Influence of cryotherapy on muscle damage markers in jiu-jitsu fighters after competition: a cross-over study

Effects of cold water immersion after exercise on fatigue recovery and exercise performance--meta analysis

Cold water immersion (CWI) is very popular as a method reducing post-exercise muscle stiffness, eliminating fatigue, decreasing exercise-induced muscle damage (EIMD), and recovering sports performance. However, there are conflicting opinions as to whether CWI functions positively or negatively. The mechanisms of CWI are still not clear. In this systematic review, we used meta-analysis aims to examine the effect of CWI on fatigue recovery after high-intensity exercise and exercise performance. A total of 20 studies were retrieved and included from PubMed, PEDro and Elsevier databases in this review. Publication years of articles ranged from 2002 to 2022. In selected studies including randomized controlled trials (RCTs) and Crossover design (COD). Analyses of subjective indicators such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE), and objective indicators such as countermovement jump (CMJ) and blood plasma markers including creatine kinase(CK), lactate/lactate dehydrogenase(LDH), C-reactive protein(CRP), and IL-6 were performed. Pooled data showed as follows: CWI resulted in a significant decline in subjective characteristics (delayed-onset muscle soreness and perceived exertion at 0 h); CWI reduced countermovement jump(CMJ) significantly at 0 h, creatine kinase(CK) was lowered at 24 h, and lactate at 24 and 48 h. There was no evidence that CWI affects C-reactive protein(CRP) and IL-6 during a 48-h recovery period. Subgroup analysis revealed that different CWI sites and water temperatures have no effect on post-exercise fatigue recovery. Recommended athletes immersed in cold water immediately after exercise, which can effectively reduce muscle soreness and accelerate fatigue recovery.

What Parameters Influence the Effect of Cold-Water Immersion on Muscle Soreness? An Updated Systematic Review and Meta-Analysis

OBJECTIVE

Our objective was to determine the efficacy of cold-water immersion (CWI) on the management of muscle soreness to identify the impact of immersion time, water temperature, CWI protocol, and type of exercise on this outcome.

DESIGN

Intervention systematic review and meta-analysis.

SETTING

MEDLINE/PubMed, Embase, Central, and SPORTDiscus databases were searched from their earliest record to July 30, 2020. Only randomized controlled trials that assessed muscle soreness comparing CWI and control were included. Studies were pooled in different subgroups regarding the used protocol: water temperature (severe or moderate cold), immersion time (short, medium, or longer time), CWI protocol (intermittent or continuous application), and type of exercise (endurance or resistance exercise). Data were pooled in a meta-analysis and described as weighted mean difference (95% confidence interval, P < 0.05).

PARTICIPANTS

Athletes and nonathletes.

INTERVENTIONS

Cold-water immersion and control condition.

MAIN OUTCOME MEASURES

Muscle soreness.

RESULTS

Forty-four studies were included. For immediate effects, CWI was superior to control regardless of water temperature and protocol, and for short and medium immersion times and endurance exercises. For delayed effects, CWI was superior to control in all subgroups except longer immersions time.

CONCLUSIONS

This study suggests that CWI is better than control for the management of muscle soreness and water temperature and CWI protocol do not influence this result, but only short and medium immersions times presented positive effects. Aiming immediate effects, the best results suggest CWI application only after endurance exercises, while delayed effect CWI was superior both after endurance and resistance exercises.

Brown adipose tissue human biomarkers: Which one fits best? A narrative review

Adipose tissue (AT) is an endocrine metabolically dynamic active tissue that plays a central role in the systemic energy balance and metabolic regulation. Brown AT represents approximately 1% of adult human AT, with an energy-burning function that uses fat to create heat. Brown AT activity was measured using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. It has been shown that cold exposure could promote brown AT activation. However, many factors, such as aging and body mass index, may interfere with this activity. Many authors have discussed the role of factors specifically secreted by the AT in response to cold exposure. The aim of this review is to properly understand the effects of cold on AT and biomarkers and their possible application in rehabilitation medicine. A comprehensive literature review was performed to identify published studies regarding biomarkers of cold effects on Brown AT searching the following databases: PubMed, Science Direct, and Web of Science, from 2012 to 2022. After evaluation of the inclusion and exclusion criteria, 9 studies were included in this review. We reported the overall influence of cold exposure on brown AT activity, its related biomarkers, and metabolism, demonstrating that the therapeutic role of cold exposure needs to be better standardized. From our data, it is important to design proper clinical trials because most cold applied protocols lack a common and homogeneous methodology.

Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression

Background

Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations.

Objectives

The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations.

Study Design

Systematic review with meta-analysis and meta-regression.

Methods

A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables.

Results

Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise.

Conclusion

CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise.

Funding

Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training.

Protocol registration

Open Science Framework: 10.17605/OSF.IO/SRB9D.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01644-9.

Effects of Pre-, Post- and Intra-Exercise Hyperbaric Oxygen Therapy on Performance and Recovery: A Systematic Review and Meta-Analysis

Background: As a World Anti-doping Agency (WADA)-approved treatment, hyperbaric oxygen (HBO₂) therapy has been used to improve exercise performance in sports practice.

Objective: We aimed to investigate the effect of pre-, post-, and intra-exercise HBO₂ therapy on performance and recovery.

Methods: A literature search was conducted using EMBASE, CENTRAL, PubMed, Web of Science, and SPORTDiscus to obtain literature published until May 2021. A total of 1,712 studies that met the following criteria were identified: (1) enrolled healthy adults who were considered physically active; (2) evaluated HBO₂ therapy; (3) included a control group exposed to normobaric normoxic (NN) conditions; (4) involved physical testing (isokinetic or dynamic strength exercise, maximal incremental treadmill/cycle exercise, etc.); and (5) included at least one exercise performance/recovery index as an outcome measure. The Cochrane risk of bias assessment tool was used to evaluate the included studies, and the heterogeneity of therapy effects was assessed using the I² statistic by Review Manager 5.3.

Results: Ten studies (166 participants) were included in the qualitative analysis, and six studies (69 participants) were included in the quantitative synthesis (meta-analysis). In comparisons between participants who underwent HBO₂ therapy and NN conditions, the effects of pre-exercise HBO₂ therapy on exercise performance were not statistically significant (P > 0.05), and the effects of post-exercise HBO₂ therapy on recovery were not statistically significant either (P > 0.05). Although individual studies showed positive effects of intra-exercise HBO₂ therapy on exercise performance, a meta-analysis could not be performed.

Conclusion: Hyperbaric oxygen therapy before or after exercise had no significant effect on performance and recovery. However, hyperbaric oxygen therapy during exercise could improve muscle endurance performance, which needs to be confirmed by further empirical studies. At present, the practical relevance of these findings should be treated with caution.

Different Training Methods Cause Similar Muscle Damage in Youth Judo Athletes

It is well known that different factors can contribute to muscle damage in judo matches or training. Previous research analyzed only the effects of simulated judo combat or judo training on biochemical markers of muscle damage without determining its specific causes. Our objective was to identify possible differences in biochemical markers of muscular damage in response to different training methods in youth judo athletes. Twelve high-level male judo athletes were randomly assigned to a standing (SP, n = 6, age = 16.6 ± 1.1 years) or a groundwork (GP, n = 6, age = 17.8 ± 0.8 years) position combat practice group. Both groups had the same protocol of four 4-minute combat practice bouts separated by 1-minute rest intervals. Before and immediately after combat practice blood samples were taken to assess muscle damage markers: creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT). There were significant increases in AST, LDH, and CK after the standing and groundwork training sessions compared with resting values in both groups. Additionally, no significant differences in the enzyme's activity between SP and GP groups were found. These results showed that standing and groundwork randori training (free sparring or free practice) causes similar muscle damage in adolescent judo athletes. Future research should assess the effects of the same damage mechanisms over a longer period of time.

