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Keriven H, Sánchez-Sierra A, Miñambres-Martín D, González de la Flor Á, García-Pérez-de-Sevilla G, Domínguez-Balmaseda D. Effects of peripheral electromagnetic stimulation after an eccentric exercise-induced delayed-onset muscle soreness protocol in professional soccer players: a randomized controlled trial. Front Physiol 2023; 14:1206293. [PMID: 37465698 PMCID: PMC10351376 DOI: 10.3389/fphys.2023.1206293] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction: To examine the effects of peripheral electromagnetic stimulation in male professional soccer players on markers of Delayed Onset Muscular Soreness (DOMS), induced by a protocol of exercise (60 min of eccentric and plyometric). Methods: A randomized controlled trial with fourty-five professional soccer players aged 22.33 ± 4.82 years participated in the study. Twenty-three participants were assigned to the experimental group with peripheral electromagnetic stimulation (5 stimulations of 5 s at 100 HZ with 55 s of rest for a total of 5 min of treatment) and the remaining 22 participants were assigned to the control group. Pain pressure threshold (PPT) of the vastus medialis, the Visual Analogue Scale-Fatigue (VAS-F), half squat (HS) test and the maximum voluntary contraction of the quadriceps were assessed. All evaluations were performed before and after 1 h of the eccentric exercise induced DOMS, as well as at post 24-48, and 72 h. Results: Group-by-time interaction was observed in PPT of the vastus medialis (p = 0.040) with a medium effect size (η2 p = 0.069). From 48 to 72 h the experimental group showed an increase of PPT compared to control group (p = 0.015). There was no group-by-time interaction for HS, quadriceps strength and VAS-F (p > 0.05). Discussion: Peripheral electromagnetic stimulation in male professional soccer players did not produce significant improvements in the power and strength of the lower limbs but decreased the peripheral sensitization of the vastus medialis after eccentric exercise protocol. Clinical Trial Registration: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384050&isReview=true, Identifier: ACTRN12622000841774.
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Affiliation(s)
- Hugo Keriven
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Alberto Sánchez-Sierra
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Faculty of Phisioterapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- Toledo Physiotherapy Research Group (GIFTO), Toledo, Spain
| | | | | | | | - Diego Domínguez-Balmaseda
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Masmicrobiota Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
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George SZ, Bishop MD, Wu SS, Staud R, Borsa PA, Wallace MR, Greenfield WH, Dai Y, Fillingim RB. Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury. Pain 2023; 164:305-315. [PMID: 35604152 PMCID: PMC9930191 DOI: 10.1097/j.pain.0000000000002700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/18/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACT Prior cohort studies validated that a subgroup defined by a specific COMT genotype and pain catastrophizing is at increased risk for heightened responses to exercise-induced or surgically induced shoulder pain. In this clinical trial, we used our preclinical model of exercise-induced muscle injury and pain to test the efficacy of interventions matched to characteristics of this high-risk subgroup (ie, personalized medicine approach). Potential participants provided informed consent to be screened for eligibility based on subgroup membership and then, as appropriate, were enrolled into the trial. Participants (n = 261) were randomized to 1 of 4 intervention groups comprised of pharmaceutical (propranolol or placebo) and informational (general education or psychologic intervention) combinations. After muscle injury was induced, participants received randomly assigned treatment and were followed for the primary outcome of shoulder pain intensity recovery over 4 consecutive days. Recovery rates were 56.4% (placebo and psychologic intervention), 55.4% (placebo and general education), 62.9% (propranolol and psychologic intervention), and 56.1% (propranolol and general education). No statistical differences were found between intervention groups in the primary analyses. Additional analyses found no differences between these intervention groups when shoulder pain duration was an outcome, and no differential treatment responses were detected based on sex, race, or level of pain catastrophizing. This trial indicates that these treatments were not efficacious for this high-risk subgroup when shoulder pain was induced by exercise-induced muscle injury. Accordingly, this phenotype should only be used for prognostic purposes until additional trials are completed in clinical populations.
