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Rossi R. Heat therapy for different knee diseases: expert opinion. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1390416. [PMID: 39055174 PMCID: PMC11270809 DOI: 10.3389/fresc.2024.1390416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024]
Abstract
Musculoskeletal pain is a major burden in our society. Management of musculoskeletal pain or injuries includes both pharmacological and non-pharmacological approaches, including heat therapy (HT). HT is a well-established treatment option due to its ability to promote muscle relaxation, enhance blood circulation, and modulate nociceptors with a good safety profile. The main focus of this paper is to review the available literature about HT in knee pathologies (i.e., arthrosis, arthritis, traumatic pathologies in the subacute phase, muscle and tendon pathologies linked to fatigue, muscle tension and distractions) and to provide an expert opinion in case of lack of data.
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Affiliation(s)
- Roberto Rossi
- Surgical Department, Mauriziano Umberto I Hospital, Turin, Italy
- Department of Surgical Sciences, University of Turin, Turin, Italy
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2
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Establishment of loop-mediated isothermal amplification for Brucella detection using a warmer pad as a heating source. Biotechniques 2022; 73:142-150. [PMID: 35997071 DOI: 10.2144/btn-2021-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The study sought to establish a sensitive and specific on-site loop-mediated isothermal amplification (LAMP) for Brucella heated using a warmer pad. LAMP primers specific to the conserved BvrR gene were designed, and the LAMP reaction was optimized. The heating characteristics of the warmer pad were investigated. The detection validity (specificity, sensitivity) of clinical samples by warmer-pad LAMP (WP-LAMP) was compared with that of qPCR. The WP-LAMP method displayed high specificity and sensitivity for five Brucella gene copies. The detection of 104 clinical samples was 97.1% concordant with quantitative polymerase chain reaction. The results showed the success of the WP-LAMP for on-site detection. The method requires no special equipment and is conducive to the prevention and control of brucellosis.
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Dagnino APA, Campos MM. Chronic Pain in the Elderly: Mechanisms and Perspectives. Front Hum Neurosci 2022; 16:736688. [PMID: 35308613 PMCID: PMC8928105 DOI: 10.3389/fnhum.2022.736688] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/27/2022] [Indexed: 12/12/2022] Open
Abstract
Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives.
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Affiliation(s)
- Ana P. A. Dagnino
- Programa de Pós-graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria M. Campos
- Programa de Pós-graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- *Correspondence: Maria M. Campos, ,
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Kumar P, Gaurav A, Rajnish RK, Sharma S, Kumar V, Aggarwal S, Patel S. Applications of thermal imaging with infrared thermography in Orthopaedics. J Clin Orthop Trauma 2021; 24:101722. [PMID: 34926152 PMCID: PMC8646160 DOI: 10.1016/j.jcot.2021.101722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pathological conditions with ongoing inflammatory processes result in specific heat signatures at the affected body parts; infrared thermography (IRT) detects these changes and can be utilied in screening such conditions. The modern devices are advanced and their non contact, convenient and precise readings can aid in multiple medical sub fields. Orthopaedics as a broad entity has witnessed utilisation of this technology for different indications and the present scoping review was done to assess these established indications and further scope of its utility. METHOD ology: A Medline search was done on April 26, 2021 with specific keywords for studies of any design in English language discussing the usage of thermography in Orthopaedics. Animal studies, conference abstracts, systematic reviews, e-posters, case reports, book chapters, and studies describing the use of thermography in non-Orthopaedic patients were excluded. RESULTS Total number of hits were 1380. 43 studies including case series and case control studies were included in the review. The subfields or indications described were pain/arthritis, Charcot's foot/neuropathic ulcers, infections associated with diabetic feet and arthroplasties, reflex sympathetic dystrophy, carpal tunnel syndrome, sports medicine, paediatric orthopaedics, spine, ergonomics and compartment syndrome. CONCLUSION IRT has been described to be effective in orthopaedic conditions with specific heat signatures and this can assess the trend of the ongoing inflammatory process as well as response to a particular treatment. Additionally, it can specifically determine the exact loci of the pathology for targeted interventions.
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Freiwald J, Magni A, Fanlo-Mazas P, Paulino E, Sequeira de Medeiros L, Moretti B, Schleip R, Solarino G. A Role for Superficial Heat Therapy in the Management of Non-Specific, Mild-to-Moderate Low Back Pain in Current Clinical Practice: A Narrative Review. Life (Basel) 2021; 11:780. [PMID: 34440524 PMCID: PMC8401625 DOI: 10.3390/life11080780] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 12/29/2022] Open
Abstract
Low back pain (LBP) is a leading cause of disability. It significantly impacts the patient's quality of life, limits their daily living activities, and reduces their work productivity. To reduce the burden of LBP, several pharmacological and non-pharmacological treatment options are available. This review summarizes the role of superficial heat therapy in the management of non-specific mild-to-moderate LBP. First, we outline the common causes of LBP, then discuss the general mechanisms of heat therapy on (LBP), and finally review the published evidence regarding the impact of superficial heat therapy in patients with acute or chronic non-specific LBP. This review demonstrates that continuous, low-level heat therapy provides pain relief, improves muscular strength, and increases flexibility. Therefore, this effective, safe, easy-to-use, and cost-effective non-pharmacological pain relief option is relevant for the management of non-specific mild or moderate low back pain in current clinical practice.
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Affiliation(s)
- Jürgen Freiwald
- Department of Movement and Training Science, Bergische University Wuppertal, 42119 Wuppertal, Germany;
| | - Alberto Magni
- S.I.M.G. Società Italiana di Medicina Generale, 50242 Florence, Italy;
| | - Pablo Fanlo-Mazas
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Ema Paulino
- Farmácia Nuno Álvares, 2800-179 Almada, Portugal;
| | - Luís Sequeira de Medeiros
- Nova Medical School, Nova University Lisbon, 1099-085 Lisbon, Portugal;
- Physical Medicine and Rehabilitation Department, Centro Hospitalar Universitário de Lisboa Central, 1150-199 Lisbon, Portugal
| | - Biagio Moretti
- Orthopedic & Trauma Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (B.M.); (G.S.)
| | - Robert Schleip
- Department of Sport and Health Sciences, Associate Professorship of Conservative and Rehabilitative Orthopedics, Technical University of Munich, 80992 Munich, Germany
- Department for Medical Professions, Diploma University of Applied Sciences Bad Sooden-Allendorf, 37242 Bad Sooden-Allendorf, Germany
| | - Giuseppe Solarino
- Orthopedic & Trauma Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (B.M.); (G.S.)
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Lai YC, Chao YH, Kuo CY, Lee WN, Chuang L, Shih TTF, Rolf C, Wang HK. Microcirculatory Responses to Muscle and Tendon Exercises in Individuals With and Without Type 2 Diabetes Mellitus and the Association Between Microcirculatory and Exercise Performance. Metab Syndr Relat Disord 2021; 19:325-331. [PMID: 34030471 DOI: 10.1089/met.2020.0111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to measure and compare (1) the microcirculation and microcirculatory responses of the muscles and tendons at rest and during isometric muscle contractions in participants with and without diabetes mellitus (DM) and (2) to determine correlations between microcirculation and muscle strength. Methods: Sixty-three participants with type 2 DM and 42 physically matched controls were recruited. Baseline measurements of the microcirculation of the rectus femoris (RF) and medial gastrocnemius (MG) muscles and patellar (PT) and Achilles tendons (AT), as well as their microcirculatory changes during maximal isometric exercises, were performed and recorded by using near-infrared spectroscopy and a red laser. Data on various laboratory tests (including glycated hemoglobin, triglyceride, high-density cholesterol), the monofilament test, and the ankle-brachial index were also obtained. Results: The baseline measurements indicated that, compared with the controls, the diabetic participants had lower oxygen saturation (SpO2) in their RF and MG muscles (both P < 0.001), and the total hemoglobin in the diabetic PT and AT was higher (P = 0.001 and P = 0.01). The minimal SpO2 levels in the aforementioned muscles during isometric contractions were lower in the diabetes group than in the control group (P ≤ 0.001). Furthermore, there were correlations between the microcirculatory change of the RF muscle and the knee extension force. Conclusions: This study demonstrated the effects of diabetes on the microcirculation of skeletal muscles and tendons during baseline measurements and responses to maximal isometric exercises. The results support the need for preventive strategies for diabetic muscles to prevent adverse complications when performing resistance training.
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Affiliation(s)
- Ying-Chuen Lai
- Division of Metabolism and Endocrinology, Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yuan-Hung Chao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Yu Kuo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, and Medical Engineering Programme, The University of Hong Kong, Hong Kong, China
| | - Leeming Chuang
- Division of Metabolism and Endocrinology, Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tiffany T F Shih
- Department of Medical Image and Radiology, National Taiwan University, Medical College and Hospital, Taipei, Taiwan
| | - Christer Rolf
- Department of Orthopaedics, Clintec, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Hsing-Kuo Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
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Petrofsky J, Laymon M, Lee H. Local heating of trigger points reduces neck and plantar fascia pain. J Back Musculoskelet Rehabil 2020; 33:21-28. [PMID: 31594202 DOI: 10.3233/bmr-181222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Heating the skin and muscles is a commonly accepted method of pain relief and a modality to increase relaxation in muscles and increase tissue blood flow. OBJECTIVE The purpose of the present study was to examine the effect of local heat applied to trigger points and to determine if there was pain relief in the neck and plantar fascia. METHODS Forty adults were divided into 2 different groups according to their pain; twenty subjects had plantar foot pain and the other 20 had nonspecific neck pain. The 20 subjects in each group were randomly subdivided into a heat and a sham group. Sensitivity to pressure was measured with an algometer. A stopwatch was given to the subject and started when either the heat patch or placebo was applied. Heat cells were applied at trigger points on the pain area. RESULTS Subjective pain significantly decreased in both sham and heat group patients with neck pain (p< 0.05), however, the change was greater in the heat group and there was a significant difference between the heat and sham groups (p= 0.002, d= 0.81). For the plantar pain group, a significant decrease in subjective pain was found in the heat group but not in the sham group. Pressure pain threshold significantly decreased in the heat group patients both with neck and plantar pain but for the sham group there was an increase in the pressure after sham treatment. Pain relief during the intervention was also significantly different between the heat and sham group in both patients with neck and plantar pain. CONCLUSION The effect of local heat on trigger points of the body on pain relief was significantly better in the heat groups than in the sham groups. This finding is significant because using heat on trigger points could be an alternative to dry needling performed by healthcare professionals. This modality can be alternative for home use and avoids opioids.
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Affiliation(s)
- Jerrold Petrofsky
- School of Physical Therapy, Touro University Nevada, Henderson, Nevada, USA
| | - Michael Laymon
- School of Physical Therapy, Touro University Nevada, Henderson, Nevada, USA
| | - Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
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Petrofsky JS, Laymon M, Alshammari F, Khowailed IA, Lee H. Use of low level of continuous heat and Ibuprofen as an adjunct to physical therapy improves pain relief, range of motion and the compliance for home exercise in patients with nonspecific neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2018; 30:889-896. [PMID: 28282796 DOI: 10.3233/bmr-160577] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND It has been well documented at heat reduces pain and increases healing by increasing blood flow in tissue. OBJECTIVE The purpose of this study was to see if the use of low level continuous heat (LLCH) and Ibuprofen used as a home therapy between physical therapy sessions at a clinic resulted in better therapy outcomes in people with chronic neck pain. METHODS Ninety-two patients with chronic nonspecific neck pain were randomly divided into 4 groups; LLCH group, LLCH with Ibuprofen (IP) group, sham LLCH with sham IP group, and controls. All subjects underwent 45 minutes of conventional physical therapy twice a week for 2 weeks. the neck disability index (NDI), subjective pain, range of motion (ROM), strength of the neck, and home exercise compliance were measured. RESULTS Both LLCH and IP significantly reduced pain and NDI score, and increased ROM (p< 0.01). Home exercise compliance in LLCH and LLCH with IP group was significantly higher than the placebo and control groups (p < 0.05). CONCUSION The use of LLCH alone and LLCH with IP as an adjunct to conventional physical therapy for chronic neck pain significantly improved pain attenuation and it causes greater compliance for home.
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Affiliation(s)
| | - Michael Laymon
- School of Physical Therapy, Touro University, Henderson, NV, USA
| | - Faris Alshammari
- Department of Physical Therapy, Hashemite University, Zarqa, Jordan
| | | | - Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
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Abstract
OBJECTIVE To assess the impact of heat applied for 8 hours immediately after or 24 hours after exercise on delayed-onset muscle soreness (DOMS) in large skeletal muscle groups measured by subjective and objective means. DESIGN Cross-sectional repeated measure design study. SETTING Research laboratory. SUBJECTS Three groups of 20 subjects, age range 20 to 40 years. INTERVENTION Squats were conducted in three 5-minute bouts to initiate DOMS; 3 minutes of rest separated the bouts. One group had heat applied immediately after exercise, and a second group had heat applied 24 hours after exercise. A third group was the control group where no heat was applied. MAIN OUTCOME MEASURES Visual analog pain scales, muscle strength of quads, range of motion of quads, stiffness of quads (Continuous Passive Motion machine), algometer to measure quadriceps soreness, and blood myoglobin. RESULTS The most significant outcome was a reduction in soreness in the group that had low-temperature heat wraps applied immediately after exercise (P < 0.01). There was benefit to applying heat 24 hours after exercise, but to a smaller extent. This was corroborated by myoglobin, algometer, and stiffness data. CONCLUSIONS Low-level continuous heat wraps left for 8 hours just after heavy exercise reduced DOMS in the population tested as assessed by subjective and objective measures. CLINICAL RELEVANCE Although cold is commonly used after heavy exercise to reduce soreness, heat applied just after exercise seems very effective in reducing soreness. Unlike cold, it increases flexibility of tissue and tissue blood flow. For joint, it is still probably better to use cold to reduce swelling.
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Petrofsky JS, Laymon MS, Alshammari FS, Lee H. Use of Low Level of Continuous Heat as an Adjunct to Physical Therapy Improves Knee Pain Recovery and the Compliance for Home Exercise in Patients With Chronic Knee Pain: A Randomized Controlled Trial. J Strength Cond Res 2016; 30:3107-3115. [PMID: 27776079 DOI: 10.1519/jsc.0000000000001409] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Petrofsky, JS, Laymon, MS, Alshammari, FS, and Lee, H. Use of low level of continuous heat as an adjunct to physical therapy improves knee pain recovery and the compliance for home exercise in patients with chronic knee pain: a randomized controlled trial. J Strength Cond Res 30(11): 3107-3115, 2016-This study examined if the use of low level continuous heat (LLCH) wraps at home between physical therapy sessions at a clinic resulted in better therapy outcomes in patients with chronic knee pain. Fifty individuals with chronic nonspecific knee pain was randomly allocated to 2 groups: the LLCH group and the placebo group. All subjects underwent 1 hour of conventional physical therapy twice per week for 2 weeks at the outpatient clinic and they were asked to accomplish 1 hour of therapeutic exercise at home each day between sessions. The LLCH group applied LLCH knee wraps for 6 hours at home before home exercise while placebo group took a placebo ibuprofen. (This was done since placebo heat is impossible to use since subjects would notice that the wraps were cold) Before, during, and after intervention, pain intensity, active range of motion of the knee (AROM), knee strength, and home exercise compliance were measured. The LLCH group showed pain attenuation after 2 weeks of therapy sessions (p ≤ 0.05). AROM and strength of the knee significantly improved over time compared to the placebo group. Home exercise compliance was significantly higher in the LLCH group than placebo group (p ≤ 0.05). These results indicated that the use of LLCH as an adjunct to conventional physical therapy for chronic knee pain significantly improved pain attenuation and recovery of strength and movement in patients with chronic knee pain.
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Affiliation(s)
- Jerrold S Petrofsky
- 1School of Physical, Touro University, Henderson, Nevada; 2Department of Physical Therapy, Hashemite University, Zarqa, Jordan; and 3Department of Physical Therapy, College of Health Science, Gachon University, Incheon, South Korea
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Petrofsky JS, Khowailed IA, Lee H, Berk L, Bains GS, Akerkar S, Shah J, Al-Dabbak F, Laymon MS. Cold Vs. Heat After Exercise—Is There a Clear Winner for Muscle Soreness. J Strength Cond Res 2015; 29:3245-52. [DOI: 10.1519/jsc.0000000000001127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lee YS, Bae SH, Hwang JA, Kim KY. The effects of kinesio taping on architecture, strength and pain of muscles in delayed onset muscle soreness of biceps brachii. J Phys Ther Sci 2015; 27:457-9. [PMID: 25729190 PMCID: PMC4339160 DOI: 10.1589/jpts.27.457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022] Open
Abstract
[Purpose] This study aimed to confirm the effects of kinesio taping (KT) on muscle
function and pain due to delayed onset muscle soreness (DOMS) of the biceps brachii.
[Subjects and Methods] Thirty-seven subjects with induced DOMS were randomized into either
Group I (control, n=19) or Group II (KT, n=18). Outcome measures were recorded before the
intervention (application of KT) and at 24, 48, and 72 hours after the intervention. DOMS
was induced, and muscle thickness was measured using ultrasonic radiography. Maximal
voluntary isometric contraction (%MVIC) was measured via electromyography (EMG).
Subjective pain was measured using a visual analogue scale (VAS). [Results] Group I
exhibited a positive correlation between muscle thickness and elapsed time from
intervention (24, 48, and 72 hours post induction of DOMS); they also showed a significant
decrease in MVIC(%). Group II showed significant increases in muscle thickness up to the
48-hour interval post induction of DOMS, along with a significant decrease in MVIC (%).
However, in contrast to Group I, Group II did not show a significant difference in muscle
thickness or MVIC (%) at the 72-hour interval in comparison with the values prior to DOMS
induction. [Conclusion] In adults with DOMS, activation of muscles by applying KT was
found to be an effective and faster method of recovering muscle strength than rest
alone.
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Affiliation(s)
- Yong Sin Lee
- Department of Physical Therapy, Graduate School of Dongshin University, Republic of Korea
| | - Sea Hyun Bae
- Department of Physical Therapy, Cheongam College, Republic of Korea
| | - Jin Ah Hwang
- Department of Physical Therapy, Graduate School of Dongshin University, Republic of Korea
| | - Kyung Yoon Kim
- Department of Physical Therapy, College of Health and Welfare, Dongshin University, Republic of Korea
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Laymon M, Petrofsky J, McKivigan J, Lee H, Yim J. Effect of heat, cold, and pressure on the transverse carpal ligament and median nerve: a pilot study. Med Sci Monit 2015; 21:446-51. [PMID: 25669437 PMCID: PMC4335578 DOI: 10.12659/msm.892462] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background This study quantified the effects of heat, cold, and pressure on the median nerve and transverse carpal ligament in subjects without carpal tunnel syndrome. Material/Methods Subjects were individuals ages 20–50 who had no symptoms of carpal tunnel disease. Imaging ultrasound was used to measure the clearance around the median nerve, transverse ligament elasticity, nerve conduction velocity, thickness of the carpal ligament, and area of the median nerve. Pressure was applied to the carpal ligament to assess the effects of increasing pressure on these structures. On 3 separate days, 10 subjects had ThermaCare heat or cold packs applied, for either 60 or 120 minutes for heat or 20 minutes for cold, to the palmer surface of the hand. Results Tissue changes were recorded as a response to pressure applied at 0, 5, 10, and 20 N. The size of the nerve and ligaments were not significantly altered by pressure with the hand at room temperature and after cold exposure. After heat, the nerve, ligaments, and tendons showed significantly more elasticity. Conclusions Application of cold to the hand may reduce compression of the carpal ligament and nerve.
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Affiliation(s)
- Michael Laymon
- School of Physical Therapy, Touro University Nevada, Henderson, NV, USA
| | - Jerrold Petrofsky
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - James McKivigan
- School of Physical Therapy, Touro University Nevada, Henderson, NV, USA
| | - Haneul Lee
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - JongEun Yim
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
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Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med 2014; 127:57-65. [PMID: 25526231 DOI: 10.1080/00325481.2015.992719] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Nonpharmacological treatment strategies for acute musculoskeletal injury revolve around pain reduction and promotion of healing in order to facilitate a return to normal function and activity. Heat and cold therapy modalities are often used to facilitate this outcome despite prevalent confusion about which modality (heat vs cold) to use and when to use it. Most recommendations for the use of heat and cold therapy are based on empirical experience, with limited evidence to support the efficacy of specific modalities. This literature review provides information for practitioners on the use of heat and cold therapies based on the mechanisms of action, physiological effects, and the medical evidence to support their clinical use. The physiological effects of cold therapy include reductions in pain, blood flow, edema, inflammation, muscle spasm, and metabolic demand. There is limited evidence from randomized clinical trials (RCTs) supporting the use of cold therapy following acute musculoskeletal injury and delayed-onset muscle soreness (DOMS). The physiological effects of heat therapy include pain relief and increases in blood flow, metabolism, and elasticity of connective tissues. There is limited overall evidence to support the use of topical heat in general; however, RCTs have shown that heat-wrap therapy provides short-term reductions in pain and disability in patients with acute low back pain and provides significantly greater pain relief of DOMS than does cold therapy. There remains an ongoing need for more sufficiently powered high-quality RCTs on the effects of cold and heat therapy on recovery from acute musculoskeletal injury and DOMS.
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Petrofsky J, Laymon M, Alshammari F, Khowailed IA, Lee H. Use of ThermaCare heat wraps as an adjunct to physical therapy. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.9.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Jerrold Petrofsky
- professor, department of physical therapy, Loma Linda University, California
| | - Michael Laymon
- professor and head of the school of physical therapy, Touro University, Henderson Nevada
| | - Faris Alshammari
- a PHD candidate and physical therapist, Loma Linda University, California
| | | | - Haneul Lee
- a research scientist and Doctor of Science, Loma Linda University, California
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Petrofsky J, Berk L, Bains G, Khowailed IA, Hui T, Granado M, Laymon M, Lee H. Moist heat or dry heat for delayed onset muscle soreness. J Clin Med Res 2013; 5:416-25. [PMID: 24171053 PMCID: PMC3808259 DOI: 10.4021/jocmr1521w] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 02/04/2023] Open
Abstract
Background Heat is commonly used in physical therapy following exercise induced delayed onset muscle soreness (DOMS). Most heat modalities used in a clinical setting for DOMS are only applied for 5 to 20 minutes. This minimal heat exposure causes little, if any, change in deep tissue temperature. For this reason, long duration dry chemical heat packs are used at home to slowly and safely warm tissue and reduce potential heat damage while reducing pain associated from DOMS. Clinically, it has been shown that moist heat penetrates deep tissue faster than dry heat. Therefore, in home use chemical moist heat may be more efficacious than dry heat to provide pain relief and reduce tissue damage following exercise DOMS. However, chemical moist heat only lasts for 2 hours compared to the 8 hours duration of chemical dry heat packs. The purpose of this study was to compare the beneficial effect of dry heat versus moist heat on 100 young subjects after exercise induce DOMS. Methods One hundred subjects exercised for 15 minutes accomplishing squats. Before and for 3 days after, strength, muscle soreness, tissue resistance, and the force to passively move the knee were recorded. Heat and moist heat were applied in different groups either immediately after exercise or 24 hours later. Results The research results of this study showed that immediate application of heat, either dry (8 hours application) or moist (2 hours application), had a similar preservation of quadriceps muscle strength and muscle activity. Results also revealed that the greatest pain reduction was shown after immediate application of moist heat. Never the less, immediate application of dry heat had a similar effect but to a lesser extent. Conclusion It should be noted that moist heat had not only similar benefits of dry heat but in some cases enhanced benefits, and with only 25% of the time of application of the dry heat.
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Affiliation(s)
- Jerrold Petrofsky
- Department of Physical Therapy, Loma Linda University, Loma Linda, California, USA
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Al-Nakhli HH, Petrofsky JS, Laymon MS, Arai D, Holland K, Berk LS. The use of thermal infrared imaging to assess the efficacy of a therapeutic exercise program in individuals with diabetes. Diabetes Technol Ther 2012; 14:159-67. [PMID: 22011006 DOI: 10.1089/dia.2011.0187] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Exercise is of great value for individuals with diabetes in helping to control their hemoglobin A1c levels and in increasing their insulin sensitivity. Delayed-onset muscle soreness (DOMS) is a common problem in healthy individuals and in people who have diabetes. People with diabetes are also faced with metabolic and endothelial impairments, which could make DOMS even worse. But because they usually have neuropathies, they may not feel this soreness appropriately, leading to premature return to exercise and causing further injuries. RESEARCH DESIGN One hundred eighteen subjects participated in this study and were divided into four groups. Two groups (healthy and diabetes) performed a series of abdominal exercises, and the other two groups (healthy and diabetes) performed a series of arm exercises to induce DOMS. Skin temperature above the muscle was assessed using a thermal infrared camera, and perceived soreness of the exercised muscle was assessed using a 100-mm visual analog scale. Serum myoglobin concentrations were also measured. RESULTS There was a significant increase in skin temperature 24 h post-exercise for all four exercise groups (P<0.05), where the combined average increase in skin temperature for all four groups was approximately 0.65°C from baseline. Also, 24 h post-exercise, all four groups were significantly sorer than they were at baseline (P<0.05). Serum myoglobin levels were also significantly higher on day 3 compared with day 1 (P<0.05). CONCLUSION Infrared thermal imaging may be a valuable technique of seeing which muscles are sore hours or even days after the exercise is over. Thus, thermal imaging would be an efficient and painless way of looking at DOMS in both healthy individuals and individuals who have diabetes, even if they are facing neurological problems.
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Petrofsky J, Berk L, Alshammari F, Lee H, Hamdan A, Yim JE, Patel D, Kodawala Y, Shetye G, Chen WT, Moniz H, Pathak K, Somanaboina K, Desai R, Dave B, Malthane S, Alshaharani M, Neupane S, Shenoy S, Nevgi B, Cho S, Al-Nakhli H. The effect of moist air on skin blood flow and temperature in subjects with and without diabetes. Diabetes Technol Ther 2012; 14:105-16. [PMID: 22017463 DOI: 10.1089/dia.2011.0128] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Endothelial function is known to be impaired in response to heat in people with diabetes, but little has been done to see how air humidity alters the skin blood flow response to heat. METHODS Seventeen male and female subjects were divided in two groups, one with type 2 diabetes and the other the control subjects without diabetes, age-matched to the diabetes group. All subjects participated in a series of experiments to determine the effect of the warming of the skin by air on skin temperature and skin blood flow. On different days, skin temperature was warmed with air that was 38°C, 40°C, or 42°C for 20 min. Also, on different days, at each temperature, the air humidity was adjusted to 0%, 25%, 50%, 75%, or 100% humidity. Skin blood flow and temperature were measured throughout the exposure period. This allowed the interactions between air humidity and temperature to be assessed. RESULTS For the control subjects, the moisture in the air had no different effect on skin blood flow at air temperatures of 38°C and 40°C (analysis of variance, P>0.05), although skin blood flow progressively increased at each air temperature that was applied. But for the warmest air temperature, 42°C, although the four lower humidities had the same effect on skin blood flow, air at 100% humidity caused the largest increase in skin blood flow. In contrast, in the subjects with diabetes, blood flow was always significantly less at any air temperature applied to the skin than was observed in the control subjects (P<0.05), and skin blood flow was significantly higher for the two higher humidities for the two higher air temperatures. Skin temperature paralleled these findings. CONCLUSION These data show that individuals with diabetes do not tolerate moist, warm air above 50% humidity as well as controls without diabetes.
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Affiliation(s)
- Jerrold Petrofsky
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, California 92350, USA.
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Al-Nakhli HH, Petrofsky JS, Laymon MS, Berk LS. The use of thermal infra-red imaging to detect delayed onset muscle soreness. J Vis Exp 2012:3551. [PMID: 22297829 DOI: 10.3791/3551] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Delayed onset muscle soreness (DOMS), also known as exercise induced muscle damage (EIMD), is commonly experienced in individuals who have been physically inactive for prolonged periods of time, and begin with an unexpected bout of exercise, but can also occur in athletes who exercise beyond their normal limits of training. The symptoms associated with this painful phenomenon can range from slight muscle tenderness, to severe debilitating pain. The intensity of these symptoms and the related discomfort increases within the first 24 hours following the termination of the exercise, and peaks between 24 to 72 hours post exercise. For this reason, DOMS is one of the most common recurrent forms of sports injury that can affect an individual's performance, and become intimidating for many. For the last 3 decades, the DOMS phenomenon has gained a considerable amount of interest amongst researchers and specialists in exercise physiology, sports, and rehabilitation fields. There has been a variety of published studies investigating this painful occurrence in regards to its underlying mechanisms, treatment interventions, and preventive strategies. However, it is evident from the literature that DOMS is not an easy pathology to quantify, as there is a wide amount of variability between the measurement tools and methods used to quantify this condition. It is obvious that no agreement has been made on one best evaluation measure for DOMS, which makes it difficult to verify whether a specific intervention really helps in decreasing the symptoms associated with this type of soreness or not. Thus, DOMS can be seen as somewhat ambiguous, because many studies depend on measuring soreness using a visual analog scale (VAS), which is a subjective rather than an objective measure. Even though needle biopsies of the muscle, and blood levels of myofibre proteins might be considered a gold standard to some, large variations in some of these blood proteins have been documented, in addition to the high risks sometimes associated with invasive techniques. Therefore, in the current investigation, we tested a thermal infra-red (IR) imaging technique of the skin above the exercised muscle to detect the associated muscle soreness. Infra-red thermography has been used, and found to be successful in detecting different types of diseases and infections since the 1950's. But surprisingly, near to nothing has been done on DOMS and changes in skin temperature. The main purpose of this investigation was to examine changes in DOMS using this safe and non-invasive technique.
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