RESEARCH ARTICLE
Pos -compe i ion eco e y s a egies in eli e
male socce playe s. E ec s on pe o mance:
A sys ema ic e iew and me a-analysis
Albe Al a iba-Ba esID
1,2☯
, Ja ie PeñaID
1,2☯
*, Jo di Vicens-Bo dasID
2,3,4☯
,
Raimon Milà-Villa oel
5‡
, Julio Calleja-Gonza
´lezID
6‡
1Spo Pe o mance Analysis Resea ch G oup (SPARG), Uni e si y o Vic-Cen al Uni e si y o Ca alonia,
Vic, Ba celona, Spain, 2UVic-UCC Spo and Physical Ac i i y S udies Cen e (CEEAF), Uni e si y o Vic-
Cen al Uni e si y o Ca alonia, Vic, Ba celona, Spain, 3Depa men o Medical Sciences, Resea ch G oup
o Clinical Ana omy, Emb yology and Neu oscience (NEOMA), School o Heal h and Spo Sciences
(EUSES), Uni e si y o Gi ona, Gi ona, Spain, 4School o Heal h and Spo Sciences (EUSES), Uni e si a
de Gi ona, Sal , Spain, 5Global Resea ch on Wellbeing (GRoW), Blanque na School o Heal h Sciences-
Ramon Llull Uni e si y, Ba celona, Spain, 6Depa men o Physical Educa ion and Spo s, Facul y o
Educa ion and Spo , Uni e si y o he Basque Coun y, UPV/EHU, Vi o ia-Gas eiz, Spain
☯These au ho s con ibu ed equally o his wo k.
‡ These au ho s also con ibu ed equally o his wo k.
*[email p o ec ed]a
Abs ac
Aims
The main aim o he p esen e iew was o upda e he a ailable e idence on he alue in e -
es o pos -compe i ion eco e y s a egies in male p o essional o semi-p o essional socce
playe s o de e mine i s e ec on pos -game pe o mance ou comes, physiological ma ke s,
and wellness indica o s.
Me hods
A s uc u ed sea ch was ca ied ou ollowing he PRISMA guidelines using six online da a-
bases: Pubmed, Scopus, SPORTDiscus, Web o Science, CINAHL and Coch ane Cen al
Regis e o Con olled T ials. The isk o bias was comple ed ollowing he Coch ane Collab-
o a ion Guidelines. Me a-analyses o andomized con olled ials we e conduc ed o de e -
mine he be ween and wi hin-g oup e ec s o di e en eco e y s a egies on pe o mance,
physiological ma ke s and wellness da a. Final me a-analyses we e pe o med using he
andom-e ec s model and pooled s anda dized mean di e ences (SMD).
Resul s
Fi e andomized con olled ials ha used Comp ession Ga men s (n = 3), Cold Wa e
Imme sion (n = 1), and acu e Sleep Hygiene S a egy (n = 1) we e included. G ea e CMJ
alues a 48h o he in e en ion g oup (SMD = 0.70; 95% CI 0.14 o 1.25; p = 0.001; I
2
=
10.4%) we e ound. Fo he 20-m sp in and MVC, he esul s showed no di e ence ei he a
24h o 48h. Fo physiological ma ke s (CK and CRP) and wellness da a (DOMS), small o
la ge SMD we e p esen in a o o he in e en ion g oup bo h a 24h (-0.12 o -1.86) and
PLOS ONE
PLOS ONE | h ps://doi.o g/10.1371/jou nal.pone.0240135 Oc obe 2, 2020 1 / 20
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OPEN ACCESS
Ci a ion: Al a iba-Ba es A, Peña J, Vicens-Bo das
J, Milà-Villa oel R, Calleja-Gonza
´lez J (2020) Pos -
compe i ion eco e y s a egies in eli e male socce
playe s. E ec s on pe o mance: A sys ema ic
e iew and me a-analysis. PLoS ONE 15(10):
e0240135. h ps://doi.o g/10.1371/jou nal.
pone.0240135
Edi o : Moaci Ma ocolo, Uni e sidade Fede al de
Juiz de Fo a, BRAZIL
Recei ed: May 20, 2020
Accep ed: Sep embe 19, 2020
Published: Oc obe 2, 2020
Pee Re iew His o y: PLOS ecognizes he
bene i s o anspa ency in he pee e iew
p ocess; he e o e, we enable he publica ion o
all o he con en o pee e iew and au ho
esponses alongside inal, published a icles. The
edi o ial his o y o his a icle is a ailable he e:
h ps://doi.o g/10.1371/jou nal.pone.0240135
Copy igh : ©2020 Al a iba-Ba es e al. This is an
open access a icle dis ibu ed unde he e ms o
he C ea i e Commons A ibu ion License, which
pe mi s un es ic ed use, dis ibu ion, and
ep oduc ion in any medium, p o ided he o iginal
au ho and sou ce a e c edi ed.
