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Keriven H, Sánchez Sierra A, González de-la-Flor Á, García-Arrabé M, Bravo-Aguilar M, de la Plaza San Frutos M, Garcia-Perez-de-Sevilla G, Tornero-Aguilera JF, Clemente-Suarez VJ, Domínguez-Balmaseda D. Effects of combined treatment with transcranial and peripheral electromagnetic stimulation on performance and pain recovery from delayed onset muscle soreness induced by eccentric exercise in young athletes. A randomized clinical trial. Front Physiol 2023; 14:1267315. [PMID: 37900951 PMCID: PMC10603222 DOI: 10.3389/fphys.2023.1267315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background: There is a common interest in finding a common consensus in the approach of athletes suffering from DOMS with the aim of accelerating recovery and thereby enhancing performance. The objective of this study was to observe the effects of a paired-associative transcranial and peripheral electromagnetic stimulation on young athletes suffering from DOMS, induced by 1 h of eccentric and plyometric exercises. Methods: Forty-eight young athletes participated in this randomized control trial: 13 were assigned to the peripheral group (P); 12 were in the control group (Cont); 11 were assigned to the transcranial group (T) and 12 were included in the paired-associative group (Comb). The Visual Analogue Scale (VAS) of pain perception and the mechanical Pressure Pain Threshold (PPT) were the tools used to analyze the symptoms of DOMS. On the other hand, the Half Squat (HS) test evaluated with an accelerometer, and the 30 m sprint velocity (30-mSP) test were used to observe the evolution of the sports performance of the lower limbs. All evaluations were performed before and after the eccentric exercise session that caused DOMS, as well as at 24-48, and 72 h afterward. Results: The AS group improved the symptoms of the induced DOMS, since significant positive differences were observed in the VAS and PPT compared to the other groups (p < 0.001). In addition, the AS group showed a significant improvement in the HS and the 30-mSP tests (p < 0.001). Based on the results a treatment with both peripheral and transcranial electromagnetic stimulation improves recovery and performance in athletes at 72 h, although these data would need to be verified in future research with a larger sample size. Conclusion: Paired-associative electromagnetic stimulation improved DOMS symptomatology, velocity, and sports performance in the lower limbs.
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Affiliation(s)
- Hugo Keriven
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Alberto Sánchez Sierra
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Faculty of Phisioterapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- Toledo Physiotherapy Research Group (GIFTO), Madrid, Spain
| | - Ángel González de-la-Flor
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - María García-Arrabé
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - María Bravo-Aguilar
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Marta de la Plaza San Frutos
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Guillermo Garcia-Perez-de-Sevilla
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Jose Francisco Tornero-Aguilera
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Vicente Javier Clemente-Suarez
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Diego Domínguez-Balmaseda
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Masmicrobiota Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
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Sudhakar S, Kirthika S V, J C, M SK. Enhancing Skeletal Muscle Rehabilitation: The Effects of Diclofenac Phonophoresis and Shock Wave Therapy on Serum Creatine Kinase in Athletes With Delayed-Onset Muscle Soreness. Cureus 2023; 15:e46267. [PMID: 37908915 PMCID: PMC10615225 DOI: 10.7759/cureus.46267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
Background Delayed-onset muscle soreness (DOMS) is a common condition in athletes characterized by muscle pain and stiffness after intense or unfamiliar exercise. It significantly impairs an athlete's performance by reducing muscle strength, flexibility, and overall physical capacity, often leading to suboptimal training or competition outcomes. Managing and mitigating DOMS is crucial for athletes to maintain peak performance and prevent potential injuries. The evaluation of effective treatment techniques is essential for expediting DOMS recovery by identifying biomarkers of skeletal muscle damage. This approach not only aids in optimizing recovery strategies but also contributes to the rehabilitation process, enabling athletes to return to peak performance quickly and safely. This study aims to evaluate the effects of shock wave therapy and diclofenac phonophoresis on serum creatine kinase levels in novice athletes suffering from DOMS in comparison to a control group. This research aims to assess the potential benefits of these therapeutic interventions in reducing skeletal muscle damage and enhancing recovery for individuals new to athletic training. Methodology A total of 48 novice athletes