Cannabidiol’s effectiveness in post-exercise recovery: an integrated systematic review
DOI:
https://doi.org/10.15359/mhs.23-1.20144Keywords:
cannabidiol, anti-inflammatory, dietary supplements, sports, recoveryAbstract
Objectives: Recovery between physical efforts is essential to achieving optimal performance in sports. Dietary supplements have been proposed to facilitate recovery and performance optimization, including the phytocannabinoid cannabidiol (CBD). This systematic review aimed to: a) systematize the scientific evidence related to the study of CBD, b) associate the biomedical properties of CBD with those required for optimal fatigue recovery, and c) recommend a future research agenda. Methods: An integrative systematic review was conducted following PRISMA guidelines. Searches of PubMed, Scopus, Web of Science, and Google Scholar combined keywords cannabidiol, sport, and recovery from 1990-2022. Studies providing first and second-level scientific evidence were included. After screening 1761 articles, 70 studies were selected for analysis, including preclinical, clinical, and review/meta-analysis designs. Key data extracted included study aims, methodology, dosing, and main results. Results: The 70 included studies comprised 38.6% preclinical, 31.4% clinical, and 30.0% reviews/meta-analyses, evaluating various populations including mice, rats, epileptics, and athletes. CBD has demonstrated anti-inflammatory, neuroprotective, anxiolytic, and analgesic properties, which are potentially beneficial for athlete recovery. Doses ranging from 5 to 600mg have been administered orally, intravenously, and via other routes. However, rigorous confirmatory research in athlete populations is lacking. Conclusions: CBD appears to have beneficial properties for athlete recovery, but further randomized placebo-controlled trials are needed to test the acute and chronic effects of different CBD dosing regimens. Future research should focus on CBD’s physiological mechanisms of action and comparative effectiveness versus conventional recovery medications. Advancing the scientific understanding of CBD’s role in athlete recovery could provide new therapeutic strategies.
Downloads
References
Alhamoruni, A., Wright, K. L., Larvin, M., & O’Sullivan, S. E. (2012). Cannabinoids mediate opposing effects on inflammation-induced intestinal permeability. British Journal of Pharmacology, 165(8), 2598-2610. https://doi.org/10.1111/j.1476-5381.2011.01589.x
Allendorfer, J. B., Nenert, R., Bebin, E. M., Gaston, T. E., Grayson, L. E., Hernando, K. A., Houston, J. T., Hansen, B., & Szaflarski, J. P. (2019). fMRI study of cannabidiol-induced changes in attention control in treatment-resistant epilepsy. Epilepsy & Behavior, 96, 114-121. https://doi.org/10.1016/j.yebeh.2019.04.008
Ament, W., & Verkerke, G. J. (2009). Exercise and fatigue. Sports Medicine (Auckland, N. Z.), 39(5), 389-422. https://doi.org/10.2165/00007256-200939050-00005
Armstrong, R., Warren, G., & Warren, J. (1991). Mechanisms of Exercise-Induced Muscle-Fiber Injury. Sports Medicine, 12(3), 184-207. https://doi.org/10.2165/00007256-199112030-00004
Arndt, D. L., & de Wit, H. (2017). Cannabidiol Does Not Dampen Responses to Emotional Stimuli in Healthy Adults. Cannabis and Cannabinoid Research, 2(1), 105-113.
https://doi.org/10.1089/can.2017.0014
Belardo, C., Iannotta, M., Boccella, S., Rubino, R. C., Ricciardi, F., Infantino, R., Pieretti, G., Stella, L., Paino, S., Marabese, I., Maisto, R., Luongo, L., Maione, S., & Guida, F. (2019). Oral Cannabidiol Prevents Allodynia and Neurological Dysfunctions in a Mouse Model of Mild Traumatic Brain Injury. Frontiers in Pharmacology, 10, 352. https://doi.org/10.3389/fphar.2019.00352
Bergamaschi, M. M., Queiroz, R. H. C., Chagas, M. H. N., de Oliveira, D. C. G., De Martinis, B. S., Kapczinski, F., Quevedo, J., Roesler, R., Schröder, N., Nardi, A. E., Martín-Santos, R., Hallak, J. E. C., Zuardi, A. W., & Crippa, J. A. S. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 36(6), 1219-1226. https://doi.org/10.1038/npp.2011.6
Birnbaum, A. K., Karanam, A., Marino, S. E., Barkley, C. M., Remmel, R. P., Roslawski, M., Gramling-Aden, M., & Leppik, I. E. (2019). Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsy. Epilepsia, 60(8), 1586-1592. https://doi.org/10.1111/epi.16093
Bis-Humbert, C., García-Cabrerizo, R., & García-Fuster, M. J. (2021). Antidepressant-like effects of cannabidiol in a rat model of early-life stress with or without adolescent cocaine exposure. Pharmacological Reports. https://doi.org/10.1007/s43440-021-00285-5
Booz, G. W. (2011). Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress. Free Radical Biology and Medicine, 51(5), 1054-1061. https://doi.org/10.1016/j.freeradbiomed.2011.01.007