Da a A ailabili y S a emen : All ele an da a a e
wi hin he manusc ip and i s Suppo ing
In o ma ion iles.
48h (-0.21 o -0.85). No he e ogenei y was p esen , excep o MVC a 24h (I
2
= 90.4%; p =
0.0012) and CALF DOMS a 48h (I
2
= 93.7%; p = 0.013).
Conclusion
The use o eco e y s a egies o e s signi ican posi i e e ec s only in jumping pe o mance
(CMJ), wi h no e ec s on he 20-m sp in o MVC. Also, he use o eco e y s a egies o e s
g ea e posi i e e ec s on muscle damage (physiological ma ke s and wellness da a),
highligh ing he impo ance o pos -ma ch eco e y s a egies in socce .
In oduc ion
The in e ac ion be ween aining load, a igue, adap a ion, and eco e y is an elemen o
ex eme complexi y comp ising ac o s o a e y di e en na u e [1,2]. Acco ding o he li e a-
u e, maximizing he pe o mance o an a hle e is no only a ma e o aining, bu i is also
a ec ed by a wide a ay o in insic and ex insic elemen s [2,3]. Cu en e idence highligh s
ha enough and op imal eco e y is necessa y o p e en heal h p oblems and o achie e peak
pe o mance and he choice o eco e y s a egies by coaches and a hle es may be c ucial [4,
5]. P ope eco e y s a egies can lead a hle es o be e pe o mances, helping hem o eel
mo e es ed and heal hy [6]. Howe e , high-pe o mance a hle es ace a wide a ay o daily
aining s imuli ha may no allow comple e eco e ies [7], emphasizing he need o op imal
eco e y s a egies based on indi idual a igue h esholds [4,8].
Reco e ing as quickly as possible, es o ing p e-pe o mance le els is conside ed a c ucial
elemen o success in almos e e y a hle ic discipline [9]. Fo his eason, coaches and a hle es
a e always in a con inuous sea ch o he mos e ec i e s a egies o speed up pos -exe cise
eco e y [2,9–11]. Howe e , p ecisely de ining he concep o “ eco e y om exe cise” is a
challenging mission due o he numbe o a iables a ec ing an op imal eco e y [12]. This
pionee ing idea has inspi ed a mul i- ac o ial app oach o he “physiology o eco e y,”
e idencing he need o mo e conclusi e esea ch [13].
Placing he ocus on a igue in eli e compe i i e socce , we obse e ha he a e age playe
a his le el is exposed o high-conges ed game schedules wi h a mean o 60 compe i i e games
played pe season, equa ing 5.5 games pe mon h [14] o one game e e y 4.3 days [15]. Conse-
quen ly, a lo o physical and psychological s ess is imposed on p o essional socce playe s [9,
16]. Playe s pa icipa ing in wo games pe week and less han o equal o ou eco e y days
a e unde a subs an ial isk o sus aining an inju y. I is es ima ed ha i is mo e han six imes
highe , compa ed o ha ing only one game pe week and a eco e y ime o six days o mo e
be ween compe i ions [17–19]. Imposing load wi hou enough eco e y migh also be an
essen ial ac o leading o illnesses o inju ies [20,21].
Among o he pe o mance ac o s in socce , epea ed sp in abili y, jumping abili y, maxi-
mal s eng h seem o be educed immedia ely a e a game; and he ime needed o eco e
om aining sessions o compe i i e e en s ully may a y be ween 48 hou s and 96 hou s
depending on he au ho s and he physical i ness alues analyzed [18,22–30]. Besides, bio-
chemical ma ke s in eam spo s a e also al e ed inconsis en ly a e aining o compe i ion,
showing ele an di e ences in he eco e y p o ile o e e y spo [31]. Pa icula ly in socce ,
CK and ho monal pa ame e s seem he mos ele an bioma ke s o he eco e y p ocess [32].
Es ablishing he impo ance o eco e y, se e al s udies show non-signi ican di e ences in
inju y isk, unning pe o mances, o pace in echnical ac i i ies du ing conges ed compe i i e
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Reco e y s a egies in eli e male socce playe s: A sys ema ic e iew and me a-analysis
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Funding: The au ho s ecei ed no speci ic unding
o his wo k.
