Cold Water Immersion Research Articles

Influence of hydrotherapy on change in weight: a narrative review.

There is a growing interest in weight loss in today's world. Environmental factors are the main contributor behind the rapidly spreading obesity during pandemic. Exercise and diet are two controllable elements that significantly effect on energy balance., The use of cold application such as cold-water immersion, cold abdominal pack, balneotherapy, cold exposure, water drinking, steam, and sauna sessions, has shown a positive impact in weight management. This review explains the mechanism and various types of hydrotherapy applications managing weight through thermogenesis and non-shivering thermogenic pathways, which involve the brown adipose tissue, and dependent on uncoupling protein 1 (UCP1) in the inner mitochondrial membrane. Hence the present literature provides insight into use of hydrotherapy applications for future direction in weight management.

Influence of Acute and Chronic Therapeutic Cooling on Cognitive Performance and Well-being

PurposeResearch regarding the effect cold-water immersion (CWI) has on cognitive performance often uses excessive cooling protocols (>1-hour) to measure the detrimental impact prolonged cold exposure has on cognition. Previous studies have not considered shorter CWI protocols, similar to that used in recovery and wellness practices (∼10 min). AimsTo investigate a more ecologically valid CWI protocol on cognition, well-being and sleep in an acute and chronic manner. It was hypothesised that a therapeutic CWI protocol would improve well-being, and sleep and have no detrimental effect on cognition. MethodsThirteen healthy participants (20.85±2.15 years), (169.96±7.77 cm), (72.03±14.92 kg), (27.67±9.55 BF%) volunteered to complete a 4-week CWI protocol. Participants were immersed in cold water (10.42±0.59°C) 3-times a week for 4-weeks. Cognitive performance (Stroop & TMT), well-being (WEMWBS, PSWQ, GAD-7, SHS) and sleep (PSQI) were measured acutely and chronically over the 4-week protocol along with thermoregulatory measures (Tsk, Tco, thermal comfort). ResultsResults show that CWI had no detrimental impact on cognitive performance, with Stroop performance & well-being seeing no differences acutely or chronically. Alternatively, the trail making test showed significant improvement from baseline (TMT-A 15.17±4.81-seconds, TMT-B 39.68±15.12-seconds) to week-3 (TMT-A 11.06±3.29-seconds, TMT-B 26.18±10.23-seconds). A reduction in sleep disturbances was seen from baseline scores of 7.85±3.44 AU to the end of week-3 measures 5.75±3.77 AU. ConclusionTherapeutic cooling can improve sleep quality when utilised in short frequent doses (3 times per week, for 4-weeks) and is not detrimental to cognitive performance, improving certain aspects of executive function.

An Evidence-Based Approach to Utilizing Cold Therapies for Post-Exercise Recovery

Whilst cold therapies such as cold-water immersion are regularly used in practice, the practical application does not always align with best practices. In this commentary, we highlight the key components of the British Association of Sport and Exercise Sciences (BASES) Expert Statement on the use of cooling therapies for post-exercise recovery and provide additional discussion on the empirical evidence and rationale that informed our perspective. We developed a series of specific questions to ensure that cold therapy recovery protocols are context-specific and tailored to the needs of the individual athletes. These questions, which cover the WHEN, WHAT, and HOW of cold therapy, were central to the development of the Expert Statement. This was presented as a decision tree to ensure that key messages could be concisely disseminated across a range of sporting environments and populations (e.g., gyms, locker rooms, and treatment rooms), supporting and informing decision-making for those wanting to use cold therapy to assist their recovery in line with previously published peer-reviewed work. Discussion points included the suitability of cooling therapies in some contexts, how athletes’ choice of cooling mode should be largely driven by practicalities (e.g., budget and availability), and, lastly, future research directions.

