BACKGROUND: Recovery in sport plays a major role, and especially hydrotherapy as an intervention is gaining in importance. Due to various sports, cold water immersions have recently become quite popular. Because of a huge amount of investigations about hydrotherapy it is difficult to elicit clear suggestions for the sport praxis. Existing reviews often investigate several or merely physiological outcomes. OBJECTIVE: Explore precise findings about the effect of hydrotherapy for restoring the performance of athletes, with specific information about type and intensity of the exercise. This systematic review elicits the current information about the efficacy of cold water immersion for restoring the performance of athletes after intensive cycling or running exercise. METHOD: Systematic literature research was conducted in the databases Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Physiotherapy Evidence Database (PEDro). Two independent researchers screened the databases and included matching investigations by means of defined in- and exclusion criteria. A qualitative assessment of the studies was performed using the Cochrane risk-of-bias tool. RESULTS: Six randomised control trials were included. One trial detected positive effects of cold water immersion for sprint-endurance and sprint-speed, one trial no effect regarding the maximal isometric voluntary contraction as well as counter movement jump-height and four trials showed both positive, negative and no effects for different parameter of athletic performance. CONCLUSION: The efficacy of cold-water immersions seems to be strongly dependent on the exercise proceedings. It is therefore important to use different immersion protocols for different sports. The exact design of those protocols remains still unclear and further investigations have to be made.

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