Compe ing in e es s: The au ho s ha e decla ed
ha no compe ing in e es s exis .
pe iods in p o essional socce playe s [33,34]. Socce playe s seem o be able o cope wi h he
physical demands o consecu i e games [34–37]. Thus, he decline in pe o mance can be
a ibu ed o an inc ease in game in e up ions and no o he e ec o physical a igue, and i
may be a common end o o e es ima e a igue-induced pe o mance declines [35]. Playe ’s
co e ed dis ances and eloci ies also show dependency on con ex ual game ac o s such as he
enue and he esul o he game [36]. To expe ience ansien esidual a igue o e he games
and he season is some hing common in p o essional socce playe s, causing ad e se e ec s on
he on- ield physical pe o mance and p edisposing o o e use and non-con ac inju ies [18,
37–40]. Minimizing he e ec s o a el a igue should also be aken in o accoun [41], gi en
ha a eling long dis ances by plane has a signi ican e ec on he subjec i e a ings o je -lag,
neu ological a igue, and sleepiness [42].
The knowledge abou physical pe o mance p o iles, playe s managemen (squad o a ion)
eco e y s a egies, and ime cou ses seems o be an essen ial ac o in ge ing a ealis ic
app oach o eco e y, es ablishing an op imal pe iodiza ion design o he season, and op i-
mizing playe s’ eadiness o he upcoming compe i ions. [16,33,38,43–46].
To enhance he eco e y p ocess, he mo e common s a egies employed by a hle es include
e gogenic aids, hyd o he apy, ac i e eco e y, s e ching, comp ession ga men s, and massage
[47,48]. These me hods a e equen ly used by p o essional socce playe s, being nu i ion,
sleep, comp ession ga men s, cold-wa e imme sion, and con as wa e he apy, he ones
wi h a be e subjec i e pe cep ion [49]. Howe e , in many cases, scien i ic e idence is no
aken in o accoun be o e implemen ing hese s a egies, showing inadequacies o spo s sci-
ence knowledge ansla ion o he day- o-day p ac ice [4]. Abaïdia and Dupon [50] p oposed
a p ac ical eco e y p o ocol based on an ex ensi e scien i ic e ision, inding a high g ade o
ecommenda ion o se e al nu i ional s a egies and hyd a ion, cold wa e imme sion,
whole-body c yo he apy, and comp ession ga men s. In his p oposal, o he eco e y s a e-
gies such as sleep, massage, oam olling, elec ical s imula ion, and massage we e conside ed
inapp op ia e, o i s bene i s in physical pe o mance and eco e y we e no clea . Mo eo e ,
o he au ho s concluded ha e en ac i e s a egies we e la gely ine ec i e o imp o ing pos -
exe cise eco e y, o e ed some bene i s compa ed wi h passi e ones [51,52].
Speci ically, in socce , some s udies show ha ac i e eco e y nei he has e ec s on neu o-
muscula eco e y no in an ioxidan esponse o compe i i e games and muscle so eness [27,
45,53]. O he s ound i use ul, educing muscle pain, concluding ha i may help o es o e
pe o mance abili ies such as e ical jump [54]. Cold-wa e imme sion is ano he o he mos
common s a egies employed and has been epo ed as e ec i e imp o ing muscula damage
and discom o and o e all a igue pe cep ion a e aining and compe i ion, bu no ha ing a
de ini e posi i e e ec on physical pe o mance [55–58]. Mode n echniques, such as elec o-
s imula ion and oam olle , ha e also shown a signi ican e ec on he eco e y in agili y and
pe cei ed muscle so eness [59,60] while comp ession ga men s ha e educed his ological
damage in some expe imen al s udies [61]. Howe e , he s udies wi h p o essional o semi-
p o essional socce playe s a e sca ce, and consequen ly, decision making e y complex.
Se e al au ho s ha e ied o ind pooled posi i e e ec s o using combina ions o di e en
eco e y s a egies. Kinugasa & Kilding [62] obse ed highe posi i e e ec s on pe cei ed
eco e y a e combining cold-wa e imme sion and ac i e eco e y. In ano he s udy, whole-
body ib a ion (WBV), in combina ion wi h a adi ional cool-down educed pe cei ed mus-
cle pain and enhanced eco e y as e han he p o ocols wi hou WBV a e a socce -speci ic
d ill [10]. O he au ho s ha e demons a ed ha no eco e y s a egy is mo e e ec i e han
he o he s. Howe e , he use o combined s a egies ended o be mo e e ec i e han a simple
s a egy [63]. To he bes o ou knowledge, no sys ema ic e iew has analyzed he empi ic use
o hese s a egies in p o essional socce se ings p e iously.
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Reco e y s a egies in eli e male socce playe s: A sys ema ic e iew and me a-analysis
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The e o e, he main aim o he p esen s udy is o e iew he a ailable e idence on he alue
o pos -ma ch eco e y s a egies and in e en ions in male p o essional o semi-p o essional
socce playe s in o de o de e mine i s e ec on pos -ma ch pe o mance ou comes, physio-
logical ma ke s, and wellness indica o s.
