***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of the present study was to assess the effect of cold water immersion ( CWI ) on postexercise parasympathetic reactivation .  Ten male cyclists ( age , 29 + /- 6 yr ) performed two repeated supramaximal cycling exercises ( SE(1 ) and SE(2 ) ) interspersed with a 20-min passive recovery period , during which they were r and omly assigned to either 5 min of CWI in 14 degrees C or a control ( N ) condition where they sat in an environmental chamber ( 35.0 + /- 0.3 degrees C and 40.0 + /- 3.0 % relative humidity ) . Rectal temperature ( T(re ) ) and beat-to-beat heart rate ( HR ) were recorded continuously . The time constant of HR recovery ( HRRtau ) and a time ( 30-s ) varying vagal-related HR variability ( HRV ) index ( rMSSD(30s ) ) were assessed during the 6-min period immediately following exercise . Resting vagal-related HRV indexes were calculated during 3-min periods 2 min before and 3 min after SE(1 ) and SE(2 ) . Results showed no effect of  CWI  on T(re ) ( P = 0.29 ) , SE performance ( P = 0.76 ) , and HRRtau ( P = 0.61 ) . In contrast , all vagal-related HRV indexes were decreased after SE(1 ) ( P < 0.001 ) and tended to decrease even further after SE(2 ) under N condition but not with CWI . When compared with the N condition , CWI increased HRV indexes before ( P < 0.05 ) and rMSSD(30s ) after ( P < 0.05 ) SE(2 ) . Our study shows that CWI can significantly restore the impaired vagal-related HRV indexes observed after supramaximal exercise . CWI may serve as a simple and effective means to accelerate parasympathetic reactivation during the immediate period following supramaximal exercise Objective To evaluate the impact of combinations of lifestyle factors on  mortality in middle aged women . Design Prospect i ve cohort study . Setting Nurses ’ health study , United States . Participants 77 782 women aged 34 to 59 years and free from cardiovascular disease and cancer in 1980 . Main outcome measure Relative risk of mortality during 24 years of follow-up in relation to five lifestyle factors ( cigarette smoking , being overweight , taking little moderate to vigorous physical activity , no light to moderate alcohol intake , and low diet quality score ) . Results 8882 deaths were documented , including 1790 from cardiovascular disease and 4527 from cancer . Each lifestyle factor independently and significantly predicted mortality . Relative risks for five compared with zero lifestyle risk factors were 3.26 ( 95 % confidence interval 2.45 to 4.34 ) for cancer mortality , 8.17 ( 4.96 to 13.47 ) for cardiovascular mortality , and 4.31 ( 3.51 to 5.31 ) for all cause mortality . A total of 28 % ( 25 % to 31 % ) of deaths during follow-up could be attributed to smoking and 55 % ( 47 % to 62 % ) to the combination of smoking , being overweight , lack of physical activity , and a low diet quality . Additionally considering alcohol intake did not substantially change this estimate . Conclusions These results indicate that adherence to lifestyle guidelines is associated with markedly lower  mortality in middle aged women . Both efforts to eradicate cigarette smoking and those to stimulate regular physical activity and a healthy diet should be intensified The aim of this investigation was to eluci date the efficacy of repeated cold water immersions ( CWI ) in the recovery of  exercise induced muscle damage . A r and omised group consisting of eighteen males , mean ± s age , height and body mass were 24 ± 5 years , 1.82 ± 0.06 m and 85.7 ± 16.6 kg respectively , completed a bout of 100 drop jumps . Following the bout of damaging exercise , participants were r and omly but equally assigned to either a 12 min CWI ( 15 ± 1 ° C ; n = 9 ) group who experienced immersions immediately post-exercise and every 24 h thereafter for the following 3 days , or a control group ( no treatment ; n = 9 ) . Maximal voluntary contraction ( MVC ) of the knee extensors , creatine kinase activity ( CK ) , muscle soreness ( DOMS ) , range of motion ( ROM ) and limb girth were measured pre-exercise and then for the following 96 h at 24 h increments . In addition MVC was also recorded immediately post-exercise . Significant time effects were seen for MVC , CK , DOMS and limb girth ( p < 0.05 ) indicating muscle damage was evident , however there was no group effect or interaction observed showing that CWI did not attenuate any of the dependent variables ( p > 0.05 ) . These results suggest that repeated CWI do not enhance recovery from a bout of damaging eccentric contractions . Key pointsCryotherapy , particularly cold water immersions are one of the most common interventions used in order to enhance recovery post-exercise . There is little empirical evidence demonstrating benefits from cold water immersions . Research evidence is equivocal , probably due to method ological inconsistencies . Our results show that the cryotherapy administered did not attenuate any markers of EIMD or enhance the recovery of function . We conclude that repeated cold water immersions are ineffective in the recovery from heavy plyometric exercise and suggest athletes and coaches should use caution before using this intervention as a recovery strategy PURPOSE To investigate the effects of cooling human skeletal muscle after strenuous exercise using 31P MR spectroscopy and MR imaging . METHODS 14 male subjects ( mean age + /- SD , 23.8 + /- 2.3 yr ) were r and omly assigned to the normal ( N = 7 ) or the cooling group ( N = 7 ) . All subjects performed the ankle plantar flexion exercise ( 12 repetitions , 5 sets ) . Localized 31P-spectra were collected from the medial gastrocnemius before and after exercise ( immediately , 30 , 60 min , 24 , 48 , 96 , and 168 h ) to determine the ratio of inorganic phosphate to phosphocreatine ( Pi/PCr ) and intracellular pH. Transaxial T2-weighted MR images of the medial gastrocnemius were obtained to calculate T2 relaxation time ( T2 ) , indicative of intramuscular water level , before and after exercise ( 24 , 48 , 96 , and 168 h ) . In addition , the muscle soreness level was assessed at the same time as 31P-spectra measurements . Fifteen-minute cold-water immersion was administered to the cooling group after exercise and initial postexercise measurements . RESULTS The control group showed significantly increased T2 from rest at 48 h after exercise ( P < 0.05 ) , but the cooling group showed no significant change in T2 throughout this study . Both groups showed a significantly decreased intracellular pH immediately after exercise ( P < 0.05 ) . After that , the cooling group showed a significantly greater value than the value at rest or the control group at 60 min after exercise ( P < 0.05 ) . For the Pi/PCr , no significant change was observed in both groups throughout this study . The muscle soreness level significantly increased immediately and at 24 - 48 h after exercise in both groups ( P < 0.05 ) . CONCLUSION The findings of this study suggest that cooling causes an increase in intracellular pH and prevents the delayed muscle edema Athletes with spinal cord injury ( SCI ) , and in particular tetraplegia , have an increased risk of heat strain and consequently heat illness relative to able-bodied individuals . Strategies that reduce the heat strain during exercise in a hot environment may reduce the risk of heat illness . To test the hypotheses that precooling or cooling during intermittent sprint exercise in a heated environment would attenuate the rise in core temperature in tetraplegic athletes , eight male subjects with SCI ( lesions C(5)-C(7 ) ; 2 incomplete lesions ) undertook four heat stress trials ( 32.0 + /- 0.1 degrees C , 50 + /- 0.1 % relative humidity ) . After assessment of baseline thermoregulatory responses at rest for 80 min , subjects performed three intermittent sprint protocol s for 28 min . All trials were undertaken on an arm crank ergometer and involved a no-cooling control ( Con ) , 20 min of precooling ( Pre ) , or cooling during exercise ( Dur ) . Trials were administered in a r and omized order . After the intermittent sprint protocol s , mean core temperature was higher during Con ( 37.3 + /- 0.3 degrees C ) compared with Pre and Dur ( 36.5 + /- 0.6 degrees C and 37.0 + /- 0.5 degrees C , respectively ; P < 0.01 ) . Moreover , perceived exertion was lower during Pre ( 13 + /- 2 ; P < 0.01 ) and Dur ( 12 + /- 1 ; P < 0.01 ) compared with Con ( 14 + /- 2 ) . These results suggest that both precooling and cooling during intermittent