Effects of sternocleidomastoid muscle and suboccipital muscle soft tissue release on muscle hardness and pressure pain of the sternocleidomastoid muscle and upper trapezius muscle in smartphone users with latent trigger points

The influence of chair recline and head and neck position on upper trapezius activity and stiffness during seated computer work

Increasing chair recline during seated computer work may reduce the load placed on the upper trapezius (UT), a common location of pain for those with idiopathic chronic neck pain. This study determined the effect of increasing chair recline on UT stiffness and muscle activity during computer work in people with and without idiopathic chronic neck pain. Surface electromyography and ultrasound shear wave elastography were collected from three subdivisions of the UT in 15 individuals with idiopathic chronic neck pain and 15 sex-matched healthy controls. Participants sat in a standardized computer-work setup while chair recline (0°, 25°, 45°) and head and neck position (self-selected, neutral, flexed) were systematically adjusted and maintained for 2.5-min intervals. Repeated-measures ANOVAs were completed for each sex, muscle, and data type, with group (chronic neck pain, control), chair recline (0°,25°,45°), head and neck position (self-selected, flexed, neutral), and side of collected data (dominant, non-dominant) as fixed factors. Men with idiopathic chronic neck pain demonstrated greater UT stiffness in the cranial subdivision when compared to healthy men. Additionally, the 25° and 45° recline levels increased the stiffness of men's dominant UT compared to men's non-dominant UT. Women's UT was more affected by head and neck position, and a neutral head and neck position resulted in lower UT activation, but higher UT stiffness for the cranial subdivision and midway between C-7 and the acromion process. Overall, our findings suggest that the commonly suggested neutral position may not be a beneficial prompt when positioning someone during seated computer work.

Massage for neck pain

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.

Ergonomic evaluation of upper extremities muscle activity pattern during 60-min smartphone texting

BACKGROUND

Smartphone usage has increased rapidly in the last decade due to rapid technological advancements. This extensive usage of smartphones led to physiological problems and musculoskeletal disorders (MSD) due to inappropriate postures.

OBJECTIVE

Past studies have reported the effects/discomfort of smartphone usage for short periods, ranging from 3-20 min, which does not represent the current era of smartphone dependency (approximately 7-hr/day).

METHODS

This study was performed on fifty-four participants aged 20-28 with 1-hr smartphone texting in a sitting posture. Flexion angles, both sides (dominant and non-dominant) muscle activity (maximum voluntary contraction %) at sternocleidomastoid (SCM), upper-trapezius (TRP), extensor digitorum (EDM) and abductor pollicis brevis (APB) muscles, and subjective discomfort were analyzed.

RESULTS

After 1-hr smartphone texting, the muscle activity at eight upper extremities: SCM (24.80%), TRP (29.45%), EDM (14.44%) and APB (19.87%) significantly (p < 0.001) increased by 1.5-1.9 times with 27.4±3.18° and 82.94±7.03° head and lower-arm flexion angles, respectively. The mechanical loads on the cervical spine increased by 4.6 times, and subjective discomfort by 3 times.

CONCLUSION

Maintaining the same posture for a long duration causes postural stress, muscular imbalances, and discomfort, leading to MSD with increased cervical intervertebral disc pressure.

Effect of CO2 and H2 gas mixture in cold water immersion on recovery after eccentric loading

Background

The findings of previous studies support the efficacy of cold water immersion (CWI) with carbon dioxide (CO2) in enhancing muscle blood flow and maintaining aerobic performance efficiency. We hypothesize that the addition of hydrogen gas (H2), known for its antioxidant properties and role in inflammation regulation, to C-CWI can enhance recovery after eccentric exercise.

Subjects

and Methods: Thirty-four healthy subjects performed a knee-extensor eccentric exercise. They were randomly allocated into four groups: control, CWI, CO2-rich CWI (C-CWI), and CO2 + H2 gas mixture CWI (CH-CWI). In the three CWI groups, all subjects were immersed in the appropriate bath at 20 °C for 20 min immediately after 60 repetitions of eccentric exercise. Before exercise and after 48 h of recovery, the subjects' maximal voluntary isometric contraction torque (MVC-ISO), maximal voluntary concentric (MVC-CON) contraction torque, countermovement jump (CMJ) height, knee flexion range of motion (ROM), muscle soreness, and muscle thickness were measured.