Borys, H. K., Ingall, G. B., & Karler, R. (1979). Development of tolerance to the prolongation of hexobarbitone sleeping time caused by cannabidiol. British Journal of Pharmacology, 67(1), 93-101. https://doi.org/10.1111/j.1476-5381.1979.tb16111.x
Bruni, N., Della Pepa, C., Oliaro-Bosso, S., Pessione, E., Gastaldi, D., & Dosio, F. (2018). Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules (Basel, Switzerland), 23(10), 2478. https://doi.org/10.3390/molecules23102478
Burggren, A. C., Shirazi, A., Ginder, N., & London, E. D. (2019). Cannabis effects on brain structure, function, and cognition: Considerations for medical uses of cannabis and its derivatives. The American Journal of Drug and Alcohol Abuse, 45(6), 563-579. https://doi.org/10.1080/00952990.2019.1634086
Burstein, S. (2015). Cannabidiol (CBD) and its analogs: A review of their effects on inflammation. Bioorganic & Medicinal Chemistry, 23(7), 1377-1385. https://doi.org/10.1016/j.bmc.2015.01.059
Campos, A. C., Moreira, F. A., Gomes, F. V., Del Bel, E. A., & Guimarães, F. S. (2012). Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders. Philosophical Transactions of the Royal Society B: Biological Sciences, 367(1607), 3364-3378. https://doi.org/10.1098/rstb.2011.0389
Carek, P. J., Laibstain, S. E., & Carek, S. M. (2011). Exercise for the treatment of depression and anxiety. International Journal of Psychiatry in Medicine, 41(1), 15-28. https://doi.org/10.2190/PM.41.1.c
Casey, S. L., Atwal, N., & Vaughan, C. W. (2017). Cannabis constituent synergy in a mouse neuropathic pain model. Pain, 158(12), 2452-2460. https://doi.org/10.1097/j.pain.0000000000001051
Ceprián, M., Jiménez-Sánchez, L., Vargas, C., Barata, L., Hind, W., & Martínez-Orgado, J. (2017). Cannabidiol reduces brain damage and improves functional recovery in a neonatal rat model of arterial ischemic stroke. Neuropharmacology, 116, 151-159. https://doi.org/10.1016/j.neuropharm.2016.12.017
Clarkson, P., Nosaka, K., & Braun, B. (1992). Muscle Function After Exercise-Induced Muscle Damage and Rapid Adaptation. Medicine and Science in Sports and Exercise, 24(5), 512-520. https://doi.org/10.1249/00005768-199205000-00004
Cochrane-Snyman, K. C., Cruz, C., Morales, J., & Coles, M. (2021). The Effects of Cannabidiol Oil on Noninvasive Measures of Muscle Damage in Men. Medicine and Science in Sports and Exercise, 53(7), 1460-1472. https://doi.org/10.1249/MSS.0000000000002606
Costa, B., Colleoni, M., & Conti, S. (2004a). Oral anti-inflammatory activity of cannabidiol, a non-psychoactive constituent of Cannabis, in acute carrageenan-induced inflammation in the rat paw. Naunyn-Schmiedeberg’s Archives of Pharmacology, 369(3), 294-299. https://doi.org/10.1007/s00210-004-0871-3
Costa, B., Giagnoni, G., Franke, C., Trovato, A., & Colleoni, M. (2004b). Vanilloid TRPV1 receptor mediates the antihyperalgesic effect of the nonpsychoactive cannabinoid, cannabidiol, in a rat model of acute inflammation. British Journal of Pharmacology, 143(2), 247-250. https://doi.org/10.1038/sj.bjp.0705920
Costa, B., Trovato, A., Comelli, F., Giagnoni, G., & Colleoni, M. (2007). The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. European Journal of Pharmacology, 556(1-3), 75-83. https://doi.org/10.1016/j.ejphar.2006.11.006
Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L. S., Martin-Santos, R., Simões, M. V., Bhattacharyya, S., Fusar-Poli, P., Atakan, Z., Santos Filho, A., Freitas-Ferrari, M. C., McGuire, P. K., Zuardi, A. W., Busatto, G. F., & Hallak, J. E. C. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: A preliminary report. Journal of Psychopharmacology (Oxford, England), 25(1), 121-130. https://doi.org/10.1177/0269881110379283
Crocker, T. F., Lam, N., Jordão, M., Brundle, C., Prescott, M., Forster, A., Ensor, J., Gladman, J., & Clegg, A. (2023). Risk-of-bias assessment using Cochrane’s revised tool for randomized trials (RoB 2) was useful but challenging and resource-intensive: Observations from a systematic review. Journal of Clinical Epidemiology, 161, 39-45. https://doi.org/10.1016/j.jclinepi.2023.06.015
Crossland, B. W., Rigby, B. R., Duplanty, A. A., King, G. A., Juma, S., Levine, N. A., Clark, C. E., Ramirez, K. P., & Varone, N. L. (2022). Acute Supplementation with Cannabidiol Does Not Attenuate Inflammation or Improve Measures of Performance following Strenuous Exercise. Healthcare, 10(6), Article 6. https://doi.org/10.3390/healthcare10061133
Cuñetti, L., Manzo, L., Peyraube, R., Arnaiz, J., Curi, L., & Orihuela, S. (2018). Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay. Transplantation Proceedings, 50(2), 461-464. https://doi.org/10.1016/j.transproceed.2017.12.042
Cunha, J. M., Carlini, E. A., Pereira, A. E., Ramos, O. L., Pimentel, C., Gagliardi, R., Sanvito, W. L., Lander, N., & Mechoulam, R. (1980). Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology, 21(3), 175-185.
