1
|
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.
Collapse
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
| |
Collapse
|
2
|
Menezes MA, Pereira TAB, Tavares LM, Leite BTQ, Neto AGR, Chaves LMS, Lima LV, Da Silva-Grigolleto ME, DeSantana JM. Immediate effects of transcutaneous electrical nerve stimulation (TENS) administered during resistance exercise on pain intensity and physical performance of healthy subjects: a randomized clinical trial. Eur J Appl Physiol 2018; 118:1941-1958. [PMID: 29978261 DOI: 10.1007/s00421-018-3919-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Exercise-induced muscle pain is a self-limiting condition which impacts physical activity habits. Transcutaneous electrical nerve stimulation (TENS) promotes pain reduction and functional improvement in different pain conditions. We propose that applying TENS during exercise might reduce pain and improve physical performance. Thus, we aimed to investigate immediate effects of TENS applied during resistance exercise. METHODS Healthy subjects of both sexes, irregularly active or sedentary were assigned into two groups: active (n = 24) or placebo (n = 22) TENS. The study was conducted over five moments: on day 0, subjects were recruited, on day 1 subjects performed the one-repetition maximum test (1RM); 72 h later, on day 2, 1RM was retested; 48 h later, on day 3, TENS was applied during a functional-resisted exercise protocol for upper limbs (bench press and rowing), with an intensity of 80% of 1RM; and 24 h after, on day 4, subjects were reevaluated. Assessment included pain intensity at rest and with movement, pressure pain thresholds, and muscle fatigue. RESULTS TENS did not reduce pain intensity when compared to placebo (p > 0.05). TENS reduce PPT in the latissmus dorsi: p = 0.02 and anterior tibialis: p = 0.04 in immediate reassessment. Immediate effects of TENS were significant for fatigue perception at rest (p = 0.01) and number of maximum repetitions during exercise sets, starting from the 5th set of rowing exercise (p = 0.002). CONCLUSION Our results show that TENS did not reduce pain perception in healthy individuals, but its use induced increased muscle action, contributing to a greater fatigue perception.
Collapse
Affiliation(s)
- Mayara A Menezes
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Thaís A B Pereira
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Leonardo M Tavares
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Belissa T Q Leite
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Antônio G R Neto
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Leury M S Chaves
- Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Lucas V Lima
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Marzo E Da Silva-Grigolleto
- Graduate Program in Physiological Sciences, Federal University of Sergipe, Aracaju, SE, Brazil.,Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Josimari M DeSantana
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil. .,Graduate Program in Physiological Sciences, Federal University of Sergipe, Aracaju, SE, Brazil. .,Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil. .,Department of Physical Therapy, Federal University of Sergipe, Av. Marechal Rondon, s/n, São Cristóvão, SE, 49100-000, Brazil.
| |
Collapse
|
3
|
Malmir K, Ghotbi N, Mir SM, Moradi B. Comparing Effects of Cryotherapy and Transcutaneous Electrical Nerve Stimulation on Signs and Symptoms of Delayed Onset Muscle Soreness in Amateur Athletes. ACTA ACUST UNITED AC 2017. [DOI: 10.2174/1876386301710010073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Although self-limiting, delayed-onset muscle soreness (DOMS) declines performance of the athletes. The aim of the present study was to compare the effects of repeated use of cryotherapy and transcutaneous electrical nerve stimulation (TENS) on signs and symptoms following hamstring DOMS.
Methods:
This study used a randomized controlled trial design. Thirty-two participants were randomly allocated into a TENS or cryotherapy group. Ten participants were also considered as a control group. Pain, active knee extension range of motion (AROM), triple-hop distance and thigh girth were assessed before, 24, 48 and 72 hours after inducing DOMS in the dominant hamstrings muscle.
Results:
Two-factor repeated measures analysis of variance showed a significant main effect of time for pain intensity, AROM and triple hop distance(P<0.05), and main effect of group for pain intensity and AROM(P<0.05), and interaction effects of group×time for pain intensity and AROM(P<0.05). Post hoc statistical tests showed that mean of pain intensity and AROM was changed by cryotherapy group(P<0.017).
