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Davis J, Feldman RI, Traylor MK, Gray SM, Drake SM, Keller JL. Myofascial release induces declines in heart rate and changes to microvascular reactivity in young healthy adults. J Bodyw Mov Ther 2024; 38:254-262. [PMID: 38763567 DOI: 10.1016/j.jbmt.2024.01.006] [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: 04/24/2023] [Revised: 11/20/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES The purpose of this study was to compare physiological responses to myofascial release (MFR) and passive limb movement (PLM). DESIGN Nineteen (23 ± 2.6yrs) adults (10 men and 9 women) completed two experiments on separate days: MFR and PLM. Participation included collecting ultrasound images, blood pressure, and heart rate (HR) as well as performing a vascular occlusion test (VOT). The VOT assessed muscle tissue oxygenation (StO2) with near-infrared spectroscopy. Experiments consisted of moving the upper limb to release subtle barriers of resistance in the muscle/fascia (MFR) and passive, assisted range of motion (PLM). RESULTS There was a significantly (p = 0.012) greater decrease in HR following MFR (-7.3 ± 5.2 BPM) than PLM (-1.3 ± 0.9 BPM). There was an equivalent change in brachial blood flow (-17.3 ± 23.0 vs. -11.9 ± 14.9 mL min-1; p = 0.37) and vascular conductance (-19.3 ± 31.1 vs. -12.4 ± 15.3 mL min-1 mmHg-1; p = 0.38). Microvascular responses differed between the experiments such that MFR exhibited greater area under the curve (AUC, 1503 ± 499.1%∙s-1 vs. 1203 ± 411.1%∙s-1; p = 0.021) and time to maximum StO2 (40.0 ± 8.4s vs. 35.8 ± 7.3s; p = 0.009). CONCLUSIONS As evidenced by HR, MFR induced greater parasympathetic activity than PLM. The greater AUC and time to StO2max following MFR suggested a spillover effect to induce prolonged hyper-saturation. These results may be of interest to those investigating possible MFR-related rehabilitative benefits.
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Affiliation(s)
- Jackson Davis
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL, USA
| | - Rachel I Feldman
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL, USA
| | - Miranda K Traylor
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL, USA
| | - Sylvie M Gray
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL, USA; Department of Physical Therapy, College of Allied Health, University of South Alabama, Mobile, AL, USA
| | - Shawn M Drake
- Department of Physical Therapy, College of Allied Health, University of South Alabama, Mobile, AL, USA
| | - Joshua L Keller
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL, USA; Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, AL, USA.
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Gross AR, Lee H, Ezzo J, Chacko N, Gelley G, Forget M, Morien A, Graham N, Santaguida PL, Rice M, Dixon C. Massage for neck pain. Cochrane Database Syst Rev 2024; 2:CD004871. [PMID: 38415786 PMCID: PMC10900303 DOI: 10.1002/14651858.cd004871.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Massage is widely used for neck pain, but its effectiveness remains unclear. OBJECTIVES To assess the benefits and harms of massage compared to placebo or sham, no treatment or exercise as an adjuvant to the same co-intervention for acute to chronic persisting neck pain in adults with or without radiculopathy, including whiplash-associated disorders and cervicogenic headache. SEARCH METHODS We searched multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, Index to Chiropractic Literature, trial registries) to 1 October 2023. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing any type of massage with sham or placebo, no treatment or wait-list, or massage as an adjuvant treatment, in adults with acute, subacute or chronic neck pain. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. We transformed outcomes to standardise the direction of the effect (a smaller score is better). We used a partially contextualised approach relative to identified thresholds to report the effect size as slight-small, moderate or large-substantive. MAIN RESULTS We included 33 studies (1994 participants analysed). Selection (82%) and detection bias (94%) were common; multiple trials had unclear allocation concealment, utilised a placebo that may not be credible and did not test whether blinding to the placebo was effective. Massage was compared with placebo (n = 10) or no treatment (n = 8), or assessed as an adjuvant to the same co-treatment (n = 15). The trials studied adults aged 18 to 70 years, 70% female, with mean pain severity of 51.8 (standard deviation (SD) 14.1) on a visual analogue scale (0 to 100). Neck pain was subacute-chronic and classified as non-specific neck pain (85%, including n = 1 whiplash), radiculopathy (6%) or cervicogenic headache (9%). Trials were conducted in outpatient settings in Asia (n = 11), America (n = 5), Africa (n = 1), Europe (n = 12) and the Middle East (n = 4). Trials received research funding (15%) from research institutes. We report the main results for the comparison of massage versus placebo. Low-certainty evidence indicates that massage probably results in little to no difference in pain, function-disability and health-related quality of life when compared against a placebo for subacute-chronic neck pain at up to 12 weeks follow-up. It may slightly improve participant-reported treatment success. Subgroup analysis by dose showed a clinically important difference favouring a high dose (≥ 8 sessions over four weeks for ≥ 30 minutes duration). There is very low-certainty evidence for total adverse events. Data on patient satisfaction and serious adverse events were not