Ma e ials and me hods
Design
A sys ema ic e iew and me a-analysis ocusing on he e ec s o di e en eco e y s a egies
in p o essional socce con ex s we e epo ed ollowing he ecommenda ions o he P e e ed
Repo ing I ems o Sys ema ic Re iews and Me a-analyses s a emen (PRISMA) [64]. Be o e
he sea ch, a e iew p o ocol based on PRISMA-P [65] was comple ed (S1 File) and egis e ed
a PROSPERO (ID = CRD42018094854). The e iew p o ocol was upda ed du ing he e iew
p ocess and is a ailable a h p://www.c d.yo k.ac.uk/PROSPERO/display_ eco d.asp?ID=
CRD42018094854 (07 No embe 2019)
Sea ch s a egy and s udy selec ion
A sys ema ic compu e ized li e a u e sea ch was pe o med using six online da abases: Med-
line (PubMed), Scopus, SPORTDiscus, WOS (Web o Science), CINAHL, and Coch ane Cen-
al Regis e o Con olled T ials (CENTRAL). The sea ch included a icles published be o e
May 20
h
, 2020. All da abases we e sea ched using Boolean ope a o s wi h he ollowing medi-
cal subjec headings (MeSH) and ee ex wo ds o c i ical concep s ela ed o eco e y and
socce pe o mance: “A hle es,” “Spo ,” “Reco e y,” “Ma ch,” “Pe o mance,” “Feeling pe -
cep ion.” The eligibili y o he s udies was o mula ed acco ding o he ollowing PICOS c i e-
ia, which e u ned ele an a icles in he ield using a snowballing app oach:
• Popula ion: eli e p o essional o semi-p o essional male oo ball o socce playe s.
• In e en ion: s uc u ed in e en ions compa ing me hods and con ol g oups.
• Compa ison: s udies ha compa e di e en eco e y modali ies o be ween a modali y and
con ol g oup.
• Ou comes: physical pe o mance was aken in o accoun as a p ima y ou come. Subjec i e
pe cep ion, wellness, echnical, ac ical, and physiological pe o mance we e conside ed as
seconda y ou comes.
• S udy design: andomized clinical ials we e included.
S udies we e included i 1) we e andomized con olled ials (RCTs) wi h pa icipan s an-
domly sepa a ed in o equal g oups (con ol g oup and in e en ion g oup); 2) pa icipan s
we e semi-p o essional o p o essional adul oo ball/socce playe s; 3) eco e y s a egies
we e pe o med a e a compe i ion. S udies we e excluded i : 1) emale playe s we e aken
in o accoun . Only ull- ex publica ions in English we e conside ed.
The comple e sea ch s a egy o each da abase can be ound in he S2 File. The sea ches
we e cus omized o accommoda e he layou and cha ac e is ics o each sea ch ool. The e e -
ence sec ions o all iden i ied a icles we e examined, and a hand-sea ch o i was also con-
duc ed o o he po en ially ele an e e ences.
One au ho selec ed pape s o inclusion (AAB). Ti les and abs ac s ob ained by he sea ch
we e sc eened and downloaded in o Mendeley Desk op (Glyph & Cog) o a subsequen ull-
ex e iew. C oss- e e ences and duplica es we e emo ed. All publica ions po en ially ele-
an o inclusion in he me a-analysis we e independen ly assessed by wo e iewe s (AAB
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Reco e y s a egies in eli e male socce playe s: A sys ema ic e iew and me a-analysis
PLOS ONE | h ps://doi.o g/10.1371/jou nal.pone.0240135 Oc obe 2, 2020 4 / 20
and JVB). Any disc epancies a his s age we e esol ed du ing a consensus mee ing, and a
hi d (JP) e iewe was a ailable i needed.
Ou come a iables
Fo he p ima y ou come, changes in muscle s eng h, sp in and jump pe o mance alues
ob ained om di e en es s a e using eco e y modali ies we e conside ed.
Fo he seconda y ou comes, changes in psychological, wellness, and physiological da a
we e conside ed.
Da a ex ac ion
Gene al s udy in o ma ion, pa icipan s, in e en ion cha ac e is ics, and ou come measu es
we e ex ac ed independen ly by wo e iewe s (AAB and JVB) using a speci ic s anda dized
da a ex ac ion o m (S3 File). When s udies p o ided insu icien da a o inclusion in he
me a-analysis, he i s au ho o he s udy made con ac wi h he co esponding au ho (s) o
de e mine whe he addi ional da a could be p o ided; in o he cases, da a was ex ac ed om
g aphs using Digi izei digi ize so wa e (h ps://www.digi izei .de).
