Effect of cold water immersion on balance and postural control in young healthy individuals: a systematic review

BACKGROUND: Proper recovery and a faster return to activity play an important role in injury prevention and can significantly impact performance. Also, maintaining balance and postural control are prerequisites for effective performance that can be strengthened based on proper recovery. This systematic review examined the effect of cold water immersion (CWI) on balance and postural control in healthy young adults.

The study was searched from inception to early March 2025. Six databases, Web of Science (WOS), Scopus, PubMed, ScienceDirect, PEDro, and Cochrane Library, were searched, and studies published in English were selected. Experimental studies and controlled clinical trials that included at least two groups, a CWI experimental group and a control group, had to use at least traditional or no-intervention retrieval methods. The mean age of participants was 16. The Rob2 and critical appraisal scales were used to assess the risk of bias and quality of studies.

386 studies were found in the first stage of the search, and eight were included in this review. The effects of CWI on balance in healthy individuals are varied, with some studies suggesting a positive impact and others suggesting no effect. Duration and temperature play important roles, with shorter and more moderate immersions being more effective. Temporary neural responses cause short-term instability, but in the long term, they help improve stability and control. Due to the heterogeneity among studies, conducting a meta-analysis was impossible.

The use of CWI can be done under different conditions, depending on the target population and their needs. Overall, its use yields more positive effects, although contradictions persist. It should be used with caution and tailored to the needs of the individual.