Potential impact of cold water immersion on arrhythmogenesis: a pilot exploratory study surrounding the Geneva christmas cup

Abstract Background Cold-water immersion (CWI) is gaining popularity and is regulated by sports federations with guidelines for various cold temperature ranges. Small studies suggest cardiovascular and stress reduction benefits from regular CWI, yet acute effects and cardiac risks remain underexplored. Purpose This study aimed to assess the impact of CWI on arrhythmogenesis among participants of the 2023 Geneva Christmas Cup, the world's largest cold-water swimming event. Methods Volunteers aged 45 and older were recruited through the organizing committee. Each underwent baseline cardiovascular risk assessment 10 days prior to the event, including medical interviews, physical exams, blood tests, and 12-lead ECGs. A waterproof ECG recorder (BodyGuardian Mini®) was attached to participants, monitoring them for 10 days up to the end of the race. An activity diary recorded training sessions, CWI exposure, and any symptoms. Data from BodyGuardian Mini® were analyzed for CWI-induced arrhythmias and conduction disturbances. The local ethics committee approved the study. Results Twenty volunteers (11 women, mean age 56 ± 6.4 years) participated. Their mean SCORE2/SCORE2-OP was 4 ± 1.8%, with 60% at low to moderate and 40% at high cardiovascular risk. Average weekly training was 5.5 ± 2.9 hours. Lake temperature was 7.0 degrees. One participant could not race but all completed CWI training and wore ECG recorders for an average of 226 ± 32 hours. Sixteen participants (80%) exhibited non-sustained atrial tachycardia (average 12.4 ± 8.8 events), and four (20%) had non-sustained ventricular tachycardia events (average 1.2 ± 0.5), with no significant pauses or >1st degree AV block observed. No arrhythmic events were directly linked to CWI. Conclusion This exploratory study of active, middle-aged participants with moderate cardiovascular risk found no association between CWI and arrhythmias. Further, larger-scale studies are necessary to conclusively determine CWI's safety.

Sex differences in autonomic functions and cognitive performance during cold-air exposure and cold-water partial immersion.

This study investigated the differences between males and females in autonomic functions and cognitive performance during cold-air exposure and cold-water partial-immersion compared to a room temperature-air environment. Although several studies have investigated the effects of cold-air or cold-water exposures on autonomic function and cognitive performance, biological sex differences are often under-researched. Twenty-two males and nineteen females participated in the current study. Subjects completed a battery of cognitive tasks based upon those used within the Defense Automated Neurobehavioral Assessment (DANA), consisting of five subtasks that assess simple and procedural reaction time, spatial manipulation, attention, and immediate memory. In total, subjects took the battery within a 15-minute period across 30-minute intervals throughout the duration of environmental exposure. Across three separate days, subjects were exposed to three different environmental conditions: room temperature air (23°C), cold air (10°C), and cold water (15°C; in which subjects were immersed up to their necks). Room temperature and cold-air conditions consisted of five sessions (about 2.5h), and the cold-water condition consisted of three sessions (about 1.5h). During each experimental condition, physiological data were collected to assess autonomic function, including electrodermal activity (EDA) data and heart rate variability (HRV) derived from electrocardiogram signals. Females showed slower reaction time in spatial manipulation tasks, immediate memory, and attention during cold-air exposures compared to room temperature air, whereas the performance of males were similar or better during cold-air exposures compared to room temperature air. Cold-water immersion affected the immediate memory performance of males. Both males and females exhibited smaller EDA amplitudes during cold-air and cold-water conditions compared to room temperature air. For HRV, only male subjects exhibited significantly greater values in low-frequency and very-low-frequency components during cold air exposure compared to the normal condition. Sex introduces important differences in cognitive performance and autonomic functions during exposure to cold-air and cold-water. Therefore, sex should be considered when assessing the autonomic nervous system in cold environments and when establishing optimal thermal clothing for performance in operational environments. Our findings can assist with determination of operational clothing, temperature in operating environment, and personnel deployment to operational sites, particularly in settings involving both males and females.

Acute ergogenic effects of repetitive maximal breath-holding maneuvers on hematological and physiological responses: a graded exercise test investigation.

