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.

Recovery effects of repeated exposures to normobaric hyperoxia on local muscle fatigue

Reported recovery effects of hyeroxia are conflicted. This study aimed to identify the effects and the mechanisms of normobaric hyperoxia on the recovery of local muscle fatigue, which is the most commonly encountered form of fatigue both daily and in training and competitions. Twelve male subjects performed 3 × 3 × no less than 30 seconds of isometric quadriceps exercise at 70% of maximum voluntary isometric contraction (MVIC) separated by two 15-minute recovery sessions under 1 of 2 different atmospheric oxygen concentrations, one in normoxia (NOX; 20.9% O2) and another in hyperoxia (HOX; 30.0% O2). To assess the degree of fatigue and recovery, 4 parameters were used; MVIC, endurance time to exhaustion, blood lactate, and perceived exertion measured by a visual analog scale (VAS). Maximum voluntary isometric contraction improved an average by approximately 14% in HOX compared with NOX at the conclusion of the second recovery session. However, this was not associated with changes in other parameters because changes in endurance time, blood lactate, and VAS during the trials were similar. Based on our findings, we conclude that 2 sets of 15-minute recovery session in normobaric hyperoxia are effective for restoring MVIC from local muscle fatigue induced by intermittent intense exercises. For quicker recovery, athletes are recommended to repeat 15-minute recovery process under 30.0% hyperoxia.

The influence of soccer playing actions on the recovery kinetics after a soccer match

This study examined the relationship between the frequency of playing actions performed during a soccer match and the recovery kinetics after the match. Time motion analyses were performed on 10 professional soccer players during 4 competitive matches (14 observations) to determine the number of playing actions completed by players. Subjective ratings, creatine kinase, and physical tests (countermovement jump [CMJ], isometric maximum voluntary contraction of the hamstrings, 6-second sprint on a nonmotorized treadmill) were performed before the match and 24 hours, 48 hours, and 72 hours after the match. During the 72-hour recovery period, CMJ, isometric strength of the hamstring muscles, and peak sprint speed significantly (p ≤ 0.05) decreased, whereas muscle soreness increased (p ≤ 0.05). Significant correlations were observed between the increase in muscle soreness and number of short sprints (<5 m) performed at 48 hours (r = 0.74; confidence interval [CI], 0.35-0.91; p < 0.01) and 72 hours (r = 0.57; CI, 0.05-0.84; p ≤ 0.05) after match play. A significant relationship (r = -0.55; CI, -0.84 to -0.03; p ≤ 0.05) was also observed between CMJ performance decrement at 24 hours and the number of hard changes in direction performed. Soccer match play resulted in significant neuromuscular fatigue for up to 72 hours after match and was dependent on the number of sprints and hard changes in direction performed during the match. Time motion analysis data currently used during a soccer match should quantify hard changes in direction, acceleration and deceleration phases to enable better estimations of postmatch fatigue.

Effects of exposure to normobaric hyperoxia on the recovery of local muscle fatigue in the quadriceps femoris of young people

[Purpose] Acute development of local muscle fatigue and recovery often become large issues on sports fields. This study aimed to identify the effects of normobaric hyperoxia on the recovery of local muscle fatigue. [Subjects] Eleven healthy males participated in this study, and they all completed two protocols in a random order. [Methods] Subjects performed single-leg isometric knee extension at 70% of their maximum voluntary isometric contraction (MVIC) for as long as possible. Each participant was subsequently treated with one of two recovery conditions: 20.9% O₂ or 30.0% O₂ for 30 minutes. Afterwards, they performed an identical isometric task to measure the extent of their recovery. The following parameters were used to assess the degrees of muscle fatigue: MVIC, endurance time, surface electromyography (sEMG) power spectra, and changes in hemoglobin concentration using near-infrared spectroscopy (NIRS). [Results] The treatment of 30.0% O₂ induced a significant recovery rate in MVIC compared to the 20.9% O₂. Additionally, the data revealed a significantly higher concentration of total hemoglobin after the 30.0% O₂ treatment than after the 20.9% O₂ treatment. [Conclusion] The results of this study suggest that recovery from acute muscle fatigue can be better facilitated under 30.0% normobaric hyperoxia than a normoxic condition. Therefore, for cases requiring quicker full recovery, treatment under 30.0% O₂ environment for 30 minutes is recommended.

Effects of Electrostimulation Therapy on Recovery From Acute Team-Sport Activity

Purpose:

To assess the efficacy of a 1-off electrostimulation treatment as a recovery modality from acute teamsport exercise, directly comparing the benefits to contrast water therapy.

Methods:

Ten moderately trained male athletes completed a simulated team-game circuit (STGC). At the conclusion of exercise, participants then completed a 30-min recovery modality of either electrostimulation therapy (EST), contrast water therapy (CWT), or a passive resting control condition (CON). Twenty-four hours later, participants were required to complete a modified STGC as a measure of next-day performance. Venous blood samples were collected preexercise and 3 and 24 h postexercise. Blood samples were analyzed for circulating levels of interleukin-6 (IL-6) and C-reactive protein (CRP).

Results:

The EST trial resulted in significantly faster sprint times during the 24-h postrecovery than with CON (P < .05), with no significant differences recorded between EST and CWT or between CWT and CON (P > .05). There were no differences in IL-6 or CRP across all trials. Finally, the perception of recovery was significantly greater in the EST trial than in the CWT and CON (P < .05).

Conclusions:

These results suggest that a 1-off treatment with EST may be beneficial to perceptual recovery, which may enhance next-day performance.