A Comparison of the Effect of 20- and 40-Min Session Durations of External Counterpulsation on Neuromuscular Function, Cortisol and Comfort in Physically Active Young Men

External Counterpulsation (ECP) is a well-established treatment for coronary disease, with interest growing in the potential to act as a sports recovery modality or pre-performance strategy. This pilot study compared the effects of different ECP durations upon neuromuscular function (NF), cortisol and subjective perceptions in a rested state. Eleven physically active male volunteers received two ECP treatments (Renew Sport, Singapore) of differing duration (20-min and 40-min) in a randomised, repeated measures crossover design. Testing occurred pre-ECP, post-ECP, and 24-h post-ECP. NF testing comprised counter-movement jumps (CMJs) and 6-s sprint cycling. Saliva samples were analysed for cortisol. Rate of Perceived Exertion (RPE, 6 to 20) and Bipolar Comfort Scales (− 10 to 10) quantified participants’ experiences, and ECP duration preference was examined. Repeated measures ANOVA and effect size (ES: Cohen’s d) analysed NF and cortisol results. Paired t-tests analysed RPE and comfort ratings. ECP demonstrated no effect, neither positive nor negative, upon NF outcome measures in both groups. A trend of reduced salivary cortisol levels across both groups following ECP was observed (P = 0.066). No RPE difference existed between groups. 20-min of ECP was rated as significantly more comfortable than 40-min (P