Results

In the CH-CWI group only, the MVC-ISO, CMJ height, and ROM did not decrease significantly post-exercise, whereas all of these decreased in the other three groups. Muscle soreness at palpation, contraction, and stretching significantly increased post-exercise in all groups. Echo intensity and tissue hardness did not increase significantly in the CH-CWI group.

Conclusions

CH-CWI stimulated recovery from impairments in MVC-ISO torque, CMJ height, knee-flexion ROM, tissue hardness, and echo intensity. These findings indicate that CH-CWI can promote recovery after eccentric exercise.

The comparison between foam rolling either combined with static or dynamic stretching on knee extensors' function and structure

Static stretching (SS) and dynamic stretching (DS) in combination with foam rolling (FR) have been attracting attention as warm-up routines in sports. However, the combined and intervention order effects of SS or DS and FR on flexibility, muscle strength, and jump performance are still unclear. Therefore, this study aimed to compare the combined effects of FR and SS or DS with the various intervention orders (i.e., SS + FR, DS + FR, FR + SS, DS + FR) on the function and properties of the knee extensors. Using a crossover, random allocation design, 17 male university students (21.0 ± 1.1 y) performed four conditions combining FR and SS or DS. The measurement included knee flexion range of motion (ROM), pain pressure threshold (PPT), tissue hardness, maximum voluntary isometric contraction (MVC-ISO), maximum voluntary concentric contraction (MVC-CON) torque, and single-leg countermovement jump (CMJ) height of the knee extensors. All interventions significantly (p < 0.01) increased knee flexion ROM (SS + FR: d = 1.29, DS + FR: d = 0.45, FR + SS: d = 0.95, FR + DS: d = 0.49), and significantly (p < 0.01) decreased tissue hardness (SS + FR: d = -1.11, DS + FR: d = -0.86, FR + SS: d = -1.29, DS + FR: d = -0.65). There were no significant changes in MVC-ISO, MVC-CON, and CMJ height in all conditions, but a near significant, small magnitude (p = 0.056, d = -0.31) decrease of MVC-ISO was observed in the FR + SS condition. Our results showed that all the combinations of SS or DS and FR effectively decreased tissue hardness and increased ROM without decreasing muscle strength. Also, effect sizes indicated the largest increase in ROM and decrease in tissue stiffness after SS + FR without decreasing muscle strength and jump performance.

Remission of Dowager's hump by manipulative correction of spinal alignment: a case report

Dowager's hump is described as excessive kyphotic curvature in the thoracic spine with a Cobb angle of more than 40 degrees. This case report presents a 61 years old female office clerk who experienced headaches and neck pain for 3 years that extended into her right shoulder and upper chest. She consulted her primary care physician two months before seeing the chiropractor when the neck pain worsened. A diagnosis of cervicalgia related to osteoarthritis was made based on cervical and thoracic X-ray findings. The patient received non-steroid anti-inflammatory drugs (celecoxib and etoricoxib) and stretching exercises at home. At the onset of chiropractic care, radiographs showed loss of cervical lordosis, narrowing at the C4-5, C5-C6, and C6-7 intervertebral disc space with marginal osteophytes. Based on these findings, a working diagnosis of cervicogenic headache was established. After treatment for 9 months, the patient showed improvement in symptoms and function from cervical curve radiographic change and dextro-convexity of the thoracic spine. Avoiding forward head flexion and maintaining correct posture in daily activities will be key mechanisms to prevent the reoccurrence of Dowager's hump. The improvement of symptoms following chiropractic therapy has been shown to correlate with radiographic markers of spinal realignment.

