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

Journal article

Moore, Emma, Fuller, Joel T., Bellenger, Clint R., Saunders, Siena, Halson, Shona L., Broatch, James R. and Buckley, Jonathan D.. (2023). 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. Sports Medicine. 53(3), pp. 687-705. https://doi.org/10.1007/s40279-022-01800-1
AuthorsMoore, Emma, Fuller, Joel T., Bellenger, Clint R., Saunders, Siena, Halson, Shona L., Broatch, James R. and Buckley, Jonathan D.
Abstract

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

Year2023
JournalSports Medicine
Journal citation53 (3), pp. 687-705
PublisherSpringer Nature Switzerland AG
ISSN0112-1642
Digital Object Identifier (DOI)https://doi.org/10.1007/s40279-022-01800-1
PubMed ID36527593
Scopus EID2-s2.0-85144194213
Page range687-705
FunderResearch Training Program Scholarship (RTP), Australian Government
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online17 Dec 2022
Publication process dates
Accepted26 Nov 2022
Deposited20 Jul 2023
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Dunican, Ian C., Higgin, Charles C., Murray, Kevin, Jones, Maddison J., Dawson, Brian, Caldwell, John A., Halson, Shona L. and Eastwood, Peter R.. (2019). Sleep patterns and alertness in an elite super rugby team during a game week. Journal of Human Kinetics. 67(1), pp. 111-121. https://doi.org/10.2478/hukin-2018-0088
Sleep and salivary testosterone and cortisol during a short preseason camp : A study in professional rugby union
Serpell, Benjamin G., Horgan, Barry G., Colomer, Carmen M. E., Field, Byron, Halson, Shona L. and Cook, Christian J.. (2019). Sleep and salivary testosterone and cortisol during a short preseason camp : A study in professional rugby union. International Journal of Sports Physiology and Performance. 14(6), pp. 796-804. https://doi.org/10.1123/ijspp.2018-0600
Effects of various recovery strategies on repeated bouts of simulated intermittent activity
Crowther, Fiona A., Sealey, Rebecca M., Crowe, Melissa J., Edwards, Andrew M. and Halson, Shona L.. (2019). Effects of various recovery strategies on repeated bouts of simulated intermittent activity. Journal of Strength and Conditioning Research. 33(7), pp. 1781-1794. https://doi.org/10.1519/JSC.0000000000002396
Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training
Fyfe, Jackson J., Broatch, James R., Trewin, Adam J., Hanson, Erik D., Argus, Christos K., Garnham, Andrew P., Halson, Shona L., Polman, Remco C., Bishop, David J. and Petersen, Aaron C.. (2019). Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. Journal of Applied Physiology. 127(5), pp. 1403-1418. https://doi.org/10.1152/japplphysiol.00127.2019
Nutrition for travel : From jet lag to catering
Halson, Shona L., Burke, Louise M. and Pearce, Jeni. (2019). Nutrition for travel : From jet lag to catering. International Journal of Sport Nutrition and Exercise Metabolism. 29(2), pp. 228-235. https://doi.org/10.1123/ijsnem.2018-0278
The effects of cold water immersion on the amount and quality of sleep obtained by elite cyclists during a simulated hill climbing tour
Lastella, Michelle, Roach, G. D., Halson, Shona and Sargent, C.. (2019). The effects of cold water immersion on the amount and quality of sleep obtained by elite cyclists during a simulated hill climbing tour. Sport Sciences for Health. 15(1), pp. 223 - 228. https://doi.org/10.1007/s11332-018-0522-6
Effects of sports compression socks on performance, physiological, and hematological alterations after long-haul air travel in elite female volleyballers
Broatch, James R., Bishop, David J., Zadow, Emma K. and Halson, Shona. (2019). Effects of sports compression socks on performance, physiological, and hematological alterations after long-haul air travel in elite female volleyballers. Journal of Strength and Conditioning Research. 33(2), pp. 492-501. https://doi.org/10.1519/JSC.0000000000003002
Monitoring athletes during training camps : Observations and translatable strategies from elite road cyclists and swimmers
Saw, Anna E., Halson, Shona L. and Mujika, Iñigo. (2018). Monitoring athletes during training camps : Observations and translatable strategies from elite road cyclists and swimmers. Sports. 6(3), p. Article 63. https://doi.org/10.3390/sports6030063
Longer sleep durations are positively associated with finishing place during a national multiday netball competition
Laura E. Juliff, Shona Halson, Jeffrey J. Hebert, Peta L. Forsyth and Jeremiah John Peiffer. (2018). Longer sleep durations are positively associated with finishing place during a national multiday netball competition. Journal of Strength and Conditioning Research. 32(1), pp. 189-194. https://doi.org/10.1519/jsc.0000000000001793
Can sleep be used as an indicator of overreaching and overtraining in athletes?
