Optimizing Cold Water Immersion for Exercise-Induced Hyperthermia: A Meta-analysis
Zhang Y, Davis JK, Casa DJ, Bishop PA
Medicine and science in sports and exercise · 36 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2015-04-24 · Med Sci Sports Exerc · vol. 47 · issue 11 · pp. 2464–2472
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 50 citations · more than 87% of similar papers · 2.2× the field average
- References
- 62 works
- Access
- Paywalled
- Research areas
- Thermoregulation and physiological responses · Exercise and Physiological Responses · Thermal Regulation in Medicine
- Keywords
- Confidence interval, Medicine, Mean difference, Immersion (mathematics), Hyperthermia, Internal medicine, Mathematics
- MeSH
- humans, fever, water, body surface area, exercise, cryotherapy, immersion, body temperature regulation, adult, cold temperature
4 authors
From US
- Yang ZhangGatorade Sports Science Institute
- Jon-Kyle DavisGatorade Sports Science Institute
- Douglas J. CasaUniversity of Connecticut
- Phillip A. BishopUniversity of Alabama
Abstract
Purpose
Cold water immersion (CWI) provides rapid cooling in events of exertional heat stroke. Optimal procedures for CWI in the field are not well established. This meta-analysis aimed to provide structured analysis of the effectiveness of CWI on the cooling rate in healthy adults subjected to exercise-induced hyperthermia.
Methods
An electronic search (December 2014) was conducted using the PubMed and Web of Science. The mean difference of the cooling rate between CWI and passive recovery was calculated. Pooled analyses were based on a random-effects model. Sources of heterogeneity were identified through a mixed-effects model Q statistic. Inferential statistics aggregated the CWI cooling rate for extrapolation.
Results
Nineteen studies qualified for inclusion. Results demonstrate CWI elicited a significant effect: mean difference, 0.03°C·min(-1); 95% confidence interval, 0.03-0.04°C·min(-1). A conservative, observed estimate of the CWI cooling rate was 0.08°C·min(-1) across various conditions. CWI cooled individuals twice as fast as passive recovery. Subgroup analyses revealed that cooling was more effective (Q test P < 0.10) when preimmersion core temperature ≥38.6°C, immersion water temperature ≤10°C, ambient temperature ≥20°C, immersion duration ≤10 min, and using torso plus limbs immersion. There is insufficient evidence of effect using forearms/hands CWI for rapid cooling: mean difference, 0.01°C·min(-1); 95% confidence interval, -0.01°C·min(-1) to 0.04°C·min(-1). A combined data summary, pertaining to 607 subjects from 29 relevant studies, was presented for referencing the weighted cooling rate and recovery time, aiming for practitioners to better plan emergency procedures.
Conclusions
An optimal procedure for yielding high cooling rates is proposed. Using prompt vigorous CWI should be encouraged for treating exercise-induced hyperthermia whenever possible, using cold water temperature (approximately 10°C) and maximizing body surface contact (whole-body immersion).
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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