Symmetry of the Neck Muscles' Activity in the Electromyography Signal during Basic Motion Patterns

The activity of muscles during motion in one direction should be symmetrical when compared to the activity of the contralateral muscles during motion in the opposite direction, while symmetrical movements should result in symmetrical muscle activation. The literature lacks data on the symmetry of neck muscle activation. Therefore, this study aimed to analyse the activity of the upper trapezius (UT) and sternocleidomastoid (SCM) muscles at rest and during basic motions of the neck and to determine the symmetry of the muscle activation. Surface electromyography (sEMG) was collected from UT and SCM bilaterally during rest, maximum voluntary contraction (MVC) and six functional movements from 18 participants. The muscle activity was related to the MVC, and the Symmetry Index was calculated. The muscle activity at rest was 23.74% and 27.88% higher on the left side than on the right side for the UT and SCM, respectively. The highest asymmetries during motion were for the SCM for the right arc movement (116%) and for the UT in the lower arc movement (55%). The lowest asymmetry was recorded for extension-flexion movement for both muscles. It was concluded that this movement can be useful for assessing the symmetry of neck muscles' activation. Further studies are required to verify the above-presented results, determine muscle activation patterns and compare healthy people to patients with neck pain.

The Combined Effect of Static Stretching and Foam Rolling With or Without Vibration on the Range of Motion, Muscle Performance, and Tissue Hardness of the Knee Extensor

ABSTRACT

Nakamura, M, Konrad, A, Kasahara, K, Yoshida, R, Murakami, Y, Sato, S, Aizawa, K, Koizumi, R, and Wilke, J. The combined effect of static stretching and foam rolling with or without vibration on the range of motion, muscle performance, and tissue hardness of the knee extensor. J Strength Cond Res 37(2): 322-327, 2023-Although the combination of static stretching (SS) and foam rolling (FR) is frequently used for warm-up in sports, the effect of the intervention order is unclear. This study compared mechanical tissue properties, pain sensitivity, and motor function after SS and FR (with and without vibration) performed in different orders. Our randomized, controlled, crossover experiment included 15 healthy male subjects (22.5 ± 3.3 years) who visited the laboratory 5 times (inactive control condition, FR + SS, FR vibration + SS, SS + FR, and SS + FR vibration ) with an interval of ≥48 hours. In each session, subjects completed three 60-second bouts of FR and SS, targeting the anterior thigh. Pressure pain threshold, tissue hardness, knee flexion range of motion (ROM), maximal voluntary isometric (MVC-ISO), and concentric (MVC-CON) torque, as well as countermovement jump height, were determined before and after the intervention. All interventions significantly ( p < 0.01) increased knee flexion ROM ( d = 0.78, d = 0.87, d = 1.39, and d = 0.87, respectively) while decreasing tissue hardness ( d = -1.25, d = -1.09, d = -1.18, and d = -1.24, respectively). However, MVC-ISO torque was significantly reduced only after FR + SS ( p = 0.05, d = -0.59). Our results suggest that SS should be followed by FR when aiming to increase ROM and reduce tissue hardness without concomitant stretch-induced force deficits (MVC-ISO, MVC-CON, and countermovement jump height). Additionally, adding vibration to FR does not seem to affect the magnitude of changes observed in the examined outcomes.

Influence of smartphone game play on head flexion angle, muscle activity, and load at C7 among adolescents

BACKGROUND

Smartphones cause physiological problems due to inappropriate postures and extensive usage. India, being the second leading country with the highest number of smartphone users (492 million in 2021), has witnessed a significant rise in smartphone-related musculoskeletal disorders (MSD).

OBJECTIVE

This study compared the effects of 60-min smartphone gameplay on head flexion angle, muscle activity, and loads at C7 on Indian adolescents.

METHODS

A subjective assessment was conducted on 1659 participants, of which, 40 young male adults aged between 20-28 years performed the experimental trial. Muscle (Sternocleidomastoid) activity, head flexion angle, and load acting at the neck (C7) were analyzed through postural assessment, pre-and post-subjective analysis.

RESULTS

Participants maintained an average of 28.46°±4.04° head flexion angle for more than 43 min (71%) in an hour while performing the task. The muscle activity increased to 23% (p < 0.001) of MVC at the end of the task compared to the beginning.

CONCLUSION

The results indicated a significant increase in muscle activity (1.61 times), spinal loads (4.6 times) and subjective discomfort (2.9 times) after prolonged smartphone usage. It is evident that various aspects (duration, posture, content) play a vital role in smartphone-related MSD and there is a potential risk of cervical spine problems. The increased loads reduce muscle stiffness and increase intervertebral disc pressure.