available. Pain was a mean of 20.55 points with placebo and improved by 3.43 points with massage (95% confidence interval (CI) 8.16 better to 1.29 worse) on a 0 to 100 scale, where a lower score indicates less pain (8 studies, 403 participants; I2 = 39%). We downgraded the evidence to low-certainty due to indirectness; most trials in the placebo comparison used suboptimal massage doses (only single sessions). Selection, performance and detection bias were evident as multiple trials had unclear allocation concealment, utilised a placebo that may not be credible and did not test whether blinding was effective, respectively. Function-disability was a mean of 30.90 points with placebo and improved by 9.69 points with massage (95% CI 17.57 better to 1.81 better) on the Neck Disability Index 0 to 100, where a lower score indicates better function (2 studies, 68 participants; I2 = 0%). We downgraded the evidence to low-certainty due to imprecision (the wide CI represents slight to moderate benefit that does not rule in or rule out a clinically important change) and risk of selection, performance and detection biases. Participant-reported treatment success was a mean of 3.1 points with placebo and improved by 0.80 points with massage (95% CI 1.39 better to 0.21 better) on a Global Improvement 1 to 7 scale, where a lower score indicates very much improved (1 study, 54 participants). We downgraded the evidence to low-certainty due to imprecision (single study with a wide CI that does not rule in or rule out a clinically important change) and risk of performance as well as detection bias. Health-related quality of life was a mean of 43.2 points with placebo and improved by 5.30 points with massage (95% CI 8.24 better to 2.36 better) on the SF-12 (physical) 0 to 100 scale, where 0 indicates the lowest level of health (1 study, 54 participants). We downgraded the evidence once for imprecision (a single small study) and risk of performance and detection bias. We are uncertain whether massage results in increased total adverse events, such as treatment soreness, sweating or low blood pressure (RR 0.99, 95% CI 0.08 to 11.55; 2 studies, 175 participants; I2 = 77%). We downgraded the evidence to very low-certainty due to unexplained inconsistency, risk of performance and detection bias, and imprecision (the CI was extremely wide and the total number of events was very small, i.e < 200 events). AUTHORS' CONCLUSIONS The contribution of massage to the management of neck pain remains uncertain given the predominance of low-certainty evidence in this field. For subacute and chronic neck pain (closest to 12 weeks follow-up), massage may result in a little or no difference in improving pain, function-disability, health-related quality of life and participant-reported treatment success when compared to a placebo. Inadequate reporting on adverse events precluded analysis. Focused planning for larger, adequately dosed, well-designed trials is needed.
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Affiliation(s)
- Anita R Gross
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Haejung Lee
- Department of Physical Therapy, Silla University, Busan, Korea, South
| | - Jeanette Ezzo
- Research Director, JME Enterprises, Baltimore, Maryland, USA
| | - Nejin Chacko
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Geoffrey Gelley
- Applied Health Sciences PhD Program, University of Manitoba, Winnipeg, MB, Canada
- Integrative Medicine, University of Manitoba, Winnipeg, Canada
| | - Mario Forget
- Canadian Forces Health Services Group | Groupe de services de santé des Forces Canadiennes, National Defense | Défense Nationale, Kingston, Canada
| | - Annie Morien
- Research Department, Florida School of Massage, Gainesville, FL, USA
| | - Nadine Graham
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Pasqualina L Santaguida
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Craig Dixon
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
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Li Y, Mo PC, Peng F, Guo J, Sheng Z, Lyu S, Jan YK. Using multi-channel near-infrared spectroscopy to assess the effect of cupping therapy on the spatial hemodynamic response of the biceps muscle: A preliminary study. J Back Musculoskelet Rehabil 2024; 37:459-471. [PMID: 37899055 DOI: 10.3233/bmr-230158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND The local hemodynamic response after cupping therapy has been considered as a contributing factor for improving muscle tissue health; however, the effects of cupping pressure and duration on the spatial hemodynamic response have not been investigated. OBJECTIVE The objective of this study was to investigate the hemodynamic response inside and outside the cupping cup under various pressures and durations of cupping therapy. METHODS A 3-way factorial design with repeated measures was used to investigate the main and interaction effects of the location (areas inside and outside the cup), pressure (-225 and -300 mmHg) and duration (5 and 10 min) on the hemodynamic response of the biceps muscle. A functional near-infrared spectroscopy was used to assess hemodynamic changes in 18 participants. RESULTS A significant three-way interaction of the location, pressure, and duration factors was observed in oxyhemoglobin (p= 0.023), deoxy-hemoglobin (p= 0.013), and blood volume (p= 0.013). A significant increase was observed in oxyhemoglobin, blood volume, and oxygenation compared to pre-cupping (p< 0.05) in the area outside the cup. CONCLUSION Our findings indicate that an appropriate combination of cupping pressure and duration can effectively affect the spatial hemodynamic response of the biceps.
