The comparison of cold-water immersion and cold air therapy on maximal cycling performance and recovery markers following strength exercises

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.

The Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-Analysis

Background

Several studies have examined the effect of creatine monohydrate (CrM) on indirect muscle damage markers and muscle performance, although pooled data from several studies indicate that the benefits of CrM on recovery dynamics are limited.

Objective

This systematic review and meta-analysis determined whether the ergogenic effects of CrM ameliorated markers of muscle damage and performance following muscle-damaging exercises.

Methods

In total, 23 studies were included, consisting of 240 participants in the CrM group (age 23.9 ± 10.4 years, height 178 ± 5 cm, body mass 76.9 ± 7.6 kg, females 10.4%) and 229 participants in the placebo group (age 23.7 ± 8.5 years, height 177 ± 5 cm, body mass 77.0 ± 6.6 kg, females 10.0%). These studies were rated as fair to excellent following the PEDro scale. The outcome measures were compared between the CrM and placebo groups at 24–36 h and 48–90 h following muscle-damaging exercises, using standardised mean differences (SMDs) and associated p-values via forest plots. Furthermore, sub-group analyses were conducted by separating studies into those that examined the effects of CrM as an acute training response (i.e., after one muscle-damaging exercise bout) and those that examined the chronic training response (i.e., examining the acute response after the last training session following several weeks of training).

Results

According to the meta-analysis, the CrM group exhibited significantly lower indirect muscle damage markers (i.e., creatine kinase, lactate dehydrogenase, and/or myoglobin) at 48–90 h post-exercise for the acute training response (SMD − 1.09; p = 0.03). However, indirect muscle damage markers were significantly greater in the CrM group at 24 h post-exercise (SMD 0.95; p = 0.04) for the chronic training response. Although not significant, a large difference in indirect muscle damage markers was also found at 48 h post-exercise (SMD 1.24) for the chronic training response. The CrM group also showed lower inflammation for the acute training response at 24–36 h post-exercise and 48–90 h post-exercise with a large effect size (SMD − 1.38 ≤ d ≤  − 1.79). Similarly, the oxidative stress markers were lower for the acute training response in the CrM group at 24–36 h post-exercise and 90 h post-exercise, with a large effect size (SMD − 1.37 and − 1.36, respectively). For delayed-onset muscle soreness (DOMS), the measures were lower for the CrM group at 24 h post-exercise with a moderate effect size (SMD − 0.66) as an acute training response. However, the inter-group differences for inflammation, oxidative stress, and DOMS were not statistically significant (p > 0.05).

Conclusion

Overall, our meta-analysis demonstrated a paradoxical effect of CrM supplementation post-exercise, where CrM appears to minimise exercise-induced muscle damage as an acute training response, although this trend is reversed as a chronic training response. Thus, CrM may be effective in reducing the level of exercise-induced muscle damage following a single bout of strenuous exercises, although training-induced stress could be exacerbated following long-term supplementation of CrM. Although long-term usage of CrM is known to enhance training adaptations, whether the increased level of exercise-induced muscle damage as a chronic training response may provide potential mechanisms to enhance chronic training adaptations with CrM supplementation remains to be confirmed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01640-z.

The effect of branched-chain amino acid on muscle damage markers and performance following strenuous exercise: a systematic review and meta-analysis

This systematic review and meta-analysis determined whether the ergogenic effects of branched-chain amino acids (BCAA) ameliorated markers of muscle damage and performance following strenuous exercise. In total, 25 studies were included, consisting of 479 participants (age 24.3 ± 8.3 years, height 1.73 ± 0.06 m, body mass 70.8 ± 9.5 kg, females 26.3%). These studies were rated as fair to excellent following the PEDro scale. The outcome measures were compared between the BCAA and placebo conditions at 24 and 48 hours following muscle-damaging exercises, using standardised mean differences and associated p-values via forest plots. Our meta-analysis demonstrated significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) at 48 hours post-exercise (standardised mean difference [SMD] = -0.41; p < 0.05) for the BCAA than placebo conditions, whilst muscle soreness was significant at 24 hours post-exercise (SMD = -0.28 ≤ d ≤ -0.61; p < 0.05) and 48 hours post-exercise (SMD = -0.41 ≤ d≤ -0.92; p < 0.01). However, no significant differences were identified between the BCAA and placebo conditions for muscle performance at 24 or 48 hours post-exercise (SMD = 0.08 ≤ d ≤ 0.21; p > 0.05). Overall, BCAA reduced the level of muscle damage biomarkers and muscle soreness following muscle-damaging exercises. However, the potential benefits of BCAA for muscle performance recovery is questionable and warrants further investigation to determine the practicality of BCAA for ameliorating muscle damage symptoms in diverse populations. PROSPERO registration number: CRD42020191248. Novelty: BCAA reduces the level of creatine kinase and muscle soreness following strenuous exercise with a dose-response relationship. BCAA does not accelerate recovery for muscle performance.