Repetitive maximal breath-holds (BHs or apneas) have been noted to induce advantageous hematological and blood buffering changes. Building on this, the hypothesis was formulated that the execution of repeated maximal BH efforts might lead to subsequent enhancements in performance during a time-to-exhaustion test. This study investigated the acute effects of five static maximal breath-holding maneuvers conducted with face immersion in cold water (10°C) on subsequent graded exercise test (GET) performance. Seventeen well-trained participants completed a GET on a motorized treadmill under two randomized cross-over conditions: baseline measurement (CON) and after five repeated maximal breath-holding efforts (EXP). The GET protocol consists of incremental increases in speed until exhaustion. After the fifth breath-hold, participants in the EXP condition exhibited significant (P < 0.05) increases in hematocrit, hemoglobin concentration, red blood cell count, and muscle deoxygenation, accompanied by a reduction in blood lactate concentration (4.09 ± 2.21%, 3.9 ± 1.76%, 3.96 ± 2.1%, 81.48 ± 23.83%, and 15.22 ± 17.64%, respectively), compared to CON. During GET, the EXP condition showed a significantly (P < 0.05) delayed onset time of the second ventilatory threshold (3.14 ± 5.85%) and (P < 0.05) increased time to exhaustion (0.75 ± 1.02%). This evidence suggests that repeated maximal static breath-holding maneuvers enhance the oxygen delivery system by increasing the circulation of reserve red blood cells, heightened muscle oxygen deoxygenation, enhanced aerobic metabolism utilization, and postponing the transition from aerobic to anaerobic metabolism, implying a potential ergogenic effect. While pre-exercise breath-holding shows promise for improving time-to-exhaustion and optimizing subsequent distance running performance, further in-depth investigation is essential to fully elucidate the underlying mechanistic factors.

Case Study of Severe Accidental Hypothermia with Rapid Cooling, Preserved Shivering, and Consciousness with a Summary of Similar Case Reports.

We describe a case of severe accidental hypothermia of a kayaker with preserved consciousness and shivering despite a rectal temperature of 22.9°C following a 50-min immersion in 3°C water with an estimated core temperature cooling rate of 10.6°C/h. Based on survival at sea prediction curves and cooling rates from physiology studies, cold water (eg, 0-5°C) immersion is expected to drop core temperature by 2 to 4°C/h. Furthermore, accidental hypothermia classification systems predict that severely hypothermic patients are usually unconscious and not shivering. The patient in this report rewarmed rapidly at 3.6°C/h with only minimally invasive measures and was discharged fully neurologically intact. In 41 similar cases of survival in moderate to severe hypothermia with core temperatures <32°C due to cold water immersion, cold air exposure, or avalanche burial, mean cooling rates were 4.3±3.3°C/h (range 0.4-10.6°C/h). Including the current patient, shivering was reported in only four cases. We found several other cases of rewarming from moderate to severe hypothermia with only minimally invasive measures. The current and summarized cases lead us to conclude that patients may be at risk of severe hypothermia in <60 min of cold water immersion and that it is possible for severely hypothermic patients to have preserved consciousness, close to normal vital signs, and shivering. Minimally invasive or noninvasive rewarming of patients with severe hypothermia is also possible, especially in those who continue to shiver. Hypothermia management should not necessarily be guided by classification systems or core temperature alone but rather by a careful consideration of the entire clinical picture.

Cold Exposure Alleviates T2DM Through Plasma-Derived Extracellular Vesicles.

