Evidence map›Paper›PMID 42909756›Full record

SynthesisSports medicine - open2026

Cold-Water Immersion for Post-exercise Recovery: An Overlap-Aware Umbrella Review.

Weibao Liang, Xiaoge Ma, Guanping Sun, Chuannan Liu, Xujie Yan

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Sports medicine - open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Weibao Liang *Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, SAR, China. 2017020800@m.scnu.edu.cn.ORCID http://orcid.org/0000-0003-1856-1853
Xiaoge Ma *School of Physical Education and Leisure, Guangdong Ocean University, Zhanjiang, China.
Guanping SunDepartment of Physical Education, Kunsan National University, Gunsan-si, South Korea.
Chuannan LiuSchool of Physical Education and Health, Zunyi Medical University, Zunyi, China.
Xujie YanSchool of Physical Education and Sports Science, Hengyang Normal University, Hengyang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCold-water immersion (CWI) is widely used after strenuous exercise, but review-level findings vary by outcome, comparator, recovery window, population, and protocol. Reuse of the same primary studies across reviews can also exaggerate apparent consistency.

methodsWe searched PubMed, Web of Science, SPORTDiscus, Cochrane Library, Embase, and Scopus from inception to 30 January 2026 for systematic reviews, meta-analyses, and network meta-analyses of post-exercise CWI. Fourteen reviews were included. Primary-study overlap was quantified using the corrected covered area (CCA) overall and for outcome-specific study-to-review mappings. Because overlap was high and review-level estimates were statistically dependent, we did not perform second-order meta-analysis. Source-verified estimates were synthesized in a structured, overlap-aware format. Methodological quality was assessed with AMSTAR 2.

resultsOf the 14 included reviews, 13 provided quantitative estimates, whereas one review provided narrative evidence on heart rate variability (HRV). Overall CCA was 12.68% (high); 99 of 165 primary-study families appeared in at least two reviews. Outcome-specific CCA was 15.03% for delayed onset muscle soreness (DOMS; very high) and ranged from 0.00% for interleukin-6 (IL-6) to 25.00% for C-reactive protein (CRP). It was not calculable for HRV, because one review contributed. AMSTAR 2 confidence was low in 2 reviews and critically low in 12. DOMS showed the most consistent favorable pattern: source-review standardized mean differences ranged from -1.04 to -0.37, although the largest estimate was soccer-specific and its 95% prediction interval crossed zero. Because DOMS evidence was highly redundant across the contributing reviews, this apparent consistency does not represent independent replications. Findings for objective performance and biochemical outcomes were inconsistent, time-dependent, or comparator-dependent.

conclusionsWithin the available review-level evidence, CWI was associated with the most consistent reduction in self-reported short-term post-exercise DOMS, but the clinical importance of the observed effects remains uncertain. Evidence does not support a uniform benefit across objective performance or inflammatory outcomes. Protocol observations, including commonly studied temperatures and durations, are descriptive and should not be interpreted as an optimized prescription. Trial Registration PROSPERO CRD420261332482.

Indexed as

Cold-water immersionCorrected covered areaDelayed onset muscle sorenessEvidence overlapPost-exercise recoveryUmbrella review

Identifiers

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.