Effect of Total Cold Water Immersion Vs Ice Massage Modalities

NCT ID: NCT04183816

Last Updated: 2019-12-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-11-01
• Study Completion Date: 2019-01-20

Brief Summary

Evidence regarding the effect of the therapeutic modalities on muscle recovery after exercise-induced muscle damage (EIMD) was lacking. Therefore, this study played a role in bridging this gap, where total cold-water immersion (TCWI) values return to baseline 72 h after the muscle damage protocol, regarding creatine kinase (CK) levels, power and strength, and delayed onset of muscle soreness (DOMS).

Detailed Description

Participants were recruited by means of convenience sampling. A message was sent via WhatsApp for all the contact list of the investigators. This message included a brief explanation of the study purpose, phone numbers of the three investigators and a request to forward this message to the contact lists of the recipients.

At the beginning of the study, all participants' data were recorded, including their physical characteristics and eligibility.

Eligible participants were given information sheets and signed consent forms. Afterward, they were familiarized with the experimental procedure and given numbers in order to assure blindness during the processes of allocating them into groups and assessing the outcomes. Final participants included 60 eligible stratified into two blocks (30 males and 30 females).

Then a randomization website -website spreadsheet generator; http://www.randomization.com was used to randomly allocate each into one of two intervention groups: 1) Total CWI (TCWI) or 2) IM.

Baseline measurements of both groups (TCWI and IM) were taken and include one repetition maximun (1-RM), (2) CMJ, (3) VAS, and (4) Serum CK tests. Testing was followed by a warm-up session and then by muscle damage protocol. Thereafter, each of the interventions (TCWI or IM) were performed and followed by post-exercise measurements at 2; 24, 48 and 72 hours.

Muscle damage protocol. Muscle damage was induced by 20 sets of 5 drop jumps each, with a two-minute rest between sets. Participants were instructed to drop jump from a 60-cm box, then perform a maximal bipodal CMJ, then land on the floor with knees flexed to at least 90°, while keeping their hands on their knees to eliminate additional force by upper limbs. This protocol produces a response similar to that obtained from high-intensity multi-joint exercises (Vieira et al., 2016).

Total cold-water immersion. The best results of recovery from EIMD were provided by TCWI with a water temperature between 11 and 15°C and an immersion time of 11 to 15 minutes according to Lee et al. (2012) and Machado et al. (2016). For that reason, participants allocated to the TCWI group completed a session of 15-minutes in cold water with temperature of 12°C.

Participants were seated while immersing their whole body in water except their head and neck. The water's temperature was continuously measured by a mercury-in-glass thermometer and was maintained at a temperature of 12°C by adding blocks of ice when needed.

With respect to depth, TCWI is more efficient than partial CWI since exposing a larger mass of the body including the core is needed for cardiovascular changes to occur, since the major heat exchange that leads to cooling occurs via conduction by surrounding water, so the higher the level of water immersion is, the greater the surface area of the body in contact with water will be, leading to better recovery effect (Murray and Cardinale, 2015; Stephens et al., 2016).

Ice massage. The IM group was seated and subjected to a circular local massage by a cube of ice for 15 minutes for each leg on the region of quadriceps muscles.

Data Analysis The results were analyzed by the Statistical Package for the Social Sciences (SPSS) version 21.0 for windows. The Shapiro-Wilk test was used to check the normality of the data distribution. A probability (p) value of >0.05 indicates that there is no significant difference between groups.

Analysis of variance (ANOVA) test was used to compute the within-group differences of each variable (muscle damage, strength, power, and DOMS) at different testing times (Baseline, 2h, 24h, 48h and 72h after exercise).

Factorial repeated measures ANOVA test was used to determine between-group difference between TCWI and IM groups, of each variable (muscle damage, strength, power, and DOMS) at different testing times (Baseline, 2h, 24h, 48h and 72h after exercise).

Conditions

Exercise-induced Muscle Damage

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: TRIPLE

Study Groups

Total cold-water immersion group

Participants allocated to the TCWI group completed a session of 15-minutes in cold water with a temperature of 12°C. Each Participant was totally immersed in a pool while his/her head and neck remained above water level. The water's temperature was continuously measured by a mercury-in-glass thermometer and maintained at the aforementioned temperature by continuously adding ice blocks.

With respect to depth of immersion, TCWI is more efficient than partial CWI since exposing a larger area of the body is needed for cardiovascular changes to occur (Murray and Cardinale, 2015; Stephens et al., 2016).

Group Type: EXPERIMENTAL

Total cold-water immersion

Intervention Type: OTHER

TCWI group completed a session of 15-minutes in cold water with a temperature of 12°C.

Ice massage group

Participants in the IM group were seated. The investigator in charge of this intervention group applied Ice cubes massage in a clockwise circular motion on the thigh area (quadriceps) for 15 minutes.

Group Type: ACTIVE_COMPARATOR

Ice massage

Intervention Type: OTHER

Ice cubes massage in a clockwise circular motion on the thigh area (quadriceps) for 15 minutes.

Interventions

Total cold-water immersion

TCWI group completed a session of 15-minutes in cold water with a temperature of 12°C.

Intervention Type: OTHER

Ice massage

Ice cubes massage in a clockwise circular motion on the thigh area (quadriceps) for 15 minutes.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Lebanese adults aged between 19 and 44 years,
• resided in Tyre and Saida districts, and Beirut governorate,
• regular exercise (30 min of moderate-intensity physical activity on at least 3 d. wk-1 for at least the past 3 months).

Exclusion Criteria

• history of serious lower limb trauma (fractures, meniscus or ligament tears)
• troubles of the sensation of cold temperature,
• cardiopulmonary or inflammatory diseases
• follow regular strength and plyometric training exercises

• Minimum Eligible Age: 19 Years
• Maximum Eligible Age: 44 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Lebanese German University

OTHER

Sponsor Role: lead

Responsible Party

Mohammed Ali FAKHRO, DPT

Instructor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Lebanese German University

Jounieh, Keserwan, Lebanon

Countries

Lebanon

References

Fakhro MA, AlAmeen F, Fayad R. Comparison of total cold-water immersion's effects to ice massage on recovery from exercise-induced muscle damage. J Exp Orthop. 2022 Jun 22;9(1):59. doi: 10.1186/s40634-022-00497-5.

Reference Type: DERIVED

PMID: 35731373 (View on PubMed)

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

Lebanese German University

Identifier Type: -

Identifier Source: org_study_id