Conclusion:
Presence of pain, decreasing AROM and reducing triple hop distance confirmed the induction of DOMS in the hamstrings. Cryotherapy was more effective than TENS for controlling pain and improving AROM after DOMS. Triple hop distance, as a measure of function, was not able to detect dominance of cryotherapy or TENS for controlling DOMS of the hamstrings in spite of repeated use of these interventions.
Collapse
|
4
|
Astokorki AHY, Mauger AR. Transcutaneous electrical nerve stimulation reduces exercise-induced perceived pain and improves endurance exercise performance. Eur J Appl Physiol 2017; 117:483-492. [PMID: 28160085 PMCID: PMC5346431 DOI: 10.1007/s00421-016-3532-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/29/2016] [Indexed: 11/21/2022]
Abstract
Purpose Muscle pain is a natural consequence of intense and prolonged exercise and has been suggested to be a limiter of performance. Transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) have been shown to reduce both chronic and acute pain in a variety of conditions. This study sought to ascertain whether TENS and IFC could reduce exercise-induced pain (EIP) and whether this would affect exercise performance. It was hypothesised that TENS and IFC would reduce EIP and result in an improved exercise performance. Methods In two parts, 18 (Part I) and 22 (Part II) healthy male and female participants completed an isometric contraction of the dominant bicep until exhaustion (Part I) and a 16.1 km cycling time trial as quickly as they could (Part II) whilst receiving TENS, IFC, and a SHAM placebo in a repeated measures, randomised cross-over, and placebo-controlled design. Perceived EIP was recorded in both tasks using a validated subjective scale. Results In Part I, TENS significantly reduced perceived EIP (mean reduction of 12%) during the isometric contraction (P = 0.006) and significantly improved participants’ time to exhaustion by a mean of 38% (P = 0.02). In Part II, TENS significantly improved (P = 0.003) participants’ time trial completion time (~2% improvement) through an increased mean power output. Conclusion These findings demonstrate that TENS can attenuate perceived EIP in a healthy population and that doing so significantly improves endurance performance in both submaximal isometric single limb exercise and whole-body dynamic exercise.
Collapse
Affiliation(s)
- Ali H Y Astokorki
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, Chatham, ME4 4AG, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, Chatham, ME4 4AG, UK.
| |
Collapse
|
5
|
Haas C, Butterfield TA, Abshire S, Zhao Y, Zhang X, Jarjoura D, Best TM. Massage timing affects postexercise muscle recovery and inflammation in a rabbit model. Med Sci Sports Exerc 2014; 45:1105-12. [PMID: 23274593 DOI: 10.1249/mss.0b013e31827fdf18] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study compared the effect of immediate versus delayed massage-like compressive loading (MLL) on peak isometric torque recovery and inflammatory cell infiltration after eccentric exercise (EEX). METHODS Eighteen skeletally mature New Zealand White rabbits were instrumented with peroneal nerve cuffs for the stimulation of hindlimb tibialis anterior muscles. After a bout of EEX, rabbits were randomly assigned to an MLL protocol (0.5 Hz, 10 N, 15 min) that started immediately post-EEX, 48 h post-EXX, or no-MLL control and performed for four consecutive days. A torque-angle (T-Θ) relationship was obtained for 21 joint angles pre- and post-EEX and after four consecutive days of MLL or no-MLL. Muscle wet weights and immunohistochemical sections were obtained after final treatments. RESULTS EEX produced an average 51% ± 13% decrease in peak isometric torque output. The greatest peak torque recovery occurred with the immediate application of MLL. There were differences in torque recovery between immediate and delayed MLL (P = 0.0012), immediate MLL and control (P < 0.0001), and delayed MLL and control (P = 0.025). Immunohistochemical analysis showed 39.3% and 366.0% differences in the number of RPN3/57 and CD11b-positive cells between immediate (P = 0.71) and delayed MLL (P = 0.12). The area under the T-Θ curve showed a difference for immediate (P < 0.0001) and delayed (P = 0.0051) MLL as compared with control. Exercise produced an average 10° ± 0.2° rightward shift from preexercise peak isometric torque angle. Control, immediate MLL, and delayed MLL produced an average leftward angular shift from the postexercise angle (P = 0.28, P = 0.03, and P = 0.47, respectively). CONCLUSION Post-EEX, immediate MLL was more beneficial than delayed MLL in restoring muscle function and in modulating inflammatory cell infiltration. These findings invite similar human studies to make definitive conclusions on optimal timing of massage-based therapies.
