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3Effect of immersion in cold water after training on subjective pain in the muscles in the aspect
of theoretical analysis
UDC (796+57.043): 303
PhD, Associate Professor A.V. Kabachkova1 Postgraduate student F. Xiao1 Postgraduate student L. Jiao1 Postgraduate student S.N. Kapitanov1 1National Research Tomsk State University, Tomsk
Corresponding author: avkabachkova@gmail.com
Abstract
Objective of the study was to conduct a meta-analysis of English-language literature sources on the issue of the effect of immersion in cold water after exercise on subjective muscle pain.
Methods and structure of the study. A search was made for English-language scientific papers by keywords in various electronic databases (Pubmed, PEDro, Elsevier) for the period 2002-2022. Among the selected articles, those that addressed delayed muscle soreness syndrome and the effects of cold water immersion (CWI) immediately and/or 24 hours and/or 48 hours after high-intensity exercise were highlighted.
Results and conclusions. It has been shown that the duration of such immersion influences the severity of pain sensations. At the same time, the temperature of the water had no effect on the severity of these sensations. It is best to use cold water immersion immediately after exercise. The article also presents the likely limitations of the study designs used, which must be taken into account when designing your own studies using cold water immersion.
Keywords: krepatura, delayed muscle soreness syndrome, DOMS, cooling, immersion in water, CWI.
Introduction. Effective management of recovery processes after high-intensity physical activity remains an urgent problem, especially in conditions of limited time intervals of rest. The discrepancy between the rate of recovery processes and the depth of fatigue leads to the accumulation of fatigue, which can lead to negative consequences for the athlete's body. To eliminate this discrepancy, it is possible to use an active directed influence on the course of recovery processes. In sports practice, various means are used - pedagogical, psychological and medical. Cold water immersion (CWI) has a certain popularity [11]. The results of studies indicate that CWI can accelerate recovery processes, including reducing muscle damage caused by exercise [4]. At the same time, there is evidence of its negative impact on work performance
[8], as well as the assumption of a placebo effect [9].
Objective of the study was to conduct a metaanalysis of English-language literature sources on the issue of the effect of immersion in cold water after exercise on subjective muscle pain.
Methods and structure of the study. A search was made for English-language scientific papers by keywords in various electronic databases (Pubmed, PEDro, Elsevier) for the period 2002-2022. according to the PRISMA protocol [9] - 1) cold water immersion OR cooling OR ice bath; AND 2) exercise performance OR sports performance; AND 3) fatigue OR recovery. Among the selected articles, those were highlighted that dealt with Delayed Onset Muscle Sorness Syndrome (DOMS) and the effects of cold water immersion immediately and/or 24 hours
Theory and Practice of Physical Culture I teoriya.ru I november I № 11 2022
and/or 48 hours after high-intensity exercise. For the qualitative selection of publications on this topic, the criteria for inclusion and exclusion of individual independent original studies in the meta-analysis were determined. The studies were supposed to involve people who received cold water immersion after training, where CWI was immersion in water with a temperature of <15°C. Selected studies were randomized controlled trials and crossover designs that examined the effect of post-exercise CWI on subsequent muscle soreness. Studies were excluded if the design of the experiment did not meet the requirements, there was a duplication of publication, the experiment was conducted on animals, the publication language was different from English. Data analysis was carried out using Revman 5.4 software.
Results of the study and their discussion. Seven articles were selected for analysis (see table) containing DOMS scores immediately, 24 and 48 hours after exercise. The results showed that the level of DOMS in the CWI group was significantly lower than in the control group immediately after 24 hours (0 h: SMD -0.59, 95%CL -0.90 to -0.28, n=6); (24 h: SMD -0.34, 95%CL -0.65 to -0.04, n=7). However, no significant difference was found at 48 hours (48 hours: SMD -0.25, 95%CL -0.58 to 0.07, n=6). Heterogeneity was found between literature data at 24 hours and 48 hours (24 hours: 12=67%; 48 hours: 12=66%), so a random effects model was chosen. The results showed
that CWI immediately after training had a pronounced effect on the reduction of subjective pain sensations. While after 24 and 48 hours, there is no such effect.
To investigate whether interstudy heterogeneity was due to individual studies, a sensitivity analysis was performed using itemized literature exclusion. Heterogeneity was found to have decreased after the exclusion of Ingram, J. (2009), but the effect size did not change significantly (24 h SMD -0.26 95% CL -0.69 to 0.16, n=6) (48 h: SMD -0.08 95% CL -0.42 to 0.26, n=5). All this indicates stable results of the study. It should be noted that the water temperature did not affect the severity of DOMS.
Most of the studies had a high or unclear risk of bias, leaving the validity of most results uncertain. The main bias was caused by the disclosure of information in the experiments, since the use of the blind method in this case was limited.
The second problem was the distribution concealment procedure. Only four studies used random assignment of participants, two studies used an envelope to conceal allocation, and others used a computer to ensure random assignment.