were recruited using simple random sampling and the block randomization approach to participate in this single-blind, multi-group, repeated-measures design. Male novice athletes in the age group of 18-25 years were included, and athletes with elevated serum creatine kinase variables at baseline measurements were excluded from the study. Before obtaining a written informed consent form, athletes were made aware of the procedure and associated risks. Group A received focused shock wave therapy, Group B received diclofenac phonophoresis, while Group C received no treatment. The Epley formula was used to compute the one-repetition maximum for each subject. Blood samples were taken at the baseline, 24, 48, 72, and 96 hours. Blood samples were taken before initiation of the study, as well as 24 hours, 48 hours, 72 hours, and 96 hours after DOMS was induced. Creatine kinase skeletal muscle biomarker was used as a dependent variable. Results In the evaluation of serum creatine kinase levels using analysis of variance (ANOVA), no statistically significant differences were observed between the three groups at baseline and 24-hour measurements (p > 0.05). However, statistically significant differences were found between the three groups at 48 hours, 72 hours, and 96 hours (p < 0.05). The repeated-measures ANOVA revealed significant overall changes in creatine kinase levels within the three groups, indicating time-dependent effects (p < 0.05). Specifically, during the 48 to 96-hour interval, the shock wave therapy group showed a lower mean value compared to the diclofenac phonophoresis group, followed by the control group. Conclusions The study demonstrates that a single administration of focused shock wave therapy effectively mitigated the elevation of creatine kinase levels in novice athletes with DOMS, surpassing the outcomes of diclofenac phonophoresis and the control group. These findings suggest the potential benefits of shock wave therapy in accelerating recovery from DOMS in the athletic population.
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Affiliation(s)
- Selvaraj Sudhakar
- Sports Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Veena Kirthika S
- Physiotherapy (Neurology), Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Chanemougavally J
- Anatomy, A.C.S. Medical College and Hospital, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Shruthy K M
- Anatomy, A.C.S. Medical College and Hospital, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
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Mazin Y, Lemos C, Paiva C, Amaral Oliveira L, Borges A, Lopes T. The Role of Extracorporeal Shock Wave Therapy in the Treatment of Muscle Injuries: A Systematic Review. Cureus 2023; 15:e44196. [PMID: 37767244 PMCID: PMC10521343 DOI: 10.7759/cureus.44196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
Muscle injuries commonly occur in sports and can be classified as indirect and direct, according to the 2013 Munich Consensus Statement (MCS). Since recent evidence suggests that extracorporeal shock wave therapy (ESWT) improves muscular microcirculation and may increase regeneration after acute muscle injury, we performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines to access the efficacy and safety of ESWT in the treatment of patients with muscle injuries. PubMed and Cochrane were searched to screen for potentially relevant articles and the literature search was last updated in June 2023. The inclusion criteria were randomized controlled trials, observational studies, or case controls published in English, Portuguese, or Spanish that studied the effect of ESWT on indirect and direct muscle injuries in individuals aged ≥18, with at least one of the following reported outcomes: pain on the visual analog scale (VAS), functionality assessed either with disability scales or subjectively, time for return to play (RTP), re-injury rate, and ultrasonographic evaluation. The exclusion criteria were literature reviews, systematic reviews, studies in animals, studies in other languages, studies that failed to meet the targeted population or intervention and studies that didn't report any of the outcomes of interest. The quality of the studies was analyzed using the Cochrane Assessment Tool, the Newcastle-Ottawa Quality Assessment Scale, and the JBI Critical Appraisal Checklist. Eight studies were included in the systematic review (two randomized controlled trials, one prospective observational study, two retrospective observational studies, and three case reports), with a total of 143 adult participants. ESWT was associated with less pain on VAS, better function, reduction of size of lesion on ultrasound evaluation, faster RTP and/or lower re-injury rate in patients with indirect and direct muscle injuries and muscular hematomas, a frequent secondary complication of muscle injuries. The evidence regarding the use of ESWT for these types of injuries is therefore promising. Nevertheless, higher-quality studies are needed in the future to prove its efficacy, better comprehend its mechanisms of action and define treatment protocols (timing, type and parameters of ESWT).