Collapse
Affiliation(s)
- Caroline Haas
- Division of Sports Medicine, Department of Family Medicine, The Ohio State University, Columbus, OH 43221, USA
| | | | | | | | | | | | | |
Collapse
|
6
|
Rocha CS, Lanferdini FJ, Kolberg C, Silva MF, Vaz MA, Partata WA, Zaro MA. Interferential therapy effect on mechanical pain threshold and isometric torque after delayed onset muscle soreness induction in human hamstrings. J Sports Sci 2012; 30:733-42. [DOI: 10.1080/02640414.2012.672025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
7
|
Butterfield TA, Zhao Y, Agarwal S, Haq F, Best TM. Cyclic compressive loading facilitates recovery after eccentric exercise. Med Sci Sports Exerc 2010; 40:1289-96. [PMID: 18580410 DOI: 10.1249/mss.0b013e31816c4e12] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess the biologic basis of massage therapies, we developed an experimental approach to mimic Swedish massage and evaluate this approach on recovery from eccentric exercise-induced muscle damage using a well-controlled animal model. METHODS Tibialis anterior muscles of six New Zealand White rabbits were subjected to one bout of damaging, eccentric contractions. One muscle was immediately subjected to cyclic compressive loads, and the contralateral served as the exercised control. RESULTS We found that commencing 30 min of cyclic compressive loading to the muscle, immediately after a bout of eccentric exercise, facilitated recovery of function and attenuated leukocyte infiltration. In addition, fiber necrosis and wet weight of the tissue were also reduced by compressive loading. CONCLUSION We conclude that subjecting muscle to compressive loads immediately after exercise leads to an enhanced recovery of muscle function and attenuation of the damaging effects of inflammation in the rabbit model. Although these observations suggest that skeletal muscle responds to cyclic compressive forces similar to those generated by clinical approaches, such as therapeutic massage, further research is needed to assess the translational efficacy of these findings.
Collapse
Affiliation(s)
- Timothy A Butterfield
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY 40536-0200, USA.
| | | | | | | | | |
Collapse
|
8
|
Kuehl KS, Perrier ET, Elliot DL, Chesnutt JC. Efficacy of tart cherry juice in reducing muscle pain during running: a randomized controlled trial. J Int Soc Sports Nutr 2010; 7:17. [PMID: 20459662 PMCID: PMC2874510 DOI: 10.1186/1550-2783-7-17] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 05/07/2010] [Indexed: 11/13/2022] Open
Abstract
Background Long distance running causes acute muscle damage resulting in inflammation and decreased force production. Endurance athletes use NSAIDs during competition to prevent or reduce pain, which carries the risk of adverse effects. Tart cherries, rich in antioxidant and anti-inflammatory properties, may have a protective effect to reduce muscle damage and pain during strenuous exercise. This study aimed to assess the effects of tart cherry juice as compared to a placebo cherry drink on pain among runners in a long distance relay race. Methods The design was a randomized, double blind, placebo controlled trial. Fifty-four healthy runners (36 male, 18 female; 35.8 ± 9.6 yrs) ran an average of 26.3 ± 2.5 km over a 24 hour period. Participants ingested 355 mL bottles of tart cherry juice or placebo cherry drink twice daily for 7 days prior to the event and on the day of the race. Participants assessed level of pain on a standard 100 mm Visual Analog Scale (VAS) at baseline, before the race, and after the race. Results While both groups reported increased pain after the race, the cherry juice group reported a significantly smaller increase in pain (12 ± 18 mm) compared to the placebo group (37 ± 20 mm) (p < .001). Participants in the cherry juice group were more willing to use the drink in the future (p < 0.001) and reported higher satisfaction with the pain reduction they attributed to the drink (p < 0.001). Conclusions Ingesting tart cherry juice for 7 days prior to and during a strenuous running event can minimize post-run muscle pain.