Effect of Exercise-Induced Muscle Damage on Bowling-Specific Motor Skills in Male Adolescent Cricketers

The current study examined the acute effects of a bout of resistance training on cricket bowling-specific motor performance. Eight sub-elite, resistance-untrained, adolescent male fast bowlers (age 15 ± 1.7 years; height 1.8 ± 0.1 m; weight 67.9 ± 7.9 kg) completed a bout of upper and lower body resistance exercises. Indirect markers of muscle damage (creatine kinase [CK] and delayed onset of muscle soreness [DOMS]), anaerobic performance (15-m sprint and vertical jump), and cricket-specific motor performance (ball speed, run-up time, and accuracy) were measured prior to and 24 (T24) and 48 (T48) hours following the resistance training bout. The resistance training bout significantly increased CK (~350%; effect size [ES] = 1.89-2.24), DOMS (~240%; ES = 1.46-3.77) and 15-m sprint times (~4.0%; ES = 1.33-1.47), whilst significantly reducing vertical jump height (~7.0%; ES = 0.76-0.96) for up to 48 h. The ball speed (~3.0%; ES = 0.50-0.61) and bowling accuracy (~79%; ES = 0.39-0.70) were significantly reduced, whilst run-up time was significantly increased (~3.5%; ES = 0.36-0.50) for up to 24 h. These findings demonstrate that a bout of resistance training evokes exercise-induced muscle damage amongst sub-elite, adolescent male cricketers, which impairs anaerobic performance and bowling-specific motor performance measures. Cricket coaches should be cautious of incorporating bowling sessions within 24-h following a bout of resistance training for sub-elite adolescent fast bowlers, particularly for those commencing a resistance training program.

Selected root plant supplementation reduces indices of exercise-induced muscle damage: A systematic review and meta-analysis

This systematic review and meta-analysis examined the effects of selected root plants (curcumin, ginseng, ginger and garlic) on markers of muscle damage and muscular performance measures following muscle-damaging protocols. We included 25 studies (parallel and crossover design) with 353 participants and used the PEDro scale to appraise each study. Forest plots were generated to report on standardised mean differences (SMD) and p-values at 24 and 48 hours following the muscle-damaging protocols. The meta-analysis showed that the supplemental (SUPP) condition showed significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) and muscle soreness at 24 hours and 48 hours (p < 0.01) than the placebo (PLA) condition. The inflammatory markers were significantly lower for the SUPP condition than the PLA condition at 24 hours (p = 0.02), although no differences were identified at 48 hours (p = 0.40). There were no significant differences in muscular performance measures between the SUPP and PLA conditions at 24 hours and 48 hours (p > 0.05) post-exercise. According to our qualitative data, a number of studies reported a reduction in oxidative stress (e.g., malondialdehyde, superoxide dismutase) with a concomitant upregulation of anti-oxidant status, although other studies showed no effects. Accordingly, selected root plants minimised the level of several biomarkers of muscle damage, inflammation and muscle soreness during periods of exercise-induced muscle damage. However, the benefits of these supplements in ameliorating oxidative stress, increasing anti-oxidant status and accelerating recovery of muscular performance appears equivocal, warranting further research in these outcome measures.

Resistance Training Acutely Impairs Agility and Spike-Specific Performance Measures in Collegiate Female Volleyball Players Returning from the Off-Season

This study examined the acute effects of resistance training (RT) on volleyball-specific performance. Sixteen female volleyball players undertook their initial, pre-season RT bout. Countermovement jump (CMJ), delayed onset of muscle soreness (DOMS), and sport-specific performances (i.e., run-up jump, agility, and spiking speed and accuracy) were measured before, 24 (T24), and 48 (T48) hours after RT. A significant increase in DOMS was observed at T24 and T48 (~207.6% ± 119.3%; p < 0.05; ES = 1.8 (95% CI: 0.94–2.57)), whilst agility was significantly impaired at T48 (1.7% ± 2.5%; p < 0.05; ES = 0.30 (95% CI: −0.99–0.40)). However, there were no differences in CMJ (~−2.21% ± 7.6%; p > 0.05; ES = −0.11 (95% CI: −0.80–0.58)) and run-up jump (~−1.4% ± 4.7%; p > 0.05; ES = −0.07 (95% CI: −0.76–0.63)). Spiking speed was significantly reduced (−3.5% ± 4.4%; p < 0.05; ES = −0.28 (95% CI: −0.43–0.97)), although accuracy was improved (38.3% ± 81.4%: p < 0.05) at T48. Thus, the initial, preseason RT bout compromised agility and spiking speed for several days post-exercise. Conversely, spiking accuracy improved, suggesting a speed–accuracy trade-off. Nonetheless, at least a 48-h recovery may be necessary after the initial RT bout for athletes returning from the off-season or injury.

