Network Meta-Analysis Assesses Cryotherapy Modalities for Delayed-Onset Muscle Soreness Recovery

This publication is a systematic review and network meta-analysis evaluating the efficacy of various cryotherapy modalities for recovery following acute exercise. The authors synthesized data from 51 randomized controlled trials encompassing 1,243 participants. Interventions included whole-body cryotherapy, cold water immersion, contrast water therapy, and local cold therapy compared against control conditions.

The primary outcome assessed was delayed-onset muscle soreness across multiple time points: immediate, 1 h, 24 h, 48 h, and 72 h. Results indicated that no cryotherapy modality significantly reduced delayed-onset muscle soreness immediately after exercise. However, cold water immersion significantly attenuated delayed-onset muscle soreness at 1 h, with a mean difference of -1.09 (95% CI (-1.93, -0.24), P < 0.05). Secondary outcomes included countermovement jump, creatine kinase, interleukin-6, and C-reactive protein.

Safety data were not reported in the included studies, with no information available on adverse events, serious adverse events, discontinuations, or tolerability. The authors note that systematic evidence identifying the optimal cryotherapy modality based on continuous time-course outcome assessments remains limited.

Practice relevance suggests cryotherapy is an effective strategy for promoting the recovery of physiological indicators following acute exercise. Efficacy demonstrates pronounced time-dependent characteristics. Clinicians should consider these findings within the context of the reported limitations and lack of safety reporting.