Palmar cooling mitigates exercise-induced immune suppression after high-intensity training: A randomized trial

Objectives We investigated whether palmar cooling alters inflammatory responses following a single session of high-intensity eccentric exercise. We hypothesized that palmar cooling during rest intervals would attenuate maladaptive inflammatory responses while preserving beneficial immune adaptations necessary for muscle repair and recovery. Methods In this randomized interventional study, 20 healthy adults were matched by sex and one-repetition maximum (1RM) for bicep curls. Participants performed 10 sets at 70% 1RM, receiving either palmar cooling at 14degreesC or a thermoneutral control at 30degreesC during 3-minute inter-set rest periods. Whole blood was collected at baseline, immediately post-exercise, and on post-exercise days 1, 2, and 4 for comprehensive immune profiling with mass cytometry. Blood lactate and pain scores were also recorded. Results Exercise induced broad immunosuppression that was significantly attenuated in the palmar cooling group by 2 days post-exercise (AUC=0.79, p=0.03). The cooled group had decreased immunosuppressive activity and increased inflammatory innate immune mechanisms in the cooled group. Palmar cooling also significantly reduced lactate levels compared to controls (p=0.024). Conclusion Palmar cooling at 14degreesC during rest intervals effectively modulated the immune response to high-intensity exercise and reduced lactate accumulation. These findings suggest palmar cooling may serve as a promising intervention to mitigate exercise-induced immunosuppression and support recovery.

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