Effects of 2 Intersection Strategies for Physical Recovery in Jiu-Jitsu Athletes

PURPOSE

To compare the effect of static stretching (SS) and cold-water immersion (CWI) on strength performance and blood lactate levels of jiu-jitsu athletes.

METHODS

A total of 21 male Brazilian jiu-jitsu fighters were randomly assigned to SS (9 × 30-s carpal extension), CWI (3 × 3 min at 10°C), or a control group (CG); their maximal handgrip strength, handgrip muscle endurance, dynamic kimono grip strength test, and blood lactate concentration were assessed before and after a simulated Brazilian jiu-jitsu fight and after one of the recovery interventions.

RESULTS

There was an interaction (F = 9.075; P = .002) and a time effect (F = 11.792; P = .003) for dynamic kimono grip strength test, showing a decrease in performance for the CG (P = .0001; effect size [ES] = 0.52, moderate) and after SS (P = .006; ES = 0.43, small). There was an interaction (F = 3.592; P = .015) and a time effect (F = 122.631; P = .0001) for blood lactate concentration, showing lower levels after CWI versus CG (P = .028; ES = 0.93, moderate) and after CWI versus SS (P = .042; ES = 0.82, moderate). There was an interaction (F = 9.617; P = .001) for handgrip strength, showing an impairment in performance after SS (P = .001; ES = 0.67, moderate).

CONCLUSION

CWI promoted restoration of muscle strength and endurance and reduction in blood lactate levels after the simulated fight and can thus be used by jiu-jitsu athletes as a recovery strategy between fights.

EFEITO DA IMERSÃO EM ÁGUA FRIA SOBRE A RECUPERAÇÃO PÓS-ESFORÇO EM ATLETAS DE JIU-JITSU

RESUMO Introdução: A imersão em água fria (IAF) tem sido usada habitualmente para a recuperação muscular, mesmo com evidências limitadas sobre sua eficácia. Objetivo: O objetivo deste estudo foi investigar os efeitos da IAF depois de uma sessão de treinamento de atletas de jiu-jitsu, sobre creatina quinase (CQ), testes funcionais de força e parâmetros isocinéticos. Métodos: Doze atletas de jiu-jitsu (idade 21,75 ± 3,10 anos; IMC 24,65 ± 3,81 kg/m2; tempo de treinamento 3,41 ± 0,51 anos) foram recrutados. Considerando que o estudo é cruzado, cada grupo teve a participação dos 12 atletas com wash-out de 30 dias. Os participantes foram divididos em dois grupos experimentais: (I) Grupo controle (CON), no qual os atletas não foram submetidos à IAF e (II) Grupo IAF, no qual os atletas foram submetidos à IAF (~12º C) durante seis minutos. O esforço físico foi realizado em uma sessão de treino com simulação de lutas de jiu-jitsu, com quatro lutas de cinco minutos cada e intervalo de três minutos entre elas. As variáveis CQ plasmática, protocolo estático e dinâmico do Kimono Grip Strength Test e parâmetros isocinéticos (pico de torque, trabalho e potência) foram avaliadas antes e depois dos procedimentos experimentais de recuperação. Para a análise estatística foi usada a análise de variância de dois fatores (tempo e tratamento). O nível de significância foi de 5%. Resultados: Observou-se o efeito do tempo ao comparar CQ plasmática (incremento de 174,39 ± 99,95 UI/l para o CON e incremento de 187,91 ± 113,02 UI/l para o IAF) e teste estático do KGST (delta de -5,83 ± 9,35 s para o CON e delta de -2,83 ± 13,94 s para o IAF) antes e depois dos procedimentos experimentais de recuperação, porém, sem efeito do tratamento (P > 0,05). Os parâmetros isocinéticos não foram influenciados. Conclusão: Conclui-se que a IAF não promoveu recuperação pós-esforço em atletas de jiu-jitsu. Nível de Evidência II; ECRC de menor qualidade.

