Temporal dynamics of muscle strength recovery following acute cold-water immersion: a systematic review and meta-analysis
Abstract
Objective: This study aimed to investigate the time-dependent effects of a single bout of acute cold-water immersion (CWI) on the recovery of post-exercise maximal muscle strength, explosive power, biochemical markers of muscle damage, and subjective pain, with the specific goal of determining the optimal temporal window for its practical application.
Methods: A systematic search was conducted in PubMed, Web of Science, Cochrane Library, and Embase databases for studies published from inception to September 1, 2025. Randomized controlled trials (RCTs) comparing a single bout of acute CWI with passive recovery regarding their effects on post-exercise strength recovery in healthy individuals were included. Methodological quality, risk of bias, and certainty of evidence were assessed using the Physiotherapy Evidence Database (PEDro) scale, the Risk of Bias 2 (RoB 2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. Statistical analysis was performed using Stata-MP 18.0 software.
Results: Twenty-two RCTs were included. For maximal voluntary isometric contraction (MVIC), no significant overall or time-dependent effects were observed (g = 0.08, 95% confidence interval (CI) [-0.11-0.26], p = 0.42; moderate certainty). For countermovement jump (CMJ) , the overall effect was not significant (g = 0.01, 95% CI [-0.25-0.28], p = 0.92), but a significant subgroup difference across time points was detected (p p = 0.01) that was…
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