https://doi.org/10.1159/000137430
Docter, S., Khan, M., Gohal, C., Ravi, B., Bhandari, M., Gandhi, R., & Leroux, T. (2020). Cannabis Use and Sport: A Systematic Review. Sports Health, 12(2), 189-199.
https://doi.org/10.1177/1941738120901670
Fine, P. G., & Rosenfeld, M. J. (2013). The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Medical Journal, 4(4), e0022. https://doi.org/10.5041/RMMJ.10129
Fox, J. L., Scanlan, A. T., Stanton, R., & Sargent, C. (2020). Insufficient Sleep in Young Athletes? Causes, Consequences, and Potential Treatments. Sports Medicine, 50(3), 461-470. https://doi.org/10.1007/s40279-019-01220-8
Gamelin, F.-X., Cuvelier, G., Mendes, A., Aucouturier, J., Berthoin, S., Di Marzo, V., & Heyman, E. (2020). Cannabidiol in sport: Ergogenic or else? Pharmacological Research, 156, 104764. https://doi.org/10.1016/j.phrs.2020.104764
García-Baos, A., Puig-Reyne, X., García-Algar, Ó., & Valverde, O. (2021). Cannabidiol attenuates cognitive deficits and neuroinflammation induced by early alcohol exposure in a mice model. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 141, 111813. https://doi.org/10.1016/j.biopha.2021.111813
Gregorio, D., McLaughlin, R., & Posa, L. (2019). Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain., 160. https://doi.org/10.1097/j.pain.0000000000001386
Hainline, B., Derman, W., Vernec, A., Budgett, R., Deie, M., Dvorak, J., Harle, C., Herring, S. A., McNamee, M., Meeuwisse, W., Moseley, G. L., Omololu, B., Orchard, J., Pipe, A., Pluim, B. M., Raeder, J., Siebert, C., Stewart, M., Stuart, M., … Engebretsen, L. (2017). International Olympic Committee consensus statement on pain management in elite athletes. British Journal of Sports Medicine, 51(17), 1245-1258. https://doi.org/10.1136/bjsports-2017-097884
Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European Journal of Pain (London, England), 20(6), 936-948. https://doi.org/10.1002/ejp.818
Hatchett, A., Armstrong, K., Hughes, B., & Parr, B. (2020). The influence cannabidiol on delayed onset of muscle soreness. International Journal of Physical Education, Sports and Health, 7, 89-94.
