Abstract
Purpose
The aim of the current study was to evaluate the effects of local cryotherapy on the main symptoms of exercise-induced muscle damage (EIMD) through a systematic literature review.
Methods
A search on Cochrane CENTRAL, MEDLINE (PubMed), Lilacs and PEDro databases was carried out from inception to March 2018. Studies that performed a protocol of muscle damage induction, and used local cryotherapy as intervention in comparison with control group/placebo were eligible. The studies should evaluate at least one of the outcomes of interest (delayed onset muscle soreness (DOMS) or muscle strength). Studies that did not evaluate any of the variables of interest or applied ice massage or other cooling modalities were excluded.
Results
The search identified 221 studies, in which 7 studies met the eligibility criteria and were included. There was a mean PEDro score of 7.28, and all studies were ranked as high methodological quality. Meta-analysis showed local cryotherapy does not seem to be effective to accelerate recovery of DOMS (− 0.11; 95% CI − 0.8 to 0.57; I2: 79%) or muscle strength (− 0.59; 95% CI − 2.89 to 1.71; I2: 0%) following EIMD.
Conclusion
In conclusion, the results showed that local cryotherapy does not seem to contribute for the improvement of DOMS and muscle weakness associated with EIMD.
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Introduction
Muscle damage (DM) can occur in muscular structures—membranes, Z-line, sarcolemma, T-tubules, and myofibrils—as a consequence of the imposition of a mechanical overload [1]. In the literature, the onset of muscle damage associated with an inflammatory process after exercise is well documented [2, 3]. In addition, it is known that, among strength exercises, there is a higher incidence of exercise-induced muscle damage (EIMD) after exercises involving eccentric contraction [4, 5]. Many indirect markers have been used to evaluate muscle damage, but delayed onset muscle soreness (DOMS) and strength are the most remarkable ones.
Currently, cryotherapy modalities are widely used in the treatment of subjective (DOMS) and objective (strength) recovery characteristics [6, 7]. The cooling of the tissue is believed to produce a decrease in blood flow, tissue temperature, and metabolism, leading to a limitation of edema formation and a reduction of cells death by secondary hypoxia, protecting the muscle cells [8]. Cryotherapy can be applied in a variety of ways such as cold-water immersion (CWI) [9], whole-body cryotherapy (WBC) [7], partial-body cryotherapy (PBC) [10] and local cryotherapy [11]. There is a growing body of evidence elucidating the positive effects of CWI [12], WBC [13] and PBC [14]. However, those cooling strategies are more applicable in sports context [15] and have limited insertion in clinical practice. Local cryotherapy, on the other hand, might be a more practical and affordable option in a clinical environment, which justifies the need to investigate its potential effects. Furthermore, little is known about the optimal dosage of local cryotherapy. Periods of application between 15 and 20 min are often prescribed, but whether this time is appropriate and sufficient to generate benefits remains unknown.
Although local cryotherapy is more compatible with clinical practice, there is no consensus in scientific research regarding its effectiveness. Review studies that have analyzed the effects of cryotherapy on the symptoms related to EIMD emphasize WBC [6] and CWI [7, 16, 17]. To this date, no review studies have specifically examined the influence of local cryotherapy on subjective and objective markers of EIMD, and it remains uncertain whether local cryotherapy has any potential to accelerate recovery from symptoms of EIMD. Therefore, the aim of the present systematic review and meta-analysis is to verify the effects of local cryotherapy on the treatment of DOMS and muscle weakness related to EIMD. We hypothesized that local cryotherapy would help decrease DOMS and attenuate loss of strength following EIMD.
Methods
The current study utilized PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) guidelines for Systematic Reviews and Meta-analysis [18]. The PRISMA is a checklist containing the 27 items that must be included in a systematic review.
Data sources and searches
We searched the following electronic databases (from inception to March 2018): MEDLINE (accessed by PubMed), Physiotherapy Evidence Database (PEDro), The Cochrane Central Register of Controlled Trials (Cochrane CENTRAL), and Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (LILACS). In addition, we searched the references of published studies. The search was performed for the last time in April 2018. The search comprised the following terms: “Cryotherapy”, “muscle damage”, “delayed onset muscle soreness”, “exercise induced muscle damage” combined with a high sensitivity combination of words used in the search for randomized clinical trials [19]. We included publications in English. For the combination of the keywords, we utilized the Boolean terms AND, and OR. The complete search strategy used for the MEDLINE database is shown in Table 1.