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Affiliation(s)
- Yuriy Mazin
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - Carolina Lemos
- Population Studies, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, PRT
| | - Carolina Paiva
- Physical Medicine and Rehabilitation, Centro de Medicina de Reabilitação da Região Centro-Rovisco Pais, Coimbra, PRT
| | - Luís Amaral Oliveira
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - Andre Borges
- Physical Medicine and Rehabilitation, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, PRT
| | - Tiago Lopes
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
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Keriven H, Sánchez-Sierra A, Miñambres-Martín D, González de la Flor Á, García-Pérez-de-Sevilla G, Domínguez-Balmaseda D. Effects of peripheral electromagnetic stimulation after an eccentric exercise-induced delayed-onset muscle soreness protocol in professional soccer players: a randomized controlled trial. Front Physiol 2023; 14:1206293. [PMID: 37465698 PMCID: PMC10351376 DOI: 10.3389/fphys.2023.1206293] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction: To examine the effects of peripheral electromagnetic stimulation in male professional soccer players on markers of Delayed Onset Muscular Soreness (DOMS), induced by a protocol of exercise (60 min of eccentric and plyometric). Methods: A randomized controlled trial with fourty-five professional soccer players aged 22.33 ± 4.82 years participated in the study. Twenty-three participants were assigned to the experimental group with peripheral electromagnetic stimulation (5 stimulations of 5 s at 100 HZ with 55 s of rest for a total of 5 min of treatment) and the remaining 22 participants were assigned to the control group. Pain pressure threshold (PPT) of the vastus medialis, the Visual Analogue Scale-Fatigue (VAS-F), half squat (HS) test and the maximum voluntary contraction of the quadriceps were assessed. All evaluations were performed before and after 1 h of the eccentric exercise induced DOMS, as well as at post 24-48, and 72 h. Results: Group-by-time interaction was observed in PPT of the vastus medialis (p = 0.040) with a medium effect size (η2 p = 0.069). From 48 to 72 h the experimental group showed an increase of PPT compared to control group (p = 0.015). There was no group-by-time interaction for HS, quadriceps strength and VAS-F (p > 0.05). Discussion: Peripheral electromagnetic stimulation in male professional soccer players did not produce significant improvements in the power and strength of the lower limbs but decreased the peripheral sensitization of the vastus medialis after eccentric exercise protocol. Clinical Trial Registration: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384050&isReview=true, Identifier: ACTRN12622000841774.
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Affiliation(s)
- Hugo Keriven
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Alberto Sánchez-Sierra
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Faculty of Phisioterapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- Toledo Physiotherapy Research Group (GIFTO), Toledo, Spain
| | | | | | | | - Diego Domínguez-Balmaseda
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Masmicrobiota Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
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Rhim HC, Borg-Stein J, Sampson S, Tenforde AS. Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes. Healthcare (Basel) 2023; 11:healthcare11071006. [PMID: 37046934 PMCID: PMC10093829 DOI: 10.3390/healthcare11071006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
An athlete’s health and availability to train and compete at an optimal performance level is a growing focus for professional sports organizations [...]