Haugen, T., Seiler, S., Sandbakk, Ø., & Tønnessen, E. (2019). The Training and Development of Elite Sprint Performance: An Integration of Scientific and Best Practice Literature. Sports Medicine - Open, 5(1), 44. https://doi.org/10.1186/s40798-019-0221-0
Hayakawa, K., Mishima, K., Nozako, M., Hazekawa, M., Irie, K., Fujioka, M., Orito, K., Abe, K., Hasebe, N., Egashira, N., Iwasaki, K., & Fujiwara, M. (2007). Delayed treatment with cannabidiol has a cerebroprotective action via a cannabinoid receptor-independent myeloperoxidase-inhibiting mechanism. Journal of Neurochemistry, 102(5), 1488-1496. https://doi.org/10.1111/j.1471-4159.2007.04565.x
Higgins, T. R., Greene, D. A., & Baker, M. K. (2017). Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis. Journal of Strength and Conditioning Research, 31(5), 1443-1460. https://doi.org/10.1519/JSC.0000000000001559
Hill, A. J., Williams, C. M., Whalley, B. J., & Stephens, G. J. (2012). Phytocannabinoids as novel therapeutic agents in CNS disorders. Pharmacology & Therapeutics, 133(1), 79-97. https://doi.org/10.1016/j.pharmthera.2011.09.002
Hill, K. P., Palastro, M. D., Johnson, B., & Ditre, J. W. (2017). Cannabis and Pain: A Clinical Review. Cannabis and Cannabinoid Research, 2(1), 96-104. https://doi.org/10.1089/can.2017.0017
Huestis, M. A., Mazzoni, I., & Rabin, O. (2011). Cannabis in sport: Anti-doping perspective. Sports Medicine (Auckland, N.Z.), 41(11), 949-966. https://doi.org/10.2165/11591430-000000000-00000
Huestis, M. A., Solimini, R., Pichini, S., Pacifici, R., Carlier, J., & Busardò, F. P. (2019). Cannabidiol Adverse Effects and Toxicity. Current Neuropharmacology, 17(10), 974-989. https://doi.org/10.2174/1570159X17666190603171901
Iannotti, F. A., Pagano, E., Moriello, A. S., Alvino, F. G., Sorrentino, N. C., D’Orsi, L., Gazzerro, E., Capasso, R., De Leonibus, E., De Petrocellis, L., & Di Marzo, V. (2019). Effects of non-euphoric plant cannabinoids on muscle quality and performance of dystrophic mdx mice. British Journal of Pharmacology, 176(10), 1568-1584.
https://doi.org/10.1111/bph.14460
Ignatowska-Jankowska, B., Jankowski, M. M., & Swiergiel, A. H. (2011). Cannabidiol decreases body weight gain in rats: Involvement of CB2 receptors. Neuroscience Letters, 490(1), 82-84. https://doi.org/10.1016/j.neulet.2010.12.031
Isenmann, E., Veit, S., Starke, L., Flenker, U., & Diel, P. (2021). Effects of Cannabidiol Supplementation on Skeletal Muscle Regeneration after Intensive Resistance Training. Nutrients, 13(9), Article 9. https://doi.org/10.3390/nu13093028
Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI Insight, 2(12), e93760, 93760. https://doi.org/10.1172/jci.insight.93760
Kasper, A. M., Sparks, S. A., Hooks, M., Skeer, M., Webb, B., Nia, H., Morton, J. P., & Close, G. L. (2020). High Prevalence of Cannabidiol Use Within Male Professional Rugby Union and League Players: A Quest for Pain Relief and Enhanced Recovery. International Journal of Sport Nutrition and Exercise Metabolism, 1-8. https://doi.org/10.1123/ijsnem.2020-0151
Kraft, B., Frickey, N. A., Kaufmann, R. M., Reif, M., Frey, R., Gustorff, B., & Kress, H. G. (2008). Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers. Anesthesiology, 109(1), 101-110. https://doi.org/10.1097/ALN.0b013e31817881e1
Kramer, A., Sinclair, J., Sharpe, L., & Sarris, J. (2020). Chronic cannabis consumption and physical exercise performance in healthy adults: A systematic review. Journal of Cannabis Research, 2(1), 34. https://doi.org/10.1186/s42238-020-00037-x
Kreher, J. B., & Schwartz, J. B. (2012). Overtraining Syndrome: A Practical Guide. Sports Health: A Multidisciplinary Approach, 4(2), 128-138. https://doi.org/10.1177/1941738111434406
Lattanzi, S., Brigo, F., Trinka, E., Zaccara, G., Cagnetti, C., Del Giovane, C., & Silvestrini, M. (2018). Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs, 78(17), 1791-1804. https://doi.org/10.1007/s40265-018-0992-5
Lim, S. Y., Sharan, S., & Woo, S. (2020). Model-Based Analysis of Cannabidiol Dose-Exposure Relationship and Bioavailability. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 40(4), 291-300. https://doi.org/10.1002/phar.2377
Linares, I. M. P., Guimaraes, F. S., Eckeli, A., Crippa, A. C. S., Zuardi, A. W., Souza, J. D. S., Hallak, J. E., & Crippa, J. A. S. (2018). No Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study. Frontiers in Pharmacology, 9, 315. https://doi.org/10.3389/fphar.2018.00315
Lopez, H. L., Cesareo, K. R., Raub, B., Kedia, A. W., Sandrock, J. E., Kerksick, C. M., & Ziegenfuss, T. N. (2020). Effects of Hemp Extract on Markers of Wellness, Stress Resilience, Recovery and Clinical Biomarkers of Safety in Overweight, But Otherwise Healthy Subjects. Journal of Dietary Supplements, 17(5), 561-586. https://doi.org/10.1080/19390211.2020.1765941
Lorenzetti, V., Solowij, N., & Yücel, M. (2016). The Role of Cannabinoids in Neuroanatomic Alterations in Cannabis Users. Biological Psychiatry, 79(7), e17-31. https://doi.org/10.1016/j.biopsych.2015.11.013
Lowin, T., Schneider, M., & Pongratz, G. (2019). Joints for joints: Cannabinoids in the treatment of rheumatoid arthritis. Current Opinion in Rheumatology, 31(3), 271-278. https://doi.org/10.1097/BOR.0000000000000590
Martin, R. C., Gaston, T. E., Thompson, M., Ampah, S. B., Cutter, G., Bebin, E. M., & Szaflarski, J. P. (2019). Cognitive functioning following long-term cannabidiol use in adults with treatment-resistant epilepsy. Epilepsy & Behavior, 97, 105-110.
