{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:06:58Z","timestamp":1784185618535,"version":"3.55.0"},"reference-count":42,"publisher":"Journal of Sports Science and Medicine","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["jsportscimed"],"abstract":"<p>Contrast heat-cold showering is popular for recovery, but multisystem evidence and persistence after cessation remain unclear. To evaluate whether a 4-week post-training contrast heat-cold shower intervention produces an integrated recovery profile across four domains (autonomic, endocrine, perceptual, and microvascular) rather than testing a single isolated physiological pathway, across baseline (T0), post-intervention (T1), and 2-week wash-out (T2). Sixty combat-sport athletes were randomized to contrast showers (10 min alternating warm 38-40\u00b0C and cold 13-15\u00b0C) or an active thermoneutral-shower comparator (10 min, 32-34\u00b0C) after training for 4 weeks. Primary analyses were per-protocol (\u2265 75% compliance; n = 57), with intention-to-treat sensitivity analyses. Outcomes were Total Quality Recovery (TQR), morning salivary cortisol (two mornings averaged), resting HRV, and post-occlusive reactive hyperemia (PORH). From T0 to T1, favorable between-group changes were observed for resting HR (\u0394\u0394 -2.10 bpm, 95% CI -2.24 to -1.96; g -0.65; p &lt; 0.001), lnRMSSD (\u0394\u0394 0.123 log units, 95% CI 0.108 to 0.137; g 0.74; p &lt; 0.001), with similar T1 effects for RMSSD and SDNN, and TQR (\u0394\u0394 0.61 points, 95% CI 0.27 to 0.95; g 0.80; p &lt; 0.001). These T1 autonomic and perceptual changes were not maintained at T2 (all T2-T0 \u0394\u0394 p &gt; 0.05). Cortisol and PORH-derived outcomes showed no statistically clear between-group differences at T1 or T2 (all p &gt; 0.05). Compared with thermoneutral showering, 4 weeks of post-training contrast heat-cold showering produced short-term favorable between-group changes in autonomic regulation and perceived recovery, but not in morning cortisol or PORH-derived microvascular reactivity. These effects were not maintained after wash-out; therefore, causal attribution to the shower intervention alone and claims of persistent physiological adaptation should be made cautiously. Trial registration: ISRCTN15418049.<\/p><\/jats:p>","DOI":"10.52082\/jssm.2026.675","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:49:47Z","timestamp":1784184587000},"page":"675-690","source":"Crossref","is-referenced-by-count":0,"title":["Contrast Heat\u2013Cold Versus Thermoneutral Showering in Trained Combat Sport Athletes: A Randomized Field Trial of Recovery Outcomes"],"prefix":"10.52082","author":[{"given":"Magdalena","family":"Hagner-Derengowska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Trybulski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Kruk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipe Manuel","family":"Clemente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyprian","family":"Olchowy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol","family":"Pilis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29163","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref0","unstructured":"Ahokas, E.K., Kyröläinen, H., Ihalainen, J.K., Hanstock, H.G. 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