Comparative Efficacy of Sauna, Steam, and Whirlpool Baths on Physiological and Psychological Recovery in Para-Athletes: A Randomized Controlled Trial

Abstract

Background: Para-athletes face unique recovery challenges that require tailored intervention. Passive heat therapies, such as saunas, steam baths, and whirlpool baths, are popular recovery strategies; however, their comparative efficacy remains underexplored.
Objective: To evaluate the effects of sauna, steam, and whirlpool baths on physiological recovery markers (heart rate, blood lactate, SpO₂) and psychological outcomes (mood disturbance and stress) in para-athletes.
Methods: A six-week randomised controlled trial with 40 para-athletes (aged 18–35 years) was conducted and assigned to one of the following four groups: sauna (n=10), steam (n=10), whirlpool (n=10), and control (n=10). The participants underwent three 20-minute sessions weekly. Pre- and post-intervention outcomes were analysed using analysis of covariance (ANCOVA) with Bonferroni correction.
Results: Sauna therapy significantly reduced mood disturbances (−31.8%, p<0.01) and stress (−24.9%, p<0.05). Steam therapy resulted in the highest SpO₂ improvement (+2.9%, p<0.01) and substantial lactate reduction (−14.9%, p<0.01). Whirlpool therapy achieved the greatest lactate clearance (−15.3%, p<0.01) and moderate psychological benefits. The control group showed worse metrics, highlighting the need for more active recovery protocols.
Conclusions: Sauna therapy excelled in psychological recovery, whereas steam and whirlpool therapies were optimal for physiological recovery. Individualized recovery protocols are recommended for para-athletes to enhance their performance and well-being.