https://doi.org/10.1016/j.yebeh.2019.04.044
Martínez-Guardado, I., Rojas-Valverde, D., Gutiérrez-Vargas, R., Ugalde Ramírez, A., Gutiérrez-Vargas, J. C., & Sánchez-Ureña, B. (2020). Intermittent Pneumatic Compression and Cold Water Immersion Effects on Physiological and Perceptual Recovery During Multi-Sports International Championship. Journal of Functional Morphology and Kinesiology, 5(3), Article 3. https://doi.org/10.3390/jfmk5030045
Masataka, N. (2019). Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. Frontiers in Psychology, 10, 2466. https://doi.org/10.3389/fpsyg.2019.02466
McCartney, D., Benson, M. J., Desbrow, B., Irwin, C., Suraev, A., & McGregor, I. S. (2020). Cannabidiol and Sports Performance: A Narrative Review of Relevant Evidence and Recommendations for Future Research. Sports Medicine - Open, 6(1), 27.
https://doi.org/10.1186/s40798-020-00251-0
McPartland, J. M., Duncan, M., Marzo, V. D., & Pertwee, R. G. (2015). Are cannabidiol and Δ9-tetrahydrocannabivarin negative modulators of the endocannabinoid system? A systematic review. British Journal of Pharmacology, 172(3), 737-753. https://doi.org/10.1111/bph.12944
Medina, J. M., McKeon, P. O., & Hertel, J. (2006). Rating the Levels of Evidence in Sports-Medicine Research. International Journal of Athletic Therapy and Training, 11(5), 38-41. https://doi.org/10.1123/att.11.5.38
Merry, T. L., & Ristow, M. (2016). Do antioxidant supplements interfere with skeletal muscle adaptation to exercise training? The Journal of Physiology, 594(18), 5135-5147. https://doi.org/10.1113/JP270654
Metsios, G. S., Moe, R. H., & Kitas, G. D. (2020). Exercise and inflammation. Best Practice & Research Clinical Rheumatology, 101504. https://doi.org/10.1016/j.berh.2020.101504
Millar, S. A., Stone, N. L., Bellman, Z. D., Yates, A. S., England, T. J., & O’Sullivan, S. E. (2019). A systematic review of cannabidiol dosing in clinical populations. British Journal of Clinical Pharmacology, 85(9), 1888-1900. https://doi.org/10.1111/bcp.14038
Mori, M. A., Meyer, E., Soares, L. M., Milani, H., Guimarães, F. S., & de Oliveira, R. M. W. (2017). Cannabidiol reduces neuroinflammation and promotes neuroplasticity and functional recovery after brain ischemia. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 75, 94-105. https://doi.org/10.1016/j.pnpbp.2016.11.005
Mukhopadhyay, P., Rajesh, M., Horváth, B., Bátkai., Park O., Tanchian, G., Gao, R. Y., Patel, V., Wink, D. A., Liaudet, L., Haskó, G., Mechoulam, R., Pacher, P., (2011). Cannabidiol protects against hepatic ischemia/reperfusion injury by attenuating inflammatory signaling and response, oxidative/nitrative stress, and cell death. Free Radic Biol Med, 50. https://doi.org/10.1016/j.freeradbiomed.2011.02.021
Murillo-Rodríguez, E., Millán-Aldaco, D., Palomero-Rivero, M., Mechoulam, R., & Drucker-Colín, R. (2006). Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats. FEBS Lett, 580. https://doi.org/10.1016/j.febslet.2006.04.102
Murillo-Rodríguez, E., Arankowsky-Sandoval, G., Rocha, N. B., Peniche-Amante, R., Veras, A. B., Machado, S., & Budde, H. (2018). Systemic Injections of Cannabidiol Enhance Acetylcholine Levels from Basal Forebrain in Rats. Neurochemical Research, 43(8), 1511-1518. https://doi.org/10.1007/s11064-018-2565-0
Murillo-Rodríguez, E., Budde, H., Veras, A. B., Rocha, N. B., Telles-Correia, D., Monteiro, D., Cid, L., Yamamoto, T., Machado, S., & Torterolo, P. (2020). The Endocannabinoid System May Modulate Sleep Disorders in Aging. Current Neuropharmacology, 18(2), 97-108. https://doi.org/10.2174/1570159X17666190801155922
Myers, A. M., Siegele, P. B., Foss, J. D., Tuma, R. F., & Ward, S. J. (2019). Single and combined effects of plant-derived and synthetic cannabinoids on cognition and cannabinoid-associated withdrawal signs in mice. British Journal of Pharmacology, 176(10), 1552-1567. https://doi.org/10.1111/bph.14147
Neubauer, D., Perković Benedik, M., & Osredkar, D. (2018). Cannabidiol for treatment of refractory childhood epilepsies: Experience from a single tertiary epilepsy center in Slovenia. Epilepsy & Behavior: E&B, 81, 79-85. https://doi.org/10.1016/j.yebeh.2018.02.009
Nichols, J. M., & Kaplan, B. L. F. (2019). Immune Responses Regulated by Cannabidiol. Cannabis and Cannabinoid Research, 5(1), 12-31. https://doi.org/10.1089/can.2018.0073
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., & Brennan, S. E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. International Journal of Surgery, 88, 105906.