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Steven Sampson
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
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Skin temperature normalizes faster than pressure pain thresholds, pain intensity, and pain distribution during recovery from eccentric exercise. J Therm Biol 2023; 111:103423. [PMID: 36585087 DOI: 10.1016/j.jtherbio.2022.103423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/03/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Acute musculoskeletal injuries have diverse symptomatology and a multidimensional recovery process, including changes in swelling, redness, hyperalgesia, and expanded pain distribution. In a small proportion of cases, the tissue heals, although these symptoms persist, reflecting altered peripheral and central pain mechanisms. However, the otherwise healthy multidimensional recovery process following damage and pain is less than clear. The objective was to assess mechanical muscle hyperalgesia, skin temperature, and pain intensity and distribution during the recovery process in response to eccentric exercise in the hamstring muscles. METHODS Twenty-four healthy males participated in four sessions (Day-0, Day-2, Day-4, and Day-7). Exercise-induced muscle soreness was induced on Day-0 by five sets of 20 repetitions of an eccentric exercise involving the hamstrings on the dominant leg. Each session included assessments of thermography, pressure pain thresholds (PPTs), pain intensity, and area of exercise-induced pain. RESULTS Decreased PPTs (P < 0.005), higher pain intensity (P < 0.001), and a larger area of pain (P < 0.001) were displayed on Day-2 and Day-4 than Day-0. Skin temperature decreased on Day-2 than Day-0 (P < 0.01) and returned to baseline assessments by Day-4, despite lower temperature than the contralateral tight (P < 0.01). Further, there was a positive correlation between pain intensity and area on Day-2 and Day-4 (P < 0.005), but no for changes in skin temperature. CONCLUSION Thermographic changes and pain-related variables altered following eccentric exercise demonstrate different recovery times. These results provide insights into potential mechanisms and measures that can be used to assess recovery from exercise-induced damage.
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Xia Y, Li J, Wang D, Chen J, Shen M, Li F, Wang Y, Jiang P. Potential Application of Low-Intensity Focused Ultrasound in Rapidly Relieving Delayed-Onset Muscle Soreness Induced by High-Intensity Exercise. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2227-2235. [PMID: 34862643 DOI: 10.1002/jum.15904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To evaluate the efficacy of low-intensity focused ultrasound (LIFU) treatment on rapid relief of delayed-onset muscle soreness (DOMS) triggered by high-intensity exercise. METHODS A total of 16 healthy male college students were randomly divided into two groups: the LIFU group (n = 8) and the Sham group (n = 8). After the exercise protocol, the LIFU group received treatment, which parameters included that the power output was 2.5 W/cm2 , the frequency was 1 MHz, and the treating time was 20 minutes. The Sham group was treated with LIFU without energy output. Visual analog scale was used to evaluate the level of DOMS in every participant. The activities of plasma creatine kinase, lactate dehydrogenase, and the plasma concentration were measured by spectrophotometry. Tumor necrosis factor-α and interleukin-6 of serum were analyzed by enzyme-linked immunosorbent assay. RESULTS The visual analog scale of quadriceps femoris and/or calf muscles in the LIFU group decreased significantly at 24 hours (P < 0.01) and 48 hours (P < .01) after the exercise protocol. Both the accumulation of lactic acid (P < .01) in muscle and the activity of lactate dehydrogenase (P < .01) reduced immediately after LIFU treatment. The activities of tumor necrosis factor-α and interleukin-6 24 hours lowered in the LIFU group (P < .01). CONCLUSIONS LIFU treatment could relieve muscle soreness rapidly and effectively in the early stages of DOMS. The application of LIFU may provide a potential strategy for clinical treatment for DOMS.