Eligibility criteria
We included randomized clinical trials (RCT) and controlled clinical trials (CCT). Studies that applied a muscle damage protocol, performed cryotherapy as a therapy in comparison with a control group, and evaluated DOMS and/or strength were included. The following exclusion criteria were used: (1) samples comprised of people with any disease/dysfunction, (2) samples of people under 18 or over 40 years old; (3) non-application of local cryotherapy; (4) non assessment of some of the outcomes of interest; (5) cross-over designs.
Studies selection and data extraction
Two investigators independently evaluated titles and abstracts of all articles identified by the search strategy. All abstracts that did not provide sufficient information regarding the inclusion and exclusion criteria were selected for full-text evaluation. In the second phase, the same reviewers independently evaluated the full-text articles and made their selection in accordance with the eligibility criteria. Disagreements between reviewers were solved by consensus or through a third person review. Using standardized forms, the same two reviewers independently conducted data extraction with regard to the methodological characteristics of the studies, number of participants, age, groups, interventions, outcomes and results. Disagreements were also solved by consensus. DOMS and strength were the outcomes extracted. To improve the clarity of the information provided, the term “strength” is going to be used to refer the muscle ability to produce force.
Quality assessment
The methodological quality of the studies was evaluated using a scale developed by the PEDro database. Based on the Delphi concept, its overall score reliability is sufficient for use in systematic reviews of physical therapy RCTs [20]. The scale contains 11 items and for each criteria defined in the scale, a point (1) is attributed to the presence of quality indicators of the presented evidence, and zero point (0) is attributed to the absence of these indicators. Each satisfied item (except the first) contributes one point to the final score, which is obtained by summing all positive responses. In the present systematic review, the cutoff point of six (6) points was adopted to define the methodological quality of the studies. Thus, the articles were classified as high methodological quality when six or more criteria were positive and of low methodological quality when their score was less than five points.
Data synthesis and analysis
Pooled-effect estimates were obtained by post-intervention values [21]. Calculations were performed using a random-effects method. P value ≤ 0.05 and confidence interval of 95% (95% CI) were considered statistically significant. Statistical heterogeneity of the treatment effects among studies was assessed using Cochran’s Q test and the inconsistency I2 test, in which values above 25% and 50% were considered indicative of moderate and high heterogeneity, respectively [22]. The effect size (ES) between intervention and control groups was calculated using the Cohen’s d formula: ES = (Mgroup1 − Mgroup2)/SDpooled, where Mgroup1 is the mean of the post-values of the intervention group, Mgroup2 is the mean of the post-values of the control group, and SDpooled is the pooled standard deviation of the intervention and control groups measurements. All analyses were conducted using Review Manager version 5.3. We explored heterogeneity between studies by re-running the meta-analyses removing one paper at a time to check whether some individual study explained heterogeneity. The main outcome used in the meta-analysis was DOMS and strength.
Results
Identification of the studies
The search strategy yielded 221 articles, among which 19 studies were considered as potentially relevant and retrieved for detailed analysis. Seven of these studies met the eligibility criteria and were included in the systematic review (n = 222), but only 6 studies had suitable data for the meta-analysis (n = 182). Figure 1 shows the flow diagram of the studies included in this review and Table 2 summarizes the characteristics of these studies.
Risk of bias
Regarding the methodological quality of the studies evaluated through the PEDro scale, all included studies were considered of high quality, with scores varying from six to nine points. The mean scores of all studies were 7.28 points. The complete score of each of the studies is described in Table 3. From the analysis of the PEDro scale, it was found that statistical comparisons between groups were reported in all included studies for at least one outcome (criterion 10). In addition, all studies clearly defined criteria 2, 4, 8 and 11, respectively: random assignment of subjects to groups; similarity between groups regarding the most important prognostic indicators; measures of at least one primary endpoint in more than 85% sample; and presence of measures of variability and precision in at least one key result. It is not possible to blind either participants or therapists during local therapy. Therefore, the criteria 5 (blindness of participants) and 6 (blindly of the therapists) were not met by any study. Item 7 (blindness of the evaluators) were filled by four studies.
Description of the studies
From the seven studies selected, six evaluated the effect of cryotherapy on EIMD using application of crushed ice at the site of interest [11, 23,24,25,26,27], and one using a cooling apparatus [28]. The groups for comparison included: control, TENS (transcutaneous electrical nerve stimulation) placebo, TENS, TENS associated with ice, photobiomodulation therapy.
