Effect of Total Cold-Water Immersion Vs Ice Massage Modalities on Recovery After Exercise-induced Muscle Damage Among Adults
Phase: NA
Conditions: Exercise-induced Muscle Damage
Sponsor: Lebanese German University

NCT                                                                                                                                  26, November, 2019 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Effect of Total Cold-Water Immersion Vs Ice Massage Modalities on Recovery after 
Exercise-induced Muscle Damage among Adults

Total Cold-water Immersion Vs Ice Massage 
2
 
 
Procedure 
 
 
Participants were recruited by means of convenience sampling.  A message was 
sent via WhatsApp for all the contact list of the investigators.  This message included a 
brief explanation of the study purpose, phone numbers of the three investigators and a 
request to forward this message to the contact lists of the recipients.   
  At the beginning of the study, all participants’ data were recorded, including 
their physical characteristics and eligibility, in addition to answering the questions of the 
PAR-Q.  
Eligible participants were given information sheets and signed consent forms. 
Afterward, they were familiarized with the experimental procedure and given numbers in 
order to assure blindness during the processes of allocating them into groups and 
assessing the outcomes.  Final participants included 60 eligible stratified into two blocks 
(30 males and 30 females).   
Then a randomization website -website spreadsheet generator; 
http://www.randomization.com was used to randomly allocate each into one of two 
intervention groups: 1) Total CWI (TCWI) or 2) IM.  
Baseline measurements of both groups (TCWI and IM) were taken and include 
1RM, (2) CMJ, (3) VAS, and (4) Serum CK tests.  Testing was followed by a warm-up 
session and then by muscle damage protocol. Thereafter, each of the interventions 
(TCWI or IM) were performed and followed by post-exercise measurements at 2; 24, 48 
and 72 hours. 
 
Muscle damage protocol. Muscle damage was induced by 20 sets of 5 
drop jumps each, with a two-minute rest between sets.  Participants were instructed to 

drop jump from a 60-cm box, then perform a maximal bipodal CMJ, then land on the 
floor with knees flexed to at least 90°, while keeping their hands on their knees to 
eliminate additional force by upper limbs.  This protocol produces a response similar to 
that obtained from high-intensity multi-joint exercises (Vieira et al., 2016). 
 
Total cold-water immersion group. Participants allocated to the TCWI 
group completed a session of 15-minutes in cold water with a temperature of 12°C.  
Each Participant was totally immersed in a pool while his/her head and neck remained 
above water level.  The water’s temperature was continuously measured by a mercury-
in-glass thermometer and maintained at the aforementioned temperature by 
continuously adding ice blocks.   
With respect to depth of immersion, TCWI is more efficient than partial CWI since 
exposing a larger area of the body is needed for cardiovascular changes to occur 
(Murray and Cardinale, 2015; Stephens et al., 2016). 
Ice massage group. Participants in the IM group were seated. The investigator in 
charge of this intervention group applied Ice cubes massage in a clockwise circular 
motion on the thigh area (quadriceps) for 15 minutes.  
Data Analysis 
The results were analyzed by the Statistical Package for the Social Sciences 
(SPSS) version 21.0 for windows.  The Shapiro–Wilk test was used to check the 
normality of the data distribution.  A probability (p) value of >0.05 indicates that there is 
no significant difference between groups. 
Analysis of variance (ANOVA) test was used to compute the within-group 
differences of each variable (muscle damage, strength, power, and DOMS) at different 
testing times (Baseline, 2h, 24h, 48h and 72h after exercise). 

Factorial repeated measures ANOVA test was used to determine between-group 
difference between TCWI and IM groups, of each variable (muscle damage, strength, 
power, and DOMS) at different testing times (Baseline, 2h, 24h, 48h and 72h after 
exercise).