Michelle Lastella, Grace E. Vincent, Rob Duffield, Gregory D. Roach, Shona Halson, Luke J. Heales and Charli Sargent. (2018). Can sleep be used as an indicator of overreaching and overtraining in athletes? Frontiers in Physiology. 9, pp. 1-4. https://doi.org/10.3389/fphys.2018.00436
Recovery and performance in sport: Consensus statement
Michael Kellmann, Maurizio Bertollo, Laurent Bosquet, Michel Brink, Aaron Coutts, Rob Duffield, Daniel Erlacher, Shona Halson, Anne Hecksteden, Jahan Heidari, Wolfgang Kallus, R Meeusen, I Mujika, Claudio Robazza, Sabrina Skorski, Ranel Venter and Jürgen Beckmann. (2018). Recovery and performance in sport: Consensus statement. International Journal of Sports Physiology and Performance. 13(2), pp. 240-245. https://doi.org/10.1123/ijspp.2017-0759
Development of the athlete sleep behavior questionnaire: A tool for identifying maladaptive sleep practices in elite athletes
Matthew W Driller, Cheri D Mah and Shona Halson. (2018). Development of the athlete sleep behavior questionnaire: A tool for identifying maladaptive sleep practices in elite athletes. Sleep Science. 11(1), pp. 37-44.
The effects of intensified training on resting metabolic rate (RMR), body composition and performance in trained cyclists
Woods, Amy L., Rice, Anthony J., Garvican-Lewis, Laura A., Wallett, Alice M., Lundy, Bronwen, Rogers, Margot A., Welvaert, Marijke, Halson, Shona, McKune, Andrew and Thompson, Kevin G.. (2018). The effects of intensified training on resting metabolic rate (RMR), body composition and performance in trained cyclists. PLoS ONE. 13(2), pp. 1 - 24. https://doi.org/10.1371/journal.pone.0191644
An integrated, multifactorial approach to periodization for optimal performance in individual and team sports
Mujika, Iñigo, Halson, Shona, Burke, Louise M., Balagué, Gloria and Farrow, Damian. (2018). An integrated, multifactorial approach to periodization for optimal performance in individual and team sports. International Journal of Sports Physiology and Performance. 13(5), pp. 538 - 561. https://doi.org/10.1123/ijspp.2018-0093
Evening electronic device use: The effects on alertness, sleep and next-day physical performance in athletes
Jones, Maddison J., Peeling, Peter, Dawson, Brian, Halson, Shona, Miller, Joanna, Dunican, Ian C., Clarke, Michael W., Goodman, Craig and Eastwood, Peter R.. (2018). Evening electronic device use: The effects on alertness, sleep and next-day physical performance in athletes. Journal of Sports Sciences. 36(2), pp. 162 - 170. https://doi.org/10.1080/02640414.2017.1287936
The psychomotor vigilance test: A comparison of different test durations in elite athletes
Jones, Maddison J., Dunican, Ian C., Murray, Kevin, Peeling, Peter, Dawson, Brian, Halson, Shona, Miller, Joanna and Eastwood, Peter R.. (2018). The psychomotor vigilance test: A comparison of different test durations in elite athletes. Journal of Sports Sciences. 36(18), pp. 2033 - 2037. https://doi.org/10.1080/02640414.2018.1433443
Lower limb sports compression garments improve muscle blood flow and exercise performance during repeated-sprint cycling
Broatch, James R., Bishop, David J. and Halson, Shona. (2018). Lower limb sports compression garments improve muscle blood flow and exercise performance during repeated-sprint cycling. International Journal of Sports Physiology and Performance. 13(7), pp. 882 - 890. https://doi.org/10.1123/ijspp.2017-0638
Sleep, sport, and the brain
Halson, Shona L. and Juliff, Laura E.. (2017). Sleep, sport, and the brain. Progress in Brain Research. 234, pp. 13-31. https://doi.org/10.1016/bs.pbr.2017.06.006
Cold-water immersion for athletic recovery: One size does not fit all
Jessica M. Stephens, Shona Halson, Joanna Miller, Gary Slater and Christopher D. Askew. (2017). Cold-water immersion for athletic recovery: One size does not fit all. International Journal of Sports Physiology and Performance. 12(1), pp. 2-9. https://doi.org/10.1123/ijspp.2016-0095
A multifactorial evaluation of illness risk factors in athletes preparing for the Summer Olympic Games