Percie du Sert, N., Hurst, V., Ahluwalia, A., Alam, S., Avey, M. T., Baker, M., Browne, W. J., Clark, A., Cuthill, I. C., Dirnagl, U., Emerson, M., Garner, P., Holgate, S. T., Howells, D. W., Karp, N. A., Lazic, S. E., Lidster, K., MacCallum, C. J., Macleod, M., … Würbel, H. (2020). The ARRIVE guidelines 2.0: Updated guidelines for reporting animal research. BMC Veterinary Research, 16(1), 242. https://doi.org/10.1186/s12917-020-02451-y
Peres, F. F., Levin, R., Suiama, M. A., Diana, M. C., Gouvêa, D. A., Almeida, V., Santos, C. M., Lungato, L., Zuardi, A. W., Hallak, J. E. C., Crippa, J. A., Vânia, D., Silva, R. H., & Abílio, V. C. (2016). Cannabidiol Prevents Motor and Cognitive Impairments Induced by Reserpine in Rats. Frontiers in Pharmacology, 7, 343. https://doi.org/10.3389/fphar.2016.00343
Pinto, J. V., Saraf, G., Frysch, C., Vigo, D., Keramatian, K., Chakrabarty, T., Lam, R. W., Kauer-Sant’Anna, M., & Yatham, L. N. (2020). Cannabidiol as a Treatment for Mood Disorders: A Systematic Review. The Canadian Journal of Psychiatry, 65(4), 213-227. https://doi.org/10.1177/0706743719895195
Reillo, M. R. (2019). Cannabidiol (CBD) in the Management of Sports-Related Traumatic Brain Injury: Research and Efficacy. Sports Injuries & Medicine, 3(2). https://doi.org/10.29011/2576-9596.100058
Rojas-Valverde, D. (2021). Potential role of cannabidiol (CBD) on sport recovery: A narrative review. Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.722550
Rojas-Valverde, D., Gutiérrez-Vargas, R., Rodríguez-Montero, A., Pereira, L. A., Loturco, I., & Martín-Rodríguez, S. (2018). Reduced muscle contractile function in elite young soccer players after a short-congested fixture period. Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, 175433711881795. https://doi.org/10.1177/1754337118817957
Rojas-Valverde, D., Montoya-Rodríguez, J., Azofeifa-Mora, C., & Sanchez-Urena, B. (2020). Effectiveness of beetroot juice derived nitrates supplementation on fatigue resistance during repeated-sprints: A systematic review. Critical Reviews in Food Science and Nutrition, 1-12. https://doi.org/10.1080/10408398.2020.1798351
Rojas-Valverde, D., Sánchez-Ureña, B., Crowe, J., Timón, R., & Olcina, G. J. (2020). Exertional Rhabdomyolysis and Acute Kidney Injury in Endurance Sports: A Systematic Review. European Journal of Sport Science, 0(ja), 1-28. https://doi.org/10.1080/17461391.2020.1746837
Rudroff, T., & Sosnoff, J. (2018). Cannabidiol to Improve Mobility in People with Multiple Sclerosis. Frontiers in Neurology, 9. https://doi.org/10.3389/fneur.2018.00183
Sahinovic, A., Irwin, C., Doohan, P. T., Kevin, R. C., Cox, A. J., Lau, N. S., Desbrow, B., Johnson, N. A., Sabag, A., Hislop, M., Haber, P. S., McGregor, I. S., & McCartney, D. (2022). Effects of Cannabidiol on Exercise Physiology and Bioenergetics: A Randomised Controlled Pilot Trial. Sports Medicine - Open, 8(1), 27. https://doi.org/10.1186/s40798-022-00417-y
Santiago, A. N., Mori, M. A., Guimaraes, F. S., Milani, H., & Weffort de Oliveira, R. M. (2019). Effects of Cannabidiol on Diabetes Outcomes and Chronic Cerebral Hypoperfusion Comorbidities in Middle-Aged Rats. Neurotoxicity Research, 35(2), 463-474.