The studies showed a great divergence regarding the protocols of muscle damage induction (series, repetitions, rest time between sets, load, type of contraction and muscle group). Regarding the muscle groups analyzed, three studies induced muscle damage on elbow flexors [24, 25, 27], one in knee flexors [11], two in knee extensors [26, 28], and one on ankle plantar flexors [23].
As for the intervention protocols, six studies applied cryotherapy in the injured area for 20 min [11, 24,25,26,27,28] and one study [23] calculated the time of the intervention according to the amount of subcutaneous tissue of the subject, ranging from 15 to 60 min. The duration of interventions ranged from immediately after protocol of muscle damage induction up to 96 h after, with a frequency of cryotherapy application ranging from 1 to 3 times per day.
Effects of interventions
Delayed onset muscle soreness
All included studies in the present review evaluated DOMS and used the visual analog pain scale (EVA) to evaluate it. However, only five studies provided suitable data for meta-analysis. The analysis showed that cryotherapy is not effective to improve DOMS at any of the time points evaluated (− 0.11; 95% CI − 0.8 to 0.57; I2: 79%; Fig. 2).
Muscle strength
Six studies evaluated muscle strength. Four did so through the maximal voluntary isometric contraction (MVIC) of the muscle group of interest [11, 25,26,27]; one evaluated the peak of concentric and eccentric peak torque [24], and one evaluated peak power output [28]. However, only two studies had sufficiently homogeneous data for the meta-analysis. The analysis showed that cryotherapy is not effective to accelerate strength recovery at any of the time points evaluated (− 0.59; 95% CI − 2.89 to 1.71; I2: 0%; Fig. 3).
Discussion
The aim of this systematic review of the literature was to determine the efficacy of local cryotherapy for the treatment of subjective (DOMS) and objective (strength) symptoms associated with EIMD. After a complete analysis of the included articles, seven studies were included in the present review. DOMS and strength were chosen as outcome measures, because they are the variables most commonly investigated. Contrary to our hypothesis, it can be suggested that local cryotherapy is not effective in accelerating recovery of either DOMS or strength.
It is known that the decrease in tissue temperature reduces the oxygen demand, cellular metabolic activity and attenuates the release of vasodilators, reducing the microcirculatory overload by the decrease in circulating blood volume [8]. This, in turn, attenuates the hydrostatic pressure in the endothelial cell, decreasing the formation of edema. Furthermore, the decrease in blood flow causes a reduction in the formation of hematomas and muscle spasm associated with possible pain relief [29]. In addition, there is a decrease in nerve transmission caused by tissue cooling, which would reduce the release of acetylcholine and possibly stimulate inhibitory surface cells to increase the pain threshold [30].
Currently, there are three main common cryotherapy modalities used in sport: cold-water immersion (CWI), whole-body cryotherapy (WBC), partial-body cryotherapy (PBC). During CWI, the water is maintained at temperatures ranging from 5 to 13 °C for 10–24 min [6, 31]. WBC and PBC are more extreme forms of cryotherapy, in the first one the individuals enter two or three closed chambers, where they are exposed to extremely cold air up to 4 min, in temperatures ranging from − 10 to − 130 °C [32, 33], while the latter involves vaporized liquid nitrogen, generating temperatures from − 110 °C down to − 195 °C [10, 34] for 1–3 min. Even though there is a growing body of investigations analyzing the effects of the aforementioned cryotherapy modalities to reduce symptoms of EIMD, there is no consensus in the literature regarding the efficacy of such strategies [12, 13, 35, 36]. Furthermore, they are hardly applicable in a clinical environment, which is the main advantage of local cryotherapy.
Many theories have tried to explain the origin of DOMS [37]. However, whether the initiating stimulus is chemical, thermal, mechanical or a combination of more than one factor remains uncertain [38]. The most accepted theory hypothesize that DOMS is related to the inflammatory response and muscle damage caused by strenuous exercise [37]. Therefore, strategies capable of decreasing inflammatory response might contribute to attenuate symptoms of DOMS. Nevertheless, according to the results found in the present review, local cryotherapy does not seem to provide any benefit to improving symptoms of DOMS. There is a possibility that local cryotherapy does not provide the same physiological benefits seen in other cooling modalities (e.g., CWI and WBC) such as muscle oxygen saturation, cutaneous vascular conductance, and mean arterial pressure [39,40,41]. Perhaps, the cooling generated by local cryotherapy is just not sufficient to produce significant responses within the tissue. However, it is worth pointing out in this context that the two studies that found advantages of local cryotherapy over control/sham groups for attenuating symptoms of DOMS used more frequent applications (three times per day) [11] and chose the duration of application according to the amount of subcutaneous tissue [23]. Hence, it is plausible to assume that a single bout of local cryotherapy for a standard period of time (15–20 min) might not be sufficient to generate positive effects on DOMS. It is worth highlighting that even though DOMS is an important variable during muscle recovery it tends to significantly decrease as the activity begins [37]. Force production, on the other hand, seems to be the most remarkable variable to be recovered following strenuous exercises, considering that most sports depend on it.