Anecdotal reports have praised the benefits of cold exposure, exemplified by activities like winter swimming and cold water immersion. Cold exposure has garnered acclaim for its potential to confer benefits and potentially alleviate diabetes. We posited that systemic cold temperature (CT, 4-8°C) likely influences the organism's blood components through ambient temperature, prompting our investigation into the effects of chronic cold exposure on type 2 diabetic (T2DM) mice and our initial exploration of how cold exposure mitigates the incidence of T2DM. The effects of CT (4-8°C) or room temperature (RT, 22-25°C) on T2DM mice were investigated. Mice blood and organ specimens were collected for fully automated biochemical testing, ELISA, HE staining, immunohistochemistry, and immunofluorescence. Glucose uptake was assessed using flow cytometry with 2-NBDG. Changes in potential signaling pathways such as protein kinase B (AKT), phosphorylated AKT (p-AKT), insulin receptor substrates 1 (IRS1), and phosphorylated IRS1 (p-IRS1) were evaluated by Western blot. CT or CT mice plasma-derived extracellular vesicles (CT-EVs) remarkably reduced blood glucose levels and improved insulin sensitivity in T2DM mice. This treatment enhanced glucose metabolism, systemic insulin sensitivity, and insulin secretion function while promoting glycogen accumulation in the liver and muscle. Additionally, CT-EVs treatment protected against the streptozocin (STZ)-induced destruction of islets in T2DM mice by inhibiting β-cell apoptosis. CT-EVs also shielded islets from destruction and increased the expression of p-IRS1 and p-AKT in adipocytes and hepatocytes. In vitro experiments further confirmed its pro-insulin sensitivity effect. Our data indicate that cold exposure may have a potentially beneficial effect on the development of T2DM, mainly through the anti-diabetic effect of plasma-derived EVs released during cold stimulation. This phenomenon could significantly contribute to understanding the lower prevalence of diabetes in colder regions.

Exploring barium-titanium-peroxo-hydroxide as an excellent single-source precursor for crystallographically diverse barium titanate ceramics – parametric study

Barium-titanium-peroxo type amorphous materials gained importance with the advent of wet-chemical methods for the production of crystalline perovskite barium titanate (BaTiO3) electroceramics. In this paper, the chemical nature of the barium-titanium-peroxo precursor was determined by means of elemental (EPMA), spectroscopic (FT-IR and FT-Raman), XRD and thermal (DSC and TGA/DTA) analyses. Several synthesis parameters such as the barium source, the peroxide treatment time, the reaction temperature and the reaction time were investigated. The precursor was also thermally treated at varying temperatures between 30 °C and 1000 °C. Relatively high reaction temperatures are detrimental to the Ba∙O∙Ti structure, resulting in plain TiO2 formation. Though relatively low temperatures (ice bath) are needed to suppress unwanted TiOCl2, ambient synthesis conditions and short reaction time (2 h) resulted in the desired single-source properties, i.e. amorphous Ba∙O∙Ti-peroxo structure with Ba/Ti ratio of unity (1.04 ± 0.04). The addition of an extra stirring step during H2O2 addition lowered the chance of carbonate incorporation in the precursor. Thermal analysis under air and nitrogen atmosphere was performed and a stoichiometric formula of Ba2,08Ti2O(O2)1,9(OH)5,3∙3,1H2O was calculated, which was in very good agreement with literature data. The barium-titanium-peroxo-hydroxide material proved to be an excellent single-source precursor. Phase-pure, highly crystalline and facetted, stoichiometric BaTiO3 particles with differently crystallographically oriented facets were obtained via the molten-salt solid-state method ({100} or {111} oriented facets) as well as the hydrothermal route ({100} oriented facets).

Hand cooling induces changes in the kinetics of oxygen uptake

The objective of this investigation was to assess the impact of elevated catecholamine concentrations, induced through cold-water hand immersion, on the oxygen consumption (V̇O2) kinetics during intense exercise, and to contrast this effect with that of the priming effect. Ten active participants underwent three 8-minute constant work rate exercises (CWR) at ∆25%, with one CWR preceded by hand cooling (2 min at 0 °C, HC) and two consecutive CWR to induced priming effect on the second bout (SB). Pulmonary gas exchange and blood samples were analyzed to measure levels of epinephrine (E) and norepinephrine (NE). Results demonstrated a significant increase in the primary phase amplitude of V̇O2 kinetics in response to both hand HC (33.9 mL.min−1.kg−1; CI [32.2;35.7], p < 0.001) and SB (34.6 mL.min−1.kg−1; CI [33.0;36.3], p < 0.001) relative to the control (32.7 mL.min−1.kg−1; CI [31.5;35.1]). Additionally, the amplitude of the V̇O2 slow component was reduced for both HC (3.2 mL.min−1.kg−1; CI [2.2;4.1], p = 0.018) and SB (2.9 mL.min−1.kg−1; CI [1.8;4.2], p = 0.009) in comparison to control (3.9 mL.min−1.kg−1; CI [2.9;4.2]). These findings suggest that the increase in E and NE induced by hand cooling prior to exercise modifies V̇O2 kinetics in a manner akin to the priming effect. This research underscores the potential role of catecholamines in facilitating the priming effect and its subsequent impact on V̇O2 kinetics. However, further studies are necessary to clearly establish this link.