Physical and Physiological Profiles of Brazilian Jiu-Jitsu Athletes: a Systematic Review

Background

Brazilian jiu-jitsu is a grappling combat sport that has intermittency as its core element; in other words, actions of high, moderate and low intensity are interspersed during matches, requiring a high level of conditioning to support optimal levels of performance for the total match time. The athletes perform from four to six matches during a day of competition, and this number may increase if the open-class competition, which is held parallel to the competition by weight class, is considered. This systematic review examined the physical and physiological profiles of Brazilian jiu-jitsu athletes.

Methods

Only scientific researches dealing with the major fitness components of Brazilian jiu-jitsu athletes (i.e. body composition and somatotype, aerobic and anaerobic profiles, muscular strength and power) and using accepted methods that provided relevant practical applications for a Brazilian jiu-jitsu athlete’s fitness training and/or performance were included in the current review. A computer literature search was carried out of the PubMed, ISI Web of Knowledge, SportDiscus and Scopus databases (up to January 2016).

Results

The database research generated 205 articles. After the application of inclusion and exclusion criteria, 58 studies were included for the present systematic review. A total of 1496 subjects were involved in all the selected investigations.

Conclusions

Body fat is generally low for these athletes and the mesomorphic component is predominant. The different studies showed VO_2max values between 42 and 52 mL/kg/min, and it seems that aerobic fitness does not discriminate among Brazilian jiu-jitsu athletes of different competitive levels. There is a lack of scientific studies that have investigated anaerobic responses both in lower and upper limbs. Maximal dynamic, isometric and endurance strength can be associated with sporting success in Brazilian jiu-jitsu athletes. Although decisive actions during Brazilian jiu-jitsu matches are mainly dependent on muscular power, more specific studies are necessary to describe it. Studies involving the female sex should be conducted. In addition, further research is needed to analyse whether there are differences between sex, belt ranks and competitive level, and among the different weight categories for different variables.

Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes

CONTEXT

Cold-water immersion (CWI) has been applied widely as a recovery method, but little evidence is available to support its effectiveness.

OBJECTIVE

To investigate the effects of CWI on muscle damage, perceived muscle soreness, and muscle power recovery of the upper and lower limbs after jiu-jitsu training.

DESIGN

Crossover study.

SETTING

Laboratory and field.

PATIENTS OR OTHER PARTICIPANTS

A total of 8 highly trained male athletes (age = 24.0 ± 3.6 years, mass = 78.4 ± 2.4 kg, percentage of body fat = 13.1% ± 3.6%) completed all study phases.

INTERVENTION(S)

We randomly selected half of the sample for recovery using CWI (6.0°C ± 0.5°C) for 19 minutes; the other participants were allocated to the control condition (passive recovery). Treatments were reversed in the second session (after 1 week).

MAIN OUTCOME MEASURE(S)

We measured serum levels of creatine phosphokinase, lactate dehydrogenase (LDH), aspartate aminotransferase, and alanine aminotransferase enzymes; perceived muscle soreness; and recovery through visual analogue scales and muscle power of the upper and lower limbs at pretraining, postrecovery, 24 hours, and 48 hours.

RESULTS

Athletes who underwent CWI showed better posttraining recovery measures because circulating LDH levels were lower at 24 hours postrecovery in the CWI condition (441.9 ± 81.4 IU/L) than in the control condition (493.6 ± 97.4 IU/L; P = .03). Estimated muscle power was higher in the CWI than in the control condition for both upper limbs (757.9 ± 125.1 W versus 695.9 ± 56.1 W) and lower limbs (53.7 ± 3.7 cm versus 35.5 ± 8.2 cm; both P values = .001). In addition, we observed less perceived muscle soreness (1.5 ± 1.1 arbitrary units [au] versus 3.1 ± 1.0 au; P = .004) and higher perceived recovery (8.8 ± 1.9 au versus 6.9 ± 1.7 au; P = .005) in the CWI than in the control condition at 24 hours postrecovery.

