Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise
Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise
复制标题
DOI：
10.1002/14651858.cd008262.pub2
复制
发表时间：
2012-01-01
影响因子：
1.4
通讯作者：
Costa, Marco Túlio
中科院分区：
文献类型：
--
作者：
Bleakley, Chris;McDonough, Suzanne;Costa, Marco Túlio
背景许多策略的使用目的是预防或最大程度地减少运动后迟发性肌肉酸痛和疲劳。冷水浸泡，水温低于15℃，是目前运动后最流行的干预策略之一。目的确定冷水浸泡在运动后肌肉酸痛管理中的效果。检索方法2010年2月，我们检索了Cochrane骨、关节和肌肉创伤组专业登记册，Cochrane中央对照试验登记册（The Cochrane图书馆（2010年，第1期） 1)、MEDLINE、EMBASE、Cumulative Index to Nursing and Allied Health (CINAHL)、British Nursing Index and archive (BNI) 和 Physiotherapy Evidence Database (PEDro) 我们还检索了文章的参考文献列表、手工检索的期刊和会议论文集并联系了专家。2011 年 11 月，我们更新了 CENTRAL（2011 年第 4 期）、MEDLINE 的检索（截至 11 月周）。 2011 年 3 月）、EMBASE（至 2011 年第 46 周）和 CINAHL（至 2011 年 11 月 28 日）检查最新出版物。选择标准随机和半随机试验比较运动后使用冷水浸泡与以下方法的效果：被动干预（休息/不干预）、对比浸泡、温水浸泡、主动恢复、压缩或不同持续时间/剂量的冷水主要结果是疼痛（肌肉酸痛）或压痛（触诊疼痛）和主观恢复（恢复之前的活动，没有体征或症状）。数据收集和分析三位作者独立评估研究质量并提取数据。在可能的情况下，使用固定效应模型汇总数据。主要结果纳入了 17 项小型试验，总共涉及 366 名受试者。不同试验中冷水浸泡的温度、持续时间和频率各不相同，大多数研究未能报告对预先定义的不良事件的主动监测。 14 项研究比较了冷水浸泡与被动干预对肌肉酸痛的影响，结果显示，运动后 24 小时冷水浸泡有显着的效果（标准化平均差 (SMD) -0.55，95% CI -0.84 至 -0.27； 10 项试验）、48 小时（SMD -0.66，95% CI -0.97 至 -0.35；8 项试验）、72 小时（SMD -0.93；95% CI -1.36 至 -0.51；4 项试验）和 96 小时（SMD -0.58；95% CI -1.00 至 -0.16；5 项试验）随访。探索性亚组分析表明，使用交叉设计或基于跑步的练习的研究表明，冷水浸泡的效果明显更大。两项研究的汇总结果发现，冷水浸泡组的疲劳评级显着降低（MD 1.70；95% CI -2.49 至 -0.90；10 个单位量表，最好到最差），并且可能提高身体恢复评级（MD 0.97；95% CI -0.10 至冷水浸泡结束后即刻为 2.05；从最差到最好）。五项研究比较了冷水与对比浸泡，结果显示两组在四个随访时间（治疗后立即、24、48 和 72 小时）的汇总分析结果相似，适用于比较冷水和温水的四项研究。单个试验仅将冷水浸泡与主动恢复、加压和 24 小时第二次冷水浸泡进行比较。作者的结论 有一些证据表明，与涉及休息或不干预的被动干预相比，冷水浸泡可减少运动后的延迟性肌肉酸痛。大多数试验没有对预先定义的不良事件进行主动监测。
BackgroundMany strategies are in use with the intention of preventing or minimising delayed onset muscle soreness and fatigue after exercise. Cold-water immersion, in water temperatures of less than 15 C, is currently one of the most popular interventional strategies used after exercise.ObjectivesTo determine the effects of cold-water immersion in the management of muscle soreness after exercise.Search methodsIn February 2010, we searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library (2010, Issue 1), MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health (CINAHL), British Nursing Index and archive (BNI), and the Physiotherapy Evidence Database (PEDro). We also searched the reference lists of articles, handsearched journals and conference proceedings and contacted experts.In November 2011, we updated the searches of CENTRAL (2011, Issue 4), MEDLINE (up to November Week 3 2011), EMBASE (to 2011 Week 46) and CINAHL (to 28 November 2011) to check for more recent publications.Selection criteriaRandomised and quasi-randomised trials comparing the effect of using cold-water immersion after exercise with: passive intervention (rest/no intervention), contrast immersion, warm-water immersion, active recovery, compression, or a different duration/dosage of cold-water immersion. Primary outcomes were pain (muscle soreness) or tenderness (pain on palpation), and subjective recovery (return to previous activities without signs or symptoms).Data collection and analysisThree authors independently evaluated study quality and extracted data. Some of the data were obtained following author correspondence or extracted from graphs in the trial reports. Where possible, data were pooled using the fixed-effect model.Main resultsSeventeen small trials were included, involving a total of 366 participants. Study quality was low. The temperature, duration and frequency of cold-water immersion varied between the different trials as did the exercises and settings. The majority of studies failed to report active surveillance of pre-defined adverse events.Fourteen studies compared cold-water immersion with passive intervention. Pooled results for muscle soreness showed statistically significant effects in favour of cold-water immersion after exercise at 24 hour (standardised mean difference (SMD) -0.55, 95% CI -0.84 to -0.27; 10 trials), 48 hour (SMD -0.66, 95% CI -0.97 to -0.35; 8 trials), 72 hour (SMD -0.93; 95% CI -1.36 to -0.51; 4 trials) and 96 hour (SMD -0.58; 95% CI -1.00 to -0.16; 5 trials) follow-ups. These results were heterogeneous. Exploratory subgroup analyses showed that studies using cross-over designs or running based exercises showed significantly larger effects in favour of cold-water immersion. Pooled results from two studies found cold-water immersion groups had significantly lower ratings of fatigue (MD 1.70; 95% CI -2.49 to -0.90; 10 units scale, best to worst), and potentially improved ratings of physical recovery (MD 0.97; 95% CI -0.10 to 2.05; 10 units scale, worst to best) immediately after the end of cold-water immersion.Five studies compared cold-water with contrast immersion. Pooled data for pain showed no evidence of differences between the two groups at four follow-up times (immediately, 24, 48 and 72 hours after treatment). Similar findings for pooled analyses at 24, 48 and 72 hour follow-ups applied to the four studies comparing cold-water with warm-water immersion. Single trials only compared cold-water immersion with respectively active recovery, compression and a second dose of cold-water immersion at 24 hours.Authors' conclusions There was some evidence that cold-water immersion reduces delayed onset muscle soreness after exercise compared with passive interventions involving rest or no intervention. There was insufficient evidence to conclude on other outcomes or for other comparisons. The majority of trials did not undertake active surveillance of pre-defined adverse events. High quality, well reported research in this area is required.