Drew, Michael K., Vlahovich, Nicole, Hughes, David, Appaneal, Renee, Peterson, Kirsten, Burke, Louise, Lundy, Bronwen, Toomey, Mary, Watts, David, Lovell, Gregory, Praet, Stephan, Halson, Shona, Colbey, Candice, Manzanero, Silvia, Welvaert, Marijke, West, Nic P., Pyne, David B. and Waddington, Gordon. (2017). A multifactorial evaluation of illness risk factors in athletes preparing for the Summer Olympic Games. Journal of Science and Medicine in Sport. 20(8), pp. 745 - 750. https://doi.org/10.1016/j.jsams.2017.02.010
Greater effect of east versus west travel on jet lag, sleep, and team sport performance
Fowler, Peter M., Knez, Wade, Crowcroft, Stephen, Mendham, Amy E., Miller, Joanna, Sargent, Charli, Halson, Shona and Duffield, Rob. (2017). Greater effect of east versus west travel on jet lag, sleep, and team sport performance. Medicine and Science in Sports and Exercise. 49(12), pp. 2548 - 2561. https://doi.org/10.1249/MSS.0000000000001374
Team sport athletes' perceptions and use of recovery strategies: A mixed-methods survey study
Crowther, Fiona, Sealey, Rebecca, Crowe, Melissa, Edwards, Andrew and Halson, Shona. (2017). Team sport athletes' perceptions and use of recovery strategies: A mixed-methods survey study. BMC Sports Science, Medicine and Rehabilitation. 9(1), pp. 1 - 10. https://doi.org/10.1186/s13102-017-0071-3
Cold-water immersion and contrast water therapy: No improvement of short-term recovery after resistance training
Argus, Christos K., Broatch, James R., Petersen, Aaron C., Polman, Remco, Bishop, David J. and Halson, Shona. (2017). Cold-water immersion and contrast water therapy: No improvement of short-term recovery after resistance training. International Journal of Sports Physiology and Performance. 12(7), pp. 886 - 892. https://doi.org/10.1123/ijspp.2016-0127
Prevalence of illness, poor mental health and sleep quality and low energy availability prior to the 2016 Summer Olympic Games
Drew, Michael, Vlahovich, Nicole, Hughes, David, Appaneal, Renee, Burke, Louise, Lundy, Bronwen, Rogers, Margot, Toomey, Mary, Watts, David, Lovell, Gregory, Praet, Stephan F. E., Halson, Shona, Colbey, Candice, Manzanero, Silvia, Welvaert, Marijke, West, NIcholas P., Pyne, David and Waddington, Gordon. (2017). Prevalence of illness, poor mental health and sleep quality and low energy availability prior to the 2016 Summer Olympic Games. British Journal of Sports Medicine. 52(1), pp. 1 - 8. https://doi.org/10.1136/bjsports-2017-098208
Protein ingestion before sleep increases overnight muscle protein synthesis rates in healthy older men: A randomized controlled trial
Kouw, Imre W.K., Holwerda, Andrew M., Trommelen, Jorn, Kramer, Irene Fleur, Bastiaanse, Jacqueline, Halson, Shona, Wodzig, Will K.W.H., Verdijk, Lex B. and Van Loon, Luc. (2017). Protein ingestion before sleep increases overnight muscle protein synthesis rates in healthy older men: A randomized controlled trial. The Journal of Nutrition. 147(12), pp. 2252 - 2261. https://doi.org/10.3945/jn.117.254532
Software thresholds alter the bias of actigraphy for monitoring sleep in team-sport athletes
Fuller, Kate L., Juliff, Laura E., Gore, Christopher J., Peiffer, Jeremiah John and Halson, Shona. (2017). Software thresholds alter the bias of actigraphy for monitoring sleep in team-sport athletes. Journal of Science and Medicine in Sport. 20(8), pp. 756 - 760. https://doi.org/10.1016/j.jsams.2016.11.021
Influence of recovery strategies upon performance and perceptions following fatiguing exercise: A randomized controlled trial
Crowther, Fiona, Sealey, Rebecca, Crowe, Melissa, Edwards, Andrew and Halson, Shona. (2017). Influence of recovery strategies upon performance and perceptions following fatiguing exercise: A randomized controlled trial. BMC Sports Science, Medicine and Rehabilitation. 9(1), pp. 1 - 9. https://doi.org/10.1186/s13102-017-0087-8
The chronotype of elite athletes
Lastella, Michelle, Roach, G. D., Halson, Shona and Sargent, C.. (2016). The chronotype of elite athletes. Journal of Human Kinetics. 54(1), pp. 219 - 225. https://doi.org/10.1515/hukin-2016-0049
Superior inhibitory control and resistance to mental fatigue in professional road cyclists