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Affiliation(s)
- Yi Xia
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Jianhu Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Disen Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Jinyun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Mingxue Shen
- College of Exercise Medicine, Chongqing Medical University, Chongqing, China
| | - Faqi Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Yan Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Ping Jiang
- College of Exercise Medicine, Chongqing Medical University, Chongqing, China
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Aleixo-Junior IDO, Leal-Junior ECP, Casalechi HL, Vanin AA, de Paiva PRV, Machado CDSM, Dias LB, Lino MMA, Teixeira AM, Johnson DS, Tomazoni SS. Immediate effects of photobiomodulation therapy combined with a static magnetic field on the subsequent performance: a preliminary randomized crossover triple-blinded placebo-controlled trial. BIOMEDICAL OPTICS EXPRESS 2021; 12:6940-6953. [PMID: 34858690 PMCID: PMC8606121 DOI: 10.1364/boe.442075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
There is evidence about the effects of photobiomodulation therapy (PBMT) alone and combined with a static magnetic field (PBMT-sMF) on skeletal muscle fatigue, physical performance and post-exercise recovery in different types of exercise protocols and sports activity. However, the effects of PBMT-sMF to improve the subsequent performance after a first set of exercises are unknown. Therefore, the aim of this study was to investigate the effects of PBMT-sMF, applied between two sets of exercises, on the subsequent physical performance. A randomized, crossover, triple-blinded (assessors, therapist, and volunteers), placebo-controlled trial was carried out. Healthy non-athlete male volunteers were randomized and treated with a single application of PBMT-sMF and placebo between two sets of an exercise protocol performed on isokinetic dynamometer. The order of interventions was randomized. The primary outcome was fatigue index and the secondary outcomes were total work, peak work, and blood lactate levels. Twelve volunteers were randomized and analyzed to each sequence. PBMT-sMF decreased the fatigue index compared to the placebo PBMT-sMF at second set of the exercise protocol (MD = -6.08, 95% CI -10.49 to -1.68). In addition, PBMT-sMF decreased the blood lactate levels post-intervention, and after the second set of the exercise protocol compared to placebo (p<0.05). There was no difference between PBMT-sMF and placebo in the remaining outcomes tested. Volunteers did not report adverse events. Our results suggest that PBMT-sMF is able to decrease skeletal muscle fatigue, accelerating post-exercise recovery and, consequently, increasing subsequent physical performance when applied between two sets of exercises.
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Affiliation(s)
- Ivo de Oliveira Aleixo-Junior
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Ernesto Cesar Pinto Leal-Junior
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- ELJ Consultancy, Scientific Consultants, São Paulo, Brazil
| | - Heliodora Leão Casalechi
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Adriane Aver Vanin
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Paulo Roberto Vicente de Paiva
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Caroline dos Santos Monteiro Machado
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Luana Barbosa Dias
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Matheus Marinho Aguiar Lino
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Adeilson Matias Teixeira
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | | | - Shaiane Silva Tomazoni
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Fleckenstein J, Neuberger EWI, Bormuth P, Comes F, Schneider A, Banzer W, Fischer L, Simon P. Investigation of the Sympathetic Regulation in Delayed Onset Muscle Soreness: Results of an RCT. Front Physiol 2021; 12:697335. [PMID: 34603072 PMCID: PMC8481669 DOI: 10.3389/fphys.2021.697335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Sports-related pain and injury is directly linked to tissue inflammation, thus involving the autonomic nervous system (ANS). In the present experimental study, we disable the sympathetic part of the ANS by applying a stellate ganglion block (SGB) in an experimental model of delayed onset muscle soreness (DOMS) of the biceps muscle. We included 45 healthy participants (female 11, male 34, age 24.16 ± 6.67 years [range 18-53], BMI 23.22 ± 2.09 kg/m2) who were equally randomized to receive either (i) an SGB prior to exercise-induced DOMS (preventive), (ii) sham intervention in addition to DOMS (control/sham), or (iii) SGB after the induction of DOMS (rehabilitative). The aim of the study was to determine whether and to what extent sympathetically maintained pain (SMP) is involved in DOMS processing. Focusing on the muscular area with the greatest eccentric load (biceps distal fifth), a significant time × group interaction on the pressure pain threshold was observed between preventive SGB and sham (p = 0.034). There was a significant effect on pain at motion (p = 0.048), with post hoc statistical difference at 48 h (preventive SGB Δ1.09 ± 0.82 cm VAS vs. sham Δ2.05 ± 1.51 cm VAS; p = 0.04). DOMS mediated an increase in venous cfDNA -as a potential molecular/inflammatory marker of DOMS- within the first 24 h after eccentric exercise (time effect p = 0.018), with a peak at 20 and 60 min. After 60 min, cfDNA levels were significantly decreased comparing preventive SGB to sham (unpaired t-test p = 0.008). At both times, 20 and 60 min, cfDNA significantly correlated with observed changes in PPT. The 20-min increase was more sensitive, as it tended toward significance at 48 h (r = 0.44; p = 0.1) and predicted the early decrease of PPT following preventive stellate blocks at 24 h (r = 0.53; p = 0.04). Our study reveals the broad impact of the ANS on DOMS and exercise-induced pain. For the first time, we have obtained insights into the sympathetic regulation of pain and inflammation following exercise overload. As this study is of a translational pilot character, further research is encouraged to confirm and specify our observations.