Effects of single- and bilateral limb immersion on systemic and cerebral hemodynamic responses to the cold pressor test.

The cold pressor test (CPT) involves cold water immersion of either the upper or lower limb(s) and elicits increases in sympathetic nervous activity (SNA), heart rate (HR), and mean arterial pressure (MAP) via stimulation of pain and cutaneous thermoreceptors. Greater pain perception during the CPT is associated with greater increases in SNA and more robust physiological responses. Due to potential differential sensitivity to both painful and thermal stimuli between upper and lower limbs, as well as potential effects of total exposure area, it is unclear whether the choice of limb(s) in CPT protocol design differentially affects systemic and cerebral hemodynamic responses. Our objective was to assess systemic and cerebral hemodynamic and ventilatory responses to different CPT protocols of the hand (CPTH), foot (CPTF), or bilateral feet (CPTBF). We hypothesized CPTBF would elicit greatest physiological responses due to increased exposure area to the cold stimulus. Twenty-eight (14 M, 14 F) healthy young adults [23.4 (SD: 2.4) yr] participated in three 3-min CPT protocols during a single visit. Blood pressure, HR, middle cerebral artery blood velocity (MCAv) and cerebrovascular conductance index, and end-tidal carbon dioxide ([Formula: see text]) were averaged over the final 30 s of each minute of the CPT for each protocol, and perceived pain was recorded at the end of each minute of the CPT. We found significant effects of the time-CPT protocol interaction on systolic blood pressure (P = 0.02), diastolic blood pressure (P < 0.01), MAP (P < 0.01), and HR (P < 0.001). There were no differences between CPT protocols on either MCAv (P = 0.4) or cerebrovascular conductance index (P = 0.1). HR responses peaked in the first minute of the CPT, and changes from baseline were greater in CPTBF [Δ14(16) beats/min] compared with CPTH [Δ5(13) beats/min; P = 0.01] and CPTF [Δ4.04(13.3) beats/min; P = 0.02]. MAP responses peaked in minute 2 of the CPT, and changes from baseline were greater in CPTH [Δ12(8) mmHg) and CPTBF (Δ13(9) mmHg] compared with CPTF [Δ8(7) mmHg; P < 0.01]. Perceived pain was significantly greater in the CPTBF [CPT1 7(2.3), CPT2 6.5(2.3), CPT3 6(3)] condition compared with CPTH [CPT1 6(1.3), CPT2 6(2.3), CPT3 6(2.3)] and CPTF [CPT1 6(3.0), CPT2 6(2.0), CPT3 5.5(3.0)] protocols at all three stages of the CPT (P ≤ 0.01). Our findings suggest choice of limb(s) in CPT protocols may lead to differences in systemic hemodynamic responses, with pain perception potentially influencing these responses. Based on our results, we suggest that choice of limb should be considered in future design of CPT studies, with hand CPT providing the best balance between participant tolerability and robust physiological responses.NEW & NOTEWORTHY Choice of limb(s) in cold pressor test (CPT) studies appears to influence systemic hemodynamics. Hand and bilateral feet induce more robust responses than single-foot CPT, potentially due to increased exposure area and pain perception. Despite no significant cerebrovascular effects, a sustained hyperventilatory response was noted in bilateral feet CPT. Hand CPTs may provide a balance between robust physiological responses and tolerability. These findings underscore the need for careful limb selection in future CPT studies.

