{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:56:26Z","timestamp":1792032986491,"version":"4.4.0"},"reference-count":84,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This network meta-analysis and systematic review evaluated the recovery impacts of varying cold water immersion (CWI) protocols on acute exercise-induced muscle damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched CNKI, PubMed, Cochrane Library, Web of Science, and Embase from January 2000 to September 2024 for randomized controlled trials examining CWI\u2019s recovery effects on acute muscle damage. Data extraction, study screening, and risk of bias assessment were conducted independently by two reviewers. Analyses were performed using Stata 16.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 55 RCTs were included, with 42 reporting delayed onset muscle soreness (DOMS), 36 reporting jump performance (JUMP), and 30 reporting creatine kinase (CK) levels. Network meta-analysis showed that compared with the control group, MD-MT-CWI: Medium-duration medium-temperature cold water immersion (10\u201315 min, 11\u00b0C\u201315\u00b0C) [SMD = \u22121.45, 95%CI(-2.13, \u22120.77), P &amp;lt; 0.01] and MD-LT-CWI: Medium-duration low-temperature cold water immersion (10\u201315 min, 5\u00b0C\u201310\u00b0C) [SMD = \u22121.12, 95%CI(-1.78, \u22120.47), P = 0.01] significantly reduced DOMS; MD-LT-CWI (10\u201315 min, 5\u00b0C\u201310\u00b0C) [SMD = 0.48, 95%CI(0.20, 0.77), P = 0.01] and MD-MT-CWI (10\u201315 min, 11\u00b0C\u201315\u00b0C) [SMD = 0.42, 95%CI(0.15, 0.70), P = 0.02] significantly improved JUMP; MD-MT-CWI (10\u201315 min, 11\u00b0C\u201315\u00b0C) [SMD = \u22120.85, 95%CI(-1.36, \u22120.35), P = 0.01] and MD-LT-CWI (10\u201315 min, 5\u00b0C\u201310\u00b0C) [SMD = \u22120.90, 95%CI(-1.46, \u22120.34), P = 0.02] significantly reduced CK. Cumulative probability ranking showed that MD-LT-CWI (10\u201315 min, 5\u00b0C\u201310\u00b0C) was the most effective for improving JUMP and reducing CK, while MD-MT-CWI (10\u201315 min, 11\u00b0C\u201315\u00b0C) was the most effective for reducing DOMS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Different dosages of cold water immersion (varying in duration and temperature) had different effects on recovery from acute exercise-induced muscle damage. We found that MD-LT-CWI (10\u201315 min, 5\u00b0C\u201310\u00b0C) was most effective for improving biochemical markers (CK) and neuromuscular recovery, while MD-MT-CWI (10\u201315 min, 11\u00b0C\u201315\u00b0C) was most effective for reducing muscle soreness. In practice, we recommend using MD-LT-CWI (10\u201315 min, 5\u00b0C\u201310\u00b0C) and MD-MT-CWI (10\u201315 min, 11\u00b0C\u201315\u00b0C) to reduce Exercise-induced muscle damage (EIMD). However, due to the limitations of the included studies, further high-quality studies are needed to verify these conclusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>, identifier CRD42024602359.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2025.1525726","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T07:32:41Z","timestamp":1740555161000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Impact of different doses of cold water immersion (duration and temperature variations) on recovery from acute exercise-induced muscle damage: a network meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Hai","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingxu","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"677581","DOI":"10.3389\/fphys.2021.677581","article-title":"The effectiveness of post-exercise stretching in short-term and delayed recovery of strength, range of motion and delayed onset muscle soreness: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Afonso","year":"2021","journal-title":"Front. 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