{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:35:19Z","timestamp":1790098519637,"version":"4.0.1"},"reference-count":121,"publisher":"Human Kinetics","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Purpose<\/jats:bold>:<\/jats:italic> Cooling the head, face, and neck can have strong perceptual effects that contribute to improved performance. This systematic review aimed to determine the effect of cooling strategies targeting the head, face, and neck on physical and cognitive performance, determine any associated physiological and perceptual responses, synthesize adverse events, and provide practical applications. <jats:italic><jats:bold>Methods<\/jats:bold>:<\/jats:italic> We conducted a systematic review and multilevel meta-analysis, adhering to PRISMA guidelines. Studies that investigated the effect of cooling strategies targeting the head, face, or neck on a physical or cognitive task using a controlled trial design were included. <jats:italic><jats:bold>Results<\/jats:bold>:<\/jats:italic> Sixty-three studies were identified, involving 618 participants (86.6% male). Cooling strategies included water-perfused devices (18.7%), phase-change neck collars (17.3%), fanning\/cold air (14.7%), phase-change headwear (13.3%), ice\/gel packs (13.3%), cold towels (5.3%), menthol application (4.0%), water spraying\/dousing (4.0%), or a combination of strategies (9.3%). The effect of cooling on both self-paced and fixed-intensity exercise tasks was inconclusive; the 95% CI of the pooled effect was compatible with no effect and medium beneficial effects but not harmful effects. We were unable to pool cognitive data. Cooling reduced the skin temperature at the target site and improved thermal sensation and comfort. Effects on heart rate and core and mean skin temperatures were negligible. Adverse events were rare, and no intervention subgroup was superior. <jats:italic><jats:bold>Conclusion<\/jats:bold>:<\/jats:italic> We recommend that athletes experiment with a range of head-, face-, and neck-cooling strategies, including using different doses and timings, to determine the optimal strategy for their individual and sport context.<\/jats:p>","DOI":"10.1123\/ijspp.2024-0561","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T16:43:21Z","timestamp":1747068201000},"page":"743-763","source":"Crossref","is-referenced-by-count":10,"title":["Head, Face, and Neck Cooling for Performance: A Systematic Review and Meta-Analysis"],"prefix":"10.1123","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4641-0342","authenticated-orcid":true,"given":"Christopher J.","family":"Stevens","sequence":"first","affiliation":[{"name":"Physical Activity, Sport and Exercise Research (PASER) Theme, Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0152-571X","authenticated-orcid":true,"given":"David","family":"Borg","sequence":"additional","affiliation":[{"name":"School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9341-1412","authenticated-orcid":true,"given":"Carly","family":"Brade","sequence":"additional","affiliation":[{"name":"School of Allied Health, Exercise Science Discipline, Curtin University, Bentley, WA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9170-9001","authenticated-orcid":true,"given":"Sarah","family":"Carter","sequence":"additional","affiliation":[{"name":"Discipline of Exercise and Sports Science, Faculty of Health, Charles Darwin University, Darwin, NT, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-395X","authenticated-orcid":true,"given":"Davide","family":"Filingeri","sequence":"additional","affiliation":[{"name":"Thermosenselab, Skin Sensing Research Group, School of Health Science, University of Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4042-795X","authenticated-orcid":true,"given":"Jason","family":"Lee","sequence":"additional","affiliation":[{"name":"Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Heat Resilience and Performance Center, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Lim","sequence":"additional","affiliation":[{"name":"Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4214-8543","authenticated-orcid":true,"given":"Toby","family":"M\u00fcndel","sequence":"additional","affiliation":[{"name":"Hydration Exercise and Temperature Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8483-7187","authenticated-orcid":true,"given":"Lee","family":"Taylor","sequence":"additional","affiliation":[{"name":"National Centre for Sport and Exercise Medicine (NCSEM), School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom"},{"name":"Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Moore Park, NSW, Australia"},{"name":"Human Performance Research Centre, University of Technology Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3233-0771","authenticated-orcid":true,"given":"Christopher J.","family":"Tyler","sequence":"additional","affiliation":[{"name":"School of Human and Life Sciences, University of Roehampton, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"key":"r1","article-title":"State of the global climate 2022","year":"2023","unstructured":"World Meteorological Organization. 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