The Effect of Thermotherapy on Recovery and Performance (Cryotherapy)

The Effect of Cryotherapy on Recovery and Performance: A Randomized Controlled Double Blind Trial

This study investigates the effects of cooling on the recovery and performance characteristic in young healthy subjects. The study is divided in two projects:

Project A: investigates the effects of 20 min. post-exercise cooling on vertical jump performance and delayed onset muscle soreness and rated perceived exertion.

Project B: investigates the effects of 20 min. pre-exercise cooling on maximal voluntary contraction of the right M. quadriceps femoris and delayed onset muscle soreness and rated perceived exertion.

Study Overview

• Status: Completed
• Conditions: Healthy
• Intervention / Treatment: Device: Zamar Therapy CT clinic

Detailed Description

The aim of this study is to investigate the effects of a 20 min. external cooling application (+8°C ) versus a external thermo neutral application (+32°C) up to 72 hours post application.

The study is divided in two projects:

Project A: This study is focusing on the recovery process after a max. jump performance (3x30 counter movement jumps). Directly after the exercise subjects receive a cooling or thermo-neutral application. Recovery characteristics measured by vertical jump performance (objective) and delayed onset muscle soreness and rated perceived exertion (subjective) are measured in function of time up to 72 hours post cooling intervention.

Project B: This study is focusing on the effect of 20 min. cooling or thermo-neutral application on the M. quadriceps femoris performance (MVC). After the thermo-application, the 60% endurance MVC is measured by means of surface EMG (OT Bioelettronica 10-750 Hz) in a ergometer chair 90° degrees knee flexion (Cor 1 Bioelettronica). Muscle conduction velocity, MVC (objective), delayed onset muscle soreness and rated perceived exertion (subjective) are measured in function of time up to 72 hours post thermo-application.

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Kanton Graubünden
    • Landquart, Kanton Graubünden, Switzerland, 7302
      • University of Applied Sciences and Arts of Southern Switzerland SUPSI

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 30 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• only healthy young subjects 18-30 years
• no musculoskeletal surgery in trunk and lower extremities
• injury history in trunk and lower extremity for more than one year
• subjects taking anticonceptive medication are allowed to participate

Exclusion Criteria:

• actual injuries or injuries for less than one year in trunk and /or lower extremities
• injury history in trunk and lower extremity for more than one year with complaints
• anxiety of cooling
• subjects on medication
• pace maker
• cardiovascular disease
• pregnancy
• skeletal problems
• appendectomy for less than two years
• Morbus Raynaud syndrome

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: cooling intervention; subjects in this study receive a single pre-exercise (3x MVC) or post-exercise intervention (3x 30 counter movement jumps), consisting of an external cooling application (Zamar Therapy CT clinic) applied to both thighs. Both interventions have a duration of 20 minutes and a temperature of 8°C	Device: Zamar Therapy CT clinic; Zamar Therapy is a certified medical product (directive 93/42/EEC and ISO 134 85:2012) (www.zamarmedical.com)
Sham Comparator: thermoneutral intervention; subjects in the control group receive a single pre-exercise (3x MVC) or post-exercise (3x 30 counter movement jumps) sham intervention, consisting of a 20 minute external thermoneutral application (Zamar Therapy CT clinic) applied to both thighs. Both sham interventions have a duration of 20 minutes and a temperature of 32°C.	Device: Zamar Therapy CT clinic; Zamar Therapy is a certified medical product (directive 93/42/EEC and ISO 134 85:2012) (www.zamarmedical.com)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Delayed-onset Muscle Soreness (DOMS)	The subjective recovery characteristics "Delayed-onset muscle soreness (DOMS)" was rated on a 0-10 cm visual analog scale. DOMS was assessed in a squat position (90° knee angle, with brief holding of maximum 3 seconds) ranging from zero (no soreness) to ten (severe soreness). Higher values mean mean more DOMS and therefore less recovery.	72 hours
Ratings of Perceived Exertion (RPE)	The subjective recovery characteristics " Ratings of perceived exertion (RPE)" was rated on a 6-20 Borg scale (from 6 = "no exertion at all" to 20 = "Maximal exertion") in a standing position. The higher value means more exertion and therefore less recovery.	72 hours
Vertical Jump Performance (VJP)	Vertical jump performance (VJP) was assessed performing three maximal counter mouvemet jumps (CMJs) with a 30-second pause between the three jumps on the Just Jump system (Probotics Inc, Huntsville, AL, USA). The highest jump was recorded.	72 hours
Peak Power Output (PPO)	Peak power output (PPO) was assessed performing three maximal counter movement jumps (CMJs) on the Just Jump system (Probotics Inc, Huntsville, AL, USA) with a 30-second pause between the three jumps. PPO (presented in watts) was calculated.	72 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The effect of a 20 minute cryotherapy application on delayed onset muscle soreness 24 hours post cold application	n= 20 subjects for subjective recovery. subjective recovery: delayed onset muscle soreness (V.A.S 0-10 cm) 24 hours post cold application is evaluated	0-24 hours post cold application
The effect of a 20 minute cryotherapy application on delayed onset muscle soreness 48 hours post cold application	n= 20 subjects for subjective recovery. subjective recovery: delayed onset muscle soreness (V.A.S 0-10 cm) 48 hours post cold application is evaluated	24-48 hours post cold application
The effect of a 20 minute cryotherapy application on delayed onset muscle 72 hours post cold application	n= 20 subjects for subjective recovery. subjective recovery: delayed onset muscle soreness (V.A.S 0-10 cm) 72 hours post cold application is evaluated	48-72 hours post cold application
The effect of a 20 minute cryotherapy application on rated perceived exertion 24 hours post cold application	n= 20 subjects for subjective recovery. subjective recovery: rated perceived exertion (Borg scale 6-20) 24 hours post cold application is evaluated	0-24 hours post cold application
The effect of a 20 minute cryotherapy application on rated perceived exertion 48 hours post cold application	n= 20 subjects for subjective recovery. subjective recovery: rated perceived exertion (Borg scale 6-20) 48 hours post cold application is evaluated	24-48 hours post cold application
The effect of a 20 minute cryotherapy application on rated perceived exertion 72 hours post cold application	n= 20 subjects for subjective recovery. subjective recovery: rated perceived exertion (Borg scale 6-20) 72 hours post cold application is evaluated	48-72 hours post cold application