Risk o bias
Me hodological quali y was no implemen ed, as no e idence o such app aisals and judg-
men s exis s and, he e o e, can be con using when in e p e ing esul s [66].
A bias is a sys ema ic e o , o de ia ion om he ac ual e ec , in esul s o in e ences. The
au ho s assessed he isk o bias in RCTs ollowing he Coch ane Collabo a ion’s ool o
assessing he isk o bias in andomized ials [67]. The i ems on he lis we e di ided in o six
domains: selec ion bias ( andom sequence gene a ion, alloca ion concealmen ); pe o mance
bias (blinding o pa icipan s and esea che s); de ec ion bias (blinding o ou come assess-
men ); a i ion bias (incomple e ou come da a); epo ing bias (selec i e epo ing); and o he
bias. Fo each s udy, bias domain was judged by consensus (AAB and JVB), o hi d-pa y
adjudica ion (JPL) and was cha ac e ized as “high” (a plausible bias ha se e ely weakens con-
idence in he esul s); “low” (a plausible bias unlikely o se iously al e he esul s); o
“unclea ” (plausible bias ha aises some doub abou he esul s). A quo e om he s udy
epo , oge he wi h a jus i ica ion o he judgmen , was p o ided.
S a is ical analysis
Desc ip i e da a o he pa icipan s’ cha ac e is ics we e epo ed as mean (SD). All me a-anal-
yses calcula ions we e conduc ed wi h he R so wa e wi h me a and me a o packages o me -
analysis (Ve sion 3.5.1.). Desc ip i e analyses and igu es o isk o bias we e pe o med using
Mic oso Excel o MAC, e sion 16.29.1 (Mic oso , USA). Mean and s anda dized mean di -
e ences (Hedges’ g) and 95% CI o each g oup we e calcula ed. The analysis o pooled da a
was conduc ed using a andom-e ec model [68] o es ima e he change o each g oup a he
same measu emen ime on p ima y and seconda y ou comes. Fo he seconda y me a-analy-
sis, he mean di e ence be ween p ima y and seconda y ou comes was collec ed o es ima e
he change om baseline o each ime measu emen o each g oup (con ol and expe imen al
g oups). S anda dized mean di e ences we e weigh ed by he in e se o he a iance o calcu-
la e he size o he e ec and 95% con idence in e al. Cohen’s c i e ia we e used o in e p e
he magni ude o he e ec : <|0.50|: small; |0.50| o |0.80|: mode a e; and >|0.80|: la ge [69].
He e ogenei y was assessed using Coch an’s Q s a is ics and i s co esponding p- alue as well
as he I
2
s a is ic, which desc ibes he pe cen age o a iabili y in e ec es ima es a ibu able o
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Reco e y s a egies in eli e male socce playe s: A sys ema ic e iew and me a-analysis
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he e ogenei y a he han chance when I
2
was >30% (30–60% ep esen ing mode a e he e o-
genei y) [66]. Publica ion bias was assessed wi h unnel plo s and Begg’s es . Signi icance was
se a p<0.05.
In he case o s udies epo ing eco e y a di e en ime ames such as 20h and 44h, hose
alues we e assimila ed o he ones epo ed in he li e a u e, 24h and 48h.
Resul s
The ini ial sea ch iden i ied 4184 e e ences (Fig 1). No o he e e ences we e iden i ied
h ough he examina ion o e e ence lis s and ci a ions o ele an a icles. A e he iden i i-
ca ion o duplica es, 3402 i les and abs ac s we e sc eened. Se en s udies emained o u he
ull- ex analysis. Subsequen ly, 2 s udies we e excluded. The easons o exclusion we e ha
pa icipan s we e no oo ball o socce playe s; o da a on p ima y ou comes (pe o mance)
was no assessed in he s udy. In he end, i e s udies we e included in he inal e iew p ocess.
Fig 1. Eligibili y low diag am showing he selec ion p ocess o he inclusion s udies in his me a-analysis. n: sample size.
h ps://doi.o g/10.1371/jou nal.pone.0240135.g001
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Reco e y s a egies in eli e male socce playe s: A sys ema ic e iew and me a-analysis
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Desc ip ion o s udies
Fi e RCTs [57,70–73] we e included in his e iew, wi h hei mos ele an cha ac e is ics
being summa ized in Table 1. A o al o 69 pa icipan s we e included in he e iew, wi h a
mean age o 20.8 ±1.3 yea s wi h a ange o 18 o 28 yea s The compe i i e le el o he socce
playe s in he s udies was semi-p o essional [57,71–73], and eli e o p o essional [70]. F om
he included s udies, h ee assessed he e ec s o wea ing lowe -body comp ession ga men s
Table 1. Cha ac e is ics o he included andomised con olled ials.