The Impact of Suboccipital Muscle Release on Pain and Range of Motion in the Cervical Spine of Young Adults

Introduction: Limited mobility and pain in the cervical spine affect 50% of the population, leading to disability and a reduction in quality of life. It is important to use effective forms of therapy. One of them, enjoying growing popularity, is deep tissue massage, the stability of which requires confirmation in scientific research. Research objective: The aim of the study was to investigate how a single deep tissue massage therapy aimed at suboccipital muscles reduces pain and improves the range of motion in the cervical spine and how long the improvement lasts. Research materials and methods: The study participants included 41 people aged 20-34. The respondents were randomly divided into 2 groups: study (21 people) and control (20 people). The subjects completed a questionnaire consisting of 14 questions and were subjected to 2 tests for evaluating cervical spine stability: the covering membrane test and the anterior occipital membrane test. Then, the measurements of pain on the VAS scale (0-10) and the range of cervical mobility were collected. Measurements were taken before, immediately after, as well as 2 and 4 weeks following the therapeutic intervention. The therapy in the study group consisted of a single, 10-minute relaxation session of the sub-occipital muscles. In the control group, cervical spine traction, lasting 30 seconds, was performed 3 times. Results: In the study group, the pain decreased statistically significantly (p<0.05), before the therapy it totalled 4.33 ± 1.49, while after the therapy, its value decreased to 2.05 ± 0.86 and lasted up to 2 weeks after the massage – 2.67 ± 1.49. In the control group, the pain level before the therapy was 4.25 ± 0.76, and following the therapy, it decreased to 3 ± 0.95 and then increased to the mean value of 4 ± 1 (after 2 weeks). On average, the level equalled 4.25 ± 0.76 (after 4 weeks). In the study group, the range of flexion motion was, on average, 3.24 ± 1.00 cm, extension, mean 6.90 ± 1.14 cm, lateral flexion to the left, on avg. 4.76 ± 0.62, to the right on avg. 4.90 ± 1.04 cm, left rotation on avg. 8.43 ± 0.81, and right rotation on avg., 8.19 ± 1.08 cm. After deep tissue massage therapy, the results differed from the range of motion results obtained in the control group: flexion totalled 5.67 ± 0.48 cm immediately after therapy and 4.90 ± 1.34 cm 2 weeks post-intervention, extension 8.57 ± 0.87 cm immediately after therapy and 7.62 ± 1.47 cm 2 weeks after therapy, and finally, left lateral flexion 5.52 ± 0.81 directly following the therapy and 5.43 ± 0.93 cm 2 weeks after therapy. Conclusions: 1. Single-session deep tissue massage therapy significantly reduces pain and increases range of motion in the cervical spine. 2. The effects last up to 2 weeks following the therapy.

Comparison of The Effect of High- and Low-Frequency Vibration Foam Rolling on The Quadriceps Muscle

Vibration foam rolling (VFR) intervention has recently gained attention in sports and rehabilitation settings since the superimposed vibration with foam rolling can affect several physiological systems. However, the sustained effect and a comparison of the effects of different VFR vibration frequencies on flexibility and muscle strength have not been examined. Therefore, in this study, we aimed to investigate the acute and sustained effects of three 60-s sets of VFR with different frequencies on knee flexion range of motion (ROM) and muscle strength of the knee extensors. Using a crossover, random allocation design, 16 male university students (21.2 ± 0.6 years) performed under two conditions: VFR with low (35 Hz) and high (67 Hz) frequencies. The acute and sustained effects (20 min after intervention) of VFR on knee flexion ROM, maximum voluntary isometric contraction (MVC-ISO) torque, maximum voluntary concentric contraction (MVC-CON) torque, rate of force development (RFD), and single-leg countermovement jump (CMJ) height were examined. Our results showed that knee flexion ROM increased significantly (p &lt; 0.01) immediately after the VFR intervention and remained elevated up to 20 min, regardless of the vibration frequency. MVC-ISO and MVC-CON torque both decreased significantly (p &lt; 0.01) immediately after the VFR intervention and remained significantly lowered up to 20 min, regardless of the vibration frequency. However, there were no significant changes in RFD or CMJ height. Our results suggest that VFR can increase knee flexion ROM but induces a decrease in muscle strength up to 20 min after VFR at both high and low frequencies.