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Affiliation(s)
- Yameng Li
- Department of Kinesiology and Community Health, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Pu-Chun Mo
- Department of Kinesiology and Community Health, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Fang Peng
- Department of Physical Education, Peking University, Beijing, China
| | - Jiaqi Guo
- Department of Kinesiology and Community Health, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Zhongzhen Sheng
- College of Liberal Arts and Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Shaojun Lyu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Effect of Localized Vibration Massage on Popliteal Blood Flow. J Clin Med 2023; 12:jcm12052047. [PMID: 36902835 PMCID: PMC10003898 DOI: 10.3390/jcm12052047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
There is a broad scope of literature investigating whole-body vibration (WBV) effects on blood flow (BF). However, it is unclear how therapeutic localized vibrations alter BF. Low-frequency massage guns are advertised to enhance muscle recovery, which may be through BF changes; however, studies using these devices are lacking. Thus, the purpose of this study was to determine if popliteal artery BF increases from localized vibration to the calf. Twenty-six healthy, recreationally active university students (fourteen males, twelve females, mean age 22.3 years) participated. Each subject received eight therapeutic conditions randomized on different days with ultrasound blood flow measurements. The eight conditions combined either control, 30 Hz, 38 Hz, or 47 Hz for a duration of 5 or 10 min. BF measurements of mean blood velocity, arterial diameter, volume flow, and heart rate were measured. Using a cell means mixed model, we found that both control conditions resulted in decreased BF and that both 38 Hz and 47 Hz resulted in significant increases in volume flow and mean blood velocity, which remained elevated longer than the BF induced by 30 Hz. This study demonstrates localized vibrations at 38 Hz and 47 Hz significantly increase BF without affecting the heart rate and may support muscle recovery.
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Pagaduan JC, Chang SY, Chang NJ. Chronic Effects of Foam Rolling on Flexibility and Performance: A Systematic Review of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4315. [PMID: 35409995 PMCID: PMC8998857 DOI: 10.3390/ijerph19074315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/08/2022] [Accepted: 04/02/2022] [Indexed: 01/15/2023]
Abstract
The purpose of this study is to review the existing literature on chronic effects of foam rolling (FR) on flexibility and performance. Electronic databases were searched during January 2022 for topics related to FR. Included studies met the following criteria: (a) peer-reviewed articles written in English; (b) FR intervention of at least four weeks; (c) non-motorized FR device during intervention; (d) randomized controlled trial with existence of a control group; and (e) any lower body parameter related to flexibility, recovery, and performance. Nine studies met that criteria. Results revealed that chronic FR demonstrated conflicting results for improvement of flexibility. On the other hand, a majority of the articles in this review showed no beneficial effects of FR on performance. Lastly, the effect of FR on recovery is unclear. These findings suggest the need for further studies to establish the consensus about the long-term application of FR in flexibility, recovery, and performance.
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Affiliation(s)
| | - Sheng-Yuan Chang
- Department of Industrial Education, National Taiwan Normal University, Taipei 106, Taiwan;
- Office of Physical Education, Taipei Municipal Nei-Hu Vocational High School, Taipei 114, Taiwan
| | - Nai-Jen Chang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Matsuda Y, Nakabayashi M, Suzuki T, Zhang S, Ichinose M, Ono Y. Evaluation of Local Skeletal Muscle Blood Flow in Manipulative Therapy by Diffuse Correlation Spectroscopy. Front Bioeng Biotechnol 2022; 9:800051. [PMID: 35087803 PMCID: PMC8786806 DOI: 10.3389/fbioe.2021.800051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Manipulative therapy (MT) is applied to motor organs through a therapist’s hands. Although MT has been utilized in various medical treatments based on its potential role for increasing the blood flow to the local muscle, a quantitative validation of local muscle blood flow in MT remains challenging due to the lack of appropriate bedside evaluation techniques. Therefore, we investigated changes in the local blood flow to the muscle undergoing MT by employing diffuse correlation spectroscopy, a portable and emerging optical measurement technology that non-invasively measures blood flow in deep tissues. This study investigated the changes in blood flow, heart rate, blood pressure, and autonomic nervous activity in the trapezius muscle through MT application in 30 volunteers without neck and shoulder injury. Five minutes of MT significantly increased the median local blood flow relative to that of the pre-MT period (p < 0.05). The post-MT local blood flow increase was significantly higher in the MT condition than in the control condition, where participants remained still without receiving MT for the same time (p < 0.05). However, MT did not affect the heart rate, blood pressure, or cardiac autonomic nervous activity. The post-MT increase in muscle blood flow was significantly higher in the participants with muscle stiffness in the neck and shoulder regions than in those without (p < 0.05). These results suggest that MT could increase the local blood flow to the target skeletal muscle, with minimal effects on systemic circulatory function.