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Affiliation(s)
- Steven Z. George
- Duke Clinical Research Institute, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27715 USA
| | - Mark D. Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610 USA
| | - Samuel S. Wu
- Department of Biostatistics, University of Florida, Gainesville, FL 32610 USA
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, FL 32610 USA
| | - Paul A. Borsa
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611 USA
| | - Margaret R. Wallace
- Department of Molecular Genetics and Microbiology, UF Genetics Institute, University of Florida, Gainesville, FL 32610 USA
| | | | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, FL 32610 USA
| | - Roger B. Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL 32610 USA
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Ni L, Yao Z, Zhao Y, Zhang T, Wang J, Li S, Chen Z. Electrical stimulation therapy for peripheral nerve injury. Front Neurol 2023; 14:1081458. [PMID: 36908597 PMCID: PMC9998520 DOI: 10.3389/fneur.2023.1081458] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/06/2023] [Indexed: 03/14/2023] Open
Abstract
Peripheral nerve injury is common and frequently occurs in extremity trauma patients. The motor and sensory impairment caused by the injury will affect patients' daily life and social work. Surgical therapeutic approaches don't assure functional recovery, which may lead to neuronal atrophy and hinder accelerated regeneration. Rehabilitation is a necessary stage for patients to recover better. A meaningful role in non-pharmacological intervention is played by rehabilitation, through individualized electrical stimulation therapy. Clinical studies have shown that electrical stimulation enhances axon growth during nerve repair and accelerates sensorimotor recovery. According to different effects and parameters, electrical stimulation can be divided into neuromuscular, transcutaneous, and functional electrical stimulation. The therapeutic mechanism of electrical stimulation may be to reduce muscle atrophy and promote muscle reinnervation by increasing the expression of structural protective proteins and neurotrophic factors. Meanwhile, it can modulate sensory feedback and reduce neuralgia by inhibiting the descending pathway. However, there are not many summary clinical application parameters of electrical stimulation, and the long-term effectiveness and safety also need to be further explored. This article aims to explore application methodologies for effective electrical stimulation in the rehabilitation of peripheral nerve injury, with simultaneous consideration for fundamental principles of electrical stimulation and the latest technology. The highlight of this paper is to identify the most appropriate stimulation parameters (frequency, intensity, duration) to achieve efficacious electrical stimulation in the rehabilitation of peripheral nerve injury.
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Affiliation(s)
- Lingmei Ni
- Infection Prevention and Control Department, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhao Yao
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yifan Zhao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tianfang Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wang
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Siyue Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zuobing Chen
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Menezes MA, Menezes DA, Vasconcelos LL, DeSantana JM. Is Electrical Stimulation Effective in Preventing or Treating Delayed-onset Muscle Soreness (DOMS) in Athletes and Untrained Adults? A Systematic Review With Meta-Analysis. THE JOURNAL OF PAIN 2022; 23:2013-2035. [PMID: 35964921 DOI: 10.1016/j.jpain.2022.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/04/2023]
Abstract
The effectiveness of electrical stimulation (ES) in preventing or treating delayed-onset muscle soreness (DOMS) and its effects on muscle recovery is unclear. The systematic review investigated the benefits or harms of ES on DOMS and muscle recovery. Databases (PubMed, Medline, CENTRAL, EMBASE, CINAHL, PsycINFO, PEDro, LILACS, SPORTDiscus) were searched up to March, 31st 2021 for randomized controlled trials (RCTs) of athletes or untrained adults with DOMS treated with ES and compared to placebo/sham (simulation or without ES), or control (no intervention). Data were pooled in a meta-analysis. Risk of bias (Cochrane Collaboration tool) and quality of evidence (GRADE) were analyzed. Fourteen trials (n=435) were included in this review and 12 trials (n=389) were pooled in a meta-analysis. Evidence of very low to low quality indicates that ES does not prevent or treat DOMS as well as ES does not help to promote muscle recovery immediately, 24, 48, 72, 96 hours after the intervention. Only one study monitored adverse events. There are no recommendations that support the use of ES in DOMS and muscle recovery. PERSPECTIVES: No recommendations support the use of electrical stimulation in delayed-onset muscle soreness and muscle recovery in athletes and untrained adults. This means that electrical stimulation is not fruitful for this population according those protocols used. Therefore, unlikely that further randomized controlled trials with the same approach will yield promising results.
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Affiliation(s)
- Mayara Alves Menezes
- Health Sciences Graduate Program, Federal University of Sergipe. R. Cláudio Batista - Palestina, nº 676, zip code: 49060-025. Aracaju, SE, Brazil
| | - Danielle Alves Menezes
- Psychology Graduate Program, Federal University of Sergipe. Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, zip code: 49100-000. São Cristóvão, SE, Brazil
| | - Lucas Lima Vasconcelos
- Department of Psychology, McGill University, 2001 Avenue McGill College, QC, H3A 1G1 Montreal, Canada
| | - Josimari Melo DeSantana
- Department of Physical Therapy, Federal University of Sergipe. Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, zip code: 49100-000. São Cristóvão, SE, Brazil..