A third limitation is that some studies used randomized trials and some used crossover trials. In crossover studies, there may be a risk of some pass-through effects that are not present in randomized control designs. Thus, it is necessary to qualitatively approach the formation of research design.
Characteristics of research objects selected for analysis
Study, year Sample (gender (male:female), age) Environmental conditions (T°С, humidity) Exercise Protocol Load intensity Immersion in cold water Control group Variable and registration time after exercise (hour)
Amir et al., 2017 physically healthy young men; (16:0); 21.6 ± 2.3 years Plyometric Loading Protocol high 15 min at 15±1°C 15 min passive cooldown DOMS (24; 48)
Argus et al., 2017 men; (13:0); 26±5 years Weight training protocol (50 min) high 14 min at 15°C 14 min passive cooldown DOMS (0)
Glasgow et al., 2014 healthy volunteers; (32:18); 18-35 years old Eccentric Load to Failure protocol (posterior thigh muscle group) high CWI 6: 10 min at 6°C; CWI 10: 10 min at 10°C 10 min passive cooldown DOMS (24; 48)
Ingram et al., 2009 athletes; (11:0); 27.5±6.0 years Game simulation (80 min) + shuttle run to failure (20 min) high 5°C 2 min at 2.5 min intervals at 10°C 15 min passive cooldown DOMS (0; 24; 48)
Machado et al., 2017 healthy men; (60:0); 18-25 years old 21°C-23°C; 40%-60% Eccentric load (knee joint) - 5 °C 15 (30 seconds of rest between repetitions) high CWI 9: 15 min at 9°C; CWI 14: 15 min at 14°C 15 min passive cooldown DOMS (0; 24; 48)
Peiffer et al., 2010 cyclists; (10:0); 29±6 years 35.0±0.3°C; 40.0±3.0% Cycling (1 km at maximum speed) high 15 min at 35°C air + 5 min at 14°C water 20 min at 35°C air DOMS (0)
Wiewelhove et al., 2018 runners; (46:0); 30.5±10.9 years Half marathon high 15min at 15±1°C 15 min passive cooldown DOMS (0; 24)
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Conclusion. Thus, CWI immediately after training reduced DOMS, but did not have a significant effect after 24 and 48 hours. Using sensitivity analysis, it was found that heterogeneity between DOMS groups may be caused by the results of Ingram J. (2009). The reason for this may be the short duration of the CWI. It can be assumed that short-term immersion is less effective in relieving exercise-induced muscle soreness.
The study was supported by the Development Program of Tomsk State University ("Priority 2030").
References
1. Levushkin S.P., Akimov E.B., Andreev R.S. et al. Fiziologicheskiye osnovaniya dlya primeneniya gipotermicheskikh vozdeystviy posle sportivnoy raboty submaksimalnoy moshchnosti [Physiological grounds for the use of hypothermic effects after sports work of submaximal power]. Meditsina ekstremalnykh situatsiy. 2015. No. 4 (54). pp. 81-89.
2. Amir N.H. et al. The effect of single bout of 15 minutes of 15-degree Celsius cold water immersion on delayed-onset muscle soreness indicators. 2017, Springer Singapore. pp. 45-51.
3. Argus C.K. et al. Cold-water immersion and contrast water therapy: no improvement of short-term recovery after resistance training. International Journal of Sports Physiology and Performance, 2017. 12(7): pp. 886-892.
4. Broatch J.R., Petersen A., and Bishop D.J. Postexercise cold water immersion benefits are not greater than the placebo effect. Medicine & Science in Sports & Exercise, 2014. 46(11): pp. 2139-2147.
5. Glasgow P.D. et al. Cold water immersion in the management of delayed-onset muscle sore-
ness: Is dose important? A randomised controlled trial. Physical therapy in sport, 2014. 15(4): pp. 228-233.
6. Ingram J. et al. Effect of water immersion methods on post-exercise recovery from simulated team sport exercise. Journal of science and medicine in sport, 2009. 12(3): pp. 417-421.
7. Machado A. et al. Dosages of cold water immersion post exercise on functional and clinical responses: a randomized controlled trial. Scandinavian journal of medicine & science in sports,
2017. 27(11): pp. 1356-1363.
8. Moher D. et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 2015. 4(1): p. 1-9.
9. Peiffer J.J. et al. Effect of cold water immersion on repeated 1-km cycling performance in the heat. Journal of science and medicine in sport, 2010. 13(1): pp. 112-116.
10. Roberts L.A. et al. Cold water immersion enhances recovery of submaximal muscle function after resistance exercise. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2014. 307(8): p. R998-R1008.
11. Sellwood K.L. et al. Ice-water immersion and delayed-onset muscle soreness: a randomised controlled trial. British journal of sports medicine, 2007. 41(6): pp. 392-397.
12. Wiewelhove T. et al. Effects of different recovery strategies following a half-marathon on fatigue markers in recreational runners. PLoS One,
2018. 13(11): p. e0207313.
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