S udy Popula ion and
le el N (male);
age ±SD
In e en ion desc ip ion G oup: In e en ion and
Con ol cha ac e is ics
P ima y
Ou come
Seconda y
ou comes
Resul s, conclusions and
in e en ion e ec
Ascensão
e al. [57].
20 junio socce
playe s Na ional
eam leagues
IG (10);
18.1 ±1.8 yea s
CG (10);
18.3 ±0.8 yea s
E ec o immedia e pos -
exe cise CWI single session on
socce playe s
A e ma ch o 10 minu es
IG: CWI 10ºC
CG: TWI 35ºC
SJ (cm)
CMJ (cm)
20-m
sp in
(sec)
MVIC
(Kg)
DOMS
Muscle damage:
CK (U/L), Mb
(μg/L)
In lamma ion
CRP (mg/L)
Dec ease in SJ a 24h and CMJ a
24h and 48h in he TWI g oup
b
Dec ease in CMJ a 24h in he
CWI g oup
b
Dec eases in peak quad iceps
s eng h in he TWI g oup a
24h and 48h and in CWI a 48h
b
Quad iceps s eng h g ea e a
24h in CWI g oup
a
CWI mo e e ec i e han TWI a
24h o quad iceps and cal
DOMS and a 30min o hip
adduc o s
a
CK inc eased in bo h g oups a
30min, 24h and 48h
b
and mo e
in he TWI a 24h and 48h
a
Mb inc eased in bo h g oups a
30min
b
, mo e in he TWI
a
CRP concen a ions inc eased in
bo h g oups a 30min and 24h
b
,
bu again mo e in he TWI han
in CWI
a
Cli o d
e al. [70].
11 eli e
p o essional
socce playe s
19.0 ±1.0 yea s
E ec o wea ing lowe body
ga men s i ed wi h cooled
phase changed ma e ial (PCM)
on accele a ing unc ional and
pe cei ed eco e y a e a
game
45 min a e ma ch o 3 hou s.
5 mmHg
IG: PCMcold 15ºC
CG: PCMwa m 22ºC
CMJ (cm)
MVIC (N)
BAM+
MS
BFQ
MVIC a 36 h and 60 h pos was
g ea e wi h PCMcold han
PCMwa m
a
MS pos 36 h and 60 h was lowe
wi h PCMcold han PCMwa m
a
No di e ences in CMJ o BAM
+ be ween g oups.
PCMcold was mo e e ec i e
han he PCMwa m a e he
in e en ion acco ding o BFQ
a
Fullaga
e al. [71].
20 highly
ained semi-
p o essional
socce playe s
25.5 ±4.6 yea s
E ec o an acu e sleep hygiene
s a egy (SHS) on physical and
pe cep ual eco e y o playe s
a e a la e-nigh game.
IG: SHS ligh s dimmed, eye-
masks and ea plugs, cool
empe a u e ooms (~17˚C).
No echnological o ligh
s imula ion ~15–30 min p io
o bed ime. 7h 30 min in bed.
CG: NSHS allowed o use
mobile phones and TV. 5 h 30
min in bed.
Ex e nal
load
In e nal
load
CMJ (cm)
YYIR2
(m)
Objec i e and
subjec i e sleep
da a
Gene al eco e y
s a e
Sleep ch ono ype
RPE
Psychological
eco e y
Physiological
eco e y
Muscle damage:
CK (mg/ml) and
u ea(mg/dl)
In lamma ion:
CRP (mg/dl)
G ea e sleep du a ion in SHS
compa ed o NSHS on ma ch
nigh
a
Less sleep du a ion wi h
NSHS
b
G ea e wake episodes on
ma ch nigh o SHS
a
No di e ences be ween
condi ions o any physical
pe o mance o enous blood
ma ke .
Maximum hea a e du ing
YYR2 highe in NSHS han SHS
a 36h
a
No di e ences be ween
condi ions o pe cep ual
“o e all eco e y” o “o e all
s ess.
(Con inued)
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[70,72,73], one assessed he e ec s o cold-wa e imme sion [57] and one assessed he e ec s
o an acu e sleep hygiene s a egy [71] on pe o mance ou comes. One o he comp ession ga -
men s in e en ions [70] combined comp ession wi h cold, using speci ic ga men s wi h
cooled phase changed ma e ial (PCM) a 15º. All he s udies assessed he e ec s o eco e y
s a egies a 24 hou s and 48 hou s pos -ma ch. Since only one o he au ho s [72,73] epo ed
he e ec s o eco e y s a egies a 72 hou s, hose alues could no be included in he analyses.