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Affiliation(s)
- Yasuhiro Matsuda
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
- Faculty of Medical Science, Nippon Sport Science University, Yokohama, Japan
| | - Mikie Nakabayashi
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
- Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Tatsuya Suzuki
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Sinan Zhang
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Masashi Ichinose
- Human Integrative Physiology Laboratory, School of Business Administration, Meiji University, Tokyo, Japan
| | - Yumie Ono
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Japan
- *Correspondence: Yumie Ono,
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Shu D, Zhang C, Dai S, Wang S, Liu J, Ding J. Acute Effects of Foam Rolling on Hamstrings After Half-Marathon: A Muscle Functional Magnetic Resonance Imaging Study. Front Physiol 2021; 12:723092. [PMID: 34690798 PMCID: PMC8526727 DOI: 10.3389/fphys.2021.723092] [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: 06/10/2021] [Accepted: 09/15/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: Foam rolling (FR) is widely used for post-exercise muscle recovery; yet, the effects of FR on skeletal muscle inflammation and microvascular perfusion following prolonged exercise are poorly understood. We aim to address the gap in knowledge by using magnetic resonance imaging (MRI) T2 mapping and intravoxel incoherent motion (IVIM) sequences to study the acute effects of FR on hamstrings following half-marathon running in recreational runners. Methods: Sixteen healthy recreational marathon runners were recruited. After half-marathon running, FR was performed on the hamstrings on the dominant side, while the other limb served as a control. MRI T2 and IVIM scans were performed bilaterally at baseline (pre-run), 2–3 h after running (post-run), immediately after FR (post-FR0), 30 min after FR (post-FR30) and 60 min after FR (post-FR60). T2, a marker for inflammatory edema, as well as IVIM microvascular perfusion fraction index f for biceps femoris long head (BFL), semitendinosus (ST) and semimembranosus (SM) were determined. Total Quality Recovery (TQR) scale score was also collected. Results: Both T2 and f were higher at post-run compared to pre-run in all hamstrings on both sides (all p < 0.05; all d > 1.0). For the FR side, T2 decreased, and f increased significantly at post-FR0 and post-FR30 compared to post-run in all muscles (p < 0.05; all d > 0.4) except for f at BFL and SM at post-FR30 (both p > 0.05), though f at BFL was still marginally elevated at post-FR30 (p = 0.074, d = 0.91). Both parameters for all muscles returned to post-run level at post-FR60 (all p > 0.05; all d < 0.4) except for T2 at SM (p = 0.037). In contrast, most MRI parameters were not changed at post-FR0, post-FR30 and post-FR60 compared to post-run for the control side (p < 0.05; d < 0.2). TQR scores were elevated at post-FR0 and post-FR30 compared to post-run (both p < 0.05; both d > 1.0), and returned to the post-run level at post-FR60 (p > 0.99; d = 0.09). Changes in TQR scores compared to post-run at any time points after FR were correlated to T2 for ST at post-FR30 (r = 0.50, p = 0.047) but not T2 for other muscles and any changes in f values. Conclusions: Hamstrings inflammatory edema and microvascular perfusion were elevated following half-marathon running, which were detectable with MRI T2 mapping and IVIM sequences. FR resulted in acute alleviation in inflammation and greater microvascular perfusion; however, the effects seemed to last only for a short period of time (30–60 min). FR can provide short-term benefits to skeletal muscle after prolonged running.
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Affiliation(s)
- Dingbo Shu
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
| | - Chuan Zhang
- School of Physical Education and Sports, Central China Normal University, Wuhan, China
| | - Siyu Dai
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
| | - Shubo Wang
- Department of Mechanical Engineering, University of Delaware, Newark, DE, United States
| | - Jie Liu
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
| | - Jianping Ding
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
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