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Affiliation(s)
- Johannes Fleckenstein
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Elmo W. I. Neuberger
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sports Sciences, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp Bormuth
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Fabio Comes
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Department of Orthopedics, Orthopedic University Hospital Friedrichsheim gGmbH, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Angelika Schneider
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Institute of Occupational, Social and Environmental Medicine, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Institute of Occupational, Social and Environmental Medicine, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Lorenz Fischer
- Professor em. Interventional Pain Management, Neural Therapy, General Internal Medicine, University of Bern, Bern, Switzerland
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sports Sciences, Johannes Gutenberg University Mainz, Mainz, Germany
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10
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Nahon RL, Silva Lopes JS, Monteiro de Magalhães Neto A. Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): Systematic review and meta-analysis. Phys Ther Sport 2021; 52:1-12. [PMID: 34365084 DOI: 10.1016/j.ptsp.2021.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the impact of interventions on pain associated with DOMS. DATA SOURCES PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to "DOMS" and "intervention therapy". ELIGIBILITY CRITERIA Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced. RESULTS One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I2 = 60 %), cryotherapy (p = 0,002 I2 = 100 %), phototherapy (p = 0,0001 I2 = 95 %), vibration (p = 0,004 I2 = 96 %), ultrasound (p = 0,02 I2 = 97 %), massage (p < 0,00001 I2 = 94 %), active exercise (p = 0,0004 I2 = 93 %) and compression (p = 0,002 I2 = 93 %) have a better positive effect than the control in the management of DOMS. CONCLUSION Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.
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Affiliation(s)
- Roberto Lohn Nahon
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Programa de Pós Graduação em Neurociências, Rio de Janeiro, RJ, Brazil
| | | | - Aníbal Monteiro de Magalhães Neto
- Universidade Federal de Mato Grosso (UFMT), Programa de Pós Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), campus do Araguaia, Barra do Garças, MT, Brazil
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11
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Fuentes V, Fernández MA, Quevedo-Aguado L. [Shock wave treatment in a case of complicated plantaris muscle rupture]. Rehabilitacion (Madr) 2019; 53:214-218. [PMID: 31370949 DOI: 10.1016/j.rh.2018.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/24/2018] [Accepted: 09/11/2018] [Indexed: 06/10/2023]
Abstract
Muscle injuries are frequent in the workplace. They are produced by sudden direct or indirect trauma that involves a rupture of the fibres, causing bruising. Currently, there is no single protocol-based model of treatment. We present the case of a patient diagnosed with complete muscular rupture of the plantaris muscle by an indirect traumatic mechanism (abrupt muscular elongation), with an associated large-volume hematoma. Clinical study consisted of ultrasound, magnetic resonance (MR), pain assessment (VAS) at the beginning and at the end of the treatment (3 weeks), as well as duration of occupational disability. The patient underwent extracorporeal shockwave therapy (ESWT) according to the protocol. At the end of treatment, the hematoma was resolved and there were no complications. ESWT could be a complementary therapeutic alternative to conventional treatment in this entity. However, there is a need for further, randomised controlled studies including a larger number of patients.
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Affiliation(s)
- V Fuentes
- Ibermutuamur, Mutua Colaboradora con la Seguridad Social n.° 274, Murcia, España.
