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Adam Grainger, Paul Comfort and Shane Heffernan

days postmatch. As a result, several recovery strategies have been developed for elite athletes to encourage restoration of performance. 7 Often, these strategies come at great economic and logistic costs, particularly the various cold therapies that are regularly used in modern rugby in an attempt to

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Susan Y. Kwiecien, Malachy P. McHugh, Stuart Goodall, Kirsty M. Hicks, Angus M. Hunter and Glyn Howatson

Purpose: To evaluate the effectiveness between cold-water immersion (CWI) and phase-change-material (PCM) cooling on intramuscular, core, and skin-temperature and cardiovascular responses. Methods: In a randomized, crossover design, 11 men completed 15 min of 15°C CWI to the umbilicus and 2-h recovery or 3 h of 15°C PCM covering the quadriceps and 1 h of recovery, separated by 24 h. Vastus lateralis intramuscular temperature at 1 and 3 cm, core and skin temperature, heart-rate variability, and thermal comfort were recorded at baseline and 15-min intervals throughout treatment and recovery. Results: Intramuscular temperature decreased (P < .001) during and after both treatments. A faster initial effect was observed from 15 min of CWI (Δ: 4.3°C [1.7°C] 1 cm; 5.5°C [2.1°C] 3 cm; P = .01). However, over time (2 h 15 min), greater effects were observed from prolonged PCM treatment (Δ: 4.2°C [1.9°C] 1 cm; 2.2°C [2.2°C] 3 cm; treatment × time, P = .0001). During the first hour of recovery from both treatments, intramuscular temperature was higher from CWI at 1 cm (P = .013) but not 3 cm. Core temperature deceased 0.25° (0.32°) from CWI (P = .001) and 0.28°C (0.27°C) from PCM (P = .0001), whereas heart-rate variability increased during both treatments (P = .001), with no differences between treatments. Conclusions: The magnitude of temperature reduction from CWI was comparable with PCM, but intramuscular temperature was decreased for longer during PCM. PCM cooling packs offer an alternative for delivering prolonged cooling whenever application of CWI is impractical while also exerting a central effect on core temperature and heart rate.

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Stephan R. Fisher, Justin H. Rigby, Joni A. Mettler and Kevin W. McCurdy

Clinical Scenario: Cryotherapy is one of the most commonly used modalities for postexercise muscle recovery despite inconsistencies in the literature validating its effectiveness. With the need to find a more effective modality, photobiomodulation therapy (PBMT) has gained popularity because of recent research demonstrating its ability to accelerate the muscle recovery process. Focused Clinical Question: Is PBMT more effective than cryotherapy at reducing recovery time and decreasing delayed onset muscle soreness after strenuous exercise? Summary of Key Findings: Three moderate- to high-quality double-blinded, randomized, placebo-controlled trials and 2 low- to moderate-quality translational studies performed on rats were included in this critically appraised topic. All 5 studies supported the use of PBMT over cryotherapy as a treatment for postexercise muscle recovery following exercise. PBMT was superior in reducing creatine kinase, inflammation markers, and blood lactate compared with cryotherapy, following strenuous/high intensity aerobic or strength muscular exercise. PBMT was also shown to improve postexercise muscle performance and function more than cryotherapy. Clinical Bottom Line: There is moderate evidence to suggest the use of PBMT over cryotherapy postexercise to enhance muscle recovery in trained and untrained athletes. Shorter recovery times and increased muscle performance can be seen 24 to 96 hours following PBMT application. Strength of Recommendation: Based on consistent findings from all 5 studies, there is grade B evidence to support the use of PBMT over cryotherapy for more effective postexercise recovery of skeletal muscle performance.

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Sara J. Golec and Alison R. Valier

passive treatments such as ultrasound, electrical stimulation, hot or cold therapy, massage and bed rest. 5 , 7 , 8 Maintaining activity and decreasing passive treatments seems to align with findings for other research studies. Staying active as compared to bed rest has been associated with reduced pain

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Jesús Seco-Calvo, Juan Mielgo-Ayuso, César Calvo-Lobo and Alfredo Córdova

physical therapy methods for postexercise recovery, including cold therapy as well as whole-body cryotherapy or contrast therapy. 1 , 3 , 4 , 18 , 33 , 34 Nevertheless, the effects of such therapy on muscle recovery have not been investigated for any of these recovery methods in real situations in the

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Katie J. Lyman, Michael McCrone, Thomas A. Hanson, Christopher D. Mellinger and Kara Gange

limb of rats . J Athl Train . 1997 ; 32 ( 3 ): 233 – 237 . PubMed ID: 16558455 16558455 8. Ernst E , Fialka V . Ice freezes pain? A review of the clinical effectiveness of analgesic cold therapy . J Pain Symptom Manage . 1994 ; 9 ( 1 ): 56 – 59 . PubMed ID: 8169463 doi:10

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Jennifer Ostrowski, C. Collin Herb, James Scifers, Teraka Gonzalez, Amada Jennings and Danvirg Breton

heat conduction. 23 The movement of the TSP, compared with the constant heating of the MHP, may have also disrupted the ability of the TSP to heat via conduction. The Dynatronics website describes the TSP as “a soft tissue mobilization tool that also allows a practitioner to deliver heat or cold