Comparison of the Acute Effects of Foam Rolling with High and Low Vibration Frequencies on Eccentrically Damaged Muscle

Previous research has shown that vibration foam rolling (VFR) on damaged muscle shows greater improvement in muscle soreness and range of motion (ROM) compared with foam rolling (FR) without vibration. However, the effect of frequency in VFR on muscle soreness and loss of function caused by damaged muscles is unknown. The purpose of this study was to compare the acute effects of 90-s low-frequency (LF)- and high-frequency (HF)-VFR intervention on ROM, muscle soreness, muscle strength, and performance of eccentrically damaged muscle. Study participants were sedentary healthy adult volunteers (n = 28) who performed a bout of eccentric exercise of the knee extensors with the dominant leg and received 90-s LF-VFR or HF-VFR intervention of the quadriceps 48 h after the eccentric exercise. The dependent variables were measured before the eccentric exercise (baseline) and before (pre-intervention) and after VFR intervention (post-intervention) 48 h after the eccentric exercise. The results showed that both LF-VFR and HF-VFR similarly (p < 0.05) improved the knee flexion ROM (11.3 ± 7.2%), muscle soreness at palpation (-37.9 ± 17.2%), and countermovement jump height (12.4 ± 12.9%). It was concluded that it was not necessary to perform VFR with a high frequency to improve muscle soreness and function.

The Effect of Static Compression via Vibration Foam Rolling on Eccentrically Damaged Muscle

Previous research has shown that vibration foam rolling (VFR) on damaged muscle can result in improvements in muscle soreness and range of motion (ROM). Furthermore, static compression via VFR (i.e., VFR without rolling) can increase the ROM and decrease the muscle stiffness of non-damaged muscle. Therefore, it is likely that static compression via VFR on eccentrically damaged muscle can mitigate muscle soreness and the decrease in ROM, and the decrease in muscle strength. The purpose of this study was to investigate the acute effects of a 90 s bout of VFR applied as a static compression on an eccentrically damaged quadriceps muscle, measuring ROM, muscle soreness, muscle strength, and jump performance. This study was a single-arm repeated measure design. Study participants were sedentary healthy male volunteers (n = 14, 20.4 ± 0.8 years) who had not performed habitual exercise activities or any regular resistance training for at least 6 months before the experiment. All participants performed a bout of eccentric exercise of the knee extensors with the dominant leg and then received a 90 s bout of static compression via VFR of the quadriceps 48 h after the eccentric exercise. The knee flexion ROM, muscle soreness at palpation, and countermovement jump height were measured before the eccentric exercise (baseline), before (pre-intervention) and after the VFR intervention (post-intervention), and 48 h after the eccentric exercise. The results showed that the static compression via VFR significantly (p < 0.05) improved the knee flexion ROM (6.5 ± 4.8%, d = 0.76), muscle soreness at palpation (-10.7 ± 8.6 mm, d = -0.68), and countermovement jump height (15.6 ± 16.0%, d = 0.49). Therefore, it can be concluded that static compression via VFR can improve muscle soreness and function.

Relationship between Eccentric-Exercise-Induced Loss in Muscle Function to Muscle Soreness and Tissue Hardness

It is well-known that unusual exercise, especially eccentric contraction (ECC), could cause delayed-onset muscle soreness. However, the factors related to the loss of muscle strength and range of motion (ROM) caused by eccentrically damaged muscle, such as increases in muscle soreness, tissue hardness, and pain threshold, have not been investigated in detail. Thus, this study was conducted to investigate the factors related to the loss of muscle strength and ROM caused by eccentrically damaged muscle in a large sample. Fifty-six sedentary healthy young male volunteers were instructed to perform 60 repetitions of ECC exercise. The outcome variables were measured before and 48 h after the ECC exercise. The results showed that a decrease in ROM was correlated to an increase in tissue hardness, whereas a decrease in muscle strength was correlated to an increase in muscle soreness. Our results suggested that tissue hardness must be controlled for ROM loss, and muscle soreness must be controlled for muscle-strength loss.