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Zech N, Seemann M, Grzesiek M, Breu A, Seyfried TF, Hansen E. Nocebo Effects on Muscular Performance - An Experimental Study About Clinical Situations. Front Pharmacol 2019; 10:219. [PMID: 30914952 PMCID: PMC6421283 DOI: 10.3389/fphar.2019.00219] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/22/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Nocebo effects are not only seen in studies of pharmacology and placebo/nocebo research but also in clinical everyday situations. For generation of objective and quantitative data on the impact of negative communication we have evaluated the immediate effects of common sentences, non-verbal signals and situations in the medical context on muscular performance. Methods: In an experimental study, 46 volunteers were tested by dynamometry of the deltoid muscle group to evaluate the maximal muscular strength during arm abduction. Baseline values were compared to performance after exposure to 18 verbal and non-verbal suggestions. Suggestions suspected to be negative were alternated with and compared to positively formulated alternatives. Results: Verbal and non-verbal communication produced significant effects on muscular performance, resulting mainly in weakening. The decrease in muscle strength after risk information for informed consent (91.4% of baseline) was absent, when benefits of the treatment were named coincidently. The weakening effect of asking about "pain" and "nausea" (89.4%), and of the announcement of medical interventions (91.7%) could be avoided with alternative wording. Impairment of muscular performance was also observed with the nocebo-inducers negative memory (89.5%) or uncertain future (93.3%), in contrast to a positive memory or the orientation into the presence. Non-verbal suggestions like overhead anesthesia induction (89.9%), a transport in strict flat supine position (89.1%), or a view from the window to a parking lot (94.1%) significantly reduced maximal muscle strength, whereas face-to face induction, half-sitting position and a view into the landscape did not. 8 out of 9 tested clinical situations reduced maximal arm muscle strength significantly, whereas alternative formulations did not. Conclusion: This study describes a quick, simple and uniform test using objective measurement of maximal muscle strength to allow for identification, quantification, and comparison of negative suggestions, regardless of their specific content and effect. Muscle strength is a clinically relevant parameter with regard to early mobilization, risk of falling and sufficient breathing. Furthermore, the observed impairment of muscular performance could reflect a general "weakening effect" of negative suggestions. In addition, the test facilitates development and verification of appropriate alternatives to prevent nocebo effects in patients, thereby improving patient communication.
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Affiliation(s)
- Nina Zech
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Milena Seemann
- Department of Anesthesiology, Klinikum Nürnberg, Nürnberg, Germany
| | - Magdalena Grzesiek
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Anita Breu
- Department of Anesthesiology, Sana Clinics Cham, Cham, Germany
| | - Timo F Seyfried
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Ernil Hansen
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
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Menezes MA, Pereira TAB, Tavares LM, Leite BTQ, Neto AGR, Chaves LMS, Lima LV, Da Silva-Grigolleto ME, DeSantana JM. Immediate effects of transcutaneous electrical nerve stimulation (TENS) administered during resistance exercise on pain intensity and physical performance of healthy subjects: a randomized clinical trial. Eur J Appl Physiol 2018; 118:1941-1958. [PMID: 29978261 DOI: 10.1007/s00421-018-3919-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Exercise-induced muscle pain is a self-limiting condition which impacts physical activity habits. Transcutaneous electrical nerve stimulation (TENS) promotes pain reduction and functional improvement in different pain conditions. We propose that applying TENS during exercise might reduce pain and improve physical performance. Thus, we aimed to investigate immediate effects of TENS applied during resistance exercise. METHODS Healthy subjects of both sexes, irregularly active or sedentary were assigned into two groups: active (n = 24) or placebo (n = 22) TENS. The study was conducted over five moments: on day 0, subjects were recruited, on day 1 subjects performed the one-repetition maximum test (1RM); 72 h later, on day 2, 1RM was retested; 48 h later, on day 3, TENS was applied during a functional-resisted exercise protocol for upper limbs (bench press and rowing), with an intensity of 80% of 1RM; and 24 h after, on day 4, subjects were reevaluated. Assessment included pain intensity at rest and with movement, pressure pain thresholds, and muscle fatigue. RESULTS TENS did not reduce pain intensity when compared to placebo (p > 0.05). TENS reduce PPT in the latissmus dorsi: p = 0.02 and anterior tibialis: p = 0.04 in immediate reassessment. Immediate effects of TENS were significant for fatigue perception at rest (p = 0.01) and number of maximum repetitions during exercise sets, starting from the 5th set of rowing exercise (p = 0.002). CONCLUSION Our results show that TENS did not reduce pain perception in healthy individuals, but its use induced increased muscle action, contributing to a greater fatigue perception.
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Affiliation(s)
- Mayara A Menezes
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Thaís A B Pereira
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Leonardo M Tavares
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Belissa T Q Leite
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Antônio G R Neto
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Leury M S Chaves
- Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Lucas V Lima
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Marzo E Da Silva-Grigolleto
- Graduate Program in Physiological Sciences, Federal University of Sergipe, Aracaju, SE, Brazil.,Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Josimari M DeSantana
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil. .,Graduate Program in Physiological Sciences, Federal University of Sergipe, Aracaju, SE, Brazil. .,Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil. .,Department of Physical Therapy, Federal University of Sergipe, Av. Marechal Rondon, s/n, São Cristóvão, SE, 49100-000, Brazil.
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