Martin, Kristy, Staiano, Walter, Menaspà, Paolo, Hennessey, Tom, Marcora, Samuele, Keegan, Richard J., Thompson, Kevin G., Martin, David, Halson, Shona and Rattray, Ben. (2016). Superior inhibitory control and resistance to mental fatigue in professional road cyclists. PLoS ONE. 11(7), pp. 1 - 15. https://doi.org/10.1371/journal.pone.0159907
Importance of standardized DXA protocol for assessing physique changes in athletes
Nana, Alisa, Slater, Gary J., Hopkins, Will, Halson, Shona, Martin, D. T., West, N. P. and Burke, Louise Mary. (2016). Importance of standardized DXA protocol for assessing physique changes in athletes. International Journal of Sport Nutrition and Exercise Metabolism. 26(3), pp. 259 - 267. https://doi.org/10.1123/ijsnem.2013-0111
Nutrition and recovery
Halson, Shona and Burke, Louise Mary. (2015). Nutrition and recovery. In Tennis science : How player and racket work together pp. 116-135 University of Chicago Press. https://doi.org/10.7208/chicago/9780226139623.001.0001
The impact of a simulated grand tour on sleep, mood, and well-being of competitive cyclists
Michelle Lastella, Gregory D Roach, Shona Halson, David Martin, Nicholas P West and Charli Sargent. (2015). The impact of a simulated grand tour on sleep, mood, and well-being of competitive cyclists. The Journal of Sports Medicine and Physical Fitness. 55(12), pp. 1555-1564.
Understanding sleep disturbance in athletes prior to important competitions
Juliff, Laura E., Halson, Shona and Peiffer, Jeremiah John. (2015). Understanding sleep disturbance in athletes prior to important competitions. Journal of Science and Medicine in Sport. 18(1), pp. 13 - 18. https://doi.org/10.1016/j.jsams.2014.02.007
Sleep/wake behaviour of endurance cyclists before and during competition
Lastella, Michelle, Roach, Gregory D., Halson, Shona, Martin, David T., West, Nicholas P. and Sargent, Charli. (2015). Sleep/wake behaviour of endurance cyclists before and during competition. Journal of Sports Sciences. 33(3), pp. 293 - 299. https://doi.org/10.1080/02640414.2014.942690
Confounding compression: The effects of posture, sizing and garment type on measured interface pressure in sports compression clothing
Brophy-Williams, Ned, Driller, Matthew W., Shing, C., Fell, James W. and Halson, Shona. (2015). Confounding compression: The effects of posture, sizing and garment type on measured interface pressure in sports compression clothing. Journal of Sports Sciences. 33(13), pp. 1403 - 1410. https://doi.org/10.1080/02640414.2014.990489
Sleep hygiene and recovery strategies in elite soccer players
Nédélec, Mathieu, Halson, Shona, Delecroix, Barthélémy, Abaidia, Abd-Elbasset, Ahmaidi, S. and Dupont, Gregory. (2015). Sleep hygiene and recovery strategies in elite soccer players. Sports Medicine. 45(11), pp. 1547 - 1559. https://doi.org/10.1007/s40279-015-0377-9
Stress, sleep and recovery in elite soccer: A critical review of the literature
Nédélec, Mathieu, Halson, Shona, Abaidia, Abd-Elbasset, Ahmaidi, S. and Dupont, Gregory. (2015). Stress, sleep and recovery in elite soccer: A critical review of the literature. Sports Medicine. 45(10), pp. 1387 - 1400. https://doi.org/10.1007/s40279-015-0358-z
Sleep/wake behaviours of elite athletes from individual and team sports
Lastella, Michelle, Roach, Gregory D., Halson, Shona and Sargent, Charli. (2015). Sleep/wake behaviours of elite athletes from individual and team sports. European Journal of Sport Science. 15(2), pp. 94 - 100. https://doi.org/10.1080/17461391.2014.932016
Influence of contrast shower and water immersion on recovery in elite netballers
Juliff, Laura E., Halson, Shona, Bonetti, Darrell L., Versey, Nathan, Driller, Matthew W. and Peiffer, Jeremiah John. (2014). Influence of contrast shower and water immersion on recovery in elite netballers. Journal of Strength and Conditioning Research. 28(8), pp. 2353 - 2358. https://doi.org/10.1519/JSC.0000000000000417
Monitoring training load to understand fatigue in athletes
Halson, Shona. (2014). Monitoring training load to understand fatigue in athletes. Sports Medicine. 44(Suppl 2), pp. 139 - 147. https://doi.org/10.1007/s40279-014-0253-z
Does hydrotherapy help or hinder adaptation to training in competitive cyclists?
