Pearce, A. J., Cassar, S., & Kidgell, D. J. (2009). Alternating hot-cold hydrotherapy accelerates recovery using TMS to measure the effect of hydrotherapy in attenuating central fatigue following repeated exercise. A paper presented at the 14th Annual Congress of the European College of Sport Science, Oslo, Norway, June 24-27.

"Hydrotherapies such as cold water immersion (CWI) and contrast hot/cold water therapy (CWT) are commonly used by athletes, following competition or training, to assist in the recovery process and to return the athlete to normative physiological state as quickly as possible. To date, investigations on recovery have focused on peripheral variables to measure the effectiveness of hydrotherapies. Conversely, limited study has been completed to investigate the role of the central nervous system (CNS) fatigue (known as central fatigue) during the post-exercise recovery period." This study used transcranial magnetic stimulation (TMS) to investigate the central nervous system in males (N = 6) following repeated exhaustive exercise bouts followed with hydrotherapy-based recovery modalities. Ss participated in three interventions; 1) 12-14°C for 14 minutes; 2) alternating one minute hot (38–40°C); 3) cold immersion (12-14°C repeated seven times); and passive rest at room ambient temperature 22°C for 14 minutes) following exhaustive performance conducted over five days. Measures included excitability of the central nervous system (motor evoked potential amplitude) assessed using transcranial magnetic stimulation, time to fatigue performance, blood markers for muscle inflammation (lactate dehydrogenase and c-reactive protein) and damage (myoglobin and creatine kinase), and visual analog scales for soreness and fatigue.

No changes were observed for muscle damage or markers of inflammation when compared to pre-exercise values. All Ss (participating in all conditions) showed a significant progressive reduction in performance and motor evoked potential amplitude. However, greater cumulative decrements in time to fatigue performance and motor evoked potential amplitude were demonstrated in the passive rest condition (30.8% decrease in performance by day five) compared to the two cold-therapy conditions. Further, motor evoked potential amplitude was associated with performance (r = 0.83) and visual analog scales for fatigue (r = 0.75).

Implication. There were no differences between hydrotherapy treatments, but compared to passive recovery they were more effective in reducing repeated performance decrements and motor evoked potential amplitudes. Changes in motor evoked potential amplitudes post-recovery did not occur immediately and took up to five days to emerge.

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