sprint exercise in the heat reduces thermal strain in tetraplegic athletes . The cooling strategies also appear to show reduced perceived exertion at equivalent time points , which may translate into improved functional capacity Kinugasa , T and Kilding , AE . A comparison of post-match recovery strategies in youth soccer players . J Strength Cond Res 23(5 ) : 1402 - 1407 , 2009-The aim of this study was to determine the effect of 3 post-match recovery modalities on physical performance , physiological measures , and players ' perceptions of recovery after 90-minute soccer match play . On separate days , 28 young ( age : 14.3 ± 0.7 years ) soccer players played 3 soccer matches each r and omly followed by 1 of 3 recovery modalities : ( a ) CONT-cold ( 12 ° C ) water immersion and hot ( 38 ° C ) shower , ( b ) COMB-cold water immersion and active recovery using a cycle ergometer , and ( c ) PASS-a passive post-match routine ( stretching and leg raise )  . Performance ( vertical jump height ) , physiological ( heart rate and tympanic temperature ) , and perceptual measures ( perceived quality of recovery ) were determined before each match , 10 minutes after each match , after each recovery method , and after 24 hours . There was a 0.6 ± 6.7 % drop in immediately after a match , but there was no difference in vertical jump height after 24 hours ( p = 0.997 ) . Perceived quality of recovery immediately after COMB was substantially higher than CONT and PASS , but the effect did not last more than 24 hours . The players perceived lighter legs after COMB , compared with the PASS , at post-24 hours . In conclusion , a combined recovery modality ( cold water immersion and active recovery ) after a soccer match did not have a substantial effect on vertical jump height performance when compared with contrast water immersion and passive recovery alone . However , the observed positive effects on perceived recovery ( higher quality of recovery and lighter legs ) after the combined modality ( cold water immersion and active recovery ) suggest that this approach may be effective for young players after intense soccer match play OBJECTIVE : To assess whether ice-water immersion or cold-water immersion is the more effective treatment for rapidly cooling hyperthermic runners . DESIGN AND SETTING : 17 heat-acclimated highly trained distance runners ( age = 28 + /- 2 years , height = 180 + /- 2 cm , weight = 68.5 + /- 2.1 kg , body fat = 11.2 + /- 1.3 % , training volume = 89 + /- 10 km/wk ) completed a hilly trail run ( approximately 19 km and 86 minutes ) in the heat ( wet-bulb globe temperature = 27 + /- 1 degrees C ) at an individually selected " comfortable " pace on 3 occasions 1 week apart . The r and om , crossover design included ( 1 ) distance run , then 12 minutes of ice-water immersion ( 5.15 + /- 0.20 degrees C ) , ( 2 ) distance run , then 12 minutes of cold-water immersion ( 14.03 + /- 0.28 degrees C ) , or ( 3 ) distance run , then 12 minutes of mock immersion ( no water , air temperature = 28.88 + /- 0.76 degrees C ) . MEASUREMENTS : Each subject was immersed from the shoulders to the hip joints for 12 minutes in a tub . Three minutes elapsed between the distance run and the start of immersion . Rectal temperature was recorded at the start of immersion , at each minute of immersion , and 3 , 6 , 10 , and 15 minutes postimmersion . No rehydration occurred during any trial . RESULTS : Length of distance run , time to complete distance run , rectal temperature , and percentage of dehydration after distance run were similar ( P > .05 ) among all trials , as was the wet-bulb globe temperature . No differences ( P > .05 ) for cooling rates were found when comparing ice-water immersion , cold-water immersion , and mock immersion at the start of immersion to 4 minutes , 4 to 8 minutes , and the start of immersion to 8 minutes .  Ice-water immersion and cold-water immersion cooling rates were similar ( P > .05 ) to each other and greater 
    Output:
    
There was some evidence that cold-water immersion reduces delayed onset muscle soreness after exercise compared with passive interventions involving rest or no intervention .
There was insufficient evidence to conclude on other outcomes or for other comparisons .