters during the performance maintenance phase of the competitive season. To ascertain the appropriation of its use, future investigations should seek to assess the use of cryotherapies at various phases of the elite rugby union competitive season.

Effects of External Counterpulsation on Postexercise Recovery in Elite Rugby League Players

PURPOSE

External counterpulsation (ECP) has previously been used to treat cardiac patients via compression of the lower extremities during diastole to increase venous return and coronary perfusion. However, the effects of ECP on exercise performance and markers of recovery in elite athletes are largely unknown.

METHODS

On 2 separate occasions, 48 h apart, 7 elite National Rugby League players performed an identical 60-min field-based conditioning session followed by a 30-min period of either regular ECP treatment or placebo. Power measures during repeated cycle bouts and countermovement jump height and contraction time derivatives were measured at rest and 5 h postexercise. Saliva samples and venous blood samples were taken at rest, postexercise, and 5 h postexercise to assess stress, inflammation, and muscle damage.

RESULTS

After ECP treatment, cycling peak power output (P = .028; 11%) and accumulated peak power (P = .027; 14%) increased compared with the placebo condition. Postexercise plasma interleukin 1 receptor antagonist only increased after ECP (P = .024; 84%), and concentrations of plasma interleukin 1 receptor antagonist tended to be higher (P = .093; 76%) 5 h postexercise. Furthermore, testosterone-to-cortisol ratio was increased above baseline and placebo 5 h postexercise (P = .017-.029; 24-77%). The ratio of postexercise salivary α-amylase to immunoglobulin A decreased after treatment (P = .013; 50%) compared with the placebo control.

CONCLUSIONS

Exercise performance and hormonal indicators of stress were improved and inflammation markers were reduced following acute ECP.

Whole-body cryotherapy does not augment adaptations to high-intensity interval training

The aim of this study was to investigate the effects of regular post-exercise whole-body cryotherapy (WBC) on physiological and performance adaptations to high-intensity interval training (HIT). In a two-group parallel design, twenty-two well-trained males performed four weeks of cycling HIT, with each session immediately followed by 3 min of WBC (−110 °C) or a passive control (CON). To assess the effects of WBC on the adaptive response to HIT, participants performed the following cycling tests before and after the training period; a graded exercise test (GXT), a time-to-exhaustion test (T_max), a 20-km time trial (20_TT), and a 120-min submaximal test (SM₁₂₀). Blood samples were taken before and after training to measure changes in basal adrenal hormones (adrenaline, noradrenaline, and cortisol). Sleep patterns were also assessed during training via wrist actigraphy. As compared with CON, the administration of WBC after each training session during four weeks of HIT had no effect on peak oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{{\rm{V}}}$$\end{document}V˙O_2peak) and peak aerobic power (P_peak) achieved during the GXT, T_max duration and work performed (W_Tmax), 20_TT performance, substrate oxidation during the SM₁₂₀, basal adrenaline/noradrenaline/cortisol concentrations, or sleep patterns (P > 0.05). These findings suggest that regular post-exercise WBC is not an effective strategy to augment training-induced aerobic adaptations to four weeks of HIT.

Whole-Body Cryotherapy: Potential to Enhance Athlete Preparation for Competition?

The final hours of preparation before competition are important for performance. Recovery, preparation and warm up protocols are evolving continuously and include passive and active modalities often developed by "trial and error" approaches. Passive modalities, such as whole-body cryotherapy (WBC), have the potential to enhance both recovery and preparation. Whole-body cryotherapy has generally been used within a recovery setting after competition or strenuous training for athletes, and in clinical settings for the general population. However, the acute hormonal, anti-inflammatory, perceptual and psychological responses yielded by a single, or repeated, bouts of WBC indicate that this practice could enhance an athlete's competition readiness when used alongside traditional elements of active warm-ups in the hours before competition in addition to aiding recovery in the hours after. Here we summarize and evaluate the acute effects of WBC exposures on physiological, performance and perceptual responses, and examine the likelihood these responses could theoretically translate into enhanced athletic performance. The potential to enhance an athlete's performance using acute passive WBC exposure is a novel intervention that requires further investigation.

Whole-body cryotherapy (-110 °C) following high-intensity intermittent exercise does not alter hormonal, inflammatory or muscle damage biomarkers in trained males

PURPOSE

This study examined the acute effects of a single session of Whole-body Cryotherapy (WBC) following severe intermittent running exercise on biomarkers of inflammation, muscle damage and stress.

METHODS

Endurance-trained males (n = 11) were tested twice using a within-participant, balanced cross-over design that consisted of 5 × 5 min of high-intensity running (HIR) followed by either 3 min of WBC at -110 °C or a passive control condition (CON). Before the HIR and after 60 min of recovery a ramp-test was completed. At seven time points up to 24 hrs post exercise venous blood samples were analyzed for serum levels of interleukin 6 (IL-6), interleukin 10 (IL-10), c-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1), myoglobin, cortisol, and testosterone.

RESULTS

HIR induced significant increases in all biomarkers except sICAM-1 in both recovery conditions, respectively. Compared to the CON condition WBC did not attenuate exercise- induced changes in IL-6, IL-10, sICAM-1, myoglobin, cortisol, testosterone or their ratio. Increased levels of cortisol following exercise were negatively correlated with subsequent running performance in both conditions (WBC: r = -0.61, p = 0.04; CON: r = -0.64, p = 0.04).

CONCLUSION

The results of this study suggest that the postulated physiological mechanisms by which WBC is proposed to improve recovery, i.e. reductions in inflammation and muscle damage, may not be accurate.

Effects of a capacitive-resistive electric transfer therapy on physiological and biomechanical parameters in recreational runners: A randomized controlled crossover trial

OBJECTIVES

This study compared the effects of a capacitive-resistive electric transfer therapy (Tecar) and passive rest on physiological and biomechanical parameters in recreational runners when performed shortly after an exhausting training session.

DESIGN

Randomized controlled crossover trial.

SETTING

University biomechanical research laboratory.

PARTICIPANTS

Fourteen trained male runners MAIN OUTCOME MEASURES: Physiological (running economy, oxygen uptake, respiratory exchange ratio, ventilation, heart rate, blood lactate concentration) and biomechanical (step length; stride angle, height, frequency, and contact time; swing time; contact phase; support phase; push-off phase) parameters were measured during two incremental treadmill running tests performed two days apart after an exhaustive training session.

RESULTS

When running at 14 km/h and 16 km/h, the Tecar treatment group presented greater increases in stride length (p < 0.001), angle (p < 0.05) and height (p < 0.001) between the first and second tests than the control group and, accordingly, greater decreases in stride frequency (p < 0.05). Physiological parameters were similar between groups.

CONCLUSIONS

The present study suggests that a Tecar therapy intervention enhances biomechanical parameters in recreational runners after an exhaustive training session more than passive rest, generating a more efficient running pattern without affecting selected physiological parameters.

Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature

Nowadays, whole-body cryotherapy is a medical physical treatment widely used in sports medicine. Recovery from injuries (e.g., trauma, overuse) and after-season recovery are the main purposes for application. However, the most recent studies confirmed the anti-inflammatory, anti-analgesic, and anti-oxidant effects of this therapy by highlighting the underlying physiological responses. In addition to its therapeutic effects, whole-body cryotherapy has been demonstrated to be a preventive strategy against the deleterious effects of exercise-induced inflammation and soreness. Novel findings have stressed the importance of fat mass on cooling effectiveness and of the starting fitness level on the final result. Exposure to the cryotherapy somehow mimics exercise, since it affects myokines expression in an exercise-like fashion, thus opening another possible window on the therapeutic strategies for metabolic diseases such as obesity and type 2 diabetes. From a biochemical point of view, whole-body cryotherapy not always induces appreciable modifications, but the final clinical output (in terms of pain, soreness, stress, and post-exercise recovery) is very often improved compared to either the starting condition or the untreated matched group. Also, the number and the frequency of sessions that should be applied in order to obtain the best therapeutic results have been deeply investigated in the last years. In this article, we reviewed the most recent literature, from 2010 until present, in order to give the most updated insight into this therapeutic strategy, whose rapidly increasing use is not always based on scientific assumptions and safety standards.