Impact of different doses of cold water immersion (duration and temperature variations) on recovery from acute exercise-induced muscle damage: a network meta-analysis

Why this matters

Adds a dose-ranking lens on post-exercise cold-water immersion—complements conventional pairwise DOMS meta-analyses (e.g. Bleakley 2023 on this wiki) by explicitly comparing short vs medium vs long immersion at low vs medium vs high temperature bins.

Design (high level)

• Trials: 55 RCTs (2000–Sep 2024 searches)
• Endpoints: DOMS (42 trials), jump performance (36), creatine kinase (30)
• Analysis: network meta-analysis vs passive control

Pooled vs-control highlights (significant network estimates reported by authors)

• DOMS: MD-MT-CWI (10–15 min, 11–15 °C) SMD −1.45 (95% CI −2.13 to −0.77; p < 0.01); MD-LT-CWI (10–15 min, 5–10 °C) SMD −1.12 (95% CI −1.78 to −0.47; p = 0.01)
• Jump performance: MD-LT-CWI SMD +0.48 (0.20–0.77; p = 0.01); MD-MT-CWI SMD +0.42 (0.15–0.70; p = 0.02)
• Creatine kinase: MD-MT-CWI SMD −0.85 (−1.36 to −0.35; p = 0.01); MD-LT-CWI SMD −0.90 (−1.46 to −0.34; p = 0.02)

Authors’ ranking caveat

SUCRA-style rankings favored MD-LT-CWI for jump + CK and MD-MT-CWI for DOMS—interpret alongside heterogeneity, sport specificity, and hypertrophy-interference literature not primary in this network.

Protocol map

Cold water immersion (cold-plunge) only—not interchangeable with short cold-shower add-ons (cold-exposure).