Some au ho s we e con ac ed o p o ide ex a in o ma ion abou he s udies. Da a om
h ee au ho s could be ob ained [70,72,73], wo we e ex ac ed om he ables and g aphs
Table 1. (Con inued)
S udy Popula ion and
le el N (male);
age ±SD
In e en ion desc ip ion G oup: In e en ion and
Con ol cha ac e is ics
P ima y
Ou come
Seconda y
ou comes
Resul s, conclusions and
in e en ion e ec
Ma qués-
Jiménez
e al. [72].
18 semi-
p o essional
socce playe s
24.0 ±4.07 yea s
E alua e physiological and
physical esponses o wea ing
comp ession ga men s du ing
socce ma ches and du ing
eco e y
Du ing game and du ing 3 days
a e o 7 h/day.
SG: 20–25 mmHg ankle / 15–20
mmHg cal
FLG: 25–30 mmHg cal / 15–20
mmHg high
QG: 15–20 mmHg high
CG: no comp ession ga men s
CMJ (cm)
10–20 m
sp in
(sec)
T-Tes
(sec)
YYIR2
(m)
[La-] mmol/L
SaO
2
(%)
RPE
TQR
The e a e signi ican
co ela ions, immedia ely pos -
ma ch, be ween 10-m sp in and
20-m sp in in he CG, 10-m
sp in and 20-m sp in and 10-m
sp in and T-Tes in he SG, and
[La-] and 10-m sp in in he QG.
A 48 h pos -ma ch, he e a e
signi ican co ela ions be ween
10-m sp in and 20-m sp in in
he EG, 10-m sp in and 20-m
sp in in he SG, 10-m sp in
and 20-m sp in in he FLG.
A 72 h pos -ma ch he e a e
signi ican co ela ions be ween
10-m sp in and 20-m sp in in
he CG.
Ma qués-
Jiménez
e al. [73].
18 semi-
p o essional
socce playe s
24.0 ±4.07 yea s
E alua e he in luence o
di e en ypes o comp ession
ga men s in educing exe cise-
induced muscle damage
(EIMD) du ing eco e y a e
a iendly socce ma ch
Du ing game and du ing 3 days
a e o 7 h/day.
SG: 20–25 mmHg ankle / 15–20
mmHg cal
FLG: 25–30 mmHg cal / 15–20
mmHg high
QG: 15–20 mmHg high
CG: no comp ession ga men s
EIMD bioma ke s
DOMS
Swelling
In CG, mos bioma ke s,
including CK, LDH, GOT and
GPT, we e g ea e a 72-h pos -
ma ch compa ed o p e-ma ch.
In EG, inc eases
a
be ween p e-
and 72-h pos -ma ch we e
obse ed only in CK and LDH.
Thigh swelling inc eases
a
wi h
ime we e p esen in CG.
Di e ences in cal swelling we e
obse ed be ween CG, EG, SG
and FLG
a
DOMS di e ences be ween
g oups we e only obse ed
be ween CG, SG and QG in
ibialis so eness, be ween CG
and FLG in quad iceps so eness,
be ween CG, EG, SG and QG in
cal so eness and be ween SG
and QG in hams ing so eness
IG: in e en ion G oup; CG: con ol g oup; EG: Expe imen al g oup; CWI: cold wa e imme sion; TWI: he moneu al wa e imme sion; SJ: squa jump; CMJ: coun e
mo emen jump; MVC: maximal olun a y con ac ion; DOMS: delayed onse muscle so eness; CK: c ea ine kinase; Mb: myoglobin; CRP: C- eac i e p o ein; PCM:
cooled phase change ma e ial; MIVC: maximal isome ic olun a y con ac ion; BAM+: b ie assessmen o mood; MS: muscle so eness; BFQ: belie ques ionnai e; SHS:
sleep hygiene s a egy; NSHS: no mal pos -game sleep hygiene s a egy; YYIR2: Yo-Yo in e mi en eco e y le el 2; RPE: a e pe cei ed exe ion; SG: s ockings g oup;
FLG: igh s g oup; QG: sho s g oup; TQR: pe cei ed eco e y; [La-]: lac a e concen a ion; SaO
2
(%): A e ial oxygen sa u a ion o hemoglobin; EIMD: exe cise-
induced muscle damage; LDH: lac a e; GOT: glu amic oxaloace ic; GPT: glu amic py u ic
a
Signi icance a p<0.05
b
Signi ican di e ences a baseline le el (p<0.05)
h ps://doi.o g/10.1371/jou nal.pone.0240135. 001
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PLOS ONE | h ps://doi.o g/10.1371/jou nal.pone.0240135 Oc obe 2, 2020 8 / 20
[57,71]. Resul s o he RCTs isk o bias assessmen a e p esen ed in Table 2 and Fig 2. The p i-
ma y sou ce o bias was he blinding o pa icipan s and ou come assesso s.
