The effects of hydrotherapy and cryotherapy on recovery from acute post-exercise induced muscle damage-a network meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and network meta-analysis of randomized controlled trials
PubMed 39294614 · doi:10.1186/s12891-024-07315-2
What was done
Authors conducted a systematic review and frequentist network meta-analysis across five English and Chinese databases to evaluate recovery strategies for exercise-induced muscle damage (EIMD) caused by resistance training, HIIT, or ball games. Random-effects models based on standardized mean differences (SMD) were used, and interventions were ranked using surface under the cumulative ranking curve (SUCRA) values. Four modalities were assessed across randomized controlled trials: cold water immersion (CWI), contrast water therapy (CWT), thermoneutral or hot water immersion (TWI/HWI), and cryotherapy (CRYO).
What was found
Across 57 studies involving 1,220 healthy participants, contrast water therapy was ranked most effective for reducing the biochemical marker creatine kinase (SUCRA: 79.9%). Cryotherapy ranked highest for relieving delayed onset muscle soreness (SUCRA: 88.3%) and for recovering jump ability (SUCRA: 83.7%). Absolute effect sizes (SMDs) and confidence intervals were not reported in the abstract.
Why it matters
This network meta-analysis distinguishes which thermal recovery modality is most effective for specific recovery domains, indicating that contrast water therapy best targets biochemical markers while cryotherapy best targets perceived soreness and neuromuscular performance.
Limits
The abstract reports only SUCRA ranking percentages rather than absolute effect sizes, precision metrics, or between-study heterogeneity estimates. The sample was restricted to healthy individuals, and substantial clinical heterogeneity is likely present given the broad range of exercise modalities and undefined temperature/duration protocols within intervention categories.
Cited by
- contradicts Cold water immersion is more effective for reducing muscle soreness than whole-body cryotherapy or cold showers.