https://doi.org/10.1007/s12640-018-9972-5
Santos de Alencar, S., Crippa, J. A. S., Brito, M. C. M., Pimentel, Â. V., Cecilio Hallak, J. E., & Tumas, V. (2021). A single oral dose of cannabidiol did not reduce upper limb tremor in patients with essential tremor. Parkinsonism & Related Disorders, 83, 37-40. https://doi.org/10.1016/j.parkreldis.2021.01.001
Schiavon, A. P., Soares, L. M., Bonato, J. M., Milani, H., Guimarães, F. S., & Weffort de Oliveira, R. M. (2014). Protective effects of cannabidiol against hippocampal cell death and cognitive impairment induced by bilateral common carotid artery occlusion in mice. Neurotoxicity Research, 26(4), 307-316. https://doi.org/10.1007/s12640-014-9457-0
Schleicher, E. M., Ott, F. W., Mueller, M., Silcher, B., Sichler, M. E., Loew, M. J., Wagner, J. M., & Bouter, Y. (2019). Prolonged Cannabidiol Treatment Lacks on Detrimental Effects on Memory, Motor Performance and Anxiety in C57BL/6J Mice. Frontiers in Behavioral Neuroscience, 13, 94. https://doi.org/10.3389/fnbeh.2019.00094
Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal, 23. https://doi.org/10.7812/TPP/18-041
Shannon, S., & Opila-Lehman, J. (2016). Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. The Permanente Journal, 20(4), 16-005. https://doi.org/10.7812/TPP/16-005
Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 358, j4008. https://doi.org/10.1136/bmj.j4008
Sholler, D. J., Schoene, L., & Spindle, T. R. (2020). Therapeutic Efficacy of Cannabidiol (CBD): A Review of the Evidence from Clinical Trials and Human Laboratory Studies. Current Addiction Reports, 7(3), 405-412. https://doi.org/10.1007/s40429-020-00326-8
Singh, J., & Neary, J. P. (2020). Neuroprotection Following Concussion: The Potential Role for Cannabidiol. The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques, 47(3), 289-300. https://doi.org/10.1017/cjn.2020.23
Souza, M. T. de, Silva, M. D. da, & Carvalho, R. de. (2010). Integrative review: What is it? How to do it? Einstein (São Paulo), 8, 102-106.
Stanley, C. P., Hind, W. H., & O’Sullivan, S. E. (2013). Is the cardiovascular system a therapeutic target for cannabidiol? British Journal of Clinical Pharmacology, 75(2), 313-322. https://doi.org/10.1111/j.1365-2125.2012.04351.x
Stout, S. M., & Cimino, N. M. (2014). Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: A systematic review. Drug Metabolism Reviews, 46(1), 86-95. https://doi.org/10.3109/03602532.2013.849268
Tantimonaco, M., Ceci, R., Sabatini, S., Catani, M. V., Rossi, A., Gasperi, V., & Maccarrone, M. (2014). Physical activity and the endocannabinoid system: An overview. Cellular and Molecular Life Sciences, 71(14), 2681-2698. https://doi.org/10.1007/s00018-014-1575-6
Thomas, D. T., Erdman, K. A., & Burke, L. M. (2016). Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. Journal of the Academy of Nutrition and Dietetics, 116(3), 501-528. https://doi.org/10.1016/j.jand.2015.12.006
Toronto, C. E., & Remington, R. (Eds.). (2020). A Step-by-Step Guide to Conducting an Integrative Review. Springer International Publishing. https://doi.org/10.1007/978-3-030-37504-1
VanDolah, H. J., Bauer, B. A., & Mauck, K. F. (2019). Clinicians’ Guide to Cannabidiol and Hemp Oils. Mayo Clinic Proceedings, 94(9), 1840-1851. https://doi.org/10.1016/j.mayocp.2019.01.003
Verma, K., Singh, D., & Srivastava, A. (2022). The Impact of Complementary and Alternative Medicine on Insomnia: A Systematic Review. Cureus, 14(8), e28425. https://doi.org/10.7759/cureus.28425
Vuolo, F., Abreu, S. C., Michels, M., Xisto, D. G., Blanco, N. G., Hallak, J. E., Zuardi, A. W., Crippa, J. A., Reis, C., Bahl, M., Pizzichinni, E., Maurici, R., Pizzichinni, M. M. M., Rocco, P. R. M., & Dal-Pizzol, F. (2019). Cannabidiol reduces airway inflammation and fibrosis in experimental allergic asthma. European Journal of Pharmacology, 843, 251-259. https://doi.org/10.1016/j.ejphar.2018.11.029
Vuolo, F., Petronilho, F., Sonai, B., Ritter, C., Hallak, J. E. C., Zuardi, A. W., Crippa, J. A., & Dal-Pizzol, F. (2015). Evaluation of Serum Cytokines Levels and the Role of Cannabidiol Treatment in Animal Model of Asthma. Mediators of Inflammation, 2015, 538670. https://doi.org/10.1155/2015/538670
Wang, Y., Mukhopadhyay, P., Cao, Z., Wang, H., Feng, D., Haskó, G., Mechoulam, R., Gao, B., & Pacher, P. (2017). Cannabidiol attenuates alcohol-induced liver steatosis, metabolic dysregulation, inflammation and neutrophil-mediated injury. Scientific Reports, 7(1), 12064. https://doi.org/10.1038/s41598-017-10924-8
Ware, M., Jensen, D., Barrette, A., Vernec, A., & Derman, W. (2018). Cannabis and the health and performance of the elite athlete. Clin J Sport Med, 28.