Cross-education effect of vibration foam rolling on eccentrically damaged muscles

OBJECTIVES

Previous studies showed that vibration foam rolling (VFR) on damaged muscles improves muscle soreness and range of motion (ROM). VFR intervention can also increase the ROM and pain pressure threshold (PPT) in the non-rolling side, known as a cross-education effect. However, this is not clear for the non-rolling side. Therefore, this study aimed to investigate the cross-education effects of VFR intervention on ROM, muscle soreness, and PPT in eccentrically damaged muscles.

METHODS

Participants were sedentary healthy male volunteers (n=14, 21.4±0.7 y) who performed eccentric exercise of the knee extensors with the dominant leg and received 90-s VFR intervention of the quadriceps at the nondamaged side 48 h after the eccentric exercise. The dependent variables were measured before the exercise (baseline), before (preintervention), and after VFR intervention (postintervention) 48 h after the eccentric exercise. The Bonferroni post hoc test was used to determine the differences between baseline, preintervention, and postintervention.

RESULTS

Results showed that the VFR intervention on the nondamaged side 48 h after the eccentric exercise improved significantly (p<0.05) the knee flexion ROM, muscle soreness at palpation, and PPT compared to baseline.

CONCLUSION

VFR intervention on the nondamaged side can recover ROM and muscle soreness in eccentrically damaged muscles.

Sex Differences in the Mechanical and Neurophysiological Response to Roller Massage of the Plantar Flexors

Self-massage using foam rollers, sticks, or balls has become a popular technique to enhance joint range of motion (ROM). Although increases are reported to be larger in females than males, the mechanisms of this observation are unclear. The present study aimed to investigate the effect of roller massage (RM) on ROM, passive tissue stiffness, and neurophysiological markers as a function of sex. Males (n = 15, 22.8 ± 2.9 yrs.) and females (n = 14, 21.1 ± 0.7 yrs.) performed three 60-second bouts of calf RM. Outcomes assessed pre-, and post-intervention included passive dorsiflexion (DF) ROM, passive tissue stiffness, passive torque, DF angle at the first stretch sensation, shear elastic modulus, and spinal excitability. DF ROM (+35.9 %), passive torque at DF ROM (+46.4 %), DF angle at first stretch sensation (+32.9 %), and pain pressure threshold (+25.2 %) increased in both groups (p<.05) with no differences between males and females (p > 0.05). No changes were observed for passive stiffness, shear elastic modulus, and spinal excitability (p > 0.05). Roller massage may increase ROM independently of sex, which, in the present study, could not be ascribed to alterations in passive stiffness or neurophysiological markers. Future studies may further elucidate the role of sensory alterations as possible factors driving RM-induced changes in flexibility.

Local and Non-local Effects of Foam Rolling on Passive Soft Tissue Properties and Spinal Excitability

In sports and clinical settings, roller massage (RM) interventions are used to acutely increase range of motion (ROM); however, the underlying mechanisms are unclear. Apart from changes in soft tissue properties (i.e., reduced passive stiffness), neurophysiological alterations such as decreased spinal excitability have been described. However, to date, no study has investigated both jointly. The purpose of this trial was to examine RM’s effects on neurophysiological markers and passive tissue properties of the plantar flexors in the treated (ROLL) and non-treated (NO-ROLL) leg. Fifteen healthy individuals (23 ± 3 years, eight females) performed three unilateral 60-s bouts of calf RM. This procedure was repeated four times on separate days to allow independent assessments of the following outcomes without reciprocal interactions: dorsiflexion ROM, passive torque during passive dorsiflexion, shear elastic modulus of the medial gastrocnemius muscle, and spinal excitability. Following RM, dorsiflexion ROM increased in both ROLL (+19.7%) and NO-ROLL (+13.9%). Similarly, also passive torque at dorsiflexion ROM increased in ROLL (+15.0%) and NO-ROLL (+15.2%). However, there were no significant changes in shear elastic modulus and spinal excitability (p > 0.05). Moreover, significant correlations were observed between the changes in DF ROM and passive torque at DF ROM in both ROLL and NO-ROLL. Changes in ROM after RM appear to be the result of sensory changes (e.g., passive torque at DF ROM), affecting both rolled and non-rolled body regions. Thus, therapists and exercise professionals may consider applying remote treatments if local loading is contraindicated.

Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review

OBJECTIVE

The objective of this study was to conduct an updated systematic review of diagnostic criteria for myofascial trigger points (MTrPs) used in clinical trials of physical therapy interventions from 2007 to 2019.

METHODS

MEDLINE and Physiotherapy Evidence Database (PEDro) were searched using the following MeSH keywords: "trigger points," "trigger point," "myofascial trigger point," "myofascial trigger points," "myofascial pain," and "myofascial pain syndrome." The MeSH keywords were combined by using Boolean operators "OR"/"AND." All physiotherapy clinical trials including patients with musculoskeletal conditions characterized by at least 1 active MTrP or latent MTrP in any body area were selected. We pooled data from an individual criterion and criteria combinations used to diagnose MTrPs. The protocol was developed in accordance with the PRISMA-P guidelines.

RESULTS

Of 478 possibly relevant publications, 198 met the inclusion criteria. Of these 198 studies, 129 studies (65.1%) stated specifically the diagnostic criteria used for MTrPs in the main text, 56 studies (28.3%) failed to report any method whereby MTrP was diagnosed, and 13 studies (6.6%) adopted expert-based definitions for MTrPs without specification. Of 129 studies, the 6 criteria applied most commonly were: "spot tenderness" (n=125, 96.9%), "referred pain" (95, 73.6%), "local twitch response" (63, 48.8%), pain recognition (59, 45.7%), limited range of motion" (29, 22.5%), and "jump sign" (10, 7.8%). Twenty-three combinations of diagnostic criteria were identified. The most frequently used combination was "spot tenderness," "referred pain," and "local twitch response" (n=28 studies, 22%).

CONCLUSIONS

A number of the included studies failed in properly reporting the MTrP diagnostic criteria. Moreover, high variability in the use of MTrP diagnostic was also observed. Spot tenderness, referred pain, and local twitch response were the 3 most popular criteria (and the most frequently used combination). A lack of transparency in the reporting of MTrP diagnostic criteria is present in the literature.

REGISTRY

This systematic review was registered under the Centre for Reviews and Dissemination, PROSPERO number: CRD42018087420.

Effect of Different Kinesio Taping Interventions on the Local Thresholds of Current Perception and Pressure Pain in Healthy Adults

Objective

Previous studies made controversial claims about the alleged effects of Kinesio taping (KT) on pain relief. To date, the mechanism by which KT relieves pain remains unclear. Moreover, pain evaluation lacks objective and quantitative parameters. This study compared the acute effects of different KT interventions on the local thresholds of pressure pain and current perception in healthy adults to determine the potential mechanisms by which KT relieves pain.

Methods

Thirty healthy female subjects randomly received four KT interventions, namely, no taping (NT), placebo taping (PT), Y strips of KT (KY), and fan strips of KT (KF), on the waist. Current perception threshold (CPT), pressure pain threshold (PPT), soft tissue hardness, and the visual analog scale (VAS) scores of the subjects’ perceived pain were immediately measured after taping. Repeated-measures ANOVA was performed to determine significant differences in these parameters among the four interventions.

Results

Significant differences in CPT values among the interventions were observed at the frequency of 5 Hz (F = 3.499, p = 0.019, η_p² = 0.111). Post hoc analysis revealed that CPT was significantly higher for KF than for NT (p = 0.008, 95% CI = 1.390–11.990). Significant differences in PPT values (F = 4.352, p = 0.012, η_p² = 0.130) and soft tissue hardness (F = 2.957, p = 0.049, η_p² = 0.093) were observed among the different taping conditions. Post hoc analysis revealed that PPT was significantly higher for KF than for PT (p = 0.011, 95% CI = 0.071–0.749), and soft tissue hardness was significantly higher for KF than for NT (p = 0.010, 95% CI = 0.461–4.586) and KY (p = 0.040, 95% CI = 0.059–3.800). No significant differences in self-perceived pain among the interventions were observed.

Conclusion

The healthy adult females had higher PPT values, lower soft tissue hardness, and higher CPT values at 5 Hz under KF intervention applied on the waist than those under the other taping interventions. Moreover, the different taping conditions had no significant differences in terms of VAS of perceived pain. These results provide guidance for the application of KT on pain management.