Repeated Short Cold-water Immersions Are Sufficient To Habituate To The Cold, But Do Not Lead To Adaptations During Exercise In Normobaric Hypoxia

Repeated Short Cold-water Immersions Are Sufficient To Habituate To The Cold, But Do Not Lead To Adaptations During Exercise In Normobaric Hypoxia

Simultaneous determination of pesticides, mycotoxins and ferulic acid in Angelica sinensis by GC/LC-Q-TOF/MS

In this study, a strong applicable method that could determine a total of 33 pesticides (54 compounds), 11 mycotoxins and functional components (ferulic acid) simultaneously in Angelica sinensis was developed. The compatibility of the sample pretreatment method for pesticides, mycotoxins, and functional components was improved by optimizing the acidity of extraction solvents, the sequence of ice bath and oscillation, the volumetric solution, and so on. The PRiME HLB SPE pretreatment method was chosen as the optimal one when comparing four pretreatment methods. Among the 65 contaminants, 38 of those determined by liquid chromatography and 41 of those by gas chromatography, which showed good linearity (R2 > 0.9801), 97 % of them had a limit of quantitation (LOQ) of lower than 0.02 mg kg-1. The recovery of all compounds were suited between 70 % to 120 % and the RSD were all lower than 20 % at the spiked levels of LOQ, 2 × LOQ, and 10 × LOQ. For ferulic acid, the LOQ was 50 ng/mL, and it showed good linearity (R2=0.9988) within the range of 0.5 to 10 μg/mL. The recovery and RSD were 98.1 %, and 3.2 % (n = 6), respectively. The simultaneous determination of cross-category compounds in a single sample preparation was obtained by the combination of SPE and GC/LC-Q-TOF/MS. Therefore, this study could not only shorten the time for data acquisition and data analysis, but also improve the experimental efficiency.

Water-soluble vitamins stability by robust liquid chromatography-mass spectrometry.

The measurement of water-soluble vitamins is essential to diagnose and monitor various vitamin deficiencies. Establishing stability limits for these vitamins is crucial to ensure accurate laboratory testing. This study aimed to assess the stability of commonly measured water-soluble vitamins under different storage conditions to improve the accuracy of water-soluble vitamin measurement. The stabilities of thiamine, riboflavin, nicotinamide, pantothenic acid, pyridoxic acid and pyridoxal, biotin, 5-methyltetrahydrofolic acid (5-MTHF), and ascorbic acid were measured using liquid chromatography-tandem mass spectrometry. We investigated three pre-analytical factors: the effect of different temperatures and time durations on serum stability, variation between serum and plasma samples, and the impact of transferring samples to an ice bath before serum separation. We evaluated stability based on differences from the baseline. Thiamine, pyridoxal, and ascorbic acid in serum exhibited instability at room temperature and 2-8℃. Riboflavin and 5-MTHF in serum were only stable for up to 48 and 72 h at 2-8℃. However, when stored at -20℃, all water-soluble vitamins remained stable for up to 72 h, whereas at -80℃, stability was maintained for up to 7 days. All vitamins in whole blood, except nicotinamide, were stable for up to 2-4 h when stored in an ice bath. Water-soluble vitamins, such as thiamine, riboflavin, pyridoxal, and ascorbic acid, are unstable at room temperature and 2-8℃. All vitamins were stable for up to 7 days and stored at -80℃. The ice bath improved the stability of whole blood samples before centrifugation. Thus, laboratories should ensure appropriate storage conditions to maintain pre-analytical quality for vitamin measurements.

Cold water immersion as an effective recovery method: its impact on heart rate and lactate levels post exercise

Cold water immersion as an effective recovery method: its impact on heart rate and lactate levels post exercise

Rapid determination of 54 dye components in hair dyes by liquid chromatography coupled to quadrupole orbitrap high-resolution mass spectrometry.