Halson, Shona, Bartram, Jason C., West, Nicholas P., Stephens, Jessica M., Argus, Christos K., Driller, Matthew W., Sargent, Charli, Lastella, Michelle, Hopkins, Will G. and Martin, David T.. (2014). Does hydrotherapy help or hinder adaptation to training in competitive cyclists? Medicine and Science in Sports and Exercise. 46(8), pp. 1631 - 1639. https://doi.org/10.1249/MSS.0000000000000268
Sleep or swim? Early-morning training severely restricts the amount of sleep obtained by elite swimmers
Sargent, Charli, Halson, Shona and Roach, Gregory D.. (2014). Sleep or swim? Early-morning training severely restricts the amount of sleep obtained by elite swimmers. European Journal of Sport Science. 14(Supplement 1), pp. 310 - 315. https://doi.org/10.1080/17461391.2012.696711
Sleep in elite athletes and nutritional interventions to enhance sleep
Halson, Shona. (2014). Sleep in elite athletes and nutritional interventions to enhance sleep. Sports Medicine. 44(Supplement 1), pp. 13 - 23. https://doi.org/10.1007/s40279-014-0147-0
Sleep quantity and quality in elite youth soccer players: A pilot study
Robey, Elisa, Dawson, Brian, Halson, Shona, Gregson, Warren, Goodman, Carmel and Eastwood, Peter R.. (2014). Sleep quantity and quality in elite youth soccer players: A pilot study. European Journal of Sport Science. 14(5), pp. 410 - 417. https://doi.org/10.1080/17461391.2013.843024
Evaluating the Kikuhime pressure monitor for use with sports compression clothing
Brophy-Williams, Ned, Driller, Matthew, Halson, Shona, Fell, James W. and Shing, C.. (2014). Evaluating the Kikuhime pressure monitor for use with sports compression clothing. Sports Engineering. 17(1), pp. 55 - 60. https://doi.org/10.1007/s12283-013-0125-z
Nitrate supplementation and high-intensity performance in competitive cyclists
Hoon, Matthew, Hopkins, William, Jones, Andrew, Martin, David, Halson, Shona, West, Nicholas, Johnson, Nathan and Burke, Louise. (2014). Nitrate supplementation and high-intensity performance in competitive cyclists. Applied Physiology, Nutrition and Metabolism. 39(9), pp. 1043 - 1049. https://doi.org/10.1139/apnm-2013-0574
Reliability of a 2-bout exercise test on a wattbike cycle ergometer
Driller, Matthew W., Argus, Christos K., Bartram, Jason C., Bonaventura, Jacinta, Martin, David T., West, Nicholas P. and Halson, Shona. (2014). Reliability of a 2-bout exercise test on a wattbike cycle ergometer. International Journal of Sports Physiology and Performance. 9(2), pp. 340 - 345. https://doi.org/10.1123/IJSPP.2013-0103
Daily training with high carbohydrate availability increases exogenous carbohydrate oxidation during endurance cycling
Cox, Geoffrey, Clark, Sally, Cox, A, Halson, Shona, Hargreaves, M, Hawley, John, Jeacocke, N, Snow, Rod, Yeo, W and Burke, Louise. (2010). Daily training with high carbohydrate availability increases exogenous carbohydrate oxidation during endurance cycling. Journal of Applied Physiology. 109(1), pp. 126 - 134. https://doi.org/10.1152/japplphysiol.00950.2009
Cytokine responses to carbohydrate ingestion during recovery from exercise-induced muscle injury
Ross, M, Halson, Shona, Suzuki, K, Garnham, A, Hawley, John, Cameron-Smith, David and Peake, J. (2010). Cytokine responses to carbohydrate ingestion during recovery from exercise-induced muscle injury. Journal of Interferon and Cytokine Research. 30(5), pp. 329 - 337. https://doi.org/10.1089/jir.2009.0079