Collapse
Affiliation(s)
- Kerry S Kuehl
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA, 97239
| | - Erica T Perrier
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA, 97239
| | - Diane L Elliot
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA, 97239
| | - James C Chesnutt
- Department of Orthopedics, Oregon Health & Science University, Portland, OR, USA, 97239
| |
Collapse
|
9
|
Abstract
Exercise-induced muscle damage (EIMD) can be caused by novel or unaccustomed exercise and results in a temporary decrease in muscle force production, a rise in passive tension, increased muscle soreness and swelling, and an increase in intramuscular proteins in blood. Consequently, EIMD can have a profound effect on the ability to perform subsequent bouts of exercise and therefore adhere to an exercise training programme. A variety of interventions have been used prophylactically and/or therapeutically in an attempt to reduce the negative effects associated with EIMD. This article focuses on some of the most commonly used strategies, including nutritional and pharmacological strategies, electrical and manual therapies and exercise. Long-term supplementation with antioxidants or beta-hydroxy-beta-methylbutyrate appears to provide a prophylactic effect in reducing EIMD, as does the ingestion of protein before and following exercise. Although the administration of high-dose NSAIDs may reduce EIMD and muscle soreness, it also attenuates the adaptive processes and should therefore not be prescribed for long-term treatment of EIMD. Whilst there is some evidence that stretching and massage may reduce muscle soreness, there is little evidence indicating any performance benefits. Electrical therapies and cryotherapy offer limited effect in the treatment of EIMD; however, inconsistencies in the dose and frequency of these and other interventions may account for the lack of consensus regarding their efficacy. Both as a cause and a consequence of this, there are very few evidence-based guidelines for the application of many of these interventions. Conversely, there is unequivocal evidence that prior bouts of eccentric exercise provide a protective effect against subsequent bouts of potentially damaging exercise. Further research is warranted to elucidate the most appropriate dose and frequency of interventions to attenuate EIMD and if these interventions attenuate the adaptation process. This will both clarify the efficacy of such strategies and provide guidelines for evidence-based practice.
Collapse
Affiliation(s)
- Glyn Howatson
- School of Human Sciences, St Mary's University College, Twickenham, UK.
| | | |
Collapse
|
10
|
Connolly DAJ, McHugh MP, Padilla-Zakour OI, Carlson L, Sayers SP. Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage. Br J Sports Med 2006; 40:679-83; discussion 683. [PMID: 16790484 PMCID: PMC2579450 DOI: 10.1136/bjsm.2005.025429] [Citation(s) in RCA: 167] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Numerous antioxidant and anti-inflammatory agents have been identified in tart cherries. OBJECTIVE To test the efficacy of a tart cherry juice blend in preventing the symptoms of exercise induced muscle damage. METHODS This was a randomised, placebo controlled, crossover design. Fourteen male college students drank 12 fl oz of a cherry juice blend or a placebo twice a day for eight consecutive days. A bout of eccentric elbow flexion contractions (2 x 20 maximum contractions) was performed on the fourth day of supplementation. Isometric elbow flexion strength, pain, muscle tenderness, and relaxed elbow angle were recorded before and for four days after the eccentric exercise. The protocol was repeated two weeks later with subjects who took the placebo initially, now taking the cherry juice (and vice versa). The opposite arm performed the eccentric exercise for the second bout to avoid the repeated bout protective effect. RESULTS Strength loss and pain were significantly less in the cherry juice trial versus placebo (time by treatment: strength p<0.0001, pain p = 0.017). Relaxed elbow angle (time by treatment p = 0.85) and muscle tenderness (time by treatment p = 0.81) were not different between trials. CONCLUSIONS These data show efficacy for this cherry juice in decreasing some of the symptoms of exercise induced muscle damage. Most notably, strength loss averaged over the four days after eccentric exercise was 22% with the placebo but only 4% with the cherry juice.
Collapse
Affiliation(s)
- D A J Connolly
- Human Performance Laboratory, University of Vermont, Burlington, VT 05405, USA.
| | | | | | | | | |
Collapse
|