The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane’s risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges’ g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges’ g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges’ g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges’ g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period.

This randomized controlled trial examined the effects of cold‐water immersion (CWI), partial‐body cryotherapy (PBC), or a passive control (CON) on physiological and recovery variables following exercise‐induced muscle damage (EIMD, 5 × 20 drop jumps) in females. Twenty‐eight females were allocated to PBC (30 seconds at −60°C, 2 minutes at −135°C), CWI (10 minutes at 10°C), or CON (10 minutes resting). Muscle oxygen saturation (SmO₂), cutaneous vascular conductance (CVC), mean arterial pressure (MAP), and local skin temperature were assessed at baseline and through 60 minutes (10‐minute intervals), while delayed onset of muscle soreness (DOMS), muscle swelling, maximum voluntary isometric contraction (MVIC), and vertical jump performance (VJP) were assessed up to 72 hours (24‐hour intervals) following treatments. SmO₂ was lower in PBC (Δ‐2.77 ± 13.08%) and CWI (Δ‐5.91 ± 11.80%) compared with CON (Δ18.96 ± 1.46%) throughout the 60‐minute follow‐up period (P < .001). CVC was lower from PBC (92.7 ± 25.0%, 90.5 ± 23.4%) and CWI (90.3 ± 23.5%, 88.1 ± 22.9%) compared with CON (119.0 ± 5.1 and 116.1 ± 6.6%, respectively) between 20 and 30 minutes (P < .05). Mean skin temperature was lower from CWI vs PBC (between 10 and 40 minutes, P < .05). Mean skin temperature was higher in CON compared with CWI up to 60 minutes and compared with PBC up to 30 minutes (P < .05). DOMS was lower following both PBC and CWI compared with CON through 72‐hour (P < .05), with no difference between groups. No main group differences for swelling, MVIC, and VJP were observed. In conclusion, CWI elicited generally greater physiological effects compared with PBC while both interventions were more effective than CON in reducing DOMS in females, but had no effect on functional measures or swelling.

The aim of this study is to compare (a) the physiological responses following cold‐water immersion (CWI) and partial‐body cryotherapy (PBC) and (b) the effects on recovery following a muscle‐damaging protocol (5 × 20 drop jumps). Nineteen healthy males were randomly allocated into either a CWI (10°C for 10 minutes; n = 9) or a PBC (−60°C for 30 seconds, −135°C for 2 minutes; n = 10) group. The physiological variables (thigh muscle oxygen saturation [SmO₂], cutaneous vascular conductance [CVC], mean arterial pressure [MAP], and local skin temperature) were assessed immediately prior and up to 60 minutes post‐treatment (10‐minutes intervals). The recovery variables (thigh muscle swelling, maximum voluntary contraction [MVC] of the right knee extensors, vertical jump performance [VJP], and delayed onset of muscle soreness [DOMS]) were measured immediately prior and up to 72 hours post‐treatment (24‐hours intervals). Compared to PBC values, CVC (at 30 minutes), SmO₂ (at 40 minutes), and lower extremity skin temperature (thigh/shin at 60 minutes) were significantly reduced in the CWI group after the treatment (all P < .05). Only lower extremity skin temperature was significantly reduced in the PBC group directly post‐treatment (all P < .05). MAP significantly increased in both groups after the treatments (both P < .05). DOMS did not differ between groups. MVC and VJP returned to baseline in both groups after 24 hours (P > .05). CWI had a greater impact on the physiological response compared to PBC. However, both treatments resulted in similar recovery profiles during a 72‐hours follow‐up period.

Study design: Clinimetric cross-sectional cohort study in adults with paraplegic spinal cord injury (SCI) and neuropathic pain (NP). Objective: To assess the reliability of standardized quantitative pain drawings in patients with NP following SCI. Setting: Hospital-based research facility at the Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland. Methods: Twenty individuals with chronic thoracic spinal cord injury and neuropathic pain were recruited from a national and local SCI registry. A thorough clinical examination and pain assessments were performed. Pain drawings were acquired at subsequent timepoints, 13 days (IQR 7.8–14.8) apart, in order to assess test-retest reliability. Results: The average extent [%] and intensity [NRS 0–10] of spontaneous NP were 11.3% (IQR 4.9–35.8) and 5 (IQR 3–7), respectively. Pain extent showed excellent inter-session reliability (intraclass correlation coefficient 0.96). Sensory loss quantified by light touch and pinprick sensation was associated with larger pain extent (r_pinprick = −0.47, p = 0.04; r_{light touch} = −0.64, p < 0.01). Conclusion: Assessing pain extent using quantitative pain drawings is readily feasible and reliable in human SCI. Relating information of sensory deficits to the presence of pain may provide distinct insights into the interaction of sensory deafferentation and the development of neuropathic pain after SCI.

Background: Investigations of the perfusion of the skin's microcirculation with laser speckle contrast imaging (LSCI) after cold treatments are rare. Therefore, the aim of this study was to compare the effects between cold‐water immersion (CWI) conduction and partial‐body cryotherapy (PBC) convection on perfusion of the microcirculation and skin temperature on the thigh.Materials and Methods: Twenty healthy males were randomly allocated to CWI (10°C for 10 minutes) or PBC (−60°C for 30 seconds, −135°C for 2 minutes). Perfusion and skin temperature measurements were conducted on the anterior thigh region up to 60 minutes post‐treatment.Results: Cold‐water immersion decreased perfusion of the microcirculation significantly compared to baseline values between 10 minutes (P = 0.003) and 30 minutes (P = 0.01) post‐treatment. PBC increased perfusion of the microcirculation and decreased skin temperature only at the first measurement interval (0 minute, both P = 0.01) post‐treatment. Additionally, local skin temperature was significantly decreased compared to baseline values only after CWI up to 30 minutes (P = 0.04) post‐treatment.Conclusion: Cold‐water immersion reduced local skin microcirculation and skin temperature while PBC only slightly increased the perfusion of the microcirculation immediately after the treatment. For cooling purposes, the conduction method seems superior compared to the convection method, assessed with a LSCI device.