The diminished ability to produce strength following EIMD is one of the most used and most reproducible objective markers of muscle damage in humans [42, 43]. The reason why muscles are unable to produce maximal force after EIMD remains unclear. However, it is known that contracting skeletal muscles have increased production of reactive oxygen species (ROS) [44], and the increased production of ROS leads to oxidative stress, which might impair force production [45]. The present review demonstrated that local cryotherapy does not seem to be effective to accelerate strength recovery following EIMD. There is no consensus in the literature regarding the effects of cold therapy strategies to accelerate strength recovery following EIMD [9, 35, 36], different methods of application and protocols make it hard to reach a definitive answer. However, it is been suggested that an increase in peripheral catecholamine concentration following CWI might generate an auto-oxidative process, which would perpetuate muscle fatigue [46] and impair force production. This premise was confirmed by a recent investigation that found that CWI seems to delay muscle recovery following EIMD [36]. Furthermore, there is a significant body of evidence suggesting that CWI might impair muscle adaptation during strength training [47,48,49]. Therefore, the use of cold therapy post-exercise has become questionable, considering that most athletes perform some sort of strength training in their routine. We are unable to state that the rules for CWI and other modalities of cold therapies apply for local cryotherapy. Therefore, the mechanisms underpinning the failure of local cryotherapy to accelerate strength recovery following EIMD remain unclear. Nonetheless, the data found in the present review allow us to suggest that local cryotherapy does not seem to be a worthwhile strategy to be used to accelerate strength recovery following EIMD.
To the best of the authors’ knowledge, this is the first review to systematically analyze the influence of local cryotherapy on DOMS and strength. The current review presents relevant methodological strengths such as the analysis of two of the most important variables of EIMD (DOMS and strength). Moreover, a strategy for a sensitive and comprehensive search to assure the location of all studies in this field was held. Another important quality of the present review is the high methodological quality of the included studies; this makes the information provided more reliable. However, the heterogeneity among the included studies prevented more robust meta-analyses, especially for strength, and this should be pointed out as a relevant limitation.
Conclusion
In conclusion, the present review showed that local cryotherapy does not seem to be effective to accelerate recovery from symptoms of EIMD. Even though, local cryotherapy is suitable for clinical practice, the evidence proving its efficacy is limited. It is possible that local cryotherapy might contribute to decrease DOMS if applied more frequently. However, cryotherapy might not be a worthwhile strategy, given the potential harm that it may cause on muscle strength. Considering the current evidence, we discourage physical therapists and conditioning coaches to use local cryotherapy in an attempt to attenuate symptoms of EIMD.
References
Lieber RL, Fridén J (1993) Muscle damage is not a function of muscle force but active muscle strain. J Appl Physiol 74:520–526
Nosaka K, Lavender A, Newton M, Sacco P (2003) Muscle damage in resistance training. Int J Sport Health Sci 1:1–8. https://doi.org/10.5432/ijshs.1.1
Chapman DW, Newton MJ, McGuigan MR, Nosaka K (2011) Effect of slow-velocity lengthening contractions on muscle damage induced by fast-velocity lengthening contractions. J Strength Cond Res 25:211–219. https://doi.org/10.1519/JSC.0b013e3181bac2bd
Nosaka K, Newton M, Sacco P et al (2005) Partial protection against muscle damage by eccentric actions at short muscle lengths. Med Sci Sports Exerc 37:746–753. https://doi.org/10.1249/01.MSS.0000162691.66162.00
Proske U, Allen TJ (2005) Damage to skeletal muscle from eccentric exercise. Exerc Sport Sci Rev 33:98–104. https://doi.org/10.1097/00003677-200504000-00007