Collaborators and Investigators

• Sponsor: University of Applied Sciences and Arts of Southern Switzerland
• Collaborators: Vrije Universiteit Brussel; Universiteit Antwerpen; THIM - die internationale Hochschule für Physiotherapie
• Investigators: Principal Investigator: Ron Clijsen, PhD, University of Applied Sciences and Arts of Southern Switzerland SUPSI

Publications and helpful links

General Publications

• Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD008262. doi: 10.1002/14651858.CD008262.pub2.
• Ross ML, Garvican LA, Jeacocke NA, Laursen PB, Abbiss CR, Martin DT, Burke LM. Novel precooling strategy enhances time trial cycling in the heat. Med Sci Sports Exerc. 2011 Jan;43(1):123-33. doi: 10.1249/MSS.0b013e3181e93210.
• Ascensao A, Leite M, Rebelo AN, Magalhaes S, Magalhaes J. Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. J Sports Sci. 2011 Feb;29(3):217-25. doi: 10.1080/02640414.2010.526132.
• Banfi G, Lombardi G, Colombini A, Melegati G. Whole-body cryotherapy in athletes. Sports Med. 2010 Jun 1;40(6):509-17. doi: 10.2165/11531940-000000000-00000.
• Barnett A. Using recovery modalities between training sessions in elite athletes: does it help? Sports Med. 2006;36(9):781-96. doi: 10.2165/00007256-200636090-00005.
• Pointon M, Duffield R, Cannon J, Marino FE. Cold application for neuromuscular recovery following intense lower-body exercise. Eur J Appl Physiol. 2011 Dec;111(12):2977-86. doi: 10.1007/s00421-011-1924-1. Epub 2011 Mar 29.
• Wegmann M, Faude O, Poppendieck W, Hecksteden A, Frohlich M, Meyer T. Pre-cooling and sports performance: a meta-analytical review. Sports Med. 2012 Jul 1;42(7):545-64. doi: 10.2165/11630550-000000000-00000.
• White GE, Wells GD. Cold-water immersion and other forms of cryotherapy: physiological changes potentially affecting recovery from high-intensity exercise. Extrem Physiol Med. 2013 Sep 1;2(1):26. doi: 10.1186/2046-7648-2-26.

Helpful Links

• Zamar thermotherapy

Study record dates

Study Major Dates

• Study Start: May 1, 2015
• Primary Completion (Actual): November 1, 2018
• Study Completion (Actual): May 1, 2019

Study Registration Dates

• First Submitted: May 27, 2015
• First Submitted That Met QC Criteria: July 21, 2015
• First Posted (Estimated): July 23, 2015

Study Record Updates

• Last Update Posted (Actual): October 20, 2025
• Last Update Submitted That Met QC Criteria: September 30, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: cryotherapy; recovery; athletic performance; delayed onset muscle soreness; maximum voluntary contraction; rated perceived exertion; jump performance
• Other Study ID Numbers: KEK-ZH-Nr.2015-0113