CONCLUSIONS

Use of CWI can be beneficial to jiu-jitsu athletes because it reduces circulating LDH levels, results in less perceived muscle soreness, and helps muscle power recovery at 24 hours postrecovery.

Brazilian Jiu-Jitsu Simulated Competition Part II: Physical Performance, Time-Motion, Technical-Tactical Analyses, and Perceptual Responses

The aim of this study was to analyze performance, time structure, technical actions, and perceptual responses in Brazilian jiu-jitsu athletes during a simulated competition. For this purpose, 10 athletes were analyzed in a simulated competition (4 matches of 10 minutes). Physical tests and scales of the perception of effort and recovery were applied. The matches were recorded for the purpose of technical-tactical analysis and to determine the time structure. The main results show that in the simulated competition, reaction time (F(2.5,17.6) = 2.7; p = 0.087; η² = 0.28) and flexibility (F(7,63) = 1.5; p = 0.172; η² = 0.15) were unchanged across the matches. An analysis of variance showed a significant difference for grip endurance using the kimono (F(2.0,15.9) = 8.1; p = 0.004; η² = 0.50), which was not confirmed by the Bonferroni test. Jump height indicated postactivation potentiation after match 2 (F(7,63) = 3.5; p = 0.003; η² = 0.28). The maximal isometric handgrip strength in the dominant hand (F(3.2,28.6) = 2.9; p = 0.049; η² = 0.24) and in the nondominant hand (F(7,63) = 3.8; p = 0.002; η² = 0.30) showed a decline after matches 3 and 4. Although these data indicate the onset of fatigue, the effort/pause ratio of the matches was not altered (F(3,12) = 0.6; p = 0.624; η² = 0.13). The perceptions of effort (F(3,27) = 0.9; p = 0.469; η² = 0.09) and recovery (F(1.9,17.0) = 2.4; p = 0.125; η² = 0.21) and the degree of fatigue reported (F(1.5,13.8) = 0.5; p = 0.588; η² = 0.05) did not change during the simulated competition. Thus, it may be concluded that the execution of successive matches causes a decline in maximal isometric handgrip strength. No changes in the time structure of the matches or in the perceptual responses were observed.

Brazilian Jiu-Jitsu Simulated Competition Part I: Metabolic, Hormonal, Cellular Damage, and Heart Rate Responses

The aim of this study was to analyze physiological responses in Brazilian jiu-jitsu athletes during simulated competition. To this end, 10 athletes (age: 28 ± 4 years, body mass: 81.8 ± 7.4 kg, body fat: 13.0 ± 4.8%, systematic practice: 11 ± 4 years) were analyzed in simulated competition (4 matches of 10 minutes). Blood samples were taken to assess energy demand, hormonal responses, and cell damage. Additionally, the heart rate variability (HRV) response was analyzed. The main results show that in simulated competition, during the last matches, athletes had lower lactate (p < 0.001), epinephrine (p < 0.001), norepinephrine (p < 0.001), and insulin (p = 0.002) concentrations. Increases observed in creatine kinase (p < 0.001), aspartate aminotransferase (p < 0.001), alanine aminotransferase (p = 0.007), and creatinine (p < 0.001) seen, especially, in the last matches are indicative of possible cell damage. The HRV reflected a decrease in the RR medium (average of the normal R-R intervals) (p = 0.001) during the competition. Thus, it is concluded that successive matches from competition generate a gradual decrease of adrenergic and glycolytic activities, which is accompanied by a gradual increase in cell damage markers and decrease in the RR medium of the HRV.