Bleakley C, McDonough S, Gardner E et al (2012) Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Sao Paulo Med J. https://doi.org/10.1590/s1516-31802012000500015
Costello JT, Baker PRA, Minett GM et al (2015) Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Cochrane Database Syst Rev 9:CD010789. https://doi.org/10.1002/14651858.cd010789.pub2
Swenson C, Sward L, Karlsson J (1996) Cryotherapy in sports medicine. Scand J Med Sci Sports 6:193–200. https://doi.org/10.1111/j.1600-0838.1996.tb00090.x
Ascensão A, Leite M, Rebelo AN et al (2011) Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. J Sports Sci 29:217–225. https://doi.org/10.1080/02640414.2010.526132
Ferreira-Junior JB, Bottaro M, Vieira CA et al (2014) Effects of partial-body cryotherapy (− 110 °C) on muscle recovery between high-intensity exercise bouts. Int J Sports Med. https://doi.org/10.1055/s-0034-1382057
Oakley ET, Pardeiro RB, Powell JW, Millar AL (2013) The effects of multiple daily applications of ice to the hamstrings on biochemical measures, signs, and symptoms associated with exercise-induced muscle damage. J Strength Cond Res 27:2743–2751. https://doi.org/10.1519/JSC.0b013e31828830df
Hohenauer E, Costello JT, Stoop R et al (2018) Cold-water or partial-body cryotherapy? Comparison of physiological responses and recovery following muscle damage. Scand J Med Sci Sports. https://doi.org/10.1111/sms.13014
Lombardi G, Ziemann E, Banfi G (2017) Whole-body cryotherapy in athletes: From therapy to stimulation. An updated review of the literature. Front Physiol. https://doi.org/10.3389/fphys.2017.00258
Ferreira-Junior JB, Bottaro M, Vieira A et al (2015) One session of partial-body cryotherapy (− 110 °C) improves muscle damage recovery. Scand J Med Sci Sports. https://doi.org/10.1111/sms.12353
Banfi G, Lombardi G, Colombini A, Melegati G (2010) Whole-body cryotherapy in athletes. Sports Med. https://doi.org/10.2165/11531940-000000000-00000
Bleakley CM, Bieuzen F, Davison GW, Costello JT (2014) Whole-body cryotherapy: empirical evidence and theoretical perspectives. Open Access J Sports Med 5:25–36. https://doi.org/10.2147/OAJSM.S41655
Torres R, Ribeiro F, Alberto Duarte J, Cabri JMH (2012) Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis. Phys Ther Sport 13:101–114. https://doi.org/10.1016/j.ptsp.2011.07.005
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Reprint—preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther 89:873–880. https://doi.org/10.1136/bmj.b2535
Robinson KA, Dickersin K (2002) Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed. Int J Epidemiol 31:150–153. https://doi.org/10.1093/ije/31.1.150
Pedro T, Ap V, Delphi T (1999) PEDro scale. Physiother Evid Database. https://doi.org/10.1016/s0004-9514(14)60281-6
Higgins JPT, Altman DG (2011) Higgins 2011 Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Cochrane Handb Syst Rev Interv. https://doi.org/10.1002/9780470712184.ch8
Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ Br Med J 327:557–560. https://doi.org/10.1136/bmj.327.7414.557
Selkow NM, Herman DC, Liu Z et al (2015) Blood flow after exercise-induced muscle damage. J Athl Train 50:400–406. https://doi.org/10.4085/1062-6050-49.6.01
Denegar CR, Perrin DH (1992) Effect of transcutaneous electrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness. J Athl Train 27:200–206
Lima CS, Medeiros DM, Prado LR et al (2017) Local cryotherapy is ineffective in accelerating recovery from exercise-induced muscle damage on biceps brachii. Sport Sci Health. https://doi.org/10.1007/s11332-017-0355-8
de Paiva PRV, Tomazoni SS, Johnson DS et al (2016) Photobiomodulation therapy (PBMT) and/or cryotherapy in skeletal muscle restitution, what is better? A randomized, double-blinded, placebo-controlled clinical trial. Lasers Med Sci 31:1925–1933. https://doi.org/10.1007/s10103-016-2071-z
De Marchi T, Schmitt VM, Machado GP et al (2017) Does photobiomodulation therapy is better than cryotherapy in muscle recovery after a high-intensity exercise? A randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci 32:429–437. https://doi.org/10.1007/s10103-016-2139-9
Hohenauer E, Clarys P, Baeyens J-P, Clijsen R (2017) The effect of local cryotherapy on subjective and objective recovery characteristics following an exhaustive jump protocol. PLoS One. https://doi.org/10.3791/55612