Chemical hair dye components can have allergenic, reproductive, and carcinogenic risks. Detecting restricted and prohibited ingredients in these products is challenging due to product diversity, isomer separation, instability, and wide polarity range. A method was developed using HPLC-high-resolution mass spectrometry for the qualitative and quantitative analysis of 54 hair dye components in various products. Samples were extracted with a 70% methanol solution, ultrasonicated in an ice bath, centrifuged, filtered, diluted with 25% methanol solution and 25% methanol solution containing 0.05% D-isoascorbic acid. Separation was achieved using an ACE Excel 3 C18 column (2.1 mm × 150 mm, 3 μm) with analysis conducted via quadrupole Orbitrap mass spectrometry. It showed good linear correlations, with detection limits of 0.1-23.5 ng mL-1, and quantitation limits of 0.2-78.1 ng mL-1. Average recovery ranged from 60.0% to 118.4%, with repeatability from 4.0% to 14.9%. Stability was confirmed within 48 hours. When applied to 20 batches of commercially available hair dyes, 24 hair dye components were found within permissible levels. The method is crucial for quality control of hair dyes, covering 10 common prohibited and 44 permissible hair dye components outlined in the Safety and Technical Standards for Cosmetics (2015 Edition). Compared to the standard methods, it can separate isomers in a single mobile phase system within 15 minutes in positive ion mode while maintaining sensitivity for phenol, hydroquinone, and other components in negative ion mode. Moreover, the pre-treatment strategy significantly improved stability and accuracy, enabling precise analysis of the 54 hair dye components.

Comparison of the effects of cold water immersion and percussive massage on the recovery after exhausting eccentric exercise: A three-armed randomized controlled trial.

Athletic training requires both challenging stimuli for adaptation and sufficient recovery for improved performance. While cold water immersion (CWI) is already a popular recovery method, handheld percussive massage (PM) devices have also gained popularity in recent years. This study aims to assess the effects of CWI and PM on performance recovery after strenuous eccentric exercises compared to a passive rest (PR) control condition. Thirty-four healthy physically active participants (9 females, 25 males) were randomly divided into three groups: CWI (n = 11), PM (n = 11), and passive rest (PR) (n = 12). They underwent an exhausting eccentric exercise protocol and different measurements at six time points (baseline, POST1, POST2, POST24, POST48, and POST72) over the time course of 72h. These included subjective assessments of muscle soreness and perceived stiffness as well as measures of skin temperature, leg volume, creatine kinase activity, and three different jump tests. The eccentric exercise protocol consisted of 15min downhill running (slope: 12%, speed: 10km/h) and 3 sets of successive depth jumps (dropping height: 0.5m) until individual exhaustion. After POST1 measurements, participants received 12min of either CWI (11 ± 0.5°C), PM (40Hz) or PR (supine posture). No significant group effects were found for the number of depth jumps performed during the exhaustion protocol. All jump tests displayed a significant group × time interaction effect. Post-hoc analysis indicated significant lower jump heights in ΔPOST2 between CWI and both PM and PR. No other significant group effects were observed at any time point. No significant group × time interaction effects were noted for CK, leg volume, and soreness. The perceived stiffness showed a significant group × time interaction effect. Post-hoc analysis revealed a significant decrease in stiffness for PM compared to PR at ΔPOST2. Neither CWI nor PM showed any significant improvement in performance recovery over the 72-h period following strenuous eccentric exercise compared to PR. CWI showed an immediate performance decline which may be attributed to a cold-related reduction in motor nerve conduction velocity.

Pre-, Per- and post-cooling strategies used by competitive tennis players in hot dry and hot humid conditions.

This research investigated the pre-, per- and post cooling strategies used by competitive tennis players from various levels of play who occasionally train and compete in hot (>28°C) and humid (>60% rH), and dry (<60% rH) environments. 129 male tennis players (Mage = 24.9) competing at regional (N = 54), national (N = 30) and international (N = 45) levels, completed an online questionnaire regarding their use (i.e., timing, type, justification and effectiveness) of pre- (i.e., before practice), per- (i.e., during exercise) and post-cooling strategies when playing tennis in hot dry (HD) and hot humid (HH) conditions. Individual follow-up interviews were also carried on 3 participants to gain an in-depth understanding of the player's experience. Competitive tennis players used both internal and external cooling strategies to combat the negative effects of HD and HH conditions, but considered the HH to be more stressful than HD and experienced more heat-related illness in HH environments. International players used cold packs and cold towel more frequently than the regional and national players in hot environments, and used cold water immersion and cold vest more frequently than the latter in HH. Differences in strategy use were mostly observed during per-cooling where regional and national players more frequently used cold drinks than international players who more frequently used cold packs in HD and cold towel in HH conditions. Moreover the latter more frequently used cold towel, cold packs and cold water immersion as post-cooling strategies than regional players. When playing tennis in the heat, it is strongly recommended to employ cooling strategies to maintain health, limit declines in performance, and promote recovery. We also recommend improving education regarding the appropriate use and effectiveness of cooling strategies, and increasing their availability in tournaments.

