Inspiratory Muscle Training Plus Cold Water Immersion After Muscle-Damaging Exercise

The Combined Effect of Cold Water Immersion and Inspiratory Muscle Training on the Recovery From Exercise-Induced Muscle Damage and Physical Performance: A Randomized, Placebo-Controlled Crossover Study

The purpose of this study is to examine, using a placebo-controlled design, the additional effect of inspiratory muscle training (IMT) added to cold water immersion (CWI) on recovery and muscle performance following exercise-induced muscle damage (EIMD), and to determine whether this effect varies depending on the timing of the intervention. The study will include 12 healthy male athletes aged 18-22 who have been licensed for at least 4 years and are actively involved in sports. Each participant will undergo four different interventions in a randomized order determined by the Williams balanced sequence following muscle damage induced by eccentric exercise on an isokinetic dynamometer: CWI + placebo IMT immediately after exercise, IMT + CWI immediately after exercise, IMT + CWI 24 hours after exercise, and a control condition with no recovery intervention. The sessions will be conducted in weekly cycles with 7-day intervals, alternating between the dominant and non-dominant legs; thus, there will be a 14-day interval between two loading sessions for the same leg. All measurements will be taken during the week. Muscle strength will be assessed using an isokinetic dynamometer; markers of muscle damage (CK, myoglobin, LDH) will be measured via blood samples; and muscle pain will be evaluated using the Visual Analog Scale (VAS) before each exercise session and 48 hours after exercise.

Study Overview

• Status: Not yet recruiting
• Conditions: Inspiratory Muscle Training; Exercise-induced Muscle Damage; Cold Water Immersion; Eccentric Exercise Training; Exercise Fatigue; Isokinetic Test
• Intervention / Treatment: Other: Cold Water Immersion; Other: Sham Inspiratory Muscle Training; Other: Inspiratory Muscle Training

• Study Type: Interventional
• Enrollment (Estimated): 12
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Şehitkamil
    • Gaziantep, Şehitkamil, Turkey (Türkiye)
      • Gaziantep University, Faculty of Sports Sciences, Sports Performance and Testing Laboratory

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 22 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Be a male between the ages of 18 and 22
• Hold a sports license valid for at least 4 years
• Be actively involved in sports
• Not smoke or use similar substances

Exclusion Criteria:

• Having sustained a sports injury within the past 2 years
• Having engaged in exercise that could cause muscle damage within the past 15 days
• Cold intolerance, cold urticaria, or Raynaud's phenomenon
• Known cardiovascular, respiratory, or musculoskeletal disease
• Use of anti-inflammatory medication or dietary supplements that could affect recovery during the study period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Sham Comparator: CWI + placebo IMT; Device: Placebo IMT - 2 × 30 breaths at 15% of MIP using POWERbreathe (1 min between sets), immediately following the short test after EIMD. Other: Immersion in cold water - immediately following the placebo IMT, in 10-12 °C water, up to waist level or with legs fully submerged, for 10-15 minutes.	Other: Cold Water Immersion; Immersion up to the waist in water at 13-15 °C for 13-15 minutes in a portable ice bath; water temperature is monitored with a thermometer and maintained by adding ice.; Other: Sham Inspiratory Muscle Training; Same device, position and volume as inspiratory muscle training (two sets of 30 breaths, 1 minute rest), but at 15% of maximal inspiratory pressure, a load considered below the training threshold. Followed immediately by cold water immersion.
Experimental: IMT + CWI (immediately); Other: Inspiratory muscle training + cold water immersion. Immediately following the short test after EIMD, 2 × 30 breaths at 40% of MIP using POWERbreathe (1 min rest between sets), followed by CWI.	Other: Cold Water Immersion; Immersion up to the waist in water at 13-15 °C for 13-15 minutes in a portable ice bath; water temperature is monitored with a thermometer and maintained by adding ice.; Other: Inspiratory Muscle Training; Two sets of 30 breaths at 40% of maximal inspiratory pressure with 1 minute rest between sets, using a POWERbreathe device; oxygen saturation is monitored by pulse oximetry. Followed immediately by cold water immersion.
Experimental: IMT + CWI (at 24 hours); Other: Inspiratory muscle training + cold water immersion. The same IMT and CWI protocol is administered 24 hours after EIMD; the 48-hour measurement is taken relative to EIMD (24 hours after the intervention).	Other: Cold Water Immersion; Immersion up to the waist in water at 13-15 °C for 13-15 minutes in a portable ice bath; water temperature is monitored with a thermometer and maintained by adding ice.; Other: Inspiratory Muscle Training; Two sets of 30 breaths at 40% of maximal inspiratory pressure with 1 minute rest between sets, using a POWERbreathe device; oxygen saturation is monitored by pulse oximetry. Followed immediately by cold water immersion.
No Intervention: Control; No recovery procedure is performed after the EIMD protocol; only measurements are taken.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak Power ( 60°/s)	Highest torque (Nm) measured during a 5-rep maximum test on an isokinetic dynamometer	The 48-hour period before and after EIMD in each phase
Peak Power ( 180°/s)	Highest torque (Nm) measured during a 10-rep maximum test on an isokinetic dynamometer	The 48-hour period before and after EIMD in each phase
Average Power ( 180°/s- 60°/s)	Average of peak torque values during test repetitions (Nm)	The 48-hour period before and after EIMD in each phase
Serum creatine kinase (CK)	CK level in venous blood (U/L)	The 48-hour period before and after EIMD in each phase
Myoglobin (Mb)	Myoglobin level in venous blood (ng/mL)	The 48-hour period before and after EIMD in each phase
Lactate dehydrogenase (LDH)	LDH level in venous blood (U/L)	The 48-hour period before and after EIMD in each phase

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
H/Q ratio	Hamstring-to-quadriceps peak torque ratio (60°/s and 180°/s)	The 48-hour period before and after EIMD in each phase
VAS	0-10 cm Visual Analog Scale (0 = no pain, 10 = very severe pain)	During each period: before EIMD, immediately after EIMD, and 48 hours after EIMD
Fatique Index	Fatigue index (%) calculated from a test consisting of 10 cycles at 180°/s	The 48-hour period before and after EIMD in each phase

Collaborators and Investigators

• Sponsor: University of Gaziantep

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: October 27, 2026
• First Submitted That Met QC Criteria: November 3, 2026
• First Posted (Actual): November 9, 2026

Study Record Updates

• Last Update Posted (Actual): November 9, 2026
• Last Update Submitted That Met QC Criteria: November 3, 2026
• Last Verified: November 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 2026/9504

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

IPD Plan Description

"Individual participant data will not be shared for privacy reasons; aggregate results will be published."

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No