| | - M A Fernández
- Ibermutuamur, Mutua Colaboradora con la Seguridad Social n.° 274, Murcia, España
| | - L Quevedo-Aguado
- Ibermutuamur, Mutua Colaboradora con la Seguridad Social n.° 274, Murcia, España
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12
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Bisciotti GN, Volpi P, Amato M, Alberti G, Allegra F, Aprato A, Artina M, Auci A, Bait C, Bastieri GM, Balzarini L, Belli A, Bellini G, Bettinsoli P, Bisciotti A, Bisciotti A, Bona S, Brambilla L, Bresciani M, Buffoli M, Calanna F, Canata GL, Cardinali D, Carimati G, Cassaghi G, Cautero E, Cena E, Corradini B, Corsini A, D'Agostino C, De Donato M, Delle Rose G, Di Marzo F, Di Pietto F, Enrica D, Eirale C, Febbrari L, Ferrua P, Foglia A, Galbiati A, Gheza A, Giammattei C, Masia F, Melegati G, Moretti B, Moretti L, Niccolai R, Orgiani A, Orizio C, Pantalone A, Parra F, Patroni P, Pereira Ruiz MT, Perri M, Petrillo S, Pulici L, Quaglia A, Ricciotti L, Rosa F, Sasso N, Sprenger C, Tarantola C, Tenconi FG, Tosi F, Trainini M, Tucciarone A, Yekdah A, Vuckovic Z, Zini R, Chamari K. Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete. BMJ Open Sport Exerc Med 2018; 4:e000323. [PMID: 29862040 PMCID: PMC5976114 DOI: 10.1136/bmjsem-2017-000323] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/14/2018] [Accepted: 03/02/2018] [Indexed: 02/07/2023] Open
Abstract
Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV.
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Affiliation(s)
- Gian Nicola Bisciotti
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | - Piero Volpi
- Istituto Clinico Humanitas, Milano, Italy
- FC Internazionale, Milano, Italy
| | | | | | | | | | | | - Alessio Auci
- UOS Angiografia e Radiologia Interventistica, Ospedale delle Apuane, Massa-Carrara, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emanuele Cena
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Biagio Moretti
- Azienda Ospedaliero-Universitaria “Policlinico”, Bari, Italy
| | - Lorenzo Moretti
- Azienda Ospedaliero-Universitaria “Policlinico”, Bari, Italy
| | | | | | | | | | - Federica Parra
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | | | | | | | | | - Luca Pulici
- Istituto Ortopedico Gaetano Pini, Milano, Italy
| | | | - Luca Ricciotti
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | | | | | | | | | | | - Fabio Tosi
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | | | | | - Ali Yekdah
- FAF Jenia Centre Med Sport, Algeri, Algeria
| | - Zarko Vuckovic
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Raul Zini
- Maria Cecilia Hospital, Cotignola, Italy
| | - Karim Chamari
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
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13
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Zissler A, Stoiber W, Pittner S, Sänger AM. Extracorporeal Shock Wave Therapy in Acute Injury Care: A Systematic Review. Rehabil Process Outcome 2018. [DOI: 10.1177/1179572718765138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives: We provide a systematic review of the literature to identify clinical studies assessing the effects of extracorporeal shock wave therapy (ESWT) on acutely injured tissues of human subjects, also highlighting the biological mechanisms by which the technique is proposed to promote the processes of early tissue repair. Special attention is also paid to the progress of research in animal models. Method: A systematic review of the literature on ESWT of acute injuries of bone and soft tissue as available in the PubMed/MEDLINE, Cochrane CENTRAL, SPORTDiscus, and CINAHL databases up to December 2017 was conducted. Results: A total of 10 studies were included. There is some evidence for the application of ESWT in an early postacute injury phase. Most studies report benefits with no or minimal side effects. However, different types of treated tissues and wounds (varying cause and severity) and resulting heterogeneity in study design and outcome measurement make it difficult to compare studies. The picture of knowledge remains limited by an apparent lack of data on optimal treatment timing and on tissue- and injury-specific parameters. Conclusions: Although the amount of studies to date is still limited, recent clinical research has presented first successful steps to introduce ESWT as a means of treatment in acute injury care. Therefore, on the basis of the analyzed data, further testing is encouraged to validate optimal timing, physical settings, and possible long-term effects to exclude potential risks.
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Affiliation(s)
- Angela Zissler
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Walter Stoiber
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Stefan Pittner
- Department of Biosciences, University of Salzburg, Salzburg, Austria
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