Wheal, A. J., Cipriano, M., Fowler, C. J., Randall, M. D., & O’Sullivan, S. E. (2014). Cannabidiol improves vasorelaxation in Zucker diabetic fatty rats through cyclooxygenase activation. The Journal of Pharmacology and Experimental Therapeutics, 351(2), 457-466. https://doi.org/10.1124/jpet.114.217125
Whiting, P. F., Wolff, R. F., Deshpande, S., Nisio, M. D., Duffy, S., Hernandez, A. V., Keurentjes, J. C., Lang, S., Misso, K., Ryder, S., Schmidlkofer, S., Westwood, M., & Kleijnen, J. (2015). Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. JAMA, 313(24), 2456-2473. https://doi.org/10.1001/jama.2015.6358
Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553. https://doi.org/10.1111/j.1365-2648.2005.03621.x
WHO. (2017). Cannabidiol (CBD): World Health Organisation expert committe on drug dependence. Thyrty-Ninth Meeting. https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf
Yeager, M. P., Pioli, P. A., & Guyre, P. M. (2010). Cortisol Exerts Bi-Phasic Regulation of Inflammation in Humans. Dose-Response, 9(3), 332-347. https://doi.org/10.2203/dose-response.10-013.Yeager
Zarrabi, A. J., Frediani, J. K., & Levy, J. M. (2020). The State of Cannabis Research Legislation in 2020. The New England Journal of Medicine, 382(20), 1876-1877. https://doi.org/10.1056/NEJMp2003095
Zieba, J., Sinclair, D., Sebree, T., Bonn-Miller, M., Gutterman, D., Siegel, S., & Karl, T. (2019). Cannabidiol (CBD) reduces anxiety-related behavior in mice via an FMRP-independent mechanism. Pharmacology Biochemistry and Behavior, 181, 93-100. https://doi.org/10.1016/j.pbb.2019.05.002
Zuardi, A., Cosme, R., Graeff, F., & Guimaraes, F. (1993). Effects of Ipsapirone and Cannabidiol on Human Experimental Anxiety. Journal of Psychopharmacology, 7(1), 82-88. https://doi.org/10.1177/026988119300700112
Zuardi, A., Crippa, J., Dursun, S., Morais, S., Vilela, J., Sanches, R., & Hallak, J. (2010). Cannabidiol was ineffective for manic episode of bipolar affective disorder. Journal of Psychopharmacology (Oxford, England), 24(1), 135-137. https://doi.org/10.1177/0269881108096521
Zuardi, A. W., Guimarães, F. S., & Moreira, A. C. (1993). Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas, 26(2), 213-217.
Zurier, R. B., & Burstein, S. H. (2016). Cannabinoids, inflammation, and fibrosis. FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology, 30(11), 3682-3689. https://doi.org/10.1096/fj.201600646R
Published
Issue
Section
License
Copyright (c) 2026 MHSalud: Revista en Ciencias del Movimiento Humano y Salud
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 Unported License.
General conditions
MHSalud: Journal in Human Movement Sciences and Health by the Universidad Nacional is cover under a Creative Commons Atribución-NoComercial-SinDerivadas 3.0 Costa Rica license.
The journal is hosted in open access repositories such as the Institutional Repository of the Universidad Nacional, the Kimuk Repository of Costa Rica and La Referencia.
The editorial source of the journal must be recognized. Use the doi identifier for this purpose.
Self-archiving policy: The journal allows the self-archiving of the articles in their peer-reviewed version, edited and approved by the Editorial Board of the Journal to be available in Open Access through the Internet. More information in the following link: https://v2.sherpa.ac.uk/id/publication/25815