A Comparison of Passive Rewarming Systems Following Cold Water Immersion.

We studied field rewarming using a typical winter sleeping bag versus two heated hypothermia wrap systems in a semi-realistic lab simulation. 10 participants (8 M, 2 F) were cooled to 36.1°C core temperature through 10.5-11.5°C water immersion, then performed 60 min of passive rewarming in 0°C air. The rewarming methods tested were: 1) a -9°C rated mummy-style Sleeping Bag; 2) Doctor Down Rescue Wrap; and 3) Thermal Yielding Vascular Airway Capsule (TYVAC) system; the latter two methods included vapor barriers and two heating pads. Rectal and skin temperatures, along with metabolic heat production calculated via indirect calorimetry, were measured throughout rewarming. One male participant was removed from analysis due to lack of sufficient cooling. Rectal temperature decreased in the remaining participants by ∼1.1-1.2°C to 36.1°C during the initial immersion phase. Over the 60 min of rewarming, rectal temperature changes were Δ0.0 ± 0.6°C in a sleeping bag, Δ+0.2 ± 0.3°C in Doctor Down, and Δ+0.2 ± 0.3°C in TYVAC, with no significant differences across methods. Mean skin temperatures, metabolic heat production, and perceptual measures were also similar across methods with no method×time interactions. After 60 min of passive rewarming in cold conditions, all three rewarming methods were able to stall continued core cooling to levels at or slightly above post-immersion temperatures. With no differences in any physiological measures, it appears that all three rewarming methods are equally viable options for wilderness responders, and the choice should come down to environmetal conditions, availability, convenience, and ergonomics rather than rewarming efficacy.

Diving Deep into Arrhythmias: Unravelling the Impact of Underwater Environments on Premature Ventricular Complexes in Divers.

This review examines the relationship between the physiological demands of diving and premature ventricular complexes (PVCs) in divers. In the general population, some individuals have a greater tendency to experience PVCs, often without awareness or a clear understanding of the triggering factors. With the increasing availability and popularity of both scuba and apnoea diving, more people, including those with a predisposition to PVCs, are engaging in these activities. The underwater environment, with its unique stressors, may increase the risk of arrhythmogenic events, particularly PVCs. Here, we review the prevalence, pathophysiology, and aggravating factors of PVCs in divers, emphasising the need for a comprehensive cardiovascular assessment. Evidence suggests a higher prevalence of PVCs in divers compared with the general population, influenced by factors such as age, dive depth, gas bubbles, cold water immersion, pre-existing cardiovascular diseases, and lifestyle factors. The change in environment during diving could potentially trigger an increased frequency of PVCs, especially in individuals with a pre-existing tendency. We discuss diagnostic strategies, management approaches, and preventive measures for divers with PVCs, noting that although guidelines for athletes can be adapted, individual assessment is crucial. Significant knowledge gaps are identified, highlighting the need for future research to develop evidence-based guidelines and understand the long-term significance of PVCs in divers. This work aims to evaluate potential contributing factors to PVCs in divers and identify individuals who may be at higher risk of experiencing major adverse cardiovascular events (MACEs). This work aims to improve diver safety by promoting collaboration between cardiologists and diving medicine specialists and by identifying key areas for future investigation in this field. This work aims to improve the safety and well-being of divers by understanding the cardiovascular challenges they face, including pressure changes, cold water immersion, and hypoxia. We seek to elucidate the relationship between these challenges and the occurrence of PVCs. By synthesising current evidence, identifying knowledge gaps, and proposing preliminary recommendations, we aim to encourage collaboration between cardiologists and diving medicine specialists to optimise the screening, management, and risk stratification of PVCs in the diving population.