Training Considerations for Optimising Endurance Development: An Alternate Concurrent Training Perspective

Whilst the "acute hypothesis" was originally coined to describe the detrimental effects of concurrent training on strength development, similar physiological processes may occur when endurance training adaptations are compromised. There is a growing body of research indicating that typical resistance exercises impair neuromuscular function and endurance performance during periods of resistance training-induced muscle damage. Furthermore, recent evidence suggests that the attenuating effects of resistance training-induced muscle damage on endurance performance are influenced by exercise intensity, exercise mode, exercise sequence, recovery and contraction velocity of resistance training. By understanding the influence that training variables have on the level of resistance training-induced muscle damage and its subsequent attenuating effects on endurance performance, concurrent training programs could be prescribed in such a way that minimises fatigue between modes of training and optimises the quality of endurance training sessions. Therefore, this review will provide considerations for concurrent training prescription for endurance development based on scientific evidence. Furthermore, recommendations will be provided for future research by identifying training variables that may impact on endurance development as a result of concurrent training.

The Effect of a Resistance Training Session on Physiological and Thermoregulatory Measures of Sub-maximal Running Performance in the Heat in Heat-Acclimatized Men

BACKGROUND

The current study examined the acute effects of a lower body resistance training (RT) session on physiological and thermoregulatory measures during a sub-maximal running protocol in the heat in heat-acclimatized men. Ten resistance-untrained men (age 27.4 ± 4.1 years; height 1.78 ± 0.06 m; body mass 76.8 ± 9.9 kg; peak oxygen uptake 48.2 ± 7.0 mL kg^-1 min^-1) undertook a high-intensity RT session at six-repetition maximum. Indirect muscle damage markers (i.e., creatine kinase [CK], delayed-onset muscle soreness [DOMS], and countermovement jump [CMJ]) were collected prior to, immediately post and 24 and 48 h after the RT session. The sub-maximal running protocol was performed at 70% of the ventilatory threshold, which was conducted prior to and 24 and 48 h following the RT session to obtain physiological and thermoregulatory measures.

RESULTS

The RT session exhibited significant increases in DOMS (p < 0.05; effect size [ES]: 1.41-10.53), whilst reduced CMJ (p < 0.05; ES: - 0.79-1.41) for 48 h post-exercise. There were no differences in CK (p > 0.05), although increased with moderate to large ES (0.71-1.12) for 48 h post-exercise. The physiological cost of running was increased for up to 48 h post-exercise (p < 0.05) with moderate to large ES (0.50-0.84), although no differences were shown in thermoregulatory measures (p > 0.05) with small ES (0.33).

CONCLUSION

These results demonstrate that a RT session impairs sub-maximal running performance for several days post-exercise, although thermoregulatory measures are unperturbed despite elevated muscle damage indicators in heat-acclimatized, resistance untrained men. Accordingly, whilst a RT session may not increase susceptibility to heat-related injuries in heat-acclimatized men during sub-maximal running in the heat, endurance sessions should be undertaken with caution for at least 48 h post-exercise following the initial RT session in resistance untrained men.

Implications of Impaired Endurance Performance following Single Bouts of Resistance Training: An Alternate Concurrent Training Perspective

A single bout of resistance training induces residual fatigue, which may impair performance during subsequent endurance training if inadequate recovery is allowed. From a concurrent training standpoint, such carry-over effects of fatigue from a resistance training session may impair the quality of a subsequent endurance training session for several hours to days with inadequate recovery. The proposed mechanisms of this phenomenon include: (1) impaired neural recruitment patterns; (2) reduced movement efficiency due to alteration in kinematics during endurance exercise and increased energy expenditure; (3) increased muscle soreness; and (4) reduced muscle glycogen. If endurance training quality is consistently compromised during the course of a specific concurrent training program, optimal endurance development may be limited. Whilst the link between acute responses of training and subsequent training adaptation has not been fully established, there is some evidence suggesting that cumulative effects of fatigue may contribute to limiting optimal endurance development. Thus, the current review will (1) explore cross-sectional studies that have reported impaired endurance performance following a single, or multiple bouts, of resistance training; (2) identify the potential impact of fatigue on chronic endurance development; (3) describe the implications of fatigue on the quality of endurance training sessions during concurrent training, and (4) explain the mechanisms contributing to resistance training-induced attenuation on endurance performance from neurological, biomechanical and metabolic standpoints. Increasing the awareness of resistance training-induced fatigue may encourage coaches to consider modulating concurrent training variables (e.g., order of training mode, between-mode recovery period, training intensity, etc.) to limit the carry-over effects of fatigue from resistance to endurance training sessions.

