An attempt to improve Ferreira-Junior model concerning the anti-inflammatory action of whole-body cryotherapy after exercise induced muscular damage (EIMD)

Pre-exercise cryotherapy reduces myoglobin and creatine kinase levels after eccentric muscle stress in young women

Introduction: The aim of this study was to investigate the effect of pre-exercise whole-body cryotherapy (WBC) on muscle damage indicators following eccentric treadmill exercise in young women. Methods: Twenty-seven participants underwent two 1-h downhill treadmill runs, replicating 60% of their maximal oxygen uptake, with a 4-week intermission for recovery and treatment application. In this intermission, one group underwent 20 sessions of WBC, delivered five times a week at -120°C for 3 min each, while the comparison group received no such treatment. Markers of muscle injury-serum myoglobin concentration, creatine kinase and lactate dehydrogenase activity and also uric acid, and cell-free DNA concentration-were measured before and after downhill runs. Results: The study observed a notable reduction in post-exercise myoglobin and CK levels in the WBC group after the second running session. Discussion: The results suggest that WBC can have a protective effects against muscle damage resulting from eccentric exercise.

Correlation between skin temperature in the lower limbs and biochemical marker, performance data, and clinical recovery scales

The aim of this study was to evaluate the correlation between tools commonly used in the detection of physiological changes, such as clinical complaints, a biochemical marker of muscle injury, and performance data during official matches, with infrared thermography, which has been commonly used in the possible tracking of musculoskeletal injuries in athletes. Twenty-two athletes from a professional soccer club (age 27.7 ± 3.93 years; BMI 24.35 ± 1.80 kg/cm²) were followed during the season of a national championship, totaling 19 matches with an interval of 7 days between matches. At each match, the athletes used a Global Positioning System (GPS) device to collect performance data. Forty-eight hours after each match, every athlete’s perception of recovery, fatigue, and pain was documented. Blood was collected for creatine kinase (CK) analysis, and infrared thermography was applied. Only athletes who presented pain above 4 in either limb were included for thermographic analysis. Each thermographic image was divided into 14 regions of interest. For statistical analysis, we included only the images that showed differences ≥ 1° C. Data normality was verified by the Kolmogorov-Smirnov test with Dallal-Wilkinson-Lilliefors correction. We used the Pearson correlation coefficient to verify the correlation between infrared thermography and the biochemical marker, performance data, and clinical recovery scales. No correlation was observed between mean skin temperature and blood CK levels, pain level, perception of recovery, and fatigue perception (r <0.2, p>0.05). Thus, infrared thermography did not correlate with CK level, pain, fatigue perception, or recovery, nor with performance variables within the field.

Whole body and partial body cryotherapies - lessons from human practice and possible application for horses

Whole body and partial body cryotherapies (WBC and PBC) have been successfully used in human medicine, and currently also are being proposed in veterinary practice.

In horses, only the partial body cryotherapy provided in cryosauna is considered, due to the technical conditions. These therapies have been dedicated to human patients with rheumatic and inflammatory diseases as well as an assistance during training in athletes. The anti-inflammatory effects have been demonstrated clinically and indicated by the changes in several hematological and immunological parameters, however, various patterns have been described, depending on the protocols and the treating subjects. The numbers of white blood cells and the differential counts either increased or remained unchanged but the cytokine concentrations generally changed towards various anti-inflammatory profiles and the modifications of immunological molecules having paracrine effects have been reported.

In equine practice, local cold therapies have been successfully used, so the therapy in cryosauna, which allows for a much shorter procedure with much lower temperature seems promising.

Thermal Sensations during a Partial-Body Cryostimulation Exposure in Elite Basketball Players

Partial-body cryostimulation is used to improve recovery after exercise, especially during competitions or heavy training; however, a limited number of studies have been conducted with international-level athletes in situ during competitions. This study was undertaken to assess the thermal sensation ratings during 3 min of cold exposure (at –130°C) in 24 international-level athletes during the European Basketball Championship. The mean thermal sensation score, measured using a perceptive scale, increased significantly (p < 0.05) during partial-body cryostimulation exposure in athletes from 3.0 ± 1.7 at 30 s to 5.7 ± 2.3 at 3 min (maximal observed value = 10.0). The mean value of 5.7 is considered a “cold” sensation on the scale (ranging from 0 = neutral sensation to 10 = very cold). However, we observed a large inter-individual variation in the perceived thermal sensations. The body mass index was significantly and negatively correlated with the thermal sensation value after 2 min 30 s and 3 min of exposure in females (r = –0.61, n = 13, p < 0.05; r = –0.56, n = 13, p = 0.054, respectively). Three participants reported high perceived thermal sensation after 30 s of exposure and their cold-induced discomfort worsened as the exposure continued. In conclusion, a 3-min exposure is globally well tolerated by athletes and can be used during a heavy competition period and/or during a training period. However, special attention should be given to female athletes with a low body mass index as they seem to be much more sensitive to cold.

An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis

Introduction: The aim of the present work was to perform a meta-analysis evaluating the impact of recovery techniques on delayed onset muscle soreness (DOMS), perceived fatigue, muscle damage, and inflammatory markers after physical exercise. Method: Three databases including PubMed, Embase, and Web-of-Science were searched using the following terms: ("recovery" or "active recovery" or "cooling" or "massage" or "compression garment" or "electrostimulation" or "stretching" or "immersion" or "cryotherapy") and ("DOMS" or "perceived fatigue" or "CK" or "CRP" or "IL-6") and ("after exercise" or "post-exercise") for randomized controlled trials, crossover trials, and repeated-measure studies. Overall, 99 studies were included. Results: Active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy induced a small to large decrease (-2.26 < g < -0.40) in the magnitude of DOMS, while there was no change for the other methods. Massage was found to be the most powerful technique for recovering from DOMS and fatigue. In terms of muscle damage and inflammatory markers, we observed an overall moderate decrease in creatine kinase [SMD (95% CI) = -0.37 (-0.58 to -0.16), I2 = 40.15%] and overall small decreases in interleukin-6 [SMD (95% CI) = -0.36 (-0.60 to -0.12), I2 = 0%] and C-reactive protein [SMD (95% CI) = -0.38 (-0.59 to-0.14), I2 = 39%]. The most powerful techniques for reducing inflammation were massage and cold exposure. Conclusion: Massage seems to be the most effective method for reducing DOMS and perceived fatigue. Perceived fatigue can be effectively managed using compression techniques, such as compression garments, massage, or water immersion.

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.