Research article - (2026)25, 350 - 370
DOI: https://doi.org/10.52082/jssm.2026.350
Acute Impact of Cold Compression Therapy Across Diverse Age Groups and Physical Conditioning Status: A Randomized Crossover Study
Robert Trybulski1,2, Adrian Kużdżał3, Gracjan Olaniszyn1,4, Ana Filipa Silva5, Filipe Manuel Clemente6,7,8,, Wang Hsing-Kuo9,10
1Faculty of Medicine, Katowice Business University, Katowice, Poland
10Center of Physical Therapy, National Taiwan University Hospital, Taipei
2Provita Medical Centre, Żory, Poland
3Institute of Physiotherapy, Faculty of Health Sciences and Psychology, Collegium Medicum, University of Rzeszów, Poland
4Olaniszyn Physiotherapy Centre, Poland
5Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
6Sport Physical Activity and Health Research & Innovation Center, Portugal
7Applied Research Institute (i2A), Polytechnic University of Coimbra, Portugal
8Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, Poland
9School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei

Filipe Manuel Clemente
✉ Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, Gdansk, Poland
Email: filipe.clemente5@gmail.com
Received: 11-02-2026 -- Accepted: 27-03-2026
Published (online): 01-06-2026
Narrated in English
ABSTRACT

To test whether a pneumatic cold-compression system (CC) improves recovery of maximal voluntary contraction (MVC) at 48 h (T4) versus Sham after a standardized hamstring fatigue protocol. Secondary aims were to compare muscle stiffness, microvascular perfusion, pressure pain threshold (PPT), blood lactate, perceived recovery (TQR), and harms across subgroups. This multicenter, randomized, participant- and assessor-blinded, sham-controlled, two-period crossover trial enrolled 80 participants. After fatigue testing, participants received CC (3 °C, 75 mmHg, 10 min twice daily for 3 days) or Sham (15 °C, 15 mmHg). Outcomes were assessed at baseline (T0), post-fatigue (T1), immediately post-first intervention (T2), 24 h (T3), and 48 h (T4). Continuous outcomes were analyzed using mixed-way ANOVA with Population as the between-subject factor and Condition and Time as within-subject factors, followed by Bonferroni-adjusted pairwise comparisons. Paired Cohen’s dz was reported for key within-participant contrasts. TQR was analyzed using rank-based factorial ANOVA, and Borg CR10 scores using ordinal logistic regression. Across populations, MVC was higher under CC than Sham from T2 to T4, with the largest between-condition difference at T4 (all p < .001). Muscle stiffness was lower under CC from T2 to T4 (all p < .001). Microvascular perfusion and pressure pain threshold were higher under CC at T2 - T4 overall (all p < .001), with earlier between-condition differences in MMA athletes and young adults and delayed differences in older adults. Blood lactate was lower under CC only immediately after the first intervention session (T2; p < .001). TQR was higher under CC at T2 - T4 in MMA athletes, at T2 - T3 in older adults, and at T3 only in young adults. No adverse events were reported. CC accelerated recovery after hamstring fatigue, improving strength, stiffness, perfusion, pain thresholds, lactate, and perceived recovery across populations, with earlier benefits in athletes and young adults and delayed but comparable improvements in older adults. Registration: ISRCTN49499065.
Key words: Cryotherapy, Compression, Muscle Fatigue, Recovery of Function, Sports Medicine

Key Points
  • Pneumatic cryo-compression (3 °C) improved hamstring recovery versus sham, with faster benefits in young/MMA athletes and delayed effects in older adults, and no adverse events.
  • A 10-min protocol twice daily for 3 days is a practical adjunct after heavy eccentric hamstring work, but expect slower onset in older adults.
  • Results may not generalize to injured/high-risk patients or other devices/doses.








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Acute Impact of Cold Compression Therapy Across Diverse Age Groups and Physical Conditioning Status: A Randomized Crossover Study
Robert Trybulski, Adrian Kużdżał, Gracjan Olaniszyn, Ana Filipa Silva, Filipe Manuel Clemente, Wang Hsing-Kuo
2026(25), 350 - 370.
DOI: https://doi.org/10.52082/jssm.2026.350