To al es ima e
P ima y analyses. Fou RCTs [57,70–72] we e included in he p ima y analyses o p i-
ma y ou comes. In o al, six analyses we e pe o med: wo o CMJ (24h and 48h), wo o he
20-m sp in (24h and 48h), and wo o MVC (24h and 48h), a e shown in Table 3 and Fig 3.
Fo he CMJ, he esul s showed no di e ence a 24h (MD = 1.26; 95% CI: -0.92 o 3.44;
p = 0.2575; I
2
= 0.0%; SMD = 0.14; 95% CI: -0.31 o 0.59), bu g ea e CMJ alues a 48h o he
in e en ion g oup (MD = 3.01; 95% CI: 1.21 o 4.80; p = 0.001; I
2
= 10.4%; SMD = 0.69; 95%
CI: 0.14 o 1.25). Fo he 20-m sp in , he esul s showed no di e ence ei he a 24h (MD =
-0.05; 95% CI: -0.14 o 0.04; p = 0.311; I
2
= 0%; SMD = -0.28; 95% CI: -0.81 o 0.24), o 48h
(MD = -0.02; 95% CI: -0.10 o 0.06; p = 0.592; I
2
= 28.1%; SMD = -0.21; 95% CI: -0.74 o 0.31).
Fo he MVC, he esul s showed no di e ence ei he a 24h (MD = -105.41; 95% CI: -189.14
o 399.97; p = 0.483; I
2
= 90.4%; SMD = 0.57; 95% CI: -1.10 o 2.25), o 48h o he in e en ion
g oup (MD = 36.21; 95% CI: -42.58 o 115.01; p = 0.3677; I
2
= 0%; SMD = 0.23; 95% CI: -0.38
o 0.84). No he e ogenei y was p esen (I
2
ange om 0 o 28.1%) in all he analyses, excep o
MVC a 24h (I
2
= 90.4%). Finally, analyses on ae obic capaci y (YYIR2) could no be pe -
o med due o lack o a ailable da a.
Seconda y analyses. Th ee RCTs [57,71,73] we e included in he seconda y analyses o
he seconda y ou comes (physiological ma ke s and wellness da a). In o al, nine analyses we e
pe o med: one o CK, wo o CRP (a 24h and 48h), wo o quad iceps (QUAD), ham-
s ings (HAMS), and cal (CALF) DOMS (a 24h and 48h) a e shown in Table 3.
Table 2. Risk o bias (RCTs).
S udy Domain
Random sequence
gene a ion
Alloca ion
concealmen
Blinding o pa icipan s
and esea che s
Blinding o ou come
assessmen
Incomple e
ou come da a
Selec i e
epo ing
O he
bias
Ascensão e al.
[57].
Low Unclea High Unclea Low Low -
Cli o d e al.[70]. Low Low Low Unclea Low Low Low
Fullaga e al. [71]. Low Unclea High Unclea Low Low Low
Ma qués-Jiménez
e al. [72].
Low Unclea High Low Low Low Low
Ma qués- Jiménez
e al. [73].
Low Unclea High Unclea Low Low Low
h ps://doi.o g/10.1371/jou nal.pone.0240135. 002
Fig 2. Risk o bias (RCTs).
h ps://doi.o g/10.1371/jou nal.pone.0240135.g002
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Reco e y s a egies in eli e male socce playe s: A sys ema ic e iew and me a-analysis
PLOS ONE | h ps://doi.o g/10.1371/jou nal.pone.0240135 Oc obe 2, 2020 9 / 20
Da a cu a ion: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Raimon Milà-
Villa oel.
Fo mal analysis: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Raimon Milà-Vil-
la oel, Julio Calleja-Gonza
´lez.
In es iga ion: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Julio Calleja-
Gonza
´lez.
Me hodology: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Raimon Milà-Villa -
oel, Julio Calleja-Gonza
´lez.
So wa e: Raimon Milà-Villa oel.
Supe ision: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Julio Calleja-Gonza
´lez.
Valida ion: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Julio Calleja-Gonza
´lez.
Visualiza ion: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das.
W i ing – o iginal d a : Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Raimon
Milà-Villa oel, Julio Calleja-Gonza
´lez.
W i ing – e iew & edi ing: Albe Al a iba-Ba es, Ja ie Peña, Jo di Vicens-Bo das, Julio
Calleja-Gonza
´lez.
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