Razi Journal of Medical Sciences

fa تاثیر غوطه‌وری در آب سرد بر شاخص‌های آسیب عضلانی حین و متعاقب وهله‌های تکراری رقابت شبیه‌سازی شده The effect of immersion in cold water on muscle injury indices during and after repetitive sessions of simulated competition فیزیولوژی ورزش Exercise Physiology پژوهشي Research زمینه و هدف: اجرای بهینه مهارتهای ورزشی، حاصل تعامل پیچیده عوامل فیزیولوژیک و انتخاب یک روش مطلوب جهت ریکاوری است. هدف این پژوهش تعیین تاثیر غوطه وری در آب سرد بر شاخصهای آسیب عضلانی حین و متعاقب وهلههای تکراری رقابت شبیهسازی شده بود. روش کار: در این تحقیق نیمه تجربی، 12 تکواندوکار مرد شهرستان کرج (میانگین قد 0.06±1.76 سانتیمتر، وزن 4.6±59 کیلوگرم و شاخص توده بدنی 18/2±20/19 کیلوگرم بر متر مربع) در دسترس و هدفمند انتخاب و بهصورت تصادفی به دو گروه غوطهوری در آب سرد و گروه کنترل (ریکاوری غیرفعال) تقسیم شدند. آزمودنیها در فواصل زمانی یک ساعته، سه مسابقه شبیه سازی شده تکواندو را انجام دادند. غوطهوری در آب سرد به صورت غوطه وری موضعی پاها در آب سرد با دمای 11 درجه سانتیگراد و به مدت 11 دقیقه، انجام شد. دادهها با استفاده از آزمون تحلیل واریانس عاملی با اندازهگیریهای مکرر، آزمون تی وابسته و آزمون تعقیبی بونفرونی در سطح معنیداری 05/0 P< تجزیه و تحلیل شدند. یافته‌ها: نتایج نشان داد که رقابت شبیهسازی شده منجر به افزایش معنیدار در میزان شاخصهای AST، ALT، CK و LDH در گروه غوطهوری در آب سرد نسبت به گروه کنترل شد. همچنین میانگین شاخصهای AST، ALT، CK و LDH گروه غوطهوری در آب سرد در کل مراحل پژوهش بهطور معنیداری کمتر از گروه کنترل بود (001/0>P). نتیجه‌گیری: با توجه به نتایج، بهنظر میرسد، میتوان برای بهحداقل رساندن دوره آسیب و کوفتگی عضلانی و همچنین برای داشتن ریکاوری بهتر در زمانهای کم، از غوطهوری در آب سرد استفاده کرد. Background & Aims: The main goal of athletes and coaches is to reach the peak of athletic performance. Optimal and optimal performance of sports skills is the result of the complex interaction of physiological, genetic, biomotor, anthropometric factors and finally the selection of a desirable method for recovery (1). Taekwondo, like any other sport, requires proper recovery principles to reduce injuries and achieve optimal performance. One of the most important concerns of Taekwondo coaches and athletes is the limited distance between activities and sports competitions for physiological recovery and return to the pre-activity state)2). Exercise-induced muscle damage is characterized by decreased isometric muscle strength, changes in joint range of motion, changes in muscle diameter, and leakage of certain enzymes into the bloodstream [6). During muscle injury, creatine kinase (CK) and lactate dehydrogenase (LDH) leave the skeletal muscle and enter the bloodstream; Therefore, they are known as physiological indicators of muscle damage (7). Also, due to the role of AST and ALT enzymes in causing muscle damage after strenuous activity, these enzymes are considered as indicators of muscle damage (10). Injury to active skeletal muscle reduces energy resources, accumulation of metabolic products due to exercise, fatigue, and decreased performance (11). In these circumstances, the ground is prepared for the need for a proper recovery. Recovery in sports is an essential and important component of the overall training pattern (12). Cold water immersion is a popular recovery method used by coaches and athletes to accelerate the process of improving performance after exercise and competition. The potential benefits of the cold-water immersion method depend on the reduction in muscle tissue temperature associated with the effects of hydrostatic pressure (14). The two most important variables in the immersion method are water temperature and immersion time. Immersion temperature and time can vary depending on the type of exercise and the variable being measured (15). Mardnik et al. (2017) showed that immersion in cold water after strenuous exercise is effective in reducing the CK and LDH in the recovery process and improving the performance of the athlete (17). However, Farajnia et al. (2017) in the study of the effect of immersion in cold water and repetition of rapid activity on antioxidant indices in trained men showed that immersion in cold water has an effect on the return to the state. Primary did not have these factors (19). As can be seen, the contradictions observed in the research are due to different methods of immersion as well as differences in the research method in this field. Since Taekwondo athletes must participate in their competitions on a regular basis and do not have enough time to recover, this study, assuming the positive effect of immersion in cold water on the indicators of muscle damage, as well as this that no research has been done in this field, Therefore, the aim of this study was to investigate the effect of immersion in cold water on muscle injury indices during and after repetitive sessions of simulated competition. Methods: In this quasi-experimental study, 12 male taekwondo practitioners of Karaj city (mean height 1.76 ± 0.06 cm, weight 59 ± 4.6 kg and body mass index 19.2 ± 2.18 kg/m2) were selected in an accessible and purposeful manner and randomly divided into two Cold water immersion and control group (inactive recovery). Subjects performed three simulated taekwondo competitions at one-hour intervals. Immersion in cold water was performed as local immersion of feet in cold water at 11 ° C for 11 minutes. Data were analyzed using analysis of variance with repeated measures, dependent t-test and Bonferroni post hoc test at P<0.05. Results: The results showed that the simulated competition led to a significant increase in AST, ALT, CK and LDH indices in the cold-water immersion group compared to the control group. Also, the mean AST, ALT, CK and LDH indices of the cold-water immersion group in all stages of the research were significantly lower than the control group (P<0.001). Conclusion: The results of the present study show that the mean indices of AST, ALT, CK and LDH of the cold-water immersion group in all stages of the research were significantly lower than the control group and in the continuation of the study, the difference between the two groups increased. These findings indicate that cold water immersion is more effective than inactive recovery after several consecutive races. The findings of this study were consistent with the results of Previous research (24-26). Both muscle fatigue and muscle damage have been reported to have specific mechanisms (impaired glycogen storage, sarcomere destruction, increased muscle protein breakdown, and inflammatory responses) that reduce muscle strength and capacity. Also, muscle dysfunction in response to muscle injury and fatigue mechanisms, depending on the intensity of the exercise, may last from a few hours to seven days (31).  Vaile et al. (2008) suggested that immersion in cold water immediately reduces muscle metabolism immediately after the shuttle run test (32). The mechanisms associated with reduced enzyme release due to immersion in cold water after exercise are generally unknown. However, some studies have suggested that immersion in cold water may reduce the release of intramuscular proteins into the lymphatic system or the extent of post-exercise injury (26). In addition, changes in CK are associated with pain sensation, which can be reduced by immersion in cold water. `Also, water Physiological changes due to immersion in cold water may include parasympathetic reactivation, reduction of cutaneous blood flow, change in the direction of intracellular fluid movement into the arteries, decrease in muscle swelling, and increase in cardiac output. These factors can increase blood flow and increase waste transport (37). On the other hand, we must consider that a combination of physiological and psychological factors can play an important role in the perception and awareness of participants in the study, which in turn potentially enhances recovery (38). In particular, there may be a psychological benefit (reducing the feeling of tiredness when immersed in cold water) for athletes. Differences in body composition, such as body fat and body mass, should also be considered in the individual effects of cold-water immersion protocols (39). There were some limitations in the present study, such as the lack of measurement of other indicators of muscle damage. It can also be noted that the subjects did not have complete control over their mental state during the research. To make the most of the benefits of therapies (methods that are low-cost and require the least equipment) to recover from muscle fatigue, it is recommended that other indicators of muscle damage be examined in a similar study. Overall, the findings of the present study showed that immersion in cold water is more effective than inactive recovery after several consecutive Taekwondo competitions; Therefore, it seems that immersion in cold water can be used to minimize the period of muscle injury and contusion, as well as to have a better recovery in short periods of time. ریکاوری, رقابت شبیه سازی شده, کراتین کیناز, لاکتات دهیدروژناز, آسپارتات آمینو ترانسفراز, آلانین آمینو ترانسفراز Recovery, Simulated competition, Creatine kinase, Lactate dehydrogenase, Aspartate aminotransferase, Alanine aminotransferase 184 195 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6156-1&slc_lang=fa&sid=1 Ameneh Agha fathi آمنه آقافتحی aghafathi.ameneh@gmail.com 3900319475328460062528 3900319475328460062528 No Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. گروه فیزیولوژی ورزشی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران. Amir Sarshin امیر سرشین Amsarshin@gmail.com 3900319475328460062529 3900319475328460062529 Yes Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. مرکز تحقیقات مراقبت‌های بالینی و ارتقای سلامت، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران Alireza Rahimi علیرضا رحیمی a_r_rahimi@hotmail.com 3900319475328460062530 3900319475328460062530 No Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. گروه فیزیولوژی ورزشی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران. Eidi Alijani عیدی علیجانی eidyalijani@yahoo.com 3900319475328460062531 3900319475328460062531 No Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. گروه فیزیولوژی ورزشی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران.