The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness

Psychometric properties of the barriers self-efficacy scale for physical activity–Korean

This study examined the psychometric properties of the Barriers Self-Efficacy Scale-Physical Activity for Korean-speaking adults with osteoarthritis at risk for metabolic syndrome (N = 150). Factor analysis identified three dimensions of the Korean Barriers scale, explaining 65.9 % of the total variance. Confirmatory factor analysis indicated that the structural validity adequately fits the data. Construct validity confirmed significant associations between the amount of physical activity and psychological variables. The test-retest reliability was 0.87; the alpha was 0.90. The standardized response mean (0.497) indicated responsiveness to medium-magnitude change. The Korean Barriers scale can assess self-efficacy to engage in regular physical activity in clinical settings.

The Effect of Single Bout Treatment of Heat or Cold Intervention on Delayed Onset Muscle Soreness Induced by Eccentric Contraction

We studied the preventive effects of heat or cold therapy after repeated eccentric contraction against torque reduction, muscle soreness, and range of motion (ROM) due to delayed-onset muscle soreness (DOMS). A total of 42 healthy male subjects were randomly allocated into three groups: the HEAT group received heat therapy using an ultra-short-wave device; the ICE group received ice therapy using an ice pack; the Control group received no intervention. The measurements included maximal voluntary isometric, concentric, and eccentric elbow flexion torque, elbow extension ROM, pressure pain threshold, and muscle soreness with stretching muscle thickness and echo intensity. The measurements were taken before (pre), after (post), after (t-post), one-four days after, and seven days after the muscle damage protocol. The results showed the main effect of time on all measurements, but no significant interactions were observed. The results of this study suggest that heat or cold therapy in the first 30 min after intense eccentric exercise is insufficient to exert a preventive effect against DOMS.

Effect of cold and heat therapies on pain relief in patients with delayed onset muscle soreness: A network meta-analysis

OBJECTIVE

To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis.

METHODS

Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers.

RESULTS

A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first.

CONCLUSION

Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness.

The effects of Biofreeze and superficial heat on masticatory myofascial pain syndrome

Purpose:

This study aims to assess the influence of superficial heat and Biofreeze on pain, mouth opening (mm), and quality of life in patients with masticatory myofascial pain syndrome (MPS).

Materials and methods:

52 patients with MPS were included in the study. They were randomly divided into two groups. Patients in the Biofreeze group (n = 26) applied 3.5% menthol gel to the masseter and temporal muscles twice a day for seven days, while the other group applied superficial heat. Baseline, 7th, and 21st days of VAS, mouth opening (mm), and Oral Health Impact Profile-14 (OHIP-14) scores of the patients were evaluated statistically.

Results:

The mouth opening increased by 4.27 ± 3.80 mm in the Biofreeze group and 2.58 ± 2.16 mm in the superficial heat group. In each group, a significant decrease in VAS and OHIP-14 scores was observed on the 7th day compared to the baseline values (p<0.001). There was no statistically significant difference between the two applications on myofascial pain, mouth opening (mm), and OHIP-14 total score variables. The favorable effects of both applications on these parameters were limited to the duration of use.

Conclusion:

Biofreeze and superficial heat in MPS were found to increase the quality of life, but the limited effectiveness of these applications underlines the importance of the underlying factors.

Local heat applications as a treatment of physical and functional parameters in acute and chronic musculoskeletal disorders or pain

OBJECTIVES

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of local heat applications (LHA) in individuals with acute or chronic musculoskeletal disorders.

DATA SOURCES

An electronic search was conducted on MEDLINE, CENTRAL, CINHAL and the PEDro databases up to December 2019.

STUDY SELECTION

Studies incorporating adults suffering from any kind of musculoskeletal issues treated by LHA compared to any treatment other than heat were included.

QUALITY ASSESSMENT

Two authors independently performed the methodological quality assessment using the Cochrane Risk of Bias tool.

DATA SYNTHESIS

LHA showed beneficial immediate effects to reduce pain vs no treatment (p < 0.001), standard therapy (p = 0.020), pharmacological therapy (p < 0.001) and placebo/sham (p = 0.044). Physical function was restored after LHA compared to no treatment (p = 0.025) and standard therapy (p = 0.006) whilst disability improved directly after LHA compared to pharmacological therapy (p = 0.003) and placebo/sham (p < 0.028). Quality of life was improved directly after LHA treatment compared to exercise therapy (p < 0.021). Range of motion increased and stiffness decreased after LHA treatment compared to pharmacological therapy (p = 0.009., p < 0.001) and placebo/sham (p < 0.001, p = 0.023). The immediate superior effects of LHA on muscular strength could be observed compared to no treatment (p < 0.001), cold (p < 0.001) and placebo/sham (p = 0.023).

CONCLUSIONS

Individuals suffering from acute musculoskeletal disorders might benefit from using LHA as an adjunct therapy. However, the studies included in this meta-analysis demonstrated a high heterogeneity and mostly an unclear risk of bias.

Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials

OBJECTIVE

The aim of this review and meta-analysis was to evaluate the effect of heat and cold therapy on the treatment of delayed onset muscle soreness (DOMS).

METHODS

We followed our protocol that was registered in PROSPERO with ID CRD42020170632. A systematic review and meta-analysis of randomized controlled trials (RCT) was conducted. Nine databases were searched up to December 2020. Data was extracted from the retained studies and underwent methodological quality assessment and meta-analysis.

RESULTS

A total of 32 RCTs involving 1098 patients were included. Meta-analysis showed that, the application of cold therapy within 1 h after exercise could reduce the pain of DOMS patients within 24 h (≤24 h) after exercise (SMD -0.57,95%CI -0.89 to -0.25, P = 0.0005) and had no obvious effect within more than 24 h (>24 h) (P = 0.05). In cold therapies, cold water immersion (SMD -0.48, 95%CI -0.84 to -0.13, P = 0.008) and other cold therapies (SMD -0.68, 95%CI -1.28 to -0.08, P = 0.03) had the significant effects within 24 h. Heat treatment could reduce the pain of patients. It had obvious effects on the pain within 24 h (SMD -1.17, 95%CI -2.62 to -0.09, P = 0.03) and over 24 h (SMD -0.82, 95%CI -1.38 to -0.26, P = 0.004). Hot pack effect was the most obvious, which reduced the pain within 24 h (SMD -2.31, 95%CI -4.33 to -0.29, P = 0.03) and over 24 h (SMD -1.78, 95%CI -2.97 to -0.59, P = 0.003). Other thermal therapies were not statistically significant (P > 0.05). Both cold and heat showed effect in reducing pain of patients, however there was no significant difference between cold and heat group (P = 0.16).

CONCLUSIONS

The current evidence indicated that the application of cold and heat therapy within 1 h after exercise could effectively reduce the pain degree of DOMS patients for 24 h cold water immersion and hot pack therapy, which had the best effect, could promote the recovery of DOMS patients. But more high-quality studies are needed to confirm whether cold or heat therapy work better.

Properties of Thermal Analgesia in a Human Chronic Low Back Pain Model

Purpose

For years, heat has been used for comfort and analgesia is recommended as a first-line therapy in many clinical guidelines. Yet, there are questions that remain about the actual effectiveness of heat for a condition as common as chronic low back pain, and factors such as time of onset, optimal temperature, and duration of effect.

Materials and Methods

A randomized double-blinded controlled trial was designed to compare the analgesic response to heat delivered via pulses at 45°C (experimental group, N=49) to steady heat at 37°C (control group, N=51) in subjects with longstanding low back pain. Treatment lasted 30 minutes with follow-up out to four hours. The hypothesis was that the experimental group would experience a higher degree of analgesia compared to the control group. Time of onset and duration of effect were also measured.

Results

Both groups were similar in average duration of pain (10.3 years). The primary outcome measure was pain reduction at 30 minutes after the end of treatment, using a 10-points numeric pain scale. Reduction in pain was greater for the experimental group than the control group (difference in mean reduction = 0.72, 95% CI 0.15–1.29, p = 0.014). Statistically significant differences in pain levels were observed from the first measure at 5 minutes of treatment through 120 minutes after completion of treatment. Reduction in pain associated movement was greater in the active heat group than the placebo group (p = 0.04).

Conclusion

High-level pulsed heat (45°C) produced significantly more analgesia as compared to steady heat at 37°C at the primary end point and for an additional 2 hours after treatment. The onset of analgesia was rapid, <5 minutes of treatment. The results of this trial provide insight into the mechanisms and properties of thermal analgesia that are not well understood in a chronic low back pain model.

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Local heating of trigger points reduces neck and plantar fascia pain

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.

Heat-induced hypervolemia: Does the mode of acclimation matter and what are the implications for performance at Tokyo 2020?

Tokyo 2020 will likely be the most heat stressful Olympics to date, so preparation to mitigate the effects of humid heat will be essential for performance in several of the 33 sports. One key consideration is heat acclimation (HA); the repeated exposure to heat to elicit physiological and psychophysical adaptations that improve tolerance and exercise performance in the heat. Heat can be imposed in various ways, including exercise in the heat, hot water immersion, or passive exposure to hot air (e.g., sauna). The physical requirements of each sport will determine the impact that the heat has on performance, and the adaptations required from HA to mitigate these effects. This review focuses on one key adaptation, plasma volume expansion (PVE), and how the mode of HA may affect the kinetics of adaptation. PVE constitutes a primary HA-mediated adaptation and contributes to functional adaptations (e.g., lower heart rate and increased heat loss capacity), which may be particularly important in athletes of "sub-elite" cardiorespiratory fitness (e.g., team sports), alongside athletes of prolonged endurance events. This review: i) highlights the ability of exercise in the heat, hot-water immersion, and passive hot air to expand PV, providing the first quantitative assessment of the efficacy of different heating modes; ii) discusses how this may apply to athletes at Tokyo 2020; and iii) provides recommendations regarding the protocol of HA and the prospect for achieving PVE (and the related outcomes).

Experimental methodology for quantitative assessment of heat-wrap thermal transient behavior

Among the numerous thermotherapy methods, heat wraps have been largely used over the last 2 decades as a self-administered practice for pain relief. Therefore, understanding their performance has become instrumental within the healthcare industry. However, the majority of the available studies have been focused on in vivo clinical performance, whereas a standardized, quantitative approach to evaluate and compare the various heat-wrap types against each other is lacking. An experimental methodology is proposed to carry out a comparative assessment between heat wraps in terms of their transient thermal behavior. A simple setup was developed to measure wrap/substrate interface temperature trend. The approach was validated by a preliminary infrared-thermography assessment and statistical analysis on the extensive dataset acquired on commercial heat-wrap types for low-back and neck pain relief. The heat-release trend was found to be qualitatively similar over all the investigated types, consisting of rapid growth, stationary phase, decay and end of the reactions. A set of parameters is also proposed to summarize heat-wrap thermal performance.

KNEE PROPRIOCEPTION MAY BE ALTERED BY TREATMENT IN ATHLETES SUFFERING FROM DELAYED ONSET MUSCLE SORENESS

Delayed onset muscle soreness (DOMS) is a very common musculoskeletal problem in athletes involved in extreme competitions. The aim of this study is to compare the effect of diathermy, sham diathermy and massage on the knee proprioception of athletes treated for DOMS. Forty athletes were enrolled after the second day of a demanding ski mountaineering race. They were randomly assigned to four groups: no treatment [Formula: see text], massage [Formula: see text], diathermy [Formula: see text], and sham diathermy [Formula: see text]. The knee reposition error was measured after the treatments in order to assess knee proprioception. Significant differences between the diathermy and sham diathermy groups were found ([Formula: see text]) with an absolute effect size of [Formula: see text]. No other significant differences were found among groups. This means that diathermy has a negative impact on joint proprioception and can be explained by the spindle desensitization consequent to deeper tissue heating. This information can be important in the DOMS management of athletes, since an altered proprioception may interfere with the athlete’s performance and can increase the risk of injury.

Impact of heat therapy on recovery after eccentric exercise in humans

The purpose of this study was to investigate the effects of heat therapy (HT) on functional recovery, the skeletal muscle expression of angiogenic factors, macrophage content, and capillarization after eccentric exercise in humans. Eleven untrained individuals (23.8 ± 0.6 yr) performed 300 bilateral maximal eccentric contractions of the knee extensors. One randomly selected thigh was treated with five daily 90-min sessions of HT, whereas the opposite thigh received a thermoneutral intervention. Peak isokinetic torque of the knee extensors was assessed at baseline and daily for 4 days and fatigue resistance was assessed at baseline and 1 and 4 days after the eccentric exercise session. Muscle biopsies were obtained 2 wk before and 1 and 5 days after the eccentric exercise bout. There were no differences between thighs in the overall recovery profile of peak torque. However, the thigh exposed to HT had greater fatigue resistance than the thigh exposed to the thermoneutral intervention. The change from baseline in mRNA expression of vascular endothelial growth factor (VEGF) was higher at day 1 in the thigh exposed to HT. Protein levels of VEGF and angiopoietin 1 were also significantly higher in the thigh treated with HT. The number of capillaries around type II fibers decreased similarly in both thighs at day 5. Exposure to HT had no impact on macrophage content. These results suggest that HT accelerates the recovery of fatigue resistance after eccentric exercise and promotes the expression of angiogenic factors in human skeletal muscle. NEW & NOTEWORTHY We investigated whether exposure to local heat therapy (HT) accelerates recovery after a bout of eccentric exercise in humans. Compared with a thermoneutral control intervention, HT improved fatigue resistance of the knee extensors and enhanced the expression of the angiogenic mediators vascular endothelial growth factor and angiopoietin 1. These results suggest that HT hastens functional recovery and enhances the expression of regulatory factors involved in muscle repair after eccentric exercise in humans.

Effect of compression garments on delayed-onset muscle soreness and blood inflammatory markers after eccentric exercise: a randomized controlled trial

The purpose of this study was to investigate how compression garments, applied after eccentric exercise, can affect delayed onset muscle soreness (DOMS) and inflammatory markers. Sixteen healthy male university students enrolled in this study and were randomly assigned to either the compression garment group (CG, n=8) or control group (CON, n=8). All participants performed two sets of eccentric exercise using elbow flexor with 25 repetitions per set on a modified preacher curl machine. Maximal isometric strength was measured before exercise and immediately, 24, 48, 72, and 96 hr after eccentric exercise. Muscle soreness was measured before exercise and 24, 48, 72, and 96 hr after eccentric exercise. Creatine kinase (CK) activity and tumor necrosis factor-alpha (TNF-α) levels were also measured before exercise and 3, 6, 24, and 48 hr after exercise. A repeated measures analysis of variance was used for statistical analysis. The CG group reported faster recovery of maximal isometric strength following exercise (P<0.001) and lower muscle soreness during the recovery period than the control group (P<0.05). However, there were no significant differences in either CK activity or TNF-α levels between the two groups (P>0.05). In conclusion, wearing compression garments during the postexercise period can be an effective way to reduce DOMS and accelerate the recovery of muscle function.