Whole body cryotherapy, cold water immersion, or a placebo following resistance exercise: a case of mind over matter?

PURPOSE

The use of cryotherapy as a recovery intervention is prevalent amongst athletes. Performance of high volume, heavy load resistance exercise is known to result in disturbances of muscle function, perceptual responses and blood borne parameters. Therefore, this study investigated the influence of cold water immersion (CWI), whole body cryotherapy (WBC) or a placebo (PL) intervention on markers of recovery following an acute resistance training session.

METHODS

24 resistance trained males were matched into a CWI (10 min at 10 °C), WBC (3- and 4 min at - 85 °C) or PL group before completing a lower body resistance training session. Perceptions of soreness and training stress, markers of muscle function, inflammation and efflux of intracellular proteins were assessed before, and up to 72 h post exercise.

RESULTS

The training session resulted in increased soreness, disturbances of muscle function, and increased inflammation and efflux of intracellular proteins. Although WBC attenuated soreness at 24 h, and positively influenced peak force at 48 h compared to CWI and PL, many of the remaining outcomes were trivial, unclear or favoured the PL condition. With the exception of CRP at 24 h, neither cryotherapy intervention attenuated the inflammatory response compared to PL.

CONCLUSION

There was some evidence to suggest that WBC is more effective than CWI at attenuating select perceptual and functional responses following resistance training. However, neither cryotherapy intervention was more effective than the placebo treatment at accelerating recovery. The implications of these findings should be carefully considered by individuals employing cryotherapy as a recovery strategy following heavy load resistance training.

Intermittent living; the use of ancient challenges as a vaccine against the deleterious effects of modern life - A hypothesis

Chronic non-communicable diseases (CNCD) are the leading cause of mortality in developed countries. They ensue from the sum of modern anthropogenic risk factors, including high calorie nutrition, malnutrition, sedentary lifestyle, social stress, environmental toxins, politics and economic factors. Many of these factors are beyond the span of control of individuals, suggesting that CNCD are inevitable. However, various studies, ours included, show that the use of intermittent challenges with hormetic effects improve subjective and objective wellbeing of individuals with CNCD, while having favourable effects on immunological, metabolic and behavioural indices. Intermittent cold, heat, fasting and hypoxia, together with phytochemicals in multiple food products, have widespread influence on many pathways related with overall health. Until recently, most of the employed challenges with hormetic effects belonged to the usual transient live experiences of our ancestors. Our hypothesis; we conclude that, whereas the total inflammatory load of multi-metabolic and psychological risk factors causes low grade inflammation and aging, the use of intermittent challenges, united in a 7-10 days lasting hormetic intervention, might serve as a vaccine against the deleterious effects of chronic low grade inflammation and it's metabolic and (premature) aging consequences.

The repeated bout effect of traditional resistance exercises on running performance across 3 bouts

This study investigated the repeated bout effect of 3 typical lower body resistance-training sessions on maximal and submaximal effort running performance. Twelve resistance-untrained men (age, 24 ± 4 years; height, 1.81 ± 0.10 m; body mass, 79.3 ± 10.9 kg; peak oxygen uptake, 48.2 ± 6.5 mL·kg^-1·min^-1; 6-repetition maximum squat, 71.7 ± 12.2 kg) undertook 3 bouts of resistance-training sessions at 6-repetitions maximum. Countermovement jump (CMJ), lower-body range of motion (ROM), muscle soreness, and creatine kinase (CK) were examined prior to and immediately, 24 h (T24), and 48 h (T48) after each resistance-training bout. Submaximal (i.e., below anaerobic threshold (AT)) and maximal (i.e., above AT) running performances were also conducted at T24 and T48. Most indirect muscle damage markers (i.e., CMJ, ROM, and muscle soreness) and submaximal running performance were significantly improved (P < 0.05; 1.9%) following the third resistance-training bout compared with the second bout. Whilst maximal running performance was also improved following the third bout (P < 0.05; 9.8%) compared with other bouts, the measures were still reduced by 12%-20% versus baseline. However, the increase in CK was attenuated following the second bout (P < 0.05) with no further protection following the third bout (P > 0.05). In conclusion, the initial bout induced the greatest change in CK; however, at least 2 bouts were required to produce protective effects on other indirect muscle damage markers and submaximal running performance measures. This suggests that submaximal running sessions should be avoided for at least 48 h after resistance training until the third bout, although a greater recovery period may be required for maximal running sessions.