Wilcock IM, Cronin JB, Hing WA (2006) Physiological response to water immersion: a method for sport recovery? Sports Med 36:747–765. https://doi.org/10.2165/00007256-200636090-00003
Algafly AA, George KP (2007) The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med 41:365–369. https://doi.org/10.1136/bjsm.2006.031237(discussion 369)
Hohenauer E, Taeymans J, Baeyens JP et al (2015) The effect of post-exercise cryotherapy on recovery characteristics: a systematic review and meta-analysis. PLoS One. https://doi.org/10.1371/journal.pone.0139028
Hausswirth C, Louis J, Bieuzen F et al (2011) Effects of whole-body cryotherapy vs. far-infrared vs. passive modalities on recovery from exercise-induced muscle damage in highly-trained runners. PLoS One. https://doi.org/10.1371/journal.pone.0027749
Klimek A, Lubkowska A, Szyguła Z et al (2010) Influence of the ten sessions of the whole body cryostimulation on aerobic and anaerobic capacity. Int J Occup Med Environ Health. https://doi.org/10.2478/v10001-010-0019-2
Fonda B, Sarabon N (2013) Effects of whole-body cryotherapy on recovery after hamstring damaging exercise: a crossover study. Scand J Med Sci Sports. https://doi.org/10.1111/sms.12074
Takeda M, Sato T, Hasegawa T et al (2014) The effects of cold water immersion after rugby training on muscle power and biochemical markers. J Sports Sci Med 13:616
Wilson LJ, Cockburn E, Paice K et al (2018) Recovery following a marathon: a comparison of cold water immersion, whole body cryotherapy and a placebo control. Eur J Appl Physiol 5:10. https://doi.org/10.1007/s00421-017-3757-z
Cheung K, Hume PA, Maxwell L (2003) Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med 33:145–164. https://doi.org/10.2165/00007256-200333020-00005
Cleak MJ, Eston RG (1992) Delayed onset muscle soreness: mechanisms and management. J Sports Sci. https://doi.org/10.1080/02640419208729932
Mawhinney C, Low DA, Jones H et al (2017) Cold water mediates greater reductions in limb blood flow than whole body cryotherapy. Med Sci Sports Exerc. https://doi.org/10.1249/mss.0000000000001223
Selfe J, Alexander J, Costello JT et al (2014) The effect of three different (− 135 °C) whole body cryotherapy exposure durations on elite rugby league players. PLoS One. https://doi.org/10.1371/journal.pone.0086420
Gregson W, Black MA, Jones H et al (2011) Influence of cold water immersion on limb and cutaneous blood flow at rest. Am J Sports Med. https://doi.org/10.1177/0363546510395497
Chen TC, Lin KY, Chen HL et al (2011) Comparison in eccentric exercise-induced muscle damage among four limb muscles. Eur J Appl Physiol 111:211–223. https://doi.org/10.1007/s00421-010-1648-7
Newton MJ, Morgan GT, Chapman DW, Nosaka KK (2008) Comparison of responses to strenuous eccentric exercise of the elbow flexors between resistance-trained and untrained men. J Strength Cond Res 22:597–607. https://doi.org/10.1519/JSC.0b013e3181660003
Powers SK, Ji LL, Kavazis AN, Jackson MJ (2011) Reactive oxygen species: impact on skeletal muscle. Compr Physiol. https://doi.org/10.1002/cphy.c100054
Powers SK, Jackson MJ (2008) Exercise-induced oxidative stress: cellular mechanisms and impact on muscle force production. Physiol Rev. https://doi.org/10.1152/physrev.00031.2007
Bleakley CM, Davison GW (2010) What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review. Br J Sports Med. https://doi.org/10.1136/bjsm.2009.065565
Roberts LA, Raastad T, Markworth JF et al (2015) Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. J Physiol. https://doi.org/10.1113/jp270570
Fröhlich M, Faude O, Klein M et al (2014) Strength training adaptations after cold-water immersion. J Strength Cond Res. https://doi.org/10.1519/jsc.0000000000000434
Yamane M, Ohnishi N, Matsumoto T (2015) Does regular post-exercise cold application attenuate trained muscle adaptation? Int J Sports Med. https://doi.org/10.1055/s-0034-1398652
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Nogueira, N.M., Felappi, C.J., Lima, C.S. et al. Effects of local cryotherapy for recovery of delayed onset muscle soreness and strength following exercise-induced muscle damage: systematic review and meta-analysis. Sport Sci Health 16, 1–11 (2020). https://doi.org/10.1007/s11332-019-00571-z
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DOI: https://doi.org/10.1007/s11332-019-00571-z