# Repeated cold immersion × muscle loss or universal strength impairment Verdict 2999 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-09-07 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-16 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: S01 Roberts concerns resistance-trained young men, with 24 assigned/21 completed. S02 Fyfe is a separate trial of 16 participants; detailed eligibility and arm-/measurement-specific denominators are unverified. Age, training history, disease/sex range, baseline nutrition and exclusions are not invented and the two sample sizes are not summed. - Ingredient, formulation and route: The selected claim concerns muscle loss or impairment of every strength adaptation with repeated cold immersion. Original research concerns repeated immersion after resistance training versus recovery controls. Distinguish Roberts lower-body/active recovery from Fyfe whole-body bibliography/passive rest; immersion extent, load, actual exposure and nutrition/adherence are unverified. No new instructions are created. - Dose: Roberts original specification is 10°C for 10 minutes within 10 minutes after training, repeated 2 times weekly. The separate Fyfe trial uses 10°C for 15 minutes versus indoor rest at 23°C. Actual temperatures, adherence and interruptions are unverified; no new total exposure, optimal temperature/timing or implementation method is calculated or recommended. - Comparator: Roberts compared cold immersion with 10 minutes of low-intensity cycling as active recovery; Fyfe used passive indoor rest at 23°C. Active and passive controls are not combined as the same comparison. Contact, nutrition products/diet, training load, actual exposure and their matching or separate contributions are unverified. - Measured outcome: Read the selected muscle-loss/universal-strength claim against Roberts gains in both groups, 309±73 g versus 103±71 g, original difference -206 g/d=-4.1/P<.001, and Fyfe less type II hypertrophy with unclear maximum-strength difference. The meaning of ±, arm-/measure-specific denominators, exact strength values/CIs and prospective hierarchy are unverified. Less gain is not baseline loss or uniform strength impairment. - Duration: Roberts 12-week MRI and Fyfe 7-week fiber/strength are separate results. Acute recovery and verdict 1247 concern other times/questions. Direct material for post-training persistence, different exposures, every sport, varied populations or medical harms is unverified. - Questions outside this scope: Transferring a gain difference of -206 g into muscle loss from baseline or impairment of every strength adaptation; Combining MRI grams, type II fiber area, maximum strength and acute signaling as the same endpoint/effect; Treating active/passive controls, training/exposure, duration and nutrition as identical conditions; Summing assigned/completer counts, multiple outcomes, acute/longer-term populations, related reports or both sheets into new participant/unique-trial totals; Inheriting original parent grade D with 28 points, E-, historical verification or independence wording as absent subclaim values or new verdicts/certification; Treating adverse adaptation for a training goal or unrelated-injury withdrawal as confirmed cold-induced medical harm; Creating new effects, CIs, attrition counts/rates, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions ## Checklist items ### N01 · How does the selected muscle-loss/universal-strength claim differ from the parent verdict? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The selected claim concerns muscle loss or impairment of every strength adaptation. Preserve subclaim D and the note of muscle gains in both groups and differing maximum-strength results. Parent grade D with 28 points/E- concerns attenuated gains. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Selected subclaim records, original note and claim boundaries. Parent scores/axes do not fill absent subclaim values. - Required materials and conditions: Selected subclaim and parent gain context - Materials to obtain first: Selected subclaim records, original note and claim boundaries. Parent scores/axes do not fill absent subclaim values. - Further research: Material needed: Selected subclaim records, original note and claim boundaries. Parent scores/axes do not fill absent subclaim values. This records needed materials; no new research was executed. - Conditions for verification: Material for Selected subclaim and parent gain context must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Selected subclaim and parent gain context with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N02 · How do attenuated gains differ from actual muscle loss? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts MRI gains are active recovery 309±73 g and CWI 103±71 g; both groups gained muscle. These preserved results are not converted into muscle loss from baseline. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original MRI tables, baseline/end values, gain definitions and analysis denominators. The meaning of ± and exact effects/CIs are unverified. - Required materials and conditions: Original MRI gains and baseline comparisons - Materials to obtain first: Original MRI tables, baseline/end values, gain definitions and analysis denominators. The meaning of ± and exact effects/CIs are unverified. - Further research: Material needed: Original MRI tables, baseline/end values, gain definitions and analysis denominators. The meaning of ± and exact effects/CIs are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Original MRI gains and baseline comparisons must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Original MRI gains and baseline comparisons with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N03 · Are universal-strength and maximum-strength results distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Fyfe records both less type II hypertrophy and no clear maximum-strength difference. The parent states that strength findings differed across trials. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Trial-specific strength measures, original tables, prospective analyses, effects/CIs and denominators. Fiber results do not establish impairment of every strength outcome. - Required materials and conditions: Hypertrophy, maximum strength and other strength measures - Materials to obtain first: Trial-specific strength measures, original tables, prospective analyses, effects/CIs and denominators. Fiber results do not establish impairment of every strength outcome. - Further research: Material needed: Trial-specific strength measures, original tables, prospective analyses, effects/CIs and denominators. Fiber results do not establish impairment of every strength outcome. This records needed materials; no new research was executed. - Conditions for verification: Material for Hypertrophy, maximum strength and other strength measures must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Hypertrophy, maximum strength and other strength measures with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N04 · Are trained young men and the separate trial the same population? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The main Roberts trial concerns resistance-trained young men with 24 assigned/21 completed. Separate Fyfe records 16 participants over 7 weeks; exact eligibility and arm-/measure-specific denominators are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Trial-specific eligibility, baseline tables and arm flow. Counts are not summed and representative populations are not automatically assigned. - Required materials and conditions: Report-specific populations and original denominators - Materials to obtain first: Trial-specific eligibility, baseline tables and arm flow. Counts are not summed and representative populations are not automatically assigned. - Further research: Material needed: Trial-specific eligibility, baseline tables and arm flow. Counts are not summed and representative populations are not automatically assigned. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific populations and original denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Report-specific populations and original denominators with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N05 · What were the original repeated post-exercise cold specifications? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts 10°C for 10 minutes within 10 minutes after training, 2 times weekly for 12 weeks, and separate Fyfe 10°C for 15 minutes over 7 weeks are original research records. Actual delivery, immersion extent and training details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Intervention/training manuals, delivery and adherence material. Research specifications are not new cold-water, exercise or treatment instructions. - Required materials and conditions: Cold/training research records - Materials to obtain first: Intervention/training manuals, delivery and adherence material. Research specifications are not new cold-water, exercise or treatment instructions. - Further research: Material needed: Intervention/training manuals, delivery and adherence material. Research specifications are not new cold-water, exercise or treatment instructions. This records needed materials; no new research was executed. - Conditions for verification: Material for Cold/training research records must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Cold/training research records with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N06 · Are active cycling and passive-rest controls distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts control is 10 minutes of low-intensity cycling as active recovery; Fyfe uses passive indoor rest at 23°C. Different controls are not combined as the same comparative effect. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Control, training/recovery, contact, exposure and nutrition material. Separate active-recovery contributions and matching of management are unverified. - Required materials and conditions: Report-specific recovery controls and shared management - Materials to obtain first: Control, training/recovery, contact, exposure and nutrition material. Separate active-recovery contributions and matching of management are unverified. - Further research: Material needed: Control, training/recovery, contact, exposure and nutrition material. Separate active-recovery contributions and matching of management are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific recovery controls and shared management must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Report-specific recovery controls and shared management with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N07 · What denominators do 24 assigned/21 completed represent? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve the original Roberts record of 24 assigned/21 completed and complete-case analysis. Arm-/measurement-specific analysis denominators, exclusions and missingness are separately unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Flow, arm denominators and missing/excluded-data material. Completer counts do not replace every endpoint denominator and no new attrition count/rate is calculated. - Required materials and conditions: Complete-case analysis and outcome denominators - Materials to obtain first: Flow, arm denominators and missing/excluded-data material. Completer counts do not replace every endpoint denominator and no new attrition count/rate is calculated. - Further research: Material needed: Flow, arm denominators and missing/excluded-data material. Completer counts do not replace every endpoint denominator and no new attrition count/rate is calculated. This records needed materials; no new research was executed. - Conditions for verification: Material for Complete-case analysis and outcome denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Complete-case analysis and outcome denominators with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N08 · Are MRI gains and fiber area the same measurement? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts concerns MRI quadriceps gains; Fyfe concerns fiber area and strength. Different measurement labels/results are not combined as the same effect or denominator. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: MRI/fiber measurement, quality, original material and denominators. Fiber area is not converted into MRI grams. - Required materials and conditions: Distinguishing measurement type, derivation and region - Materials to obtain first: MRI/fiber measurement, quality, original material and denominators. Fiber area is not converted into MRI grams. - Further research: Material needed: MRI/fiber measurement, quality, original material and denominators. Fiber area is not converted into MRI grams. This records needed materials; no new research was executed. - Conditions for verification: Material for Distinguishing measurement type, derivation and region must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Distinguishing measurement type, derivation and region with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N09 · What original record contains -206 g, d=-4.1 and P? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve parent explanation -206 g, d=-4.1, P<.001 and the evidence-summary gain difference as original values. No new difference, effect or CI is calculated and these values are not baseline muscle loss. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original estimates, effect scales/variance, analysis outputs and arm denominators. The definition of d, meaning of ±, intervals and adjustment are unverified. - Required materials and conditions: Historical original estimates and signs - Materials to obtain first: Original estimates, effect scales/variance, analysis outputs and arm denominators. The definition of d, meaning of ±, intervals and adjustment are unverified. - Further research: Material needed: Original estimates, effect scales/variance, analysis outputs and arm denominators. The definition of d, meaning of ±, intervals and adjustment are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Historical original estimates and signs must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Historical original estimates and signs with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N10 · Were Fyfe hypertrophy and strength findings both retained? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve both less type II hypertrophy and no clear maximum-strength attenuation. Directional hypertrophy support is not substituted for the same result across every strength outcome. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: All Fyfe outcome tables, SAP, exact effects/CIs and denominators. Null results do not establish 0 effect or equivalence. - Required materials and conditions: Measure-specific findings and scope boundaries - Materials to obtain first: All Fyfe outcome tables, SAP, exact effects/CIs and denominators. Null results do not establish 0 effect or equivalence. - Further research: Material needed: All Fyfe outcome tables, SAP, exact effects/CIs and denominators. Null results do not establish 0 effect or equivalence. This records needed materials; no new research was executed. - Conditions for verification: Material for Measure-specific findings and scope boundaries must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Measure-specific findings and scope boundaries with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S02 ### N11 · Were completer, assigned, actual-use analyses and baseline adjustment verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve main-trial complete-case analysis and unverified prospective hierarchy/CIs. Full-assignment/actual-use analyses, baseline adjustment, missingness/sensitivity and actual models are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: SAPs, missingness/denominators, models and sensitivity results. No new analysis, adjustment or effect estimate is executed. - Required materials and conditions: Analysis populations, models, missingness and prospective plans - Materials to obtain first: SAPs, missingness/denominators, models and sensitivity results. No new analysis, adjustment or effect estimate is executed. - Further research: Material needed: SAPs, missingness/denominators, models and sensitivity results. No new analysis, adjustment or effect estimate is executed. This records needed materials; no new research was executed. - Conditions for verification: Material for Analysis populations, models, missingness and prospective plans must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Analysis populations, models, missingness and prospective plans with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N12 · Are allocation, concealment, assessor/analyst blinding known? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Original evidence records 12-week active-control and 7-week passive-control training trials. Actual allocation, concealment and assessor/analyst allocation-awareness procedures are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Trial-specific allocation, assessor roles and protocols. Design names alone do not establish blinding, official bias assessment or passing review. - Required materials and conditions: Design labels and actual bias conditions - Materials to obtain first: Trial-specific allocation, assessor roles and protocols. Design names alone do not establish blinding, official bias assessment or passing review. - Further research: Material needed: Trial-specific allocation, assessor roles and protocols. Design names alone do not establish blinding, official bias assessment or passing review. This records needed materials; no new research was executed. - Conditions for verification: Material for Design labels and actual bias conditions must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Design names and actual bias conditions with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N13 · How do absent registration fields differ from prospective hierarchy? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Both original evidence summaries lack registration-identifier fields. The parent explicitly notes unverified prospective primary hierarchy. Field absence does not establish no registration or prospective verification. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original registration/change history, protocols and SAPs. No new identifier, registry address or successful reading is inferred. - Required materials and conditions: Original registration identity, plans and changes - Materials to obtain first: Original registration/change history, protocols and SAPs. No new identifier, registry address or successful reading is inferred. - Further research: Material needed: Original registration/change history, protocols and SAPs. No new identifier, registry address or successful reading is inferred. This records needed materials; no new research was executed. - Conditions for verification: Material for Original registration identity, plans and changes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Original registration identity, plans and changes with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N14 · Are shared training, nutrition and cold-exposure contributions separated? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The main comparison concerns gains during the same training and includes Body Science in-kind nutrition-product support. Training, nutrition, arm product distribution and actual exposure/adherence details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Training, nutrition, adherence and support-distribution material. In-kind provision does not establish matched intake or an isolated cold effect. - Required materials and conditions: Training, products, intake, adherence and shared management - Materials to obtain first: Training, nutrition, adherence and support-distribution material. In-kind provision does not establish matched intake or an isolated cold effect. - Further research: Material needed: Training, nutrition, adherence and support-distribution material. In-kind provision does not establish matched intake or an isolated cold effect. This records needed materials; no new research was executed. - Conditions for verification: Material for Training, products, intake, adherence and shared management must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Training, products, intake, adherence and shared management with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N15 · Can 12-/7-week findings extend to longer periods or every sport? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve separate 12-week MRI and 7-week fiber/strength results. Direct material for post-training persistence, different exposures, every sport and population is unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Direct duration-, population- and measure-specific material. No uniform impairment or sustained effect beyond original durations/conditions is created. - Required materials and conditions: Directness by duration, population and measure - Materials to obtain first: Direct duration-, population- and measure-specific material. No uniform impairment or sustained effect beyond original durations/conditions is created. - Further research: Material needed: Direct duration-, population- and measure-specific material. No uniform impairment or sustained effect beyond original durations/conditions is created. This records needed materials; no new research was executed. - Conditions for verification: Material for Directness by duration, population and measure must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Directness by duration, population and measure with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N16 · Are acute recovery, longer-term adaptation and the other verdict distinct? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original separates acute recovery from longer-term adaptation and describes verdict 1247 as an acute soreness/recovery question. Its original material was not newly read in this work. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Direct material for the selected longer-term question and outcome/time/cohort linkage. Acute recovery is not transferred into longer-term adaptation or replication of another verdict. - Required materials and conditions: Outcome goals, times and questions - Materials to obtain first: Direct material for the selected longer-term question and outcome/time/cohort linkage. Acute recovery is not transferred into longer-term adaptation or replication of another verdict. - Further research: Material needed: Direct material for the selected longer-term question and outcome/time/cohort linkage. Acute recovery is not transferred into longer-term adaptation or replication of another verdict. This records needed materials; no new research was executed. - Conditions for verification: Material for Outcome goals, times and questions must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Outcome goals, times and questions with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N17 · Are adverse training adaptation and medical harm the same? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve original wording that parent E-/grade D with 28 points denotes adverse adaptation and does not mean a null result. Disadvantage for a training goal is distinct from actual medical-harm occurrence/frequency. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Separate adaptation and medical-harm material. Original direction/grade does not certify new harm rates or safety. - Required materials and conditions: Verdict direction and actual medical events - Materials to obtain first: Separate adaptation and medical-harm material. Original direction/grade does not certify new harm rates or safety. - Further research: Material needed: Separate adaptation and medical-harm material. Original direction/grade does not certify new harm rates or safety. This records needed materials; no new research was executed. - Conditions for verification: Material for Verdict direction and actual medical events must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Verdict direction and actual medical events with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N18 · Was independence across reports, populations and sheets verified? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent and both subclaim sheets share the same two longer-term reports, preserving gains in both groups and maximum-strength disagreement. Multiple outcomes, acute/longer-term population relationships, related-report overlap and unique totals are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Report-specific cohorts, support, protocols and outcome lists. The same populations, sheets or measures are not summed as new participants or independent replications. - Required materials and conditions: Linkage of reports, cohorts and multiple outcomes - Materials to obtain first: Report-specific cohorts, support, protocols and outcome lists. The same populations, sheets or measures are not summed as new participants or independent replications. - Further research: Material needed: Report-specific cohorts, support, protocols and outcome lists. The same populations, sheets or measures are not summed as new participants or independent replications. This records needed materials; no new research was executed. - Conditions for verification: Material for Linkage of reports, cohorts and multiple outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Linkage of reports, cohorts and multiple outcomes with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N19 · What public/university and in-kind support did Roberts record? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve public/university support together with Body Science in-kind nutrition products. Actual products, distribution, affiliations, interests and analysis/publication involvement are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original support, affiliations, interests, products and roles. No new absence of company-employed authors or analysis/reporting involvement is established. - Required materials and conditions: Funding, product support, affiliations and roles - Materials to obtain first: Original support, affiliations, interests, products and roles. No new absence of company-employed authors or analysis/reporting involvement is established. - Further research: Material needed: Original support, affiliations, interests, products and roles. No new absence of company-employed authors or analysis/reporting involvement is established. This records needed materials; no new research was executed. - Conditions for verification: Material for Funding, product support, affiliations and roles must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Funding, product support, affiliations and roles with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N20 · What public sport/university support did Fyfe record? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve Fyfe original public sport/university support wording. This does not establish current industry-independence certification or the absence of every product-support/company role. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Fyfe support, affiliations, interests and role material. Parent independence axes remain distinct from actual support-verification scope. - Required materials and conditions: Support wording and actual roles - Materials to obtain first: Fyfe support, affiliations, interests and role material. Parent independence axes remain distinct from actual support-verification scope. - Further research: Material needed: Fyfe support, affiliations, interests and role material. Parent independence axes remain distinct from actual support-verification scope. This records needed materials; no new research was executed. - Conditions for verification: Material for Support wording and actual roles must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Support wording and actual roles with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S02 ### N21 · Were injury withdrawals kept distinct from cold causation? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original did not attribute unrelated-injury withdrawal to cold immersion. Exact arm-specific causes, timing, analysis handling and exposure causality are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original withdrawal, safety and cause-assessment material. No new attrition counts/rates or medical causal judgments are created. - Required materials and conditions: Original withdrawal, safety and causal assessment - Materials to obtain first: Original withdrawal, safety and cause-assessment material. No new attrition counts/rates or medical causal judgments are created. - Further research: Material needed: Original withdrawal, safety and cause-assessment material. No new attrition counts/rates or medical causal judgments are created. This records needed materials; no new research was executed. - Conditions for verification: Material for Original withdrawal, safety and causal assessment must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Original withdrawal, safety and causal assessment with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N22 · Were medical harms, missing data and vulnerable populations verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve parent Caution and unverified medical adverse-event rates/safety across diseases. Arm-specific collection, event counts/denominators, missing data and longer-term/vulnerable-population outcomes are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Report-specific safety collection, events/denominators and longer-term material. Unverified/missing data do not establish 0 events or safety. - Required materials and conditions: Harm collection, events, denominators and other populations - Materials to obtain first: Report-specific safety collection, events/denominators and longer-term material. Unverified/missing data do not establish 0 events or safety. - Further research: Material needed: Report-specific safety collection, events/denominators and longer-term material. Unverified/missing data do not establish 0 events or safety. This records needed materials; no new research was executed. - Conditions for verification: Material for Harm collection, events, denominators and other populations must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Harm collection, events, denominators and other populations with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N23 · How are bilingual text, original direction, historical checks and corrections retained? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve parent grade D with 28 points/E-, Korean/English wording, 2026-09-07, empty correction array/deliberation note and selected subclaim D/note with absent score/status/axes. Historical verification is not labeled as completed current content review. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Actual comments, corrections, follow-up material and complete prior originals. Material additions, condition revisions and verdict changes remain separate events. - Required materials and conditions: Original values, evidence date and absent subclaim fields - Materials to obtain first: Actual comments, corrections, follow-up material and complete prior originals. Material additions, condition revisions and verdict changes remain separate events. - Further research: Material needed: Actual comments, corrections, follow-up material and complete prior originals. Material additions, condition revisions and verdict changes remain separate events. This records needed materials; no new research was executed. - Conditions for verification: Material for Original values, evidence date and absent subclaim fields must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Original values, evidence date and absent subclaim fields with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N24 · Which materials were actually read? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: This work read summaries/bibliographies in the complete preserved JSON to create reader material. External abstracts, full texts, registration, planning and support material remain unread; no access was attempted. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Actual originals, registration, planning/support material and reading records. Original bibliographies/PMCIDs do not establish acquisition, full-text reading or new verification. - Required materials and conditions: Stored summaries versus unread external originals - Materials to obtain first: Actual originals, registration, planning/support material and reading records. Original bibliographies/PMCIDs do not establish acquisition, full-text reading or new verification. - Further research: Material needed: Actual originals, registration, planning/support material and reading records. Original bibliographies/PMCIDs do not establish acquisition, full-text reading or new verification. This records needed materials; no new research was executed. - Conditions for verification: Material for Stored summaries versus unread external originals must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material. - Why this condition is needed: This condition connects Stored summaries versus unread external originals with the selected muscle-loss/universal-strength claim, boundaries with actual gains and maximum-strength results, measurements/denominators, training/exposure/controls, support and medical harms. - Application exceptions: Preserve selected subclaim D and the original note that both groups gained muscle and maximum-strength results differed. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/E- context. Gain differences do not establish actual loss; less type II hypertrophy does not establish universal strength impairment. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ## Evidence and sources ### S01 Roberts LA et al. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. J Physiol. 2015;593(18):4285-4301. PMID: 26174323. PMCID: PMC4594298. DOI: 10.1113/JP270570. [PubMed](https://pubmed.ncbi.nlm.nih.gov/26174323/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: Active recovery 309±73 g vs CWI 103±71 g; difference -206 g, P<.001 Record level: For the selected muscle-loss claim, this delimits a comparison of gains. Preserve 12 weeks, 24 assigned/21 completed, active recovery 309±73 g versus CWI 103±71 g, original difference -206 g/P<.001 and parent d=-4.1. Both groups gained muscle. The meaning of ±, arm-/measurement-specific denominators, 95% CIs and prospective hierarchy are unverified; no new difference or attrition count/rate is calculated. Independent replication: Roberts and Fyfe have separate preserved bibliographies; the parent and both subclaim sheets share these reports. Roberts longer-term MRI/strength and acute signaling, and Fyfe fiber/strength outcomes are different results. Acute/longer-term cohort relationships, overlap with related reports and unique-trial/participant totals are unverified. Multiple measures, subgroups, repeated measurements, sheets and reports are not summed into new participants or independent replications. These delimit the selected broader claim; gains in both groups and strength disagreement do not create new independence certification. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | ### S02 Fyfe JJ et al. Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. J Appl Physiol. 2019;127(5):1403-1418. PMID: 31513450. DOI: 10.1152/japplphysiol.00127.2019. [PubMed](https://pubmed.ncbi.nlm.nih.gov/31513450/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: Less type II hypertrophy; no clear maximum-strength attenuation Record level: For the selected universal-strength claim, this delimits scope. Preserve both less type II hypertrophy and no clear maximum-strength attenuation in the separate 16-participant, 7-week trial. Exact measure-specific values, effects/CIs, denominators and prospective hierarchy are unverified. Fiber area is not converted into MRI grams or the same effect across all strength outcomes/sports. Independent replication: Roberts and Fyfe have separate preserved bibliographies; the parent and both subclaim sheets share these reports. Roberts longer-term MRI/strength and acute signaling, and Fyfe fiber/strength outcomes are different results. Acute/longer-term cohort relationships, overlap with related reports and unique-trial/participant totals are unverified. Multiple measures, subgroups, repeated measurements, sheets and reports are not summed into new participants or independent replications. These delimit the selected broader claim; gains in both groups and strength disagreement do not create new independence certification. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. ## What the statuses mean - Met: A state used when required evidence is confirmed after user review. This production does not declare that review complete. - Partly verified: Some information in the stored summary is linked into the table. External comparison/content review is not complete. - Unverified: The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety. - Review incomplete: User review pending. - Not reported: Not reported within the stored material actually read; not extended to the entire primary paper. - Inaccessible: Means an actual access failure. Access not attempted here is not assigned this state. - Not applicable: Not used as a substitute for an evidence gap. - Conflicting data: Requires an observed disagreement under the same comparison criteria; not automatically judged in this production. - Insufficient evidence for the conditions: Marks a gap in additional material required by the selected conditions; not a new efficacy grade. ## Change history 2026-10-16 · Public page/materials 1.0. Public pages and materials were prepared